Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Press release] US clean-air efforts stay on target

From the 27 March 2014 Rice University Press Release

Rice University analysis of state efforts show dramatic gains in reducing airborne particulate matter

HOUSTON – (March 27, 2014) – National efforts in the last decade to clear the air of dangerous particulate matter have been so successful that most urban areas have already attained the next benchmark, according to new research by Rice University.

Atmospheric researchers at Rice studied the state implementation plans (SIPs) from 23 regions mandated by the Environmental Protection Agency to reduce particulate matter (PM) smaller than 2.5 microns (PM 2.5) to less than 15 micrograms per cubic meter by 2009.

The Rice analysis appears this week in the Journal of the Air and Waste Management Association.

All but one of the regions studied reported they had met the goal by deadline. States with regions that met the deadline included Connecticut, Georgia, Illinois, Indiana, Kentucky, Maryland, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee and West Virginia, as well as the District of Columbia. The final region, Alabama, reported attainment in 2010.

PM 2.5 concentrations in the nonattainment regions that filed SIPs to attain the standard by 2009 declined by an average 2.6 micrograms per cubic meter – significantly greater improvement than in regions that had attained the standard from its inception. The study showed PM reductions in the SIP regions were broadly spread, rather than pinpointed at the most polluted monitors.

“One of the things we were most interested in looking at was to see if states were cherry-picking their measures to meet the standard by reducing pollution at their worst monitors, compared with how much they were doing to bring down levels all across the region so that people were breathing cleaner air,” said Daniel Cohan, an associate professor of civil and environmental engineering at Rice.

“It was encouraging to find that across the country, we have seen overall particulate-matter levels come down. We found very slight extra improvement at monitors that were targeted the most, but regions that had to develop plans achieved pretty solid controls that didn’t just pinpoint the worst monitors. And the large populations of these regions benefited.”

Cohan and Rice alumna Ran Chen also documented that air pollution continued to decline even after the 2009 standards were met. The majority of the SIP regions had already attained the mandated 2014 goal of 12 micrograms per cubic meter by 2012.

“We’ve been on a good trajectory,” Cohan said. “This demonstrates that the combination of state and federal controls has been substantially improving air quality in the U.S.”

- See more at: http://news.rice.edu/2014/03/27/us-clean-air-efforts-stay-on-target/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Science360NewsServiceComplete+%28Science360+News+Service%3A+Complete%29&utm_content=Netvibes#sthash.eZJySuaf.dpuf

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March 31, 2014 Posted by | Public Health | , , , , , | Leave a comment

Big government — or good neighbors — can improve people’s health

Big government — or good neighbors — can improve people’s health.

Study explores connection between ideology, social capital and health

Lincoln, Neb., March 20, 2014 – The nation’s left-leaning citizens might be pleased by the findings of a new University of Nebraska study that finds those who live in liberal states tend to be healthier.

But conservatives could also take satisfaction in the same study’s conclusion that strong communities also foster better health.

“Some people might like the argument that liberal government automatically leads to healthier people, because it supports their worldview,” said Mitchel Herian, a faculty fellow with the university’s Public Policy Center and lead researcher on the new study. “But in the absence of a liberal government, you also see better levels of health if you have a strong community.”

The study, published in the March issue of the journal Social Science and Medicine, combined data from the 2010 Behavioral Risk Factor Surveillance System to measure health, a 2009 Gallup Healthways Survey to measure levels of social trust and a 2010 index that rates liberalism in state government. In all, the study involved data collected from more than 450,000 people from across the country.

It found that states with high levels of liberalism and those with high levels of social trust have higher levels of health and well-being.

The two factors – liberalism and social trust – are not interchangeable. People who live in a California city might have liberal political beliefs but mistrust their neighbors, Herian said, while those who live in a small Texas town might mistrust government but count on their neighbors.

To measure a state’s social capital, Herian and his colleagues used data from a survey that asked “If you lost a wallet or purse that contained $200 and it was found by a neighbor, do you think it would be returned with the money in it or not?”

To assess states’ political profiles, the study used an index that scores each of the 50 states on their relative liberalism vs. conservatism. The index is based upon factors such as interest group ratings of congressional members, voting records and election results in congressional races. It is designed not only to assess partisanship, but the extent to which politicians favor liberal social policy.

Health and well-being were measured with questions from the behavior risk survey that asked respondents to rate their health and to report how frequently poor physical or mental health prevents them from carrying out daily activities. The researchers also took smoking habits and body mass index into consideration.

Herian authored the study with psychologists Louis Tay of Purdue University, Ed Diener of the University of Illinois and UNL graduate student Joseph A. Hamm.

“Liberals argue for government programs and conservatives argue for individual responsibility,” Diener said. “When government programs are in place, people tend to be healthier. But when government programs are weaker, a person with lots of close ties and social capital can still be healthy. Their wife can get them to exercise, their friends can help them not drink too much, and their support for each other may directly affect their health. Loneliness is bad for health.”

The researchers said the study has implications for health policy at the state and local levels. Herian, who has studied how social trust influences public policy, said he expects to do more research on how to measure social trust.

Tay said the study shows two pathways to improving people’s health: Strong communities can provide good health outcomes, but government social programs also have a strong connection to good health and could be necessary to serve more fragmented and isolated communities.

Diener said the research demonstrates that good health is not just a matter of individuals “doing the right thing” like quitting smoking, exercising more and losing excess weight.

“Social factors have an influence, too,” he said. “It might be government programs, or it might be ‘social capital’ – having supportive others around us – that can influence our health beyond just each of us doing the right things.”

 

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March 28, 2014 Posted by | Public Health | , , , , , , | Leave a comment

[Press release] Three-quarters of people with seasonal and pandemic flu have no symptoms

 

English: Influenza positive tests reported to ...

English: Influenza positive tests reported to CDC by US WHO/NREVSS collaborating laboratories, national summary, 2008-2009: subtypes and percent positive tests (Photo credit: Wikipedia)

Three-quarters of people with seasonal and pandemic flu have no symptoms.

Around 1 in 5 of the population were infected in both recent outbreaks of seasonal flu and the 2009 H1N1 influenza pandemic, but just 23% of these infections caused symptoms, and only 17% of people were ill enough to consult their doctor.

These findings come from a major new community-based study comparing the burden and severity of seasonal and pandemic influenza in England over 5 years, published in The Lancet Respiratory Medicine journal.

“Reported cases of influenza represent the tip of a large clinical and subclinical iceberg that is mainly invisible to national surveillance systems that only record cases seeking medical attention”, explains lead author Dr Andrew Hayward from University College London, UK.

“Most people don’t go to the doctor when they have flu. Even when they do consult they are often not recognised as having influenza. Surveillance based on patients who consult greatly underestimates the number of community cases, which in turn can lead to overestimates of the proportion of cases who end up in hospital or die. Information on the community burden is therefore critical to inform future control and prevention programmes.”*

The Flu Watch study tracked five successive cohorts of households across England over six influenza seasons between 2006 and 2011. The researchers calculated nationally representative estimates of the incidence of influenza infection, the proportion of infections that were symptomatic, and the proportion of symptomatic infections that led to medical attention.

Participants provided blood samples before and after each season for influenza serology, and all participating households were contacted weekly to identify any cases of cough, cold, sore throat or ‘flu-like illness”. Any person reporting such symptoms was asked to submit a nasal swab on day 2 of illness to test for a variety of respiratory viruses using Real-Time, Polymerase Chain Reaction (RT-PCR) technology.

The results show that on average 18% of the unvaccinated community were infected with influenza each winter season—19% during prepandemic seasons and 18% during the 2009 pandemic. But most (77%) of these infections showed no symptoms, and only around 17% of people with PCR-confirmed influenza visited their doctor. Compared with some seasonal flu strains, the 2009 pandemic strain caused substantially milder symptoms.

The study indicates that primary-care surveillance greatly underestimates the extent of infection and illness in the community. The rate of influenza across all winter seasons was on average 22 times higher than rates of disease recorded by the Royal College of General Practitioners Sentinel Influenza-Like Illness Surveillance Scheme.

According to Dr Hayward, “Despite its mild nature, the 2009 pandemic caused enormous international concern, expense, and disruption. We need to prepare for how to respond to both mild and severe pandemics. To do this we need more refined assessments of severity, including community studies to guide control measures early in the course of a pandemic and inform a proportionate response.”

Writing in a linked Comment, Dr Peter William Horby from the Oxford University Clinical Research Unit in Vietnam says, “In view of the undoubtedly high rates of subclinical influenza infection, an important unanswered question is the extent to which mild and asymptomatic influenza infections contribute to transmission…A large number of well individuals mixing widely in the community might, even if only mildly infectious, make a substantial contribution to onward transmission.”

He concludes, “Surveillance of medically attended illnesses provides a partial and biased picture, and is vulnerable to changes in consulting, testing, or reporting practices. As such, it is clear that reliable estimates of the infection and clinical attack rates during the early stages of an influenza epidemic requires the collection of standardised data across the whole range of disease severity, from the community, primary care, and secondary care.”

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March 28, 2014 Posted by | Public Health | , , , , , , , , | Leave a comment

How Twitter Can Revolutionize Public Health

Originally posted on NPHR Blog:

by Catherine Bartlett, MPH student
Image

credit: connection.sagepub.com

As much as people may try to deny it, traditionally healthcare organizations are rarely early adopters of new technologies. The lack of electronic health systems, computerized methods of communication, filing, and overall resistance to change has left many health care organizations years behind other high tech industries.

