From the 8 November 2014 U of M press release
Two-year study of urban teens & young adults shows high risk of additional violent injuries among assault victims, especially those with PTSD or drug use
ANN ARBOR, Mich. — Teens and young adults who get seriously injured in an assault are nearly twice as likely as their peers to end up back in the emergency room for a violent injury within the next two years, a new University of Michigan Injury Center study finds.
The researchers call this repeating pattern of violent injury a reoccurring disease, but their landmark study also suggests potentially powerful opportunities to intervene in ways that could stop the cycle.
The first six months after a young person seeks care for a violence-related injury is an especially important time, the study shows.
Patients with post-traumatic stress disorder or drug abuse problems have the highest likelihood of suffering injuries in another violent incident, the researchers find.
The findings come from a unique effort that involved multiple interviews and medical record chart reviews conducted over two years with nearly 600 residents of the Flint, Mich. area between the ages of 14 and 24 — starting when each one sought emergency care at a single hospital. Nearly 350 of them were being treated for assault injuries at that first encounter.
The findings are published online in JAMA Pediatrics by a group from the University of Michigan Medical School and School of Public Health, the VA Ann Arbor Healthcare System, and other colleagues.
Rebecca Cunningham, M.D., director of the U-M Injury Center and first author of the new paper, notes that it’s the first prospective study of its kind, and 85 percent of the young people enrolled were still in the study at 24 months. Five of the participants died before the study period ended, three from violence, one from a drug overdose, and one in a motor vehicle crash.
“In all, nearly 37 percent of those who qualified for this study because they were being treated for assault-related injuries wound up back in the ER for another violent injury within two years, most of them within six months,” says Cunningham, who is a Professor in the Department of Emergency Medicine at the U-M Medical School and the Department of Health Behavior and Health Education in the U-M School of Public Health.
“This ER recidivism rate is 10 percentage points higher than the rate for what we traditionally call chronic diseases,” she continues. “Yet we have no system of standard medical care for young people who come to us for injuries suffered in a violent incident. We hope these data will help inform the development of new options for these patients.”
The authors note that non-fatal assault-related injuries lead to more than 700,000 emergency visits each year by youth between the ages of 10 and 24. Fatal youth violence injuries cost society more than $4 billion a year in medical costs and $32 billion in lost wages and productivity.
Despite this costly toll, most research on how often the cycle of violent injury repeats itself, and in which young people, has relied on looking back at medical records. This has resulted in widely varying estimates of how big the problem is.
But through the Flint Youth Injury Study, based at U-M, the research team was able to study the issue prospectively, or starting with an index visit and tracking the participants over time.
The study was performed at Hurley Medical Center in Flint, where Cunningham holds an appointment and where U-M emergency physicians work with Hurley staff to provide care.
The study’s design allowed them to compare two groups — those whose index visit was for assault injuries and those seen for other emergency care. Each time a new assault victim was enrolled, the research team sought to enroll the next non-assault patient of the same gender and age range who was treated at the same ER.
Nearly 59 percent of the participants were male, and just over 58 percent were African American, reflecting the broader population of Flint. Nearly three-quarters of those in the study received some form of public assistance.
Among those whose first visit was for assault, nearly 37 percent wound up back in the ER for violent injuries in the next two years, compared with 22 percent of those whose first visit wasn’t for an assault injury. And a larger proportion of the “assault group” actually came back more than once for violent injuries, compared with the other group.
“Future violence interventions for youth sustaining assault-related injury may be most effective in the first six months after injury, which is the period with the highest risk for recidivism,” says Maureen Walton, MPH, Ph.D. senior author and associate professor in the U-M Department of Psychiatry. “These interventions may be most helpful if they address substance use and PTSD to decrease future morbidity and mortality.”
Public health in the 21st century.
From the 16 October 2014 press release
American Journal of Preventive Medicine supplement addresses critical challenges to public health
Ann Arbor, MI, October 16, 2014 – Although disease outbreaks and epidemics drawing worldwide attention emphasize the importance and acute need for public health professionals, the world faces a longer-term challenge—a public health workforce that is truly effective in the 21st century. In a new supplement to the American Journal of Preventive Medicine, ***experts address critical challenges to public health, from workforce development, capacity building, partnership and collaborations, and changes and needs in workforce composition.
As the U.S. healthcare system evolves and communities gain more access to care, diverse forces are driving change, and the practice of public health is adapting. Given the challenges to the public health system and those faced as a nation—including urgent health threats (e.g., antibiotic resistance, prescription drug use and overdose, global health security) and decreased funding for addressing public health concerns—having trust in public health practitioners, their scientific knowledge, and particularly the public health system, has never been more important.
“The public health workforce is now not only required to take a lead in protecting citizens’ health, but it also must provide the evidence base needed for linking public health information with clinical services and activities; offer targeted, scalable public health interventions; and support clinical services in a way that affects populations at large,” notes Guest Editor Fátima Coronado, MD, MPH, Deputy Associate Director for Science, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA. “This supplement is both timely and important because it reviews some of the critical challenges faced by the public health workforce, discusses selected changes under way, and highlights data-driven research to advance the field of public health services and systems research.”
This groundbreaking supplement, The Public Health Workforce, includes 22 articles from more than 30 institutions, agencies, foundations and public companies and covers two major areas: public health workforce capacity building and public health workforce size and composition.
Key topics in the Supplement include:
- How to clearly define the public health workforce challenges using cause-and-effect diagrams and a concise roadmap.
- Use of Massive Open Online Courses (MOOCs) by the School of Public Health at Harvard and concerns about retention of the knowledge gained using that method of instruction.
- How the CDC conducts workforce development within its own organization.
- Do students who receive adequate training in Public Health and Community Medicine tend to practice in areas with physician shortages?
- How do we count public health workers? In the first study since 2000, 50% of all public health workers are employed at the local level, with 30% and 20% at the state and federal levels, respectively.
- How can we define public health workers properly? A taxonomy has been developed which is a necessary step to continuously monitor the size and composition of the workforce to ensure sufficient capacity to deliver essential public health services.
- Data show that part-time public health workers are a low percentage of the total workforce and the percentage has decreased over the last 5 years.
- Despite relatively uncompetitive pay, local health departments experience lower rates of employee turnover than state health agencies and lower rates than state and local government in general.
- How can we align public health workforce competencies with population health improvement goals?
- How the Public Health Accreditation Board (PHAB) developed the standards and measures to encourage health departments to strengthen the current public health workforce and strategically develop the workforce of tomorrow.
- Do Internal Medicine Residency Programs develop public health competencies?
- How a training program for racial and ethnic minorities for careers in public health sciences has resulted in 60% of the students entering public health careers.
- Will epidemiology education change rapidly enough to keep up with trends in communications and computing?
- How the growth of cities, “Big Data,” and cognitive computing will change the public health workforce.
- Building a Culture of Health – How the public health workforce will not only provide medical care but will help to establish a Culture of Health.
- Nursing as a critical driver of the Culture of Health.
Guest Editors Dr. Coronado and Denise Koo, MD, MPH, Office of Public Health Scientific Services, CDC, Atlanta, GA, and Kristine Gebbie, DrPH, RN, Faculty of Health Sciences, Flinders University, Adelaide, South Australia, write that “we are buoyed by the increased efforts to meet workforce challenges and the valuable contribution of researchers and practitioners to strengthen the public health workforce. Efforts to strengthen the public health workforce should be a continuing priority involving well-planned, evidence based, and coordinated actions from decision makers undaunted by the mission of transforming public health and improving the population’s health while facing the complex landscape of the 21st century.”
***The article may be available for free or low cost at your local public, academic, or hospital/medical center library. Call ahead and ask for a reference librarian.
Keeps you informed about news in public health, upcoming meetings, and new public health online resources
Partners in Information Access for the Public Health Workforce is a collaboration of U.S. government agencies, public health organizations and health sciences libraries. This comprehensive collection of online public health resources includes the following topic pages. Each has links to news items; links to relevant agencies, associations, and subtopics; literature and reports; data tools and statistics; grants and funding; education and training; conferences and meetings; jobs and careers; and more
Main Topic pages include material on
5 things that are bigger threats to your health than Ebola (with images) · APHA · Storify.
Excerpt from an August 2014 post by the American Public Health Association
Ebola, the serious, often fatal disease spread by interaction with the blood or fluids of a symptomatic infected person, has been making headlines across the country. And for good reason: this is the largest Ebola outbreak in history. The public is asking questions and wondering if they’re at risk.
But the truth is, unless you live in West Africa, where the latest Ebola outbreak has been focused, or if you are a health worker whoworks with Ebola patients, you’re probably safe.
1. Antibiotic-resistant bacteria
2. Severe weather
Read the entire post here
Ebola virus and the dread factor
August 25 2014 item from Musings of an Academic Family Physician (and department chair) about this (dysfunctional) healthcare world and how to fix it
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…
View original 339 more words
From the 2 February 2014 post at Public Health Talks
English: one high-quality “bud ” nugget of marijuana (Photo credit: Wikipedia)
On January 1st, 2014, Colorado enacted a law that legalized the recreational use of marijuana for adults. For long, discussions have gathered around the health risks involved with the legalization of marijuana.
Marijuana’s long term use can lead to addiction along with respiratory illnesses and cognitive impairment. The risks of addiction are most prominent amongst adolescents. The legalization of marijuana and its increased accessibility can lead to increased use and abuse of the drug. However, with decriminalizing the drug many see benefits arise.
#PubHT wants to discuss the public health implications of legalization of marijuana with you! Please join us on Monday, February 3 at 9 PM ET for a one hour discussion on this topic.
For more information on marijuana use visit:http://www.drugabuse.gov/publications/drugfacts/marijuana
Excepts from the publication
- How Does Marijuana Affect the Brain?
Marijuana overactivates the endocannabinoid system, causing the “high” and other effects that users experience. These effects include altered perceptions and mood, impaired coordination, difficulty with thinking and problem solving, and disrupted learning and memory.Marijuana also affects brain development, and when it is used heavily by young people, its effects on thinking and memory may last a long time or even be permanent.
- What Are the Other Health Effects of Marijuana?
Marijuana use may have a wide range of effects, particularly on cardiopulmonary and mental health.
Marijuana smoke is an irritant to the lungs, and frequent marijuana smokers can have many of the same respiratory problems experienced by tobacco smokers, such as daily cough and phlegm production, more frequent acute chest illness, and a heightened risk of lung infections.
Many have called for the legalization of marijuana to treat conditions including pain and nausea caused by HIV/AIDS, cancer, and other conditions, but clinical evidence has not shown that the therapeutic benefits of the marijuana plant outweigh its health risks.
However, THC-based drugs to treat pain and nausea are already FDA approved and prescribed, and scientists continue to investigate the medicinal properties of other chemicals found in the cannabis plant—such as cannabidiol, a non-psychoactive cannabinoid compound that is being studied for its effects at treating pain, pediatric epilepsy, and other disorders. For more information, see DrugFacts – Is Marijuana Medicine?
- Additionally, because it seriously impairs judgment and motor coordination, marijuana contributes to risk of injury or death while driving a car. A recent analysis of data from several studies found that marijuana use more than doubles a driver’s risk of being in an accident.
- Research shows marijuana may cause problems in daily life or make a person’s existing problems worse. Heavy marijuana users generally report lower life satisfaction, poorer mental and physical health, more relationship problems, and less academic and career success compared to non-marijuana-using peers. For example, marijuana use is associated with a higher likelihood of dropping out of school. Several studies also associate workers’ marijuana smoking with increased absences, tardiness, accidents, workers’ compensation claims, and job turnover.
[Letter to editor] Legalizing marijuana and preventing youth pot use
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
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
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
The  Prevention Status Reports (PSRs) highlight—for all 50 states and the District of Columbia—the status of public health policies and practices designed to prevent or reduce important public health problems.
Related Reports and Analyses
The Guide to Community Preventive Services
A compilation of the evidence-based findings of the Community Preventive Services Task Force showing what works to improve health
County Health Rankings
A collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute examining the health and well-being of people living in nearly every county in the United States
America’s Health Rankings
An annual comprehensive assessment of the nation’s health on a state-by state basis published jointly by the United Health Foundation, American Public Health Association, and Partnership for Prevention
Trust for America’s Health
Data on key health indicators and other indicators for each state and the District of Columbia
Healthy People 2020
Science-based, 10-year national objectives for improving the health of all Americans
CDC Vital Signs
Recent data and calls to action for important public health issues
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
COLLEGE 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.”
The 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
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”.
This image shows all countries classified as “Food Insecure” by the Food and Agriculture Organization of the United Nations, FAO, between 2003 and 2005. more than 5% of the people have insufficient food more than 15% of the people have insufficient food more than 25% of the people have insufficient food more than 35% of the people have insufficient food more than 50% of the people have insufficient food (Photo credit: Wikipedia)
The twitter chat was last year, still I’m posting this timely topic. Because it is that, timely.
From the 12 November 2013 post at healthyfood112
From June 19, 2012 PLoS Medicine have a new main series of seven articles on the next three weeks , titled “Big Food” , which examines the impact of the food and beverage industry in public health. An argument between PLoS and guest editors in new product launches reports writing the series in the fact that multinational food and beverage not been adequately discussed or raised skepticism regardless of their growing impact on the program global health and its role in the obesity crisis .According to the editors of PLoS Medicine :
” The food , unlike snuff and drugs, is necessary for life and is essential for health and disease , however, large multinational food companies control what people eat around the world , resulting an austere irony and sick . D’ billion people on the planet go hungry , while two billion are overweight or obese . “
The major food and beverage companies also play an important role in the global health scenario re -branding their companies as ” nutrition companies ” and market their people as experts in malnutrition , obesity . and even poverty in major conferences and meetings of the United Nations – but its main purpose is to improve profitability through the sale of food editors and posed the question: “Why do the global health community is this acceptable and how those conflicts play out ? “The series is three weeks to address these issues and discuss the role of food industry in the field of health.
Marion Nestle of New York University and David Stuckler of the University of Cambridge , the two guest editors of the series of the journal PLoS Medicine that the public health response created Food great so far as a “failure ” and state ” public health professionals must recognize the influence of the great food in the world food system is a problem, and take steps to reach a consensus on how to engage critically … [which ] alsoshould be given high priority to nutrition as they do on HIV , infectious diseases and other health threats . “
Nestler and Stuckler follow:
“They should support initiatives such as the restrictions on marketing to children , improved nutrition standards for school meals , and taxes on sugary drinks. The public health approach should be non-profit in alignment with Great Food public health goals . Without a concerted direct action to expose and regulate the interests of Great food , epidemics of poverty , hunger and obesity are likely to be more acute . “
The editors invite readers to join the debate on Twitter ( hashtag # plosmedbigfood ) and invite comments on your articles to be published over three weeks since the June 19, 2012 and collected http://www.ploscollections.org / Bigfood
People can join a chat on Twitter Wed 27 June at 13:00 ET .
Food Industry Needs Closer Monitoring By Public Health Authorities
Industry, diet, weightloss, slimming, Monitoring, Food, Authorities, health, Closer, fitness, Public Health
via healthy food 112 http://healthyfood112.blogspot.com/2013/11/food-industry-needs-closer-monitoring.html
Read the entire blog item here
World Health Organization Regions (Photo credit: Wikipedia)
From the 23 October ScienceDaily article
mplementation of national surveys where the population can estimate and assess their own health may give policy makers important insights into the different health interventions that should be implemented. According Siddhivinayak Hirve, PhD student at Umeå University, this may include a simple tool that harmonizes the assessment of health in developing countries with the rest of the world.
When the World Health Organization, WHO, conducted a study of aging in a global context and health among adults, in 2007, they asked the simple question “In general, how would you rate your health today?” The results showed that every other elderly person, over 50, who lived in rural areas in India said that they felt very bad, bad, or moderate.
In his thesis, Siddhivinayak Hirve has examined the factors that influence the assessment of own estimated health in older individuals in the population in rural India. The thesis shows that women report worse health than men. Self-reported health also deteriorated with age. The effect of age in terms of self-rated health was affected by participants’ ability to move, ability to see, hearing, relationships, pain, sleeping problems, and more.
“Smoking and use of tobacco were factors that could be linked to at least one chronic disease, which in turn affected the self-reported health effects,” says Siddhivinayak Hirve. “Our studies also demonstrate that a large social network results in better self-rated health and also a higher quality of life.”
A four-year follow-up study that Siddhivinayak Hirve has conducted showed that the risk of dying was larger in those who reported poorer health compared with those who reported that they had good or very good health at the start of the study
Siddhivinayak Hirve concludes, based on his findings, that it is possible to use information on self-rated health from major national surveys, such as the planning of health care, even in small, isolated areas.
“My goal of this thesis has been to put aging on the agenda, both among scholars and policy makers,” says Siddhivinayak Hirve. “This is particularly important in countries where it has a rapidly aging population. The value of asking the simple question, “In general, how do you feel today?” Is very high and can be very helpful to identify health needs, and plan for targeted interventions in health. This is particularly true in developing countries.”
He also points out that measurements of self-rated health provides a driving force to strengthen research on health for the adult and aging populations in low-and middle-income countries that harmonize with international research.
Thesis is available for viewing at: http://umu.diva-portal.org/smash/record.jsf?pid=diva2:653335
Read the entire article here
English: Naval Postgraduate School emblem (Photo credit: Wikipedia)
From the [US] Homeland Security Digital Library
rom the thesis abstract: “Gun violence in America must be addressed at the highest levels of society. Newtown, Aurora, and Virginia Tech were attacks on the very fabric of America. School shootings represent attacks on our nations’ future. A public health approach to gun violence focuses on prevention. Public safety professionals, educators and community leaders are squandering opportunities to prevent horrific acts of extreme violence. Preparedness is derived by planning, which is critical to mobilizing resources when needed. Rational public policy can work. Sensible gun legislation, which is accessible through a public health approach to gun violence, neither marginalizes nor stigmatizes any one group. University administrators must fully engage the entire arsenal of resources available to confront this pernicious threat. The academic community can create powerful networks for research, collaboration and information sharing. These collective learning environments are investments in the knowledge economy. In order for the police to remain relevant, they must actively engage the community they serve by developing the operational art necessary to cultivate knowledge, relationships and expertise. Police departments must emphasize strategies that improve performance. Police officers must understand the mission and meaning of ‘To Protect and Serve’ and the consequences of public safety, which often comes at their personal peril. Gun violence in America is a public health epidemic and preventing it requires a collective responsibility.”