Public health officials have used many different strategies to engage the general public, from billboards, radio PSAs, to the CDC’s unique “prepare for the zombie apocalypse” web campaign.  Although some may dismiss Twitter as frivolous or silly, it is an excellent platform to educate and communicate with a large group of people in a succinct way (140 characters to be exact).  Indeed, over the past five years, Twitter has become one of the most popular social media and sharing platforms in the world. According to the Twitter blog, more than 500 million tweets are…

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March 13, 2014 Posted by | Public Health | , , , | Leave a comment

NYTimes: Rethinking Our ‘Rights’ to Dangerous Behaviors

Originally posted on NobodyisFlyingthePlane:

“What we need,” Freudenberg said to me, “is to return to the public sector the right to set health policy and to limit corporations’ freedom to profit at the expense of public health.”

Bittman contributes to the ongoing discussion here at NobodyisFlyingthePlane about how certain industries deflect public discourse from what is best for our citizens to what makes the most profit, no matter the consequences.

The author he quotes poses a series of questions which get at the heart of the matter.

“Shouldn’t science and technology be used to improve human well-being, not to advance business goals that harm health?”

Similarly, we need to be asking not “Do junk food companies have the right to market to children?” but “Do children have the right to a healthy diet?”

Essentially its a PR game. Do we let whole industries spin how the conversation is framed or do we let the…

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March 13, 2014 Posted by | Consumer Health, Consumer Safety, Public Health | , , , , , | Leave a comment

[Reblog] Legal High Lies

An arrangement of psychoactive drugs

An arrangement of psychoactive drugs (Photo credit: Wikipedia) Image taken from en:Image:Pyschoactive Drugs.jpg, originally uploaded by Thoric. 

 

From the 12 February 2014 2020 post at Health WellBeing Responsibility 

 

It was terribly sad listening to the bother of a “legal high” victim on the radio this morning. The now banned N-Bomb LSD copycat drug had left his brother severely brain damaged and dependent on 24 hour care for the rest of his life.

Surely it is time to stop using the incredibly misleading term ‘legal high’ with its safe, non-addictive, not-bad-enough-to-be-banned connotations. It’s a lie. The internet is littered with websites selling untold numbers of chemical compounds, blithely labelled with seductive names and proclaimed as legal, ‘quality research chemicals and herbal incense’, getting away with it through a bold disclaimer of “STRICTLY NOT FOR HUMAN CONSUMPTION”.

To try and start classifying them is financially and logistically possible, even though the All-Party Parliamentary Group for Drug Policy Reform (clue is in the name) calls for the Utopian solution of the an introduction of a new category for psychoactive substances whereby their supply can be ‘regulated’ and a review of the government lead for drugs to ensure a health focus. Yeah right.

The first step from the government surely has to be to a serious focus on deterrence. Insist on accurate labeling such as ‘high risk unclassified highs’ in all commentary – because there is never, ever anyway of the public being sure what is in the psychoactive substance. Possession should automatically incur a significant fine – pills, powder, whatever – you are potentially endangering yours and others lives. It may be herbs and talc but life is too short to test everything – the European Monitoring Centre for Drugs and Drug Addiction identified 73 new substances in 2012 alone - and it sends a message of principle. It is ridiculous that they can have ‘not fit for human consumption’ on the packet as a legal requirement alongside names such as gogaine, spellweaver, charlie and e-scape.

The American example of “analogue” legislation which simply automatically bans any new substance that has a similar chemical structure to an already banned drug is worth considering but it can never keep pace with new products coming to market. There are hundreds if not thousands of labs in Asia where new synthetic drugs are synthesised to imitate the effects of existing legal drugs. We have to keep this simple, and act now, if we are to prevent more tragic episodes of injury and death.

 

 

 

 

 

 

 

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February 13, 2014 Posted by | Public Health | , , , , , , , , , | Leave a comment

[News article] Dental care in school breaks down social inequalities

From the 10 February 2014 Science Daily article

 

A new global survey documents how dental care in the school environment is helping to assure a healthy life and social equity — even in developing countries. But there are still major challenges to overcome worldwide.

Around 60 per cent of the countries that took part in the study run formalized teaching in how to brush teeth, but not all countries have access to clean water and the necessary sanitary conditions. This constitutes a major challenge for the health and school authorities in Asia, Latin America and Africa in particular.

English: ADA/Dental Health on US postage stamp

English: ADA/Dental Health on US postage stamp (Photo credit: Wikipedia)

“Countries in these regions are battling problems involving the sale of sugary drinks and sweets in the school playgrounds. Selling sweets is often a source of extra income for school teachers, who are poorly paid,” explains Poul Erik Petersen.

He continues: “This naturally has an adverse effect on the children’s teeth. Many children suffer from toothache and general discomfort and these children may not get the full benefit of their education.”

The biggest challenges to improved dental health in low-income countries are a lack of financial resources and trained staff. Schools in the poorest countries therefore devote little or no time to dental care, and they similarly make only very limited use of fluoride in their preventative work. Moreover, the healthy schools in low-income countries find it harder to share their experience and results.

Social inequality is a serious problem

Social inequality in dental health and care is a serious problem all over the world:

“However, inequality is greater in developing countries where people are battling with limited resources, an increasing number of children with toothache, children suffering from HIV/AIDS and infectious diseases — combined with a lack of preventive measures and trained healthcare staff,” says Poul Erik Petersen, before adding:

“Even in a rich country like Denmark, we see social inequalities to dental care, despite the fact that dental health here is much improved among both children and adults. The socially and financially disadvantaged groups of the population show a high incidence of tooth and mouth complaints compared with the more affluent groups.”

 

Read the entire article here

 

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February 12, 2014 Posted by | Public Health | , , , , | Leave a comment

[Reblog] Trading Food for Medication: The Intersection of Poverty and Pain, Part 1

From the 8 February 2014 para las fridas blog item

Chronic pain syndrome is an extremely complicated diagnosis and the treatment of its symptoms requires an interdisciplinary approach ranging from primary care physicians, physical therapists, anesthesiologists, and psychologists.  Likewise, understanding the barriers to the treatment of chronic pain requires teasing out a similarly convoluted picture.  Therefore, I’ve decided to write about the extremely complex and understudied relationship between poverty and pain.  Not surprisingly, there are many components to this relationship because the American health care system is one that involves many players from the government, private sector, non-profits, and Medicare, Medicaid, TRICARE, Children’s Health Insurance Program, Social Security Administration, and the Veteran’s Administration, just to name a few.  However my focus will be narrowed to concentrate on the relationship between living in poverty and efficacious treatment of chronic pain, the flip side of that relationship where individuals fall into poverty as a result of a life-altering, limiting, and costly diagnosis of chronic pain, and the stigma of poverty that consciously or unconsciously affects access to treatment for patients in pain.

Living in poverty increases an individual’s risk for pain on almost every level including musculoskeletal, sciatica, ulcer, and neuropathic.  Poleshuck and Green suggest that an individual’s socioeconomic status permeates almost every level of why an individual may suffer with chronic pain including the ability to implement positive coping strategies, job type and satisfaction, access to quality health insurance, and even social support and interpersonal relationships.

too often research on chronic pain is conducted in areas that have significant financial resources instead of places such as churches, homeless shelters, and community centers. There are other things to consider here.  People that live in poverty and suffer from pain may not have access to primary care givers, analgesics or pharmacies that carry analgesics, and pain specialists. As the U.S. population ages and increasingly more people are diagnosed with pain disorders, those on the fringe will suffer most.  Of course, there is a moral argument to be made here but there is an economic one too.  According to an article that came out in Science Daily in 2012, health economists at Johns Hopkins estimated that chronic pain cost as much as $635 billion a year which they found was higher than heart disease, diabetes, and cancer.  This was a conservative estimate. Therefore, one could argue that it is a public health interest to employ strategies of risk management, access, and multidisciplinary approaches to pain to vulnerable groups who suffer disabling pain at a higher number and magnitude.

….

The Top Five Useless Chronic Pain Treatments (Psychology Today), What not to do to help the chronic pain patient.Published on January 31, 2014 by Dr. Mark Borigini, M.D. in Overcoming Pain

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February 9, 2014 Posted by | Consumer Health, Public Health | , | Leave a comment

[Press release] EPA’s 2012 Toxics Release Inventory Shows Air Pollutants Continue to Decline

TOXMAP, A Map of benzene release 2007-8 lower ...

TOXMAP, A Map of benzene release 2007-8 lower 48 US (Photo credit: Wikipedia) http://en.wikipedia.org/wiki/File:Benzene_release_2007-8_lower_48_US.JPG Attribution: The US National Library of Medicine’s TOXMAP, http://toxmap.nlm.nih.govFrom the 4 February 2014 EPA press release

From the 4 February 2014 EPA Press Release

Total releases of toxic chemicals decreased 12 percent from 2011-2012, according to the U.S. Environmental Protection Agency’s (EPA) annual Toxics Release Inventory (TRI) report released today. The decrease includes an eight percent decline in total toxic air releases, primarily due to reductions in hazardous air pollutant (HAP) emissions.

“People deserve to know what toxic chemicals are being used and released in their backyards, and what companies are doing to prevent pollution,” said EPA Administrator Gina McCarthy. “By making that information easily accessible through online tools, maps, and reports, TRI is helping protect our health and the environment.”