From the 16 October 2013 summary at Full Text Reports
Source: George Washington University School of Public Health
A new report by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services (SPHHS) examines the impact of health reform on community health centers (CHCs) and their patients. “Assessing the Potential Impact of the Affordable Care Act on Uninsured Community Health Center Patients: A Nationwide and State-by-State Analysis,” estimates that more than 5 million health center patients would have gained coverage had all states participated in a sweeping Medicaid expansion. However, nearly half of all CHCs are located in states that have opted out of the expansion. As a result, more than a million uninsured CHC patients who would have been covered under a nationwide Medicaid expansion will be left without the protection of health insurance, the report says.
Additional quotes from the report (George Washington University School of Public Health press release)
Shin and his colleagues analyzed data from both the 2009 Health Center User Survey and the 2011 Uniform Data System to gauge the impact of the ACA on health center patients nationally and in all 50 states and the District of Columbia. Based on conservative assumptions, the analysis showed that over one million health center patients in the opt-out states who would have gained Medicaid coverage under an expansion will likely remain without insurance. These patients are very poor but do not qualify for the traditional Medicaid program and often cannot pay for health care – even at reduced fees, the study concludes. Ironically, these patients are also too poor to qualify for subsidies that would allow them to purchase health insurance at reduced rates on the new Health Insurance Exchanges.
The bottom line for the 518 health centers located in the opt-out states: the report says they’ll forgo approximately $555 million they would have received had their states expanded Medicaid, yet by law, they will still be treating all community residents, including those who lack health insurance or the means to pay for care.
“Health centers in the opt-out states will face an ongoing struggle to meet the need for care in medically underserved communities as a result of the potential loss of hundreds of millions of dollars in revenues in 2014 alone,” said Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy at SPHHS and a co-author of the report.
The report paints a very different picture for the 582 health centers in states that participate in the Medicaid expansion. Approximately 2.8 million patients at these health centers will gain coverage as a result of that decision. This added coverage will translate into a potential revenue increase of over $2 billion, which will support expanded staff and services.
States that have rejected the Medicaid expansion might reconsider and decide to expand coverage. Ohio’s just-announced Medicaid expansion is estimated to translate to over 63,000 residents gaining coverage and an additional $29 million in revenue gains in 2014 across 33 health centers. But in the near term, the report warns that many poor people living in the 25 opt-out states will continue to lack coverage and might find long wait times at clinics, long distances to find care, and other barriers that could translate to delays in treatment or no care at all. CHCs in those states will be unable to add much-needed services such as mental health or dental care, or to expand into remote or other seriously underserved areas—places where people have to travel for hours just to find a doctor.
“Community health centers represent the backbone of the nation’s safety net, providing high quality care to more than 20 million Americans who live in underserved neighborhoods,” says Feygele Jacobs, president and CEO of the RCHN Community Health Foundation. “Without the Medicaid expansion, CHCs in opt-out states will fall behind and will have trouble providing the kind of care that keeps people and communities healthy.”
- See more at: https://sphhs.gwu.edu/content/over-one-million-community-health-center-patients-25-states-will-remain-uninsured-and-left#sthash.lgwN3pNL.dpuf
Some great information that I did not include in a previous post – How to obtain free and low cost medical articles from biomedical journals. Remember, if all else fails, try contacting the author(s). I have about a 75% success rate.
From the Web site How to Access Journal Articles by Partners in Information Access for the Public Health Workforce.
The information resources and service that you became accustomed to using while pursuing your public health training may not be freely available. Leverage the materials that are freely available to you as an employee, an association member, an alumnus/ae or a taxpayer. Contact the National Network of Libraries of Medicine (NN/LM) Staff for support with exploring any of the options and resources mentioned below, or other questions you might have.
Additional literature resources including Journal Article Databases, Individual Journal Titles, and Reports and Other Publications, are available on the PHPartners.org Literature and Guidelines page.
Free Full Text Journal Articles
Collections of Full Text
- PMC – (National Library of Medicine (NLM) U.S.) – PMC, formerly PubMed Central, is a free archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM).
Institutional Repositories from Universities with Schools of Public Health
Sponsored Special Issues or Open Access Individual Articles
- Public Health Finance and Public Health Accreditation Special Issues – (Journal of Public Health Management and Practice) – See issues marked “Free Access.” March/April 2007 – Volume 13- Issue 2 on public health finance and July/August 2007 – Volume 13 – Issue 4 on public health accreditation were sponsored by the Robert Wood Johnson Foundation (RWJF). However, other issues in other publications sponsored by RWJF are not open access.
Strategies to Obtain Journal Articles
- Council on Education for Public Health – The list of accredited Schools of Public Health and Public Health Programs contains the website for each school. See if your school has special benefits for alumni by checking the public health program site or going directly to the academic library site.
- Library Services – University of South Florida Area Health Education Center – The USF AHEC Program provides free library services to health care providers working with the medically underserved in Charlotte, Citrus, DeSoto, Hernando, Hillsborough, Pasco, Pinellas, Manatee and Sarasota counties. These services include interlibrary loan of journal articles and loan of AHEC-owned books and other materials and ability to access the USF Health Science Center Library electronic resources
International Public Health
- Blue Trunk Libraries – (World Health Organization (WHO)) – The collection, which is organized according to major subjects, contains more than one hundred books on medicine and public health. Blue Trunk Libraries are available in English, French, Portuguese, and Arabic.
- Global Health Library – (World Health Organization (WHO)) – Global and regional indexes tot he scientific and technical literature. Many of the articles found in searches are free online such as those in the Bulletin of the World Health Organization.
- HINARI Access to Research Initiative – (World Health Organization (WHO)) – The HINARI Programme, set up by WHO together with major publishers, enables developing countries to gain access to one of the world’s largest collections of biomedical and health literature. Over 6200 journal titles are available to health institutions in 108 countries, areas and territories.
- College and University Libraries – Academic libraries generally are included in WorldCat or have their own online catalog on their website. State university or community college libraries are usually open to the public living or working within that state. Look for a community college with health training programs. Those with EMS Training Programs may have disaster preparedness journals, for example. Most libraries have print subscriptions or license electronic journals to allow on site use. Friends of the Library memberships may be available for a reasonable charge and may allow you to check out materials or receive other information services.
- Directory of National Network of Libraries of Medicine Members – (National Network of Libraries of Medicine (NN/LM)) – Searchable directory of a nationwide network of health science libraries and information centers. The directory can be searched by state, type of library, and by services offered to the public including reference services, database search training, and delivery of full text journal articles.
- Law Libraries – Law librarians are experts in finding legal information to support policy making and cases. Law libraries are often open to the public for legal research. Use of resources such as Lexis-Nexis and Westlaw is generally restricted, but a wealth of other information in environmental and occupational health, infectious disease control, animal control and other topics with legal components is available.
- List of Public Health Libraries – (Medical Library Association, Public Health/Health Administration Section) – This website provides links to international, U.S. government, state and local public health libraries, and to libraries from schools of public health.
- National Network of Libraries of Medicine NN/LM – Your regional medical library can help you locate any type of library of figure out what options you have to efficiently find access to the information you need. The NN/LM also provides training on how to use information resources such as PubMed.
- Public Libraries – Public library subscriptions and services may include remote access to collections of full-text journals and newspaper articles. Interlibrary loan may be available at no charge or a minimal cost. Library cards are generally available to those who live or work in the jurisdiction at no charge.
- State Libraries – State agency libraries may be designated to serve state public health workers. If not, they should at least be open to state residents. State libraries work with public libraries to ensure access to resources for users statewide. Find your state library.
- WorldCat – See what libraries closest to you own the journal you need, just search on the title and include your zip code – one may be close enough to visit in person to print or copy the article. If not, follow the web links to the owning library to see if document delivery services are offered for a fee. Note: Most hospital libraries do not appear in Worldcat.org, so you may need to call your closest hospital library to see if they have what you need.
Organizational Partnerships and Staying Connected with Academia
- College of Medicine Voluntary Faculty – (University of South Florida (USF)) – Example of library services available to voluntary faculty involved in teaching health professional students. Maintain an adjunct faculty role or offer to precept students. The students will have remote access to the university resources, and the academic institution may also be able to provide resources or services to you as a preceptor depending on their licensing arrangements.
Paying for Full Text Journal Articles
Ordering Journal Articles
- Loansome Doc – (National Network of Libraries of Medicine (NN/LM)) – Arrangements may be made with a health sciences library to provide specific materials you request for a pre-arranged, per-item fee. Prices may be very low, or even free, when ordering from a library mandated to serve health workers in their area.
- Using Loansome Doc® – (National Network of Libraries of Medicine (NN/LM)) – Learn how to order full-text articles through a local health sciences library.
Subscriptions to Individual Titles or Packages of Titles
- Journal of Public Health Management and Practice (Example) – Most journals are available as either individual or institutional subscriptions. If you purchase the journal with organizational funds and intend for it to be used by multiple staff, then you should purchase an institutional subscription. Institutional subscriptions often allow you to set up online access using your organization’s IP addresses so that all on the organization’s network may access the publication. You may also buy individual articles on a pay per view or pay per download model.
- Veterinary Information Network (VIN) – Fee-based knowledge resource center for animal health and infectious diseases that includes many full text journals, conference proceedings and electronic books, as well as online expert forums for veterinarians.
From the 29th August 2013 article at Sound Progress by Julie Watts
Cold and flu season is just around the corner. So what do grocery and retail workers have to do with public health? In a nutshell, they handle your food and if they don’t have adequate sick days from their employers, you may be more likely to get sick.
That is why, paid sick leave for grocery and retail workers is so important.
In addition to the common colds and flus that are passed along when an ill cashier touches every item that goes into a customer’s grocery bag, serious illnesses are spread as a result of people working while sick.
A lack of paid sick leave can also harm child health and school performance.
No caregiver wants to be in the position of choosing between staying home to care for a sick child and going to work so they can pay the bills. However, without adequate paid sick leave, many families must decide between caring for a sick child at home and losing needed pay or risking their jobs.
- One in five workers in a recent survey we conducted of grocery and supercenter workers live with at least one child and do not have any other adults in their households.
- In Washington, the majority of preschoolers and school-age children live in homes where all parents are employed.
Adequate paid sick days mean fewer children going to school sick. When parents can stay at home with their kids, recovery times are shorter and germs stay home too—ensuring healthier schools, families and communities. For more information read our policy brief on Paid Sick Days on our website. Also see our article on the results of our examination of paid sick leave for grocery and retail workers.
So be sure to cover your cough with your elbow, AND ask your local supermarket if they offer paid sick days to their employees!
From the summary at the Institute on Medicine
The United States is among the wealthiest nations in the world, but it is far from the healthiest. For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This health disadvantage prevails even though the U.S. spends far more per person on health care than any other nation. To gain a better understanding of this problem, the NIH asked the National Research Council and the IOM to investigate potential reasons for the U.S. health disadvantage and to assess its larger implications.
No single factor can fully explain the U.S. health disadvantage. It likely has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions. Without action to reverse current trends, the health of Americans will probably continue to fall behind that of people in other high-income countries. The tragedy is not that the U.S. is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.
“The poorer outcomes in the United States are reflected in measures as varied as infant mortality, the rate of teen pregnancy, traffic fatalities, and heart disease. Even those with health insurance, high incomes, college educations, and healthy lifestyles appear to be sicker than their counterparts in other wealthy countries. The U.S. Council on Foreign Relations, a nonpartisan think tank, described the report as “a catalog of horrors.”
Findings that prompted this reaction include the fact that the rate of premature births in the United States is the highest among the comparison countries and more closely resembles those of sub-Saharan Africa. Premature birth is the most frequent cause of infant death in the United States, and the cost to the health care system is estimated to top $26 billion a year.
As distressing as all this is, much less attention has been given to the obvious question: Why is the United States so unwell? The answer, it turns out, is simple and yet deceptively complex: It’s almost everything.
Our health depends on much more than just medical care. Behaviors such as diet, physical activity, and even how fast we drive all have profound effects. So do the environments that expose us to health risks or discourage healthy living, as well as social determinants of health, such as education, income, and poverty.
The United States fares poorly in almost all of these. In addition to many millions of people lacking health insurance, financial barriers to care, and a lack of primary care providers compared with other rich countries, people in the United States consume more calories, are more sedentary, abuse more drugs, and shoot one another more often. The United States also lags behind on many measures of education, has higher child poverty and income inequality, and lower social mobility than most other advanced democracies.
The breadth of these causal factors, and the scope of the U.S. health disadvantage they produce, raises some fundamental questions about U.S. society. As the NRC/IOM report noted, solutions exist for many of these health problems, but there is “limited political support among both the public and policymakers to enact the policies and commit the necessary resources.”
One major impediment is that the United States, which emphasizes self-reliance, individualism, and free markets, is resistant to anything that even appears to hint at socialism. …”
From the 19th July 2013 article at Science Daily
Uruguay has it. So does Latvia, and Senegal. In fact, more than half of the world’s countries have some degree of a guaranteed, specific right to public health and medical care for their citizens written into their national constitutions.
July 19, 2013 — Uruguay has it. So does Latvia, and Senegal. In fact, more than half of the world’s countries have some degree of a guaranteed, specific right to public health and medical care for their citizens written into their national constitutions.
The United States is one of 86 countries whose constitutions do not guarantee their citizens any kind of health protection. That’s the finding of a new study from the UCLA Fielding School of Public Health that examined the level and scope of constitutional protection of specific rights to public health and medical care, as well as the broad right to health.
The study examined the constitutions of all United Nations member states and found the results to be mixed, despite the fact that all U.N. members have universally recognized the right to health, which is written into the original foundational document establishing the international body in 1948.The researchers reviewed the constitutions of all the member states as amended to two points in time: August 2007 and June 2011.
The report appears in the July issue of the journal Global Public Health.
The study also calls for regular and long-term monitoring of all countries’ protection of health rights, whether or not such rights are written into specific country’s constitutions.
That’s because a constitutional definition of what health protection actually is varies widely between nations. Further, how such protections have been implemented varies widely, said the study’s first author, Dr. Jody Heymann, dean of the Fielding School of Public Health.
“With respect to specific rights to health, the status of the world’s constitutions can be described as either half empty or half full,” Heymann said.
The study found that 73 U.N. member countries (38 percent) guaranteed the right to medical care services, while 27 (14 percent) aspired to protect this right in 2011. When it came to guaranteeing public health, the global performance was even poorer: Only 27 countries (14 percent) guaranteed this right, and 21 (11 percent) aspired to it.
But doing the math doesn’t provide a comprehensive picture, said Heymann.
“There also exists gaps between individual countries that may have strong constitutional protections but poor records of implementing health rights on the ground,” she said. “On the other hand, there are countries that lack constitutional provisions that have excellent health care systems in place.”
The latter is particularly true in the case of older constitutions that have not been significantly amended since constitutional rights to health became common, she noted.
The good news, Heymann said, is the clear trend toward greater constitutional protection of health rights overtime……..
When I was in Liberia, West Africa a few years ago it was hard not to notice how many Liberians had cell phones.
Have read quite a few articles since then on how just basic cell phones without apps can facilitate better health services, better communication about health prevention, screening, and such, and better health stats
Originally posted on health communication source:
I saw this comment posted last week on a federal government health office group page in response to their announcement of their new app, the use of technology and the release of open data and big data on their website:
Posts like these are not unique. It is a common argument for not using any technology methods for some health communication campaigns because of limited reach in populations without Internet access. In the case of the example above, reaching migrant workers is a challenge, no argument there. But is it really technology’s fault?
I’m a big advocate of boots-on-the-ground campaigns, but coupling a digital presence is better, even if it takes on a minor role. Of course no one can reach 100% of a population, whether online or offline. But we can improve reaching communities outside of the Internet by using the Internet.
While there is a lot said about the shortcomings…
View original 882 more words
From the 29 January 2013 Trust for America’s Health news release
Trust for America’s Health (TFAH) has released A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years – which provides high-impact recommendations to prioritize prevention and improve the health of Americans.
The Healthier America report outlines top policy approaches to respond to studies that show 1) more than half of Americans are living with one or more serious, chronic diseases, a majority of which could have been prevented, and 2) that today’s children could be on track to be the first in U.S. history to live shorter, less healthy lives than their parents.
“America’s health faces two possible futures,” said Gail Christopher, DN, President of the Board of TFAH and Vice President – Program Strategy of the W.K. Kellogg Foundation. “We can continue on the current path, resigning millions of Americans to health problems that could have been avoided or we invest in giving all Americans the opportunity to be healthier while saving billions in health care costs. We owe it to our children to take the smarter way.”
The Healthier America report stresses the importance of taking innovative approaches and building partnerships with a wide range of sectors in order to be effective. Some recommendations include:
- Advance the nation’s public health system by adopting a set of foundational capabilities, restructuring federal public health programs and ensuring sufficient, sustained funding to meet these defined foundational capabilities;
- Ensure insurance providers reimburse for effective prevention approaches both inside and outside the doctor’s office;
- Integrate community-based strategies into new health care models, such as by expanding Accountable Care Organizations into Accountable Care Communities;
- Work with nonprofit hospitals to identify the most effective ways they can expand support for prevention through community benefit programs;
- Maintain the Prevention and Public Health Fund and expand the Community Transformation Grant program so all Americans can benefit;
- Implement all of the recommendations for each of the 17 federal agency partners in the National Prevention Strategy; and
- Encourage all employers, including federal, state and local governments, to provide effective, evidence-based workplace wellness programs…..
From the 30 January 2013 article at Medical News Today
Some key policy changes that need to be made in the United States in order to prevent illness and improve the health of millions of Americans have just been outlined in the Trust for America’s Health (TFAH) latest Healthier Americareport.***
The report includes a range of suggestions that focus on the prevention of chronic diseases, which currently affect more than half of the U.S. population. This would also help address the health problems facing today’s youth who are set to be the first generation that are less healthy than their parents. …
The recommendations involve some new and innovative approaches:
- Implementing a series of foundational capabilities to improve the country’s health system as well as restructuring public health programs with sustained funding.
- Establishing partnerships with nonprofit hospitals to develop new community benefit programs and expand support for prevention.