The 2012 data show that 3.63 billion pounds of toxic chemicals were either disposed or otherwise released into the environment through air, water, and land. There was also a decline in releases of HAPs such as hydrochloric acid and mercury, which continues a long-term trend. Between 2011 and 2012, toxic releases into surface water decreased three percent and toxic releases to land decreased 16 percent. 

This is the first year that TRI has collected data on hydrogen sulfide. While it was added to the TRI list of reportable toxic chemicals in a 1993 rulemaking, EPA issued an Administrative Stay in 1994 that deferred reporting while the agency completed further evaluation of the chemical. EPA lifted the stay in 2011. In 2012, 25.8 million pounds of hydrogen sulfide were reported to TRI, mainly in the form of releases to air from paper, petroleum, and chemical manufacturing facilities.

Another new addition to TRI reporting is a requirement for each facility located in Indian country to submit TRI reports to EPA and the appropriate tribe, and not the state where the facility is geographically located. EPA finalized this requirement in a 2012 rule aimed at increasing tribal participation in the TRI Program.

This year’s TRI national analysis report includes new analyses and interactive maps for each U.S. metropolitan and micropolitan area, new information about industry efforts to reduce pollution through green chemistry and other pollution prevention practices, and a new feature about chemical use in consumer products.

The annual TRI report provides citizens with critical information about their communities. The TRI Program collects data on certain toxic chemical releases to the air, water, and land, as well as information on waste management and pollution prevention activities by facilities across the country.
The data are submitted annually to EPA, states, and tribes by facilities in industry sectors such as manufacturing, metal mining, electric utilities, and commercial hazardous waste. Many of the releases from facilities that are subject to TRI reporting are regulated under other EPA program requirements designed to limit harm to human health and the environment.

Also available is the expanded TRI Pollution Prevention (P2) Search Tool, which now allows users to graphically compare facilities within the same industry using a variety of environmental metrics.

Toxics Release Inventory National Analysis

Under the Emergency Planning and Community Right-to-Know Act (EPCRA), facilities must report their toxic chemical releases to EPA by July 1 of each year. The Pollution Prevention Act of 1990 also requires facilities to submit information on waste management activities related to TRI chemicals.
More information on the 2012 TRI analysis, including metropolitan and micropolitan areas is available atwww.epa.gov/tri/nationalanalysis.

Read the entire press release here

Resources

What tools are available to help me conduct my own analysis?

A variety of online tools available from the Data and Tools webpage will help you access and analyze TRI data.

Where can I get downloadable files containing the data used in the 2012 National Analysis?

  • Basic Data Files: Each file contains the most commonly requested data fields submitted by facilities on the TRI Reporting Form R or the Form A Certification Statement.
  • Basic Plus Data Files: These files collectively contain all the data fields submitted by facilities on the TRI Reporting Form R or the Form A Certification Statement.
  • Dioxin, Dioxin-Like Compounds and TEQ Data Files: These files include the individually reported mass quantity data for dioxin and dioxin-like compounds reported on the TRI Reporting Form R Schedule 1, along with the associated TEQ data.
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February 9, 2014 Posted by | Public Health | , , , , , , , , , , , , | Leave a comment

[Press release] CDC study shows that child passenger deaths have decreased 43 percent from 2002 – 2011

From the 4 February 2014 CDC press release

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Research has shown that using age- and size-appropriate child restraints (car seats, booster seats, and seat belts) is the best way to save lives and reduce injuries in a crash. Yet the report found that almost half of all black (45 percent) and Hispanic (46 percent) children who died in crashes were not buckled up, compared to 26 percent of white children (2009-2010).

The Vital Signs report also found that:

  • One in three children who died in crashes in 2011 was not buckled up.
  • Only 2 out of every 100 children live in states that require car seat or booster seat use for children age 8 and under.

Child passenger restraint laws result in more children being buckled up. A recent studyExternal Web Site Icon by Eichelberger et al, showed that among five states that increased the required car seat or booster seat age to 7 or 8 years, car seat and booster seat use tripled, and deaths and serious injuries decreased by 17 percent.


To help keep children safe on the road, parents and caregivers can:

  • Use car seats, booster seats, and seat belts in the back seat—on every trip, no matter how short.
    • Rear-facing car seat from birth up to age 2
      Buckle children in a rear-facing seat until age 2 or when they reach the upper weight or height limit of that seat.
    • Forward-facing car seat from age 2 up to at least age 5 When children outgrow their rear-facing seat, they should be buckled in a forward-facing car seat until at least age 5 or when they reach the upper weight or height limit of that seat.
    • Booster seat from age 5 up until seat belt fits properlyOnce children outgrow their forward-facing seat, they should be buckled in a booster seat until seat belts fit properly. The recommended height for proper seat belt fit is 57 inches tall.
    • Seat belt once it fits properly without a booster seatChildren no longer need to use a booster seat once seat belts fit them properly. Seat belts fit properly when the lap belt lays across the upper thighs (not the stomach) and the shoulder belt lays across the chest (not the neck).
  • Install and use car seats according to the owner’s manual or get help installing them from a certified Child Passenger Safety Technician.

 

Read the entire press release here

February 9, 2014 Posted by | Public Health | , , , , , | Leave a comment

[Reblog] One way to prevent deaths by opiate overdose – Naxolene

From the 6 February 2014 blog item by Mackenzie Fuller at 100 resumes- the perils and victories of starting a public health career

……..

For opiate users, one option for harm reduction is to provide individuals, their friends, or other people close to them with naloxone (aka Narcan), an antidote to opiate overdose that can be administered intranasally, intramuscularly, or intravenously. Paramedics carry it for responding to potential drug overdoses, but sometimes paramedics aren’t called or arrive too late.

The recent death of actor Philip Seymour Hoffman from a suspected overdose has increased the news coverage of heroin deaths and the importance of naloxone. In my opinion, this news coverage of such an excellent actor highlights that users of heroin and other life-threatening drugs are multi-faceted, complex people, rather than beyond-hope dregs of society. I’m sure to many people this is a no duh statement, yet stereotypes continue to exist.

In July of 2013, Outside In started training their clients to administer naloxone. According one of their Facebook posts, they have trained 600 people and have had 174 overdose reversals reported to them as of February 5th, 2014. That is a lot of lives. While administering naloxone does send a person into withdrawal, withdrawal is better than death. Outside In also runs a needle exchange program, another harm reduction strategy.

In 2013, Oregon passed  SB 384 A, a law allowing persons who have completedtraining (developed by Oregon Health Authority) to possess and administer naloxone for treatment of opiate overdose. The law also gives such individuals immunity from civil liability except for in the case of wanton misconduct. The law became effective June 6th, 2013.

There are naloxone laws expanding access to this antidote in 17 states plus the District of Columbia (though not all the laws are state-wide). See this informative document by the Network for Public Health Law for more information.

……

“How To Stop Heroin Deaths”: Up To 85 Percent Of Users Overdose In The Presence Of Others [mykeystrokes.com]

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February 8, 2014 Posted by | Public Health | , , , , , , | Leave a comment

[Article] Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older: United States, 2014

From the 4 February 2014 Annals of Internal Medicine article by Carolyn B. Bridges, MD; Tamera Coyne-Beasley, MD, MPH, on behalf of the Advisory Committee on Immunization Practices

Screen Shot 2014-02-05 at 5.30.32 AM

View a larger version of the graphic and the accompanying article here

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February 5, 2014 Posted by | Public Health | , , | Leave a comment

Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment | Full Text Reports…

Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment 

From the Social Science Research Network

Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment by Dan M. Kahan
Yale University – Law School; Harvard University – Edmond J. Safra Center for Ethics
January 27, 2014

CCP Risk Perception Studies Report No. 17

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Abstract: 

This Report presents empirical evidence relevant to assessing the claim — reported widely in the media and other sources — that the public is growing increasingly anxious about the safety of childhood vaccinations.

Based on survey and experimental methods (N = 2,316), the Report presents two principal findings:
first, that vaccine risks are neither a matter of concern for the vast majority of the public nor an issue of contention among recognizable demographic, political, or cultural subgroups;

and second, that ad hoc forms of risk communication that assert there is mounting resistance to childhood immunizations themselves pose a risk of creating misimpressions and arousing sensibilities that could culturally polarize the public and diminish motivation to cooperate with universal vaccination programs.

Based on these findings the Report recommends that government agencies, public health professionals, and other constituents of the public health establishment

       (1) promote the use of valid and appropriately focused empirical methods for investigating vaccine-risk perceptions and formulating responsive risk communication strategies;
       (2) discourage ad hoc risk communication based on impressionistic or psychometrically invalid alternatives to these methods;
       (3) publicize the persistently high rates of childhood vaccination and high levels of public support for universal immunization in the U.S.;
       and (4) correct ad hoc communicators who misrepresent U.S. vaccination coverage and its relationship to the incidence of childhood diseases.

Number of Pages in PDF File: 82
The report may be downloaded for free at the above URL

 

Some excerpts from the report

A. Findings    

1. There is deep and widespread public consensus, even among groups strongly divided on other issues such as climate change and evolution, that childhood vaccinations make an essential contribution to public health. …

2. In contrast to other disputed science issues, public opinion on the safety and efficacy of childhood vaccines is not meaningfully affected by differences in either science comprehension or religiosity. …

3. The public’s perception of the risks and benefits of vaccines bears the signature of a gen- eralized affective evaluation, which is positive in a very high proportion of the population. …

4. Among the manifestations of the public’s positive orientation toward childhood vaccines is the perception that vaccine benefits predominate over vaccine risks and a high degree of confi- dence in the judgment of public health officials and experts. …

…..

B. Normative and prescriptive conclusions

1. Risk communicators—including journalists, advocates, and public health professionals— should refrain from conveying the false impression that a substantial proportion of parents or of the public generally doubts vaccine safety.

2. Risk communicators should avoid resort to the factually unsupportable, polemical trope that links vaccine risk concerns to climate-change skepticism and to disbelief in evolution as evi- dence of growing societal distrust in science.

….

Remember, correlation does not equal causation!
And the selection of variables (as gun ownership) may be questioned by some…
Still, an interesting graph

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February 1, 2014 Posted by | Public Health | , , , , , | Leave a comment

[Report] Adult illicit drug users are far more likely to seriously consider suicide | Full Text Reports…

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Adult illicit drug users are far more likely to seriously consider suicide 

National Suicide Prevention Lifeline

National Suicide Prevention Lifeline (Photo credit: Wikipedia)

From the 16 January SAMSHA news release ( US Substance Abuse & Mental Health Services Administration)

Adults using illicit drugs are far more likely to seriously consider suicide than the general adult population according to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report finds that 3.9 percent of the nation’s adult population aged 18 or older had serious thoughts about suicide in the past year, but that the rate among adult illicit drug users was 9.4 percent.

According to SAMHSA’s report, the percentage of adults who had serious thoughts of suicide varied by the type of illicit substance used. For example, while 9.6 percent of adults who had used marijuana in the past year had serious thoughts of suicide during that period, the level was 20.9 percent for adults who had used sedatives non-medically in the past year.

“Suicide takes a devastating toll on individuals, families and communities across our nation,” said Dr. Peter Delany, director of SAMHSA’s Center for Behavioral Health Statistics and Quality. “We must reach out to all segments of our community to provide them with the support and treatment they need so that we can help prevent more needless deaths and shattered lives.”

Those in crisis or who know someone they believe may be at immediate risk of attempting suicide are urged to call the National Suicide Prevention Lifeline 1-800-273-TALK (8255) or go to http://www.suicidepreventionlifeline.org. The Suicide Prevention Lifeline network, funded by SAMHSA, provides immediate free and confidential, round-the-clock crisis counseling to anyone in need throughout the country, every day of the year.

This report, “1 in 11 Past Year Illicit Drug Users Had Serious Thoughts of Suicide,” is based on the findings of SAMHSA’s 2012 National Survey on Drug Use and Health (NSDUH) report. The NSDUH report is based on a scientifically conducted annual survey of approximately 70,000 people throughout the country, aged 12 and older.  Because of its statistical power, it is a primary source of statistical information on the scope and nature of many substance abuse and mental health issues affecting the nation.

The complete survey findings are available on the SAMHSA web site at: http://www.samhsa.gov/data/spotlight/spot129-suicide-thoughts-drug-use-2014.pdf

For more information about SAMHSA visit: http://www.samhsa.gov/.

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February 1, 2014 Posted by | Health Statistics, Psychiatry, Public Health, Uncategorized | , , | Leave a comment

[Press Release] Warning! Warning labels can be dangerous to your health

Warning! Warning labels can be dangerous to your health.

From the 16 January 2014 Tel Aviv University press release

AU research shows that some warning labels can make products like cigarettes more appealing

Many products, like cigarettes and medications, are stamped with warning labels alerting consumers to their risks. Common sense suggests these warnings will encourage safer choices.

But now Dr. Yael Steinhart of Tel Aviv University‘s Recanati Business School, along with Prof. Ziv Carmon of INSEAD in Singapore and Prof. Yaacov Trope of New York University, has shown that warning labels can actually have the opposite effect. When there is a time lag between reading a warning and then buying, consuming, or evaluating the associated products, the warnings may encourage trust in the manufacturers of potentially dangerous products, making them less threatening. Published in Psychological Science, the study findings could help improve the efficacy of warning labels.

“We showed that warnings may immediately increase concern and decrease consumption,” said Dr. Steinhart. “But over time, they paradoxically promote trust in a product and consequently lead to more positive product evaluation and more actual purchases.” The findings have important implications for regulators and managers in fields including consumer products, healthcare, and finance.

The best laid plans

The study is based on an idea called “the construal-level theory” (CLT), developed by Prof. Trope and Prof. Nira Liberman of TAU’s School of Psychological Sciences. When thinking about objects over a period of time, people tend to construe them abstractly, emphasizing what they describe as “high-level features” and suppressing “low-level features.” The high-level feature of warning labels is that they build trust in consumers by creating the impression that all the relevant information about the products is being presented. The low-level feature of warning labels is that they make consumers more aware of the products’ negative side effects.

The CLT holds that over long periods of time, consumers deemphasize side effects and emphasize the feeling of trust communicated by warnings over time. Ironically, this may increase the purchase, consumption, and assessment of the associated products.

Absence makes the heart grow fonder

 

 

 

Read the entire article here

 

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January 23, 2014 Posted by | Psychology, Public Health | , , , , , , | Leave a comment

[News article] Early warning: Internet surveillance predicts disease outbreak

Early warning: Internet surveillance predicts disease outbreak.

From the 7 January 2014 news article

The habit of Googling for an online diagnosis before visiting a GP can provide early warning of an infectious disease epidemic.

In a new study published in Lancet Infectious Diseases, internet-based surveillance has been found to detect infectious diseases such Dengue Fever and Influenza up to two weeks earlier than traditional surveillance methods.

Dr Hu, based at QUT’s Institute for Health and Biomedical Innovation, said there was often a lag time of two weeks before traditional surveillance methods could detect an emerging infectious disease.

“This is because traditional surveillance relies on the patient recognizing the symptoms and seeking treatment before diagnosis, along with the time taken for health professionals to alert authorities through their health networks,” Dr Hu said.

“In contrast, digital surveillance can provide real-time detection of epidemics.”

Dr Hu said the study found by using digital surveillance through search engine algorithms such as Google Trends and Google Insights, detecting the 2005-06 avian influenza outbreak “Bird Flu” would have been possible between one and two weeks earlier than official surveillance reports.

“In another example, a digital data collection network was found to be able to detect the SARS outbreak more than two months before the first publications by the World Health Organization (WHO),” he said.

“Early detection means early warning and that can help reduce or contain an epidemic, as well alert public health authorities to ensure risk management strategies such as the provision of adequate medication are implemented.”

Dr Hu said the study found social media and micoblogs including Twitter and Facebook could also be effective in detecting disease outbreaks.

“There is the potential for digital technology to revolutionize emerging infectious disease surveillance,” he said.

….

Read entire article here

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January 23, 2014 Posted by | Public Health | , , , , | Leave a comment

[News article] Heart attacks hit poor hardest

Heart attacks hit poor hardest.

From the 8 January 2014 ScienceDaily article

As people get older, their bodies wear down and become less resilient. In old age, it’s common for people to become “clinically frail,” and this “frailty syndrome” is emerging in the field of public health as a powerful predictor of healthcare use and death.

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p. 50 of The 2012 National Healthcare Disparities Report
http://www.ahrq.gov/research/findings/nhqrdr/nhdr12/2012nhdr.pdf

Now researchers Vicki Myers and Prof. Yariv Gerber of the Department of Epidemiology and Preventive Medicine at the School of Public Health at Tel Aviv University’s Sackler Faculty of Medicine and colleagues have found that poor people are more than twice as likely as the wealthy to become frail after a heart attack. The findings, published in the International Journal of Cardiology, could help doctors and policymakers improve post-heart-attack care for the poor.

“By defining frailty, which combines many areas of medicine, we can predict which people are at the highest risk after a heart attack,” said Ms. Myers. “And we found a strong connection between frailty and socioeconomic status.”

Read entire article here

Related Resource

National Healthcare Disparities Report (NHDR)

  • 2012 Web Version | PDF Version [ PDF file - .8.74 MB] | State Snapshots
     

    For the tenth year in a row, the Agency for Healthcare Research and Quality (AHRQ) has produced the National Healthcare Quality Report (NHQR) and theNational Healthcare Disparities Report (NHDR). These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care.
    New this year are chapters on care coordination, and health system infrastructure. The reports present, in chart form, the latest available findings on quality of and access to health care.
    The National Healthcare Quality Report tracks the health care system through quality measures, such as the percentage of heart attack patients who received recommended care when they reached the hospital or the percentage of children who received recommended vaccinations.
    The National Healthcare Disparities Report summarizes health care quality and access among various racial, ethnic, and income groups and other priority populations, such as residents of rural areas and people with disabilities.

     

 

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January 22, 2014 Posted by | Public Health | , , , , , , | Leave a comment

[Repost] School drug tests don’t work, but ‘positive climate’ might

School drug tests don’t work, but ‘positive climate’ might.

From the 14th January Science Daily article

School drug testing does not deter teenagers from smoking marijuana, but creating a “positive school climate” just might, according to research reported in the January issue of the Journal of Studies on Alcohol and Drugs.

An estimated 20 percent of U.S. high schools have drug testing; some target students suspected of abusing drugs, but often schools randomly test students who are going out for sports or clubs. The policies are controversial, partly because there is little evidence they work. And in the new study, researchers found no effects on high schoolers’ drug experimentation.

Of 361 students interviewed, one third said their school had a drug testing policy. Over the next year, those kids were no less likely than other students to try marijuana, cigarettes or alcohol.