- Encourage that insurance providers compensate for all types of prevention strategies
- Ensuring that the Prevention and Public Health Fund continues and improve awareness of the Community Transformation Grant program.
- Maintain workplace wellness programs with employers as well as local and state governments.
The report also includes information about recommendations that are already in action:
- The Accountable Care Community (ACC) brought more than 70 different partners to help patients with type 2 diabetes in and out of the doctor’s office. The ACC managed to reduce the cost of care by more than 10 percent per month for patients with type 2 diabetes – meaning savings of around $3,185 per person yearly.
- The Boston Children’s Hospital implemented The Community Asthma Initiative (CAI) with the purpose of supporting children with asthma in the Boston area. The initiative helped reduce hospital admissions due to asthma-related causes by around 80 percent as well as reducing emergency visits due to asthma by 60 percent.
The report concludes that there are 10 main public health issues that need addressing:
- tobacco use
- healthy aging
- improving the health of minorities
- healthy babies
- environment health threats
- injury prevention
- controlling infectious diseases
- food safety
Read the entire article here
***The report summary and link to the full text of the report may be found here
Mississippi did as well as the best states (7 out of 10). My state, Ohio, had a 6 out of 10 as did Massachusetts.
An excerpt from the December 2012 article at HealthyAmericans.org
The Ready or Not? report provides a snapshot of our nation’s public health emergency preparedness. Its indicators are developed in consultation with leading public health experts based on data from publicly available sources, or information provided by public officials. Some key findings from the report include:
- 29 states cut public health funding from fiscal years (FY) 2010-11 to 2011-12, with 23 of these states cutting funds for a second year in a row and 14 for three consecutive years. In addition, federal funds for state and local preparedness have decreased 38 percent from FY 2005-2012 (Centers for Disease Control and Prevention (CDC) funds, adjusted for inflation). States are reporting that gains in public health preparedness achieved in the past decade since September 11, 2001 are eroding, and since 2008, budget cuts have resulted in more than 45,700 job losses at state and local health departments;
- Only two states have met the national goal of vaccinating 90 percent of young children, ages 19-36 months, against whooping cough (pertussis). This year Washington state has seen one of the most significant whooping cough outbreaks in recent history;
- 35 states and Washington, D.C. do not currently have complete climate change adaptation plans, which include planning for health threats posed by extreme weather events;
- 20 states do not mandate all licensed child care facilities to have a multi-hazard written evacuation plan; and
- 13 state public health laboratories report they do not have sufficient capacity to work five, 12-hour days for six to eight weeks in response to an infectious disease outbreak, such as novel influenza A H1N1.
“Public health preparedness has improved leaps and bounds from where we were 10 years ago,” said Paul Kuehnert, MS RN Director of the Public Health Team at the Robert Wood Johnson Foundation. “But severe budget cuts at the federal, state and local levels threaten to undermine that progress. We must establish a baseline of ‘better safe than sorry’ preparedness that should not be crossed.”
The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:
- Reauthorize the Pandemic and All-Hazards Preparedness Act (PAHPA), which expires at the end of this year;
- Assure sufficient, dedicated funds for public health preparedness to ensure basic capabilities to respond to threats public health departments face every day and also to have the trained experts and systems in place to act quickly in the face of major, unexpected emergencies;
- Provide ongoing support to communities so they better cope and recover from emergencies;
- Modernize biosurveillance to a real-time, interoperable system to better detect and respond to problems;
- Seriously address antibiotic resistance;
- Improve research, development and manufacturing of medical countermeasures;
- Increase readiness for extreme weather events; and
- Update the nation’s food safety system.
The report was supported by a grant from RWJF and is available on TFAH’s website atwww.healthyamericans.org and RWJF’s website at www.rwjf.org.
English: This is CDC Clinic Chief Nurse Lee Ann Jean-Louis extracting Influenza Virus Vaccine, Fluzone® from a 5 ml. vial. (Photo credit: Wikipedia)
From the 11 December 2012 summary at Full Text Reports
….The ongoing public health burden caused by seasonal influenza and the potential global effect of a severe pandemic create an urgent need for a new generation of highly effective and cross-protective vaccines that can be manufactured rapidly. A universal vaccine should be the goal, with a novel-antigen game-changing vaccine the minimum requirement…
From the 24 October 2012 post at The Vector- A Student Blog on Veterinary Public Health
The Future of Veterinary Public Health will be
Since 60-70% of all emerging diseases are zoonotic, there will be plenty of work to go around for veterinarians, physicians and allied health professionals! Diseases that we should be particularly careful about are respiratory diseases with easy airborne transmission. Recent examples of diseases that circulated in animals and then jumped species to humans and then easily spread among humans are SARS and some influenzas such as H1N1 (pigs are origin) & H5N1 (birds are a source)….
Many professionals and pre-professionals in the field of veterinary public health see the future of the discipline becoming more expansive and comprehensive. They predict that more veterinarians will turn to public health practice and that veterinary medicine will take a more prominent role in the field of public health. Currently at Ohio State, an example of progress in bridging the gap between veterinary medicine and human medicine is Dr. Armando Hoet’s research, which adds to the knowledge base of Methicillin-Resistant Staphylococcus aureas (MRSA) by demonstrating how animals and human-animal interactions can contribute to the spread of MRSA.
New terms like Zoobiquity (or Zoob for short) describing the One Health concept may feel awkward at first, but we’ll find our groove. We just have to remind or teach ourselves and our colleagues that animals and humans have coexisted for thousands of years, sharing germs and interacting on equal and unequal terms. We may look starkly different on the outside, but we have a shared biology and our medicines should reflect that similarity.
An insightful article about the high health risks associated with farm workers.
Something to ponder when thinking about and discussing who has a “right” to health care.
education, and a fair wage.
From the 1November post by Amy Croan, MPH at To Your Health
Every time we sit at a table at night or in the morning to enjoy the fruits and grain and vegetables from our good earth, remember that they come from the work of men and women and children who have been exploited for generations. -Cesar Chavez
Of the three to five million U.S. migrant and legal immigrant workers, about 600,000 of them are children. It’s difficult to ascertain an accurate count, because they are under-reported.
Most industries allow minors to work from the age of 16, but for agriculture the minimum age drops to 12. The migrant field worker families often have several children whom each year they uproot from their homes and schools to travel sometimes many states away, to work in endless fields 10-14 hours per day from the age of 12. Sometimes as young as 7 because there is no childcare. And they do this because they feel they have no other choice.
From today’s Latin American Herald Times,
North Carolina’s regional coordinator of Association of Farmworker Opportunity Programs, Emily Drakage’s, mission is to document the amount of child labor in the agricultural sector, educate the public and local leaders about the conditions in which the children work and seek support from other organizations to get these minors out of the fields.
“It’s a very tough problem. There are cultural and linguistic barriers, economic interests, immigration, educational and health problems, but someone has to speak for these workers who have no voice and are unaware of their rights,” Drakage said.
Farm workers earn an average of just $7,000 a year and must pay part of their salary to their employer to cover transport and housing costs. Children earn $1,000 a year.
Usual migrant housing is filthy, rusted and cramped. Poverty levels are extremely high. Little to no access to health care is common. Health insurance is unheard of. One hundred thousand children are injured by sharp blades and other farm machinery each year.
Farmworkers are among the highest risk groups for:
- Poverty–among 97% of migrant workers
- Lack of basic education, literacy and language skills, job training
- Poor health: respiratory and dermatological illnesses, dehydration, heat stroke and heat illness, chronic muscular and skeletal pain, direct exposure to sanitation chemicals and pesticides, infectious disease, chronic disease, work-related injuries, depression and substance abuse, lack of sanitation
- Sexual abuse
- Gang activity
- Slave wages and wage fraud
- Failure to thrive under provisions of the Fair Labor Standards Act and child labor laws
In 1960, Edward R. Murrow’s “Harvest of Shame” aired the day after Thanksgiving. Fifty years later, CBS News revisits the very topic and details again the deplorable working conditions of the migrant family.
Feeling grateful this month as you prepare the bounty for your Thanksgiving table? In a nation where 2/3 of adults and 1/3 of children are overweight or obese from making poor choices about food, one-fifth of our farm workforce is children. These workers drive the agricultural sector and provide fresh food the millions of the rest of us enjoy everyday.
Itinerant LIfe Weighs on Farmworkers’ Children (www.nytimes.com)
NOW With Bill Moyers (www.pbs.org)
Shame On Obama Administration For Sacrificing Children to Keep Agribusiness Happy (www.citizen.org)
United Farm Workers (www.ufw.org)
From the 28 October 2012 WHO news release
As the world’s climate continues to change, hazards to human health are increasing. The Atlas of health and climate, published today jointly by WHO and the World Meteorological Organization (WMO), illustrates some of the most pressing current and emerging challenges.
Droughts, floods and cyclones affect the health of millions of people each year. Climate variability and extreme conditions such as floods can also trigger epidemics of diseases such as diarrhoea, malaria, dengue and meningitis, which cause death and suffering for many millions more. The Atlas gives practical examples of how the use of weather and climate information can protect public health.
Climate risk management
“Prevention and preparedness are the heart of public health. Risk management is our daily bread and butter. Information on climate variability and climate change is a powerful scientific tool that assists us in these tasks,” said Dr Margaret Chan, Director-General of WHO. “Climate has a profound impact on the lives, and survival, of people. Climate services can have a profound impact on improving these lives, also through better health outcomes.”
Until now, climate services have been an underutilized resource for public health.
“Stronger cooperation between the meteorological and health communities is essential to ensure that up-to-date, accurate and relevant information on weather and climate is integrated into public health management at international, national and local levels. This Atlas is an innovative and practical example of how we can work together to serve society,” said WMO Secretary-General Mr Michel Jarraud.
Links between health and climate
Numerous maps, tables and graphs assembled in the Atlas make the links between health and climate more explicit:
- In some locations the incidence of infectious diseases such as malaria, dengue, meningitis and cholera can vary by factors of more than 100 between seasons, and significantly between years, depending on weather and climate conditions. Stronger climate services in endemic countries can help predict the onset, intensity and duration of epidemics.
- Case studies illustrate how collaboration between meteorological, emergency and health services is already saving lives. For example, the death toll from cyclones of similar intensity in Bangladesh reduced from around 500 000 in 1970, to 140 000 in 1991, to 3 000 in 2007 – largely thanks to improved early warning systems and preparedness.
- Heat extremes that would currently be expected to occur only once in 20 years, may occur on average every 2-5 years by the middle of this century. At the same time, the number of older people living in cities (one of the most vulnerable groups to heat stress), will almost quadruple globally, from 380 million in 2010, to 1.4 billion in 2050. Cooperation between health and climate services can trigger measures to better protect people during periods of extreme weather.
- Shifting to clean household energy sources would both reduce climate change, and save the lives of approximately 680 000 children a year from reduced air pollution. The Atlas also shows how meteorological and health services can collaborate to monitor air pollution and its health impacts.
- In addition, the unique tool shows how the relationship between health and climate is shaped by other vulnerabilities, such as those created by poverty, environmental degradation, and poor infrastructure, especially for water and sanitation.
English: Loma Linda University Vegetarian Food Pyramid (Photo credit: Wikipedia)
Posted by acroanmph in Public Health.
Tags: Diet, Disease, Farms, Food, Nutrition, Public health, Sustainable Food
Wednesday, October 24 is Food Day. Join in this second annual national event where thousands of businesses, coalitions and other participants are holding Food Day celebrations to promote healthy, affordable and sustainable food.
Created by the Center for Science in the Public Interest, Food Day has become a movement to increase awareness of the usual unhealthy American diet which is leading to our top three causes of death and other forms of morbidity.
Our nation’s food system is not focused on promoting health, but maintaining agribusiness and food production as cheaply as possible. Fellow blogger, Ellice Campbell of Enlightened Lotus Wellness, just published a worthwhile post, Corn And It’s Stranglehold on the Food Industry. Also, have a look at The Trouble With Corn Subsidies. About 75% of all grocery store food products contain some form of corn (not the sweet kind that we enjoy during the summer) and high fructose corn syrup. This is creating a sugar addiction among our children and is one factor contributing to increased diagnoses of diabetes in adults and children, not to mention obesity. I find this to be an outrage.
What we put into our bodies is 100% up to us! Just because cheap and processed foods are available everywhere we look, does not mean we must succumb to eating them. As one of my blog readers previously commented, “Eat what you want–no one is forcing you not to.” Every time we eat and every thing we eat is completely our choice. I feel this is too fundamental to even blog about, but as a nation, we are clearly not making the best choices.
Of course this has implications beyond personal diet and disease. According to CSPI, only minor amounts of Farm Bill funding support organic and sustainable farms, while the unhealthiest farm producers reap the major funds. We have allowed our government to carry on this way for decades. Food production methods are harmful to workers, animals and the environment.
How will you celebrate Food Day? Click the link for inspiration, activities, recipes and a zip code map to see what is offered in your area. Or, take a page from their school curriculum, eat real around your dinner table and discuss healthy eating and where your food comes from.
Eat Real, y’all. Practice mindful eating and the world will be better off. Really.
From a recent CAPHIS** listserv item
As part of a project funded by the Illinois Coalition for Immigrant and
Refugee Rights (ICIRR) and the State of Illinois, Department of Human
Services, a number of multilingual educational materials are being
They cover nutrition and health during and after pregnancy,
as well as during infancy and early childhood. These resources may be
especially helpful for WIC programs who serve refugee populations. These
free materials are available as web-videos and audio files in English,
Nepali and Burmese. Arabic and Bhutanese versions are under
development. Written handouts for all languages are also under
These new materials can be found under the
Pregnancy/Reproduction and Food/Nutrition topics on the Healthy Roads
Media website – www.healthyroadsmedia.org
As always, any feedback to help guide the development of these kinds
of resources is very helpful.
**CAPHIS (Consumer and Public Health Information Section of the Medical Librarian Association)
has compiled a Top 100 List of Health Websites you can trust.
These lists of resources expand upon the MLA Top Ten List.
Stumbled on this Web site today through Facebook.
While I am still a bit wary of legalizing drugs, I am beginning to see substance abuse as more a public health issue rather than a criminal issue.
At the very least, the current war on drugs needs re-examination.
Count the Costs: 50 Years on the War on Drugs includes related reports in the areas of public health, environment, human rights, crime, and economics.
There is a growing recognition around the world that the prohibition of drugs is a counterproductive failure. However, a major barrier to drug law reform has been a widespread fear of the unknown – just what could a post-prohibition regime look like?
For the first time, ‘After the War on Drugs: Blueprint for Regulation’ answers that question by proposing specific models of regulation for each main type and preparation of prohibited drug, coupled with the principles and rationale for doing so.There is a growing recognition around the world that the prohibition of drugs is a counterproductive failure. However, a major barrier to drug law reform has been a widespread fear of the unknown – just what could a post-prohibition regime look like?
For the first time, ‘After the War on Drugs: Blueprint for Regulation’ answers that question by proposing specific models of regulation for each main type and preparation of prohibited drug, coupled with the principles and rationale for doing so.
From the 10 September 2012 article at the New York Times
Published: September 10, 2012OKLAHOMA CITY — Like a missionary, Michael Bailey, a county health worker, spends his days driving his beat-up Nissan around this city’s poorest neighborhood, spreading the word in barber shops and convenience stores about the benefits of healthy diet and exercise. “Look at the kids,” he said. “Overweight, huffing andwheezing. Their lives will be miserable if this doesn’t change.”
Mike Bailey visited James Harris at his barbershop in Oklahoma City. Mr. Bailey has persuaded residents to enroll in a heart disease prevention program.
Mr. Bailey believes that food is slowly killing his community here, and signing people up for a program to prevent heart disease is his way of saving souls.Local governments across the country are creating dozens of such experiments with money from the Obama administration’s Affordable Care Act. It is part of a broad national effort set in motion by the law to nudge a health care system geared toward responding to illness to one that tries to stop people from getting sick in the first place. To that end, the law created the $10 billion Prevention and Public Health Fund, the largest-ever federal investment in community prevention.Supporters say the effort is long overdue in an age where preventable disease is the single largest cause of death. Indeed, unhealthy behaviors, like smoking
and poor diet, account for 40 percent of premature deaths in the United States, while poor health care and limited access to the health care system accounted for a tenth of such deaths, according to an analysis of federal data and mortality studies by J. Michael McGinnis, a senior scholar at theInstitute of Medicine
But critics say efforts to influence behavior will have only a modest effect without policy measures like taxes on soda and restrictions on marketing to children to change the food environment.
Oklahoma City, run by a Republican mayor, Mick Cornett, has with little notice won federal prevention money through the new law, a surprising source of financing in this deeply conservative Republican state. The governor, Mary Fallin, turned away $54 million in federal money to help prepare for the new law last year.
Republicans in Congress derided the prevention program as “a slush fund to build sidewalks, jungle gyms and swing sets,” but Mr. Cornett has embraced its approach, turning this city — labeled one of the fattest in America in 2007 by Men’s Fitness magazine — into a laboratory for healthy living. In recent years, he has transformed it with bike lanes, walking paths and an Olympic rowing complex. He started a drive called “This City Is Going on a Diet.” He even accepted an invitation from Michelle Obama, who has made childhood obesity her signature cause, to attend the 2010 State of the Union address.
“We don’t believe in individual freedom to the extent of letting people make poor health decisions and just wither away without help,” Mr. Cornett said in an interview.
Many scientists doubt such programs actually work. Only a handful of the dozens of published studies on obesity interventions have produced results, and only when participants were intensively engaged, said Tom Baranowski, a professor of pediatrics at Baylor College of Medicine. “Sending newsletters and calling is not enough,” he said.
But some public health experts say that the kinds of things being tried under the law could help bring a cultural shift. The single biggest behavioral success of the last century — the dramatic reduction in the share of Americans who smoke — took 50 years of education, regulation and medical intervention. Likewise, only a mixture of approaches has a chance of eventually reducing rates of obesity, these experts say.
“Over time all of this effort builds up so people come to think about the problem and their own behavior in a different way,” said Bruce Link, a professor of epidemiology and sociology at the Mailman School of Public Health at Columbia University.