“Even though drug testing sounds good, based on the science, it’s not working,” said Daniel Romer, Ph.D., of the University of Pennsylvania Annenberg Public Policy Center in Philadelphia.

At best, Romer said, the policies might convince kids to lay off the drug their school is testing for — which is most commonly marijuana. But even if that’s true, Romer added, students in school sports and clubs are actually not the ones at greatest risk of developing drug problems. “So as a prevention effort,” Romer said, “school drug testing is kind of wrong-headed.”

So what does work? In this study, there was evidence that a positive school climate might help.

 

Read entire article here

January 22, 2014 Posted by | Public Health | , , , | Leave a comment

[Repost] Racism may accelerate aging in African-American men

Racism may accelerate aging in African-American men.

From the 15 January posting at the University of Maryland Web site

MD-led study is first to link racism-related factors and cellular age

Screen Shot 2014-01-21 at 5.28.01 AMCOLLEGE PARK, Md. – A new University of Maryland-led study reveals that racism may impact aging at the cellular level. Researchers found signs of accelerated aging in African American men who reported high levels of racial discrimination and who had internalized anti-Black attitudes. Findings from the study, which is the first to link racism-related factors and biological aging, are published in the American Journal of Preventive Medicine.

Racial disparities in health are well-documented, with African Americans having shorter life expectancy, and a greater likelihood of suffering from aging-related illnesses at younger ages compared to whites. Accelerated aging at the biological level may be one mechanism linking racism and disease risk.

“We examined a biomarker of systemic aging, known as leukocyte telomere length,” explained Dr. David H. Chae, assistant professor of epidemiology at UMD’s School of Public Health and the study’s lead investigator. Shorter telomere length is associated with increased risk of premature death and chronic disease such as diabetes, dementia, stroke and heart disease.  “We found that the African American men who experienced greater racial discrimination and who displayed a stronger bias against their own racial group had the shortest telomeres of those studied,” Chae explained.

Even after adjusting for participants’ chronological age, socioeconomic factors, and health-related characteristics, investigators found that the combination of high racial discrimination and anti-black bias was associated with shorter telomeres. On the other hand, the data revealed that racial discrimination had little relationship with telomere length among those holding pro-black attitudes. “African American men who have more positive views of their racial group may be buffered from the negative impact of racial discrimination,” explained Chae. “In contrast, those who have internalized an anti-black bias may be less able to cope with racist experiences, which may result in greater stress and shorter telomeres.”

Screen Shot 2014-01-21 at 5.30.04 AMThe findings from this study are timely in light of regular mediareports of racism facing African American men. “Stop-and-friskpolicies, and other forms of criminal profiling such as ‘driving orshopping while black’ are inherently stressful and have a real impact on the health of African Americans,” said Chae. Researchers found that racial discrimination by police was most commonly reported by participants in the study, followed by discrimination in employment. In addition, African American men are more routinely treated with less courtesy or respect, and experience other daily hassles related to racism.

Chae indicated the need for additional research to replicate findings, including larger studies that follow participants over time. “Despite the limitations of our study, we contribute to a growing body of research showing that social toxins disproportionately impacting African American men are harmful to health,” Chae explained. “Our findings suggest that racism literally makes people old.”

Read the entire article here

 

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January 21, 2014 Posted by | Medical and Health Research News, Public Health | , , , | Leave a comment

[Online Book] Subjective Well-Being: Measuring Happiness, Suffering, and Other Dimensions of Experience (2013)

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From the Overview at the National Academy Press

Description

Subjective well-being refers to how people experience and evaluate their lives and specific domains and activities in their lives. This information has already proven valuable to researchers, who have produced insights about the emotional states and experiences of people belonging to different groups, engaged in different activities, at different points in the life course, and involved in different family and community structures. Research has also revealed relationships between people’s self-reported, subjectively assessed states and their behavior and decisions. Research on subjective well-being has been ongoing for decades, providing new information about the human condition. During the past decade, interest in the topic among policy makers, national statistical offices, academic researchers, the media, and the public has increased markedly because of its potential for shedding light on the economic, social, and health conditions of populations and for informing policy decisions across these domains.

Subjective Well-Being: Measuring Happiness, Suffering, and Other Dimensions of Experienceexplores the use of this measure in population surveys. This report reviews the current state of research and evaluates methods for the measurement. In this report, a range of potential experienced well-being data applications are cited, from cost-benefit studies of health care delivery to commuting and transportation planning, environmental valuation, and outdoor recreation resource monitoring, and even to assessment of end-of-life treatment options.

Subjective Well-Being finds that, whether used to assess the consequence of people’s situations and policies that might affect them or to explore determinants of outcomes, contextual and covariate data are needed alongside the subjective well-being measures. This report offers guidance about adopting subjective well-being measures in official government surveys to inform social and economic policies and considers whether research has advanced to a point which warrants the federal government collecting data that allow aspects of the population’s subjective well-being to be tracked and associated with changing conditions.

 

December 14, 2013 Posted by | Consumer Health, Psychology, Public Health | , , , , | Leave a comment

[Press release] United Health Foundation’s America’s Health Rankings Finds Americans Are Making Considerable Progress in Key Health Measures

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From the 11 December 2013 press release

  •   Hawaii is the healthiest state
  •   Nationwide, Americans improved in the majority of the measures captured by the Rankings
  •   Improvements span key behavioral measures including smoking and physical inactivity
  •   2013 marks the first time since 1998 that America’s obesity crisis did not worsen
  •   Serious challenges remain; maintaining momentum is keyMINNETONKA, Minn. (Dec. 11, 2013) – Americans are making considerable progress in their overall health, according to United Health Foundation’s 2013 America’s Health Rankings®: A Call to Action for Individuals & Their Communities.

    Nationwide, Americans improved in the majority of the measures captured by the Rankings. The most notable gains came in key behavioral measures, including smoking, which dropped from 21.2 percent of the adult population to 19.6 percent. Seventeen states had significant drops in smoking, with the largest seen in Nevada, Maryland, Oklahoma, Kansas and Vermont.

    Physical inactivity dropped from 26.2 percent of the adult population to 22.9 percent, and America’s obesity rate remained approximately the same as reported in 2012 (27.6 percent of the adult population in 2013 compared with 27.8 percent in 2012). This marks the first time since 1998 that obesity rates have not worsened.

    State rankings

    Hawaii has taken the title of healthiest state. Vermont, last year’s reported No. 1 state, is ranked second this year and has ranked among the top five states for the last decade. Minnesota is third, followed by

Massachusetts and New Hampshire. Mississippi ranks 50th this year, and Arkansas (49), Louisiana (48), Alabama (47) and West Virginia (46) complete the list of the five least healthy states.

Top-seated Hawaii scored well along most measures particularly for having low rates of uninsured individuals, high rates of childhood immunization, and low rates of obesity, smoking and preventable hospitalizations. Like all states, Hawaii also has areas where it can improve: it has higher-than-average rates of binge drinking and occupational fatalities, and lower-than-average rates of high school graduation.

To see the Rankings in full, visit: http://www.americashealthrankings.org.

Despite progress, significant challenges remain

When it comes to improving the nation’s health, there is still much to be done. Obesity has leveled off; however, it must remain a top priority, as 27.6 percent of adults nationwide report being obese. With rates of physical inactivity, smoking and diabetes at 22.9 percent, 19.6 percent and 9.7 percent, respectively, there is still considerable room for improvement in key health measures.

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“I am encouraged by the progress we’ve made this year and am hopeful that the leveling off we see in America’s obesity is a sign of further improvement to come,” said Reed Tuckson, M.D., external senior medical adviser to United Health Foundation. “We should certainly celebrate these gains. They encourage us to continue to identify and effectively implement best practices in these areas and in addressing diabetes, heart disease and other chronic health conditions that compromise Americans’ health and vitality.”

Georges Benjamin, M.D., executive director of the American Public Health Association, said: “Every year, the America’s Health Rankings report details the nation’s health successes and challenges on a state- by-state level, providing specific areas where citizens and states alike can focus to continue to improve the health of our nation. I am pleased to see the progress we’ve made and hope we can keep up the good work.”

United Health Foundation calls for sustained momentum

“United Health Foundation is committed to continuing to identify ways to improve state health in measurable, meaningful ways,” said Rhonda Randall, D.O., senior adviser to United Health Foundation and chief medical officer of UnitedHealthcare Retiree Solutions. “I hope we soon see the day when we are cheering year-over-year improvements in obesity, and I look forward to seeing our nation’s percentage of smokers continue to decline.”

“Those of us who dedicate our careers to public health know we can’t improve what we don’t measure,” said Eduardo Sanchez, M.D., chairman, Partnership for Prevention. “The America’s Health Rankings report and the online tools show us where we’ve made strides in promoting better health and, importantly, where we still have work to do.”

The America’s Health Rankings report and its tools – including analysis not only of state populations but also subpopulations within states – are designed to identify health opportunities in communities as well as

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multi-stakeholder, multi-disciplinary approaches to address those opportunities. Through its programs and grants, United Health Foundation shines a spotlight on the health of America while promoting evidence- based solutions. As part of this commitment, United Health Foundation has partnered with the Association of State and Territorial Health Officials and the National Business Coalition on Health to create learning laboratories that identify and promote best practices and innovations in public health. To learn more about America’s Health Rankings – and to get information on how to help improve community health – visit http://www.americashealthrankings.org.