In Oklahoma City, county officials have focused on the least healthy ZIP code — 73111 — a sun-seared stretch of one-story bungalows, fast food restaurants and minimarts. Heart disease mortality rates are 10 times as high as in the healthiest neighborhood, which is next to one of the biggest medical complexes in the state, including a teaching hospital with a large share of charity care.
In addition to the heart program, which offers free medicine and checkups in exchange for taking a health class, the area is getting a new health complex with sports fields and walking trails, and a physical education coordinator for city schools. Public messages against sugary drinks are plastered on buses and benches. Health workers will identify the area’s highest-risk patients, connect them with doctors, and follow up with them after checkups, a measure Gary Cox, director of the county health department, said was designed to reduce emergency room visits.
Thousands of fliers for the heart program were mailed out last year, but there were few takers until Mr. Bailey, the health department worker, began persuading people to sign up in the spring….
From the web page
Using the County Health Rankings and the Georgia Department of Community Affairs county economic rankings, Georgia’s “Partner Up! For Public Health” advocacy campaign has developed a research project and presentation that visually illustrates how Georgia’s economic vitality and population health go hand in hand.
The still-evolving, data-driven narrative has already been presented, along with key observations and policy suggestions from the report, to more than 30 audiences throughout Georgia, including the Georgia Public Health Association, Georgia Rural Health Association, the Georgia Association of Regional Commissions, and a meeting of key state legislative leaders.
AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Care
From a recent email update rec’d from AHRQ (US Agency for Healthcare Research and Quality)
The July 3 issue of AHRQ’s Health Care Innovations Exchange features two profiles of partnerships between clinical practices and community organizations that leverage health provider teams and lay health advisors to improve the management of chronic diseases. One profile describes a public-private initiative that worked with community health teams to improve the delivery of preventive, health maintenance, and chronic care services in Vermont. The pilot program included incentive payments to providers who met National Committee for Quality Assurance-determined care standards, access to an insurer-funded team of community-based health providers, health information incorporated into a Web-based clinical tracking system, and interfaces with other State care coordination initiatives. Over a 4-year period, the pilot program experienced a 6 percent decrease in inpatient admissions and a 10 percent decrease in emergency department visits among participating practices. Select to read more profiles related to clinical-community linkages, including innovations and tools, on the Health Care Innovations Exchange Web site, which contains more than 700 searchable innovations and 1,500 QualityTools.
From the 27 June 2012 article at EurekAlert
Researchers from the World Health Organisation (WHO) and the Barcelona Public Health Agency (ASPB), headed by Catherine Pérez from the Healthcare Information Systems Service, have estimated the yearly economic benefits from a reduction in death rates by substituting at least one short vehicle journey for a walk….
A 2012 study by the RAND Corporation
Resilient communities prepare for, respond to, and recover from natural and man-made disasters. RAND has implemented and evaluated community resilience-building activities worldwide and identified opportunities to integrate governments with the nonprofit and for-profit sectors in public health and emergency preparedness, infrastructure protection, and development of economic recovery programs.
Overall, very good news about one facet (of many I am sure) of Mexico coming into its own..
Hopeful that cooperative efforts as this can reduce mistrust (and often terrible fallouts) among nations.
In my humble opinion, global security is best addressed through cooperation to meet basic human needs as food, potable water, living wages, and access to decent health care. (Pardon, my Peace Corps experience is showing!).
From the HHS news release of May 22, 2012
Health and Human Services (HHS) Secretary Kathleen Sebelius and Mexico Secretary of Health Salomón Chertorivski today announced a series of new steps to strengthen health security cooperation between the two countries. The health secretaries outlined these efforts during the 65th World Health Assembly in Geneva, Switzerland.
“The United States and Mexico have had a long and close relationship in supporting and improving our ability to respond to public health events and emergencies of mutual interest when they arise,” Secretary Sebelius said. “The trade links between our two countries, our common border, and the high degree of trade in food products speak to the need for close bilateral cooperation in health security for both of our nations.”
“It is important to strengthen the programs of regulation and surveillance of medical products and health services on behalf of public health. International collaboration and the development of new strategies will create a more effective process that protects against health risks,” Secretary Chertorivski said. “Mexico is committed to continue working to develop the best tools and procedures for the care and control necessary to maintain the best health possible for the population.”
The two health secretaries signed a declaration formally adopting a shared set of technical guidelines that both countries will follow to respond to public health events and emergencies of mutual interest when they arise. The guidelines describe how the two nations will coordinate the exchange of information, and they complement the International Health Regulations, which call for neighboring countries to develop accords and work together on shared epidemiologic events and public health issues. …
Secretaries Sebelius and Chertorivksi also renewed an agreement between the United States and Mexico that strengthens existing scientific and public health activities related to the regulation of food safety, including products and feed for food-producing animals. This arrangement recommits the two countries to communicate on food safety and to identify areas for coordination and collaboration between several U.S. and Mexican agencies..
Finally, Secretary Sebelius presented Secretary Chertorivksi with a plaque welcoming the Mexican Secretariat of Health’s National Institute of Epidemiological Diagnosis and Reference as a member of CDC’s Laboratory Response Network. Mexico is the fourth country to join the LRN along with Canada, Australia and the United Kingdom. This achievement is a result of Mexico’s upgraded capabilities to respond quickly to acts of biological threats, emerging infectious diseases, and other public health threats and emergencies.
” . . . it is no longer sufficient to expect that reforms in the medical care delivery system (for example, changes in payment, access and quality) alone will improve the public’s health.”
The Institute of Medicine has issued the third and final report of a series on public health that focuses on how altering the fundamental physical and social environment will lead to improved health in the general population, an essential requirement of any effective reform of the system that delivers health care services.
For the Public’s Health: Investing in a Healthier Future addresses its thesis in four chapter:
- Introduction and Context
- Reforming Public Health and Its Financing
- Informing Investment in Health
- Funding Sources and Structures to Build Public Health
The committee responsible for the report also propose ten recommendations, among which are the following:
- Greater legislative/regulatory flexibility in the allocation of funds by state and local health agencies in pursuit of public health improvement initiatives;
- Reduction in the provision of clinical care services by public health agencies so that they can focus on the delivery of population-based services, such as nurse home visits and health promotion activities;
- Development of a model chart of accounts for use by public health agencies to improve their tracking of funds and measuring program effectiveness;
- Doubling the current federal appropriation for public health, with periodic adjustments to ensure public health agencies’ ability to deliver a minimum package of services;
- Reallocation of state and local funds from paying for services currently reimbursed through Medicaid or state health insurance exchanges to financing population-based prevention and health promotion initiatives conducted by public health departments.
Source: Institute of Medicine. For the Public’s Health: Investing in a Healthier Future. Washington, DC: National Academies Press, 2012. Free online edition at:http://books.nap.edu/openbook.php?record_id=13268.
The two previous reports are also available online.
For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges. 2011. http://www.nap.edu/catalog.php?record_id=13093
or the Public’s Health: The Role of Measurement in Action and Accountability. 2010. http://books.nap.edu/openbook.php?record_id=13005
Originally posted on American Hospital Association Resource Center Blog:
” . . . it is no longer sufficient to expect that reforms in the medical care delivery system (for example, changes in payment, access and quality) alone will improve the public’s health.”
The Institute of Medicine has issued the third and final report of a series on public health that focuses on how altering the fundamental physical and social environment will lead to improved health in the general population, an essential requirement of any effective reform of the system that delivers health care services.
For the Public’s Health: Investing in a Healthier Future addresses its thesis in four chapter:
- Introduction and Context
- Reforming Public Health and Its Financing
- Informing Investment in Health
- Funding Sources and Structures to Build Public Health
The committee responsible for the report also propose ten recommendations, among which are the following:
- Greater legislative/regulatory flexibility in the allocation of funds by state and local health agencies in pursuit of public health…
View original 171 more words
From the 23 April 2012 Medical News Today article
To strengthen the public health infrastructure, ACP presents seven public policy positions:
- Position 1: ACP supports investing in the nation’s public health infrastructure. Priority funding should be given to federal, state, tribal, and local agencies that serve to ensure that the health care system is capable of assessing and responding to public health needs. ACP is greatly concerned that recent and proposed reductions in funding for agencies responsible for public health are posing a grave risk to the United States’ ability to ensure the safety of food and drugs, protect the public from environmental and infectious health risks, prepare for natural disasters and bioterrorism, and provide access to care for underserved populations.
- Position 2: In the current economic environment, it is particularly important that federal, state, tribal, and local agencies prioritize and appropriately allocate funding to programs that have the greatest need for funding and the greatest potential benefit to the public’s health. All programs that receive funding should be required to provide an ongoing assessment of their effectiveness in improving population health. ACP recommends that priority for funding be given to programs based on their effectiveness in improving the health of the public.
- Position 3: Having a health care workforce that is appropriately educated and trained in public health related competencies is essential to meet the nation’s health care needs. The education and training of sufficient numbers of physicians, nurses, allied health personnel, clinical scientists, health services researchers, public health laboratorians, and public health practitioners is an important part of the public health infrastructure. Accordingly, priority funding should be devoted to educational and training programs that prepare physicians, nurses, and allied health personnel that are in short supply and that help meet the health care needs of underserved populations.
- Position 4: The public health workforce should educate the public on new health care delivery models and the importance of primary care. It is also important for the public health sector to promote the need to have a doctor or health center so care can be better coordinated.