About America’s Health Rankings®

America’s Health Rankings is an annual comprehensive assessment of the nation’s health on a state-by state basis. It is published jointly by United Health Foundation, American Public Health Association and Partnership for Prevention.

The data in the report come from well-recognized outside sources, such as the Centers for Disease Control and Prevention, American Medical Association, FBI, Dartmouth Atlas Project, U.S. Department of Education and Census Bureau. The report is reviewed and overseen by a Scientific Advisory Committee, with members from leading academic institutions, government agencies and the private sector.

America’s Health Rankings is the longest-running report of its kind. For 24 years, the Rankings has provided an analysis of national health on a state-by-state basis by evaluating a historical and comprehensive set of health, environmental and socioeconomic data to determine national health benchmarks and state rankings. The Rankings employs a unique methodology, developed and annually reviewed by a Scientific Advisory Committee of leading public health scholars. For more information, visit http://www.americashealthrankings.org.

About United Health Foundation

Guided by a passion to help people live healthier lives, United Health Foundation provides helpful information to support decisions that lead to better health outcomes and healthier communities. The Foundation also supports activities that expand access to quality health care services for those in challenging circumstances and partners with others to improve the well-being of communities. After its establishment by UnitedHealth Group [NYSE: UNH] in 1999 as a not-for-profit, private foundation, the Foundation has committed more than $210 million to improve health and health care. For additional information, please visit http://www.unitedhealthfoundation.org.

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December 14, 2013 Posted by | Public Health | , , | Leave a comment

[Press release] U.S. stroke deaths declining due to improved prevention, treatment

From the 5 December 2013 American Heart Association press release

Statement Highlights:

  • Better blood pressure control, stop-smoking programs and faster treatment are a few of the reasons for a dramatic decline in U.S. stroke deaths in recent decades.

DALLAS, Dec. 5, 2013 — Stroke deaths in the United States have declined dramatically in recent decades due to improved treatment and prevention, according to a scientific statement published in the American Heart Association journal Stroke.

The American Stroke Association commissioned this paper to discuss the reasons that stroke dropped from the third to fourth leading cause of death.

“The decline in stroke deaths is one of the greatest public health achievements of the 20th and 21st centuries,” said Daniel T. Lackland, Dr. P.H., chair of the statement writing committee and professor of epidemiology at the Medical University of South Carolina, in Charleston, S.C. “The decline is real, not a statistical fluke or the result of more people dying of lung disease, the third leading cause of death.”

Public health efforts including lowering blood pressure and hypertension control that started in the 1970s have contributed greatly to the change, Lackland said.

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Four-year trend in survival probability by periods 1987–1991, 1992–1996, 1997–2001, and 2002– 2006 among men and women aged 18 to 54 y with a first ischemic stroke.

 

Smoking cessation programs, improved control of diabetes and abnormal cholesterol levels, and better, faster treatment have also prevented strokes. Improvement in acute stroke care and treatment is associated with lower death rates.

“We can’t attribute these positive changes to any one or two specific actions or factors as many different prevention and treatment strategies had a positive impact,” Lackland said. “Policymakers now have evidence that the money spent on stroke research and programs aimed at stroke prevention and treatment have been spent wisely and lives have been saved.

“For the public, the effort you put into lowering your blood pressure, stopping smoking, controlling your cholesterol and diabetes, exercising and eating less salt has paid off with a lower risk of stroke.”

Stroke deaths dropped in men and women of all racial/ethnic groups and ages, he said.

“Although all groups showed improvement, there are still great racial and geographic disparities with stroke risks as well many people having strokes at young ages,” Lackland said. “We need to keep doing what works and to better target these programs to groups at higher risk.”

Co-authors are Edward J. Roccella, Ph.D., M.P.JN., committee chair; Anne F. Deutsch, R.N., Ph.D.; Myriam Fornage, Ph.D.; Mary G. George, M.D., M.S.P.H.; George Howard, Dr. P.H.; Brett M. Kissela, M.D., M.S.; Steven J. Kittner, M.D., M.P.H.; Judith H. Lichtman, Ph.D., M.P.H.; Lynda D. Lisabeth, Ph.D, M.P.H.; Lee H. Schwamm, M.D.; Eric E. Smith, M.D., M.P.H.; and Amytis Towfighi, M.D., on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Quality of Care and Outcomes Research, and Council on Functional Genomics and Translational Biology.

For the latest heart and stroke news, follow us on Twitter: @HeartNews.

For updates and new science from Circulation, follow @CircAHA.

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The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at www.heart.org/corporatefunding.

For Media Inquiries: (214) 706-1173
Darcy Spitz: (212) 878-5940Darcy.Spitz@heart.org
Julie Del Barto (broadcast): (214) 706-1330Julie.DelBarto@heart.org
For Public Inquiries: (800) AHA-USA1 (242-8721)

 

December 14, 2013 Posted by | Public Health | , | Leave a comment

[Free Webinar] Hookah Lounges Today. Marijuana or E-cigarette Lounges Tomorrow?

 

 

English: Teenagers at a hookah lounge

English: Teenagers at a hookah lounge (Photo credit: Wikipedia)

 

 

 

From the description at Northwest Center for Public Health Practice

 

In this one hour webinar  which is part of the Hot Topics series, representatives from four health jurisdictions in Washington State discuss their experiences developing policies and enforcing laws to promote smoke-free air in public places.

Air date: December 17, 2013

[recording will be freely available after Dec 17]

Learning Objectives

  • Describe how public health agencies are being challenged by the presence of hookah lounges, vapor-producing products, and possibly marijuana lounges.
  • List effective public policy or enforcement strategies for combating hookah lounges, vapor-producing products, and potential marijuana lounges.
  • List three considerations when deciding whether to take legal proceedings against an establishment for violating Smoking in Public Places laws.

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Intended Audience

Local, state, and tribal public health practitioners; board of health members; health department legal counsel

Slides and Resources

 

December 14, 2013 Posted by | environmental health, Public Health | , , , , , | Leave a comment

[Press release] Is smoking cannabis and driving the new drinking and driving?

From the [undated December] Ontario Centre for Addiction and Mental Health

Use of prescription, over-the-counter medications also of concern in CAMH’s latest Ontario Student Drug Use and Health Survey (OSDUHS)

December 11, 2013 – Alcohol consumption and smoking among Ontario students in grades 7-12 is at an all-time low; however recreational use of over-the-counter drugs is on the rise.  Prescription drug misuse and driving after using drugs also remain elevated according to the 2013 Ontario Student Drug Use and Health Survey (OSDUHS) released today by the Centre for Addiction and Mental Health (CAMH). The survey of 10,272 students from across Ontario is Canada’s longest-running systematic study of alcohol and other drug use among youth, and one of the longest-running surveys in the world

Over-the-counter and prescription drugs

The survey shows one in eight (representing 120,000 middle and high school students in Ontario) reported taking a prescription opioid pain medication recreationally in the last year, and the majority of these students said that they got the drugs from home. About one per cent (representing 13,500 students) reported using stimulant drugs (used to treat ADHD) without a prescription. There was an increase in the number of students who reported using over-the-counter cough medication to “get high,” with over 94,000 students (about 10%) engaging in this behaviour. This was the only drug to show an increase in recent years. One in six high school students reported symptoms of a drug use problem; this represents 132,700 students in grades 9-12.

Substance use and driving

Eighteen per cent of students reported being a passenger in a car driven by someone who had been drinking alcohol. Four per cent of students with a G-class driver’s license said they had driven a vehicle within one hour of consuming two or more drinks – this is an estimated 12,700 adolescent drivers in Ontario.

Cannabis smoking and driving levels were even higher. Despite the serious impact that smoking cannabis can have on psychomotor skills and the ability to drive safely, one in ten licensed students reported driving a car within one hour of smoking cannabis. This represents 31,500 adolescent drivers in Ontario. Fourteen per cent of students reported being a passenger in a car where the driver had been using drugs.

“The number of students who report using cannabis and driving has remained the same in recent years which tells us that students do not take the potential dangers of driving while under the influence seriously,” said Dr. Robert Mann, CAMH Senior Scientist and OSDUHS Principal Investigator.  “The public health messages around the dangers of drinking and driving seem to have had an impact on our youth but the same can’t be said for cannabis use, which is worrisome.”

Drinking

Alcohol use among Ontario students reached an all-time low with 50 per cent (representing 483,900 students) reporting drinking alcohol in the past year. “Though the overall decline shows promise, we see that the kids who are drinking are doing so in dangerous ways,” added Dr. Mann. “One in five (representing 193,400 students) reports binge drinking at least once in the past month and a similar percentage report blacking out on at least one occasion when drinking alcohol in the past year. Eight per cent report being injured or injuring someone else while they had been drinking.”

New this year

New in this year’s OSDUHS are questions on the use of waterpipes and electronic cigarettes.  Almost 10 per cent (representing 88,400 students) reported smoking tobacco through a waterpipe in the past year. About 15 per cent of high school students (representing 99,800 students) reported smoking electronic cigarettes in their lifetime. For the first time the survey asked students whether they had used synthetic cannabis, commonly known by street names, “K2” or “spice.” Two per cent – representing over 17,000 students – had tried the drug.

“These new numbers give us some insight into the use of alternative and emerging drugs among young people,” said Dr. Hayley Hamilton, CAMH Scientist and Co-Investigator on the OSDUHS. “We see that while cannabis use among students is holding steady since our last survey at around one quarter of students, this new synthetic form has emerged and we will want to track its prevalence in future surveys. The same holds for smoking – while the rate of students smoking has leveled off over the past few years, we see that youth are still smoking cigarettes and tobacco, but in alternate ways.”

Regional differences

  • Students in Toronto and Western Ontario reported the nonmedical use of opioid prescription pain medication at higher rates than the rest of the province (15 per cent and 13 per cent respectively)
  • Students in the north were less likely to use prescription opioid pain medication (7 per cent) but reported higher rates of hazardous drinking than the provincial average (19 per cent and 16 per cent respectively)
  • Students in the east reported higher rates of hazardous drinking than the provincial average (20 per cent and 16 per cent respectively)

For further information, please contact Michael Torres, Media Relations, CAMH at (416) 595-6015 or media@camh.ca

The Centre for Addiction and Mental Health (CAMH) is Canada’s largest mental health and addiction teaching hospital, and one of the world’s leading research centres in the field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues.

CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre.

OSDUHS is Canada’s longest-running systematic study of alcohol and other drug use among youth, and one of the longest-running surveys in the world. During the 2012-13 school year, 10,272 students from across Ontario in grades 7 to 12 participated in the survey, administered on behalf of CAMH by the Institute for Social Research at York University.

 

 

December 13, 2013 Posted by | Public Health | , , , , | Leave a comment

[News article] New Strain of Bird Flu Packs a Punch Even After Becoming Drug-Resistant

English: Countries that have reported swine fl...

English: Countries that have reported swine flu Tamiflu resistance. (Photo credit: Wikipedia)

 

From the 11 December 2013 ScienceDaily article

 

Researchers at the Icahn School of Medicine at Mount Sinai reported that a virulent new strain of influenza — the virus that causes the flu — appears to retain its ability to cause serious disease in humans even after it develops resistance to antiviral medications. The finding was included in a study that was published today in the journal Nature Communications.

It is not uncommon for influenza viruses to develop genetic mutations that make them less susceptible to anti-flu drugs. However, these mutations usually come at a cost to the virus, weakening its ability to replicate and to spread from one person to another.

Initial reports suggested that H7N9, an avian strain of influenza A that emerged in China last spring, could rapidly develop a mutation that made it resistant to treatment with the antiviral medication Tamiflu (oseltamivir). However, patients in whom drug resistance developed often had prolonged, severe infections and poor clinical outcomes. No vaccine is currently available to prevent H7N9, which infected at least 135 people and caused 44 deaths during the outbreak. In the absence of a vaccine, antiviral drugs are the only means of defense for patients who are infected with new strains of the flu.

“In this outbreak, we saw some differences in the behavior of H7N9 and other avian influenza strains that can infect humans, beginning with the rapid development of antiviral resistance in some people who were treated with oseltamivir and the persistence of high viral loads in those patients,” said lead investigator Nicole Bouvier, MD, Assistant Professor of Medicine, Infectious Diseases at the Icahn School of Medicine at Mount Sinai.

 

 

 

Read the entire article here

 

 

December 13, 2013 Posted by | Public Health | , , , | Leave a comment

[Reblog] Social inequality: A blind spot for health reporters

Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

Dozens of news stories over the past year have reported on the disturbing data showing that Americans are dying younger than people in other wealthy countries and falling behind in many other measures of population health.

But much of the reporting I’ve seen shies away from covering a crucial part of the story: How social inequality may be the most important reason why the health status of Americans is failing to keep up with progress elsewhere.

Being born into poverty, growing up with curtailed opportunities for education and employment, living in a disadvantaged neighborhood – these social determinants of health are like the cards you’re dealt in a game of poker. It’s hard to win if the deck is stacked against you.

Researchers in sociology and public health have developed a fair amount of evidence that social status (typically measured by income or education) may be the most significant shaper of health, disability and lifespan at the population level. In the picture that is emerging, social status acts through a complicated chain of cause-and-effect. Education equips people with knowledge and skills to adopt healthy behaviors. It improves the chances of securing a job with healthy working conditions, higher wages, and being able to afford housing in a neighborhood secure from violence and pollution. The job security and higher income that tend to come with more education provide a buffer from chronic stress – a corrosive force that undermines health among lesser educated, lower income people. Research consistently shows that more education gives people a greater sense of personal control. Positive beliefs about personal control have a profound impact on how people approach life, make decisions about risky behavior, and cope with illness.

Since 1980, virtually all gains in life expectancy in the U.S. have occurred among highly educated groups. In a revealing analysis published in 2008, researchers looked at long-term changes in infant mortality and adult deaths before age 65 and found a widening gap between haves and have-nots over the past 30 years. If all people in the U.S. population experienced the same health gains as the most advantaged, they found that 14 percent of the premature deaths among whites and 30 percent of premature deaths among people of color would have been prevented.

But news outlets seem almost afraid to dig into questions about social inequality. Take, for example, CNN’s coverage of the Institute Of Medicine’s “Shorter Lives, Poorer Health” report in January. The IOM experts examined many measures in which the United States is lagging behind gains in other nations: infant mortality, disabilities, homicides, teen pregnancy, drug-related deaths, obesity, prevalence of AIDS, and life expectancy.

When the CNN coverage got around to explaining likely causes, it tossed out a range of possibilities, most of them blaming individual behavior. Compared with other wealthy nations we eat too much, spend more time driving than walking, fail to use seat belts, abuse more drugs, and use guns to shoot each other more. In the middle of this laundry list, the CNN report makes a glancing reference to the social determinants of health: “Americans benefit much less from social programs that could negate the effects of poverty.”

In July, a headline-garnering paper in the Journal of the American Medical Association explained how the U.S. lapsed from 20th to 27th among wealthy nations in terms of life expectancy at birth, and from 18th to 27th in terms of premature deaths.

December 8, 2013 Posted by | Public Health | , , , , , , | Leave a comment

[News article] Britain’s poor ‘will die before they retire’ if pension reforms aren’t matched by health improvements

From the 6 December 2013 article at The Independent

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”.

Read the entire article here

 

December 7, 2013 Posted by | health care, Public Health | , , | Leave a comment

[Press release] Measles Still Threatens Health Security

English: Estimated immunization coverage with ...

English: Estimated immunization coverage with Measles-containing vaccine (WHO 2010) Deutsch: Geschätzte Immunisierungsrate mit Masernimpfstoff (WHO 2010) (Photo credit: Wikipedia)

 

From the 5 December 2013 CDC Press Release

 

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.”

 

 

 

December 7, 2013 Posted by | Public Health | , , , , | Leave a comment

[Magazine article] Long-Term Disease Database Proves the Value of Vaccines | Observations, Scientific American Blog Network

Screen Shot 2013-12-07 at 3.21.04 AM

From the 27 December 2013 Scientific American article

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!]

Read the entire article here

From the Project Tycho Web site

December 6, 2013 |Project Tycho™ release featured in the New York Times

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.

December 6, 2013 |Project Tycho™ data available on HealthData.gov

Through a collaboration with the Open Government InitiativeProject 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.

November 28, 2013 |Project Tycho™ Data Version 1.0.0 released for public access

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.

December 7, 2013 Posted by | Health Statistics, Public Health | , | Leave a comment

[Reblog] Eight Bright New Ideas From Behavioral Economists That Could Help You Get Healthy

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.

 

By DEBORAH BAE at the 6 December 2013 posting at The Health Care Blog

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.

 

 

December 6, 2013 Posted by | Nutrition, Public Health | , | Leave a comment

[Reblog] Twelve ideas to help you stay healthy during flu season with home made sani-wipe recipe

From the December 2013 post at the Boone Medical Center

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.

schmerzen-11People 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.

  1. 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.
  2. 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.
  3. 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.
  4. Try Zinc lozenges. If you get a scratchy throat, zinc lozenges can relieve cold symptoms faster.
  5. 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.
  6. 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!
  7. 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.
  8. 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.
  9. 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.
  10. 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.
  11. 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.
  12. 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.

References

 

December 5, 2013 Posted by | Public Health | , , , | Leave a comment

[Press release] First real-time flu forecast successful

“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.”

 

From the 3 December 2013 Columbia University’s Mailman School of Public Health press release via EurekAlert

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.

Study Results

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.

 

 

December 4, 2013 Posted by | Public Health | , , , , , , | Leave a comment

[Pew Analysis] 37 States Increase Mental Health Budgets

From the 21 November 2013 report

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.

 

November 29, 2013 Posted by | Public Health | , , | Leave a comment

[News article] CDC Report Card: Good, Bad Marks On Target Battles

From the 21 November 2013 CBS report

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.

From the CDC Winnable Battles Progress Report page

(specifically
http://www.cdc.gov/winnablebattles/targets/pdf/winnablebattlesprogressreport.pdf)

OVERVIEW

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

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November 22, 2013 Posted by | Public Health | , | Leave a comment

[Reblog] Why Americans and Europeans may soon start dying of infections like it’s 1905 again

A schematic representation of how antibiotic r...

A schematic representation of how antibiotic resistance is enhanced by natural selection (Photo credit: Wikipedia)

From the 18 November 2013 Quartz posting

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.

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“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.

……

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http://grosvenorcontractsblog.wordpress.com/2013/11/18/european-antibiotic-awareness-day/

Read the entire article here

November 19, 2013 Posted by | health care, Public Health | , | Leave a comment

[Reblog] Criminal Law and Public Health – Working at Cross-Purposes?