- Position 5: To address current and looming pharmaceutical therapies and vaccine shortages, the federal government should work with pharmaceutical companies to ensure that there is an adequate supply of pharmaceutical therapies and vaccines to protect and treat the U.S. population.
- Position 6: Programs to inform the public of the benefit of vaccinations for children, adolescents and adults, to counter misinformation about the risks of vaccinations, and to encourage increased vaccination rates, particularly for vulnerable populations, are especially important for the health of the population. Evidence-based educational strategies should be used to influence behavior and increase vaccination rates.
- Position 7: ACP encourages the development and implementation of a comprehensive, nation-wide public health informatics infrastructure, sharable by all public health stakeholders. This will require significant investments in new and improved technologies, standards, methodologies, human resources, and education.
From the April 2012 edition of The Nation’s Health
byTeddi Dineley Johnson
In Louisville, Ky., some liquor retailers are taking down alcohol ads that once covered their exterior walls. In Chula Vista, Calif., long-vandalized utility boxes are being painted and transformed into works of art. And in a Denver neighborhood, youths at risk for gang violence are sowing seeds of hope in a community garden.
On the surface, the three scenarios might appear to lack a common thread, but joining them is an emerging public health movement that brings practitioners in the fields of violence prevention, healthy eating and active living together to transform their communities in ways that will foster health and safety.
At its core, the work aims to get to the root cause of why some people are not going outside to exercise and not eating healthy foods, said Mighty Fine, MPH, CHES, a public health practice manager in APHA’s Center for Professional Development.
“Promoting healthy eating and physical activity are front and center on the nation’s public health agenda, but people who feel unsafe in their communities are less likely to go outside for walks, take their children to parks or use community centers or services such as public transportation,” Fine said. “And to make matters worse, grocery stores are reluctant to locate in communities in which people feel unsafe, which limits residents’ access to healthy foods.”
Until recently, the connection between violence and health outcomes has not been intuitively apparent to the public health community, and the lack of attention has prevented some people from living a healthy lifestyle, Fine said….
In thanks to all public health professionals and staff do every day, here are some links to information and preventative measures for us all to use and spread.
Active Living and Healthy Eating
Promote healthy choices in your communities, such as bike lanes and farmer’s markets. Learn more >
Alcohol, Tobacco and Other Drugs
Identify alcohol and drug use disorders early to reduce high-risk alcohol and drug consumption. Learn more >
Encourage proper hand-washing and food preparation habits. Learn more >
Reproductive and Sexual Health
Practice safe sex, encourage responsible contraception behavior and promote access to preventive health services. Learn more >
Mental and Emotional Well-Being
Refer people with signs of depression and suicidal thinking to appropriate resources and help centers. Learn more >
From the 28 March 2011 Eureka news alert
WASHINGTON — The traditional separation between primary health care providers and public health professionals is impeding greater success in meeting their shared goal of ensuring the health of populations, says a new report from the Institute of Medicine. Integration of these fields will require national leadership as well as substantial adaptation at the local level, said the committee that wrote the report.
[ The report is free and available at http://www.iom.edu/Reports/2012/Primary-Care-and-Public-Health.aspx
The above link also includes a briefing slides (an overview) and a report brief.]
The report recommends ways that the Centers for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) could foster integration between primary care and public health through funding, policy levers, and other means. Collaboration presents an opportunity for both primary care and public health to extend their reach and achieve the nation’s population health objectives, the committee noted.
The committee’s recommendations are based on its review of published papers as well as case studies in specific cities — Durham, N.C.; New York City; and San Francisco — where integration efforts have taken place. The review showed that successful integration of primary care and public health requires community engagement to define and tackle local population health needs; leadership that bridges disciplines and jurisdictions and provides support and accountability; shared data and analyses; and sustained focus by partners.
The Patient Protection and Affordable Care Act (ACA) authorizes HRSA and CDC to launch several new programs. The agencies should coordinate these programs and funding streams with other partners at the national, state, and local levels to spur momentum. Promising opportunities include building incentives to promote interactions with local public health departments into HRSA’s funding for community health centers; encouraging hospitals to treat primary care and community health as priorities as they strive to earn federal tax exempt status through demonstrated community benefits; and fostering collaboration among health departments and community health centers to improve the provision of preventive clinical services to Medicaid recipients.
The medical home model and the new accountable care organizations (ACOs) established by ACA also offer opportunities for integration. As more primary care practices move toward the patient-centered medical home model, public health departments could work with these practices and spread the benefits of care coordination to the community, the committee said. As ACOs — groups of hospitals and clinicians that work together to provide primary care and other health care services to Medicare beneficiaries — begin operating, they should reach out to health departments to forge links to community programs and public health services.
Training primary care and public health professionals in aspects of each other’s fields will help promote a more integrated work force, the report adds. HRSA and CDC should work together to develop training grants and teaching tools that can prepare the next generation of health professionals for shared practice. For example, HRSA should use its Title VII and VIII primary care training programs to support curriculum development and training opportunities that involve aspects of public health, and CDC’s Epidemic Intelligence Service officers could assist HRSA-supported community health centers in using public health data to guide the care they provide.
“While integrating fields that have long operated separately may seem like a daunting endeavor, our nation has undertaken many major initiatives, such as building both a national hospital system and an extensive biomedical research infrastructure and significantly expanding high-tech clinical capacity through investments in specialty medicine,” said committee chair Paul J. Wallace, senior vice president and director, Center for Comparative Effectiveness Research, The Lewin Group, Falls Church, Va. “It’s time we did the same for primary care and public health, which together form the foundation of our population’s overall well-being. Each of these foundational elements could be stronger if they were better coordinated and collaborated more closely.”
The report was sponsored by the Centers for Disease Control and Prevention, Health Resources and Services Administration, and United Health Foundation. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The Institute of Medicine, National Academy of Sciences, National Academy of Engineering, and National Research Council together make up the independent, nonprofit National Academies. For more information, visit http://national-academies.org or http://iom.edu. A committee roster follows.
From KevinMD.com, Mon Feb 13, 2012
I have decided to spam for public health.
Phone calls, text messaging, and even apps have been shown to help improve health and sustain behavior change, even in people suffering from profound mental illness. But when it comes to using these tools for public health, there are two problems. The first is that each message (whether via phone call or text) costs money. The second is that it’s quite hard to use those platforms for blasting messages to a whole population.
Read the rest of Using Twitter to deliver health improvement messages on KevinMD.com.
From the 8 February 2012 Eureka News Alert
New community health approach aims to combats chronic disease, empower patients, reduces costs
Value of Accountable Care Community approach to public health promotion and disease prevention outlined in new paper released today
AKRON, Ohio, February 8, 2012 – A new community-wide collaboration to reduce the impact of chronic disease and empower patients is generating impressive early results, leaders of the Accountable Care Community (ACC) initiative said today. The Akron-based Austen BioInnovation Institute in Akron (ABIA) is leading the initiative with its founding institutional members and more than 60 public and private community partners.
The groundbreaking effort supported by the Centers for Disease Control and Prevention unites medical, public health and social science professions, nonprofits and faith-based and community organizations for an “all-hands-on-deck” approach to public health. Eventually, communities across the country will be able to apply this new model toward public health, reducing the tremendous negative impact chronic disease has on their economies, said Dr. Janine Janosky, head of ABIA’s Center for Community Health Improvement, who is leading the effort described in a white paper released today.
The news comes just weeks after an Institute of Medicine report called for a new public health approach based on “enhanced collaboration among the public health, health care and community non-healthcare sectors” to address the challenges of chronic disease. The World Health Organization refers to the growing impact of chronic disease as “a global epidemic” reaching crisis levels. The Robert Wood Johnson Foundation estimates that by 2030, half the U.S. population will have at least one chronic condition.
The ABIA, along with national experts and more than 60 Akron organizations, have been collaborating for more than a year on a new, integrated, and measurable strategy to community health that could be replicated in other U.S. communities. The ACC approach detailed in the report “Healthier by Design: Accountable Care Community” utilizes a unique “impact equation” that measures the benefits of a seamless approach to community health, including metrics for a patient empowerment and market value of health, said Dr. Frank L. Douglas, ABIA president and chief executive officer.
“The amount spent on healthcare and health initiatives in the United States should translate into good health for the community and its residents. Unfortunately, America’s public health continues to lag behind other nations. Further, we are now in an era of debate about how to reverse the unsustainable cost trends and improve the health outcomes and quality of life for our fellow man,” Dr. Douglas said. “The development of this inventive Accountable Care Community model, which not only speaks of the need for collaboration but actually enables all parties to be on the same page with an integrated, measurable strategy, promises to improve the health of millions of patients.”
In Akron, the ACC approach uniquely aligns public, private and philanthropic resources in a coordinated fight to improve community health by identifying and closing gaps in health education, access and delivery. The group’s initial pilot project focused on diabetes self-management. Ultimately, participants changed their behaviors and took increased control over their disease. Significant results included decreases in blood sugar and bad cholesterol levels, weight loss, decreased body mass, and a decline in emergency room visits. An additional program demonstrated nearly a total of $225,000 of cost savings or cost avoidance for local healthcare institutions through the use of volunteers and community services to monitor and serve low-income, medically underserved