: Criminal Justice Center

: Criminal Justice Center (Photo credit: Wikipedia)

 

From the 18th November 2013 post at HealUoS

 

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.

Read the entire post here

 

November 18, 2013 Posted by | Public Health | , , | Leave a comment

[Press release] CVI puts research into practice on firearms and domestic violence

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From the 13 November 203 Sam Houston University press release via EurekAlert

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/.

November 16, 2013 Posted by | Public Health | , , , , | Leave a comment

[News Report] Cuts to Local Health Departments Hurt Communities

From the 14 November 2013 Science Daily Report

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.

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http://www.sciencedirect.com/science/article/pii/S074937971300487X

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.”

Read the entire article here

November 16, 2013 Posted by | Public Health | , , , , , , , | Leave a comment

[Pew Report] Public Agrees on Obesity’s Impact, Not Government’s Role

Yes to Calories on Menus, No to Soda Limits

From the 12 November  Pew report summary

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.

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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.

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(The survey was conducted before the Food and Drug Administration’s proposal last Thursday to severely restrict trans fats nationwide.) 1

 

November 16, 2013 Posted by | Public Health | , | Leave a comment

[Magazine article] 1 In 10 People in the World Will Have Diabetes By 2035

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http://www.idf.org/diabetesatlas/data-visualisations

From the 14 November 2013 Time article By  @charlottealter

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.

Read more: 10% of World Population Will Have Diabetes By 2035 | TIME.com http://healthland.time.com/2013/11/14/1-in-10-people-in-the-world-will-have-diabetes-by-2035/#ixzz2ko5oErTU

November 16, 2013 Posted by | Public Health | , | 2 Comments

[Repost] IPhone App Wipes Out Population to Show Contagion Risks

From the 11 November 2013 Bloomberg article

The plague started in Indonesia. A viral infection, it spread quietly at first, making its way from person to person with coughing and sneezing its only symptoms. Then someone infected with the virus got on a plane.

As the disease spread around the globe, fever gave way to sweating, nausea, vomiting. Hundreds infected turned to thousands. The virus developed drug resistance. Thousands became millions.

It was all part of Ian Lipkin’s plan.

The Columbia University virus hunter wasn’t using his decades of experience researching infectious disease for evil. He was playing Plague Inc., a game for iPhone, iPad and Android. With more than 15 million downloads since its release last year, Plague Inc. has captured the attention of gamers and public health officials alike. The latter see it as a tool for raising awareness of the real-world risk of pandemics at a time when public funding for medical research is under pressure.

 

Read entire article here

 

November 16, 2013 Posted by | Public Health | , , , | Leave a comment

[Reblog] How to find good vaccine information online

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 InsolenceThe 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.

 

  • Matthew Toohey MD 

    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:

    http://pediatriciannextdoor.co…

    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.

  •  MissMeg Here are two good, government-operated sites which vaccine investigators won’t want to miss.

    The first is a CDC site that lists vaccine ingredients:
    http://www.cdc.gov/vaccines/pu…

    The second is the Vaccine Injury Compensation Program:
    http://www.hrsa.gov/vaccinecom…

 

November 15, 2013 Posted by | health care, Public Health | , , , , | Leave a comment

Overdose drug available for families of addicts

Seems to be a very humane law, even though it is controversial.

From the 20 November 2013 edition of The Oklahoman

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.

….

 

November 14, 2013 Posted by | Public Health | , , | Leave a comment

[News article] More Research Needed Into Substitution Principle and Regulation of Potentially Hazardous Chemical Materials, Experts Urge

From the 12 November 2013 ScienceDaily news item

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.

Read the entire article here

 

November 13, 2013 Posted by | Public Health | , , , , , , | Leave a comment

The Impact Of Stringent Fuel And Vehicle Standards On Premature Mortality And Emissions

From the 8 November 2013 Resources for the Future Library Blog

International Council on Clean Transportation / by Sarah Chambliss, Josh Miller, Cristiano Façanha, Ray Minjares and Kate Blumberg
http://bit.ly/HBAonT

[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…

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November 12, 2013 Posted by | Public Health | , , , , , | Leave a comment

[Ohio State University Press Release] Gun use in PG-13 movies has more than tripled since 1985

From the press release via the 10 November 2013 EurekAlert

Contact: Brad Bushman
Bushman.20@osu.edu
614-688-8779
Ohio State University

Gun use in PG-13 movies has more than tripled since 1985

Researchers worry about effects on teen viewers

COLUMBUS, Ohio – The amount of gun violence shown in PG-13 films has more than tripled since 1985, the year the rating was introduced.

In fact, the most popular PG-13 movies of 2011 and 2012 showed significantly more gun violence than R-rated movies of the same time period, a new study reveals.

“It’s shocking how gun use has skyrocketed in movies that are often marketed directly at the teen audience,” said Brad Bushman, co-author of the study and professor of communication and psychology at The Ohio State University.

“You have to wonder why we are seeing this surge in gun violence in PG-13 movies, when it isn’t appearing in G, PG and R-rated films.”

Bushman conducted the research with Patrick Jamieson, Ilana Weitz and Daniel Romer of the Annenberg Public Policy Center at the University of Pennsylvania. The study was published online Nov. 11, 2013, in the journal Pediatrics.

Bushman said the results are concerning because other research has revealed the presence of a “weapons effect”: People who simply see a gun, or even a picture of a gun, are more aggressive toward others.

“Based on what researchers have found, it is not good for teens to be viewing this much gun violence in films,” he said.

PG movies suggest that “some material may not be suitable for children,” according to the Motion Picture Association of America, which creates the ratings. PG-13 movies carry a sterner warning: “Parents strongly cautioned. Some material may be inappropriate for children under 13.” The MPAA says a PG-13 movie “may go beyond the PG rating” in violence “but does not reach the restricted R cateogry.”

PG-13 movies are also the most popular among viewers – 13 of the top 25 films in release during 2012 carried that rating, including seven of the top 10, according to the MPAA.

“By the standards of the MPAA, PG-13 movies shouldn’t have as much violence as R-rated movies, but they clearly do. It appears sex scenes are more likely to result in an R rating than scenes of violence,” Bushman said.

The researchers studied a database of 915 films that were drawn from the 30 top-grossing films for each year from 1950 to 2012. Researchers identified violent sequences performed by each character for each five-minute segment of the films.

They also noted whether each violent sequence since 1985 (the first full year after the PG-13 rating was introduced) included the use of a gun.

Overall, findings showed that the rate of violent sequences nearly quadrupled from 1950 to 2010. Since 1985, 94 percent of the movies studied (367 in total) had one or more five-minute segments that included violence. Overall, the films contained 700 segments with gun violence.

Findings showed that R-rated films averaged about 1.54 segments per hour featuring gun violence, and that number didn’t fluctuate much from 1985 to 2010. Movies rated G and PG averaged 0.41 segments of gun violence per hour, which also hasn’t changed since 1985.

The story is much different for films rated PG-13, Bushman said. In 1985, PG-13 movies essentially didn’t have any scenes of gun violence, but the number rose steadily until about 2005, when it began escalating even faster.

By 2010, PG-13 films averaged as many sequences featuring gun violence per hour as R-rated films. In 2011 and 2012, PG-13 movies actually had more gun violence than R-rated movies.

“The trend of increasing gun violence in PG-13 movies is disturbing because of what we know about the weapons effect and because those are the films kids are most attracted to,” Bushman said.

The weapons effect was first shown in 1967, in a study by psychologists that showed participants who were provoked until angry acted more aggressively toward others when there was a gun on a table in front of them.

Since then, more than 50 other studies have replicated the weapons effect, even among people who weren’t angry.

“Seeing these violent gun scenes in movies may be strengthening the weapons effect among young people,” Bushman said.

“In addition, these movies essentially provide young people scripts for how to use guns in real life, as we have seen in copycat killings. It is a bad situation.”

 

###

Data from the study were collected as part of The Coding of Media and Health Project at the Annenberg Public Policy Center. Funding for this study came from the APPC and the Robert Wood Johnson Foundation.

Contact: Brad Bushman, (614) 688-8779; Bushman.20@osu.edu

Written by Jeff Grabmeier, (614) 292-8457; Grabmeier.1@osu.edu

 

 

November 11, 2013 Posted by | Consumer Health, Consumer Safety, Psychology, Public Health | , , , , , | Leave a comment

[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.

From the 8 November 2013 article in The Atlantic

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?

 

 

November 10, 2013 Posted by | Public Health | , , , | Leave a comment

[Magazine Article] The Trans-Fat Ban as a Model of Slow Health Policy

Poster from New York City's board of health en...

Poster from New York City’s board of health encouraging consumers to limit trans fat consumption (Photo credit: Wikipedia)

 

From the 8th November 2013 article in The Atlantic

 

..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.

 

Read the entire article here

 

 

 

 

 

 

November 10, 2013 Posted by | Public Health | , , , , , | Leave a comment

How’s life? 2013 Measuring well-being [in OECD countries]

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?

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Read the book by chapter

1. The OECD Better Life Initiative: Concepts and indicators

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.

2. How’s Life? at a glance

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.

3. Well-being and the global financial crisis

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.

4. Gender differences in well-being: Can women and men have it all?

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.

5. Well-being in the workplace: Measuring job quality

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.

6. Measuring the sustainability of well-being over time

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.

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** From the About Page

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.

November 8, 2013 Posted by | Public Health | , , , | Leave a comment

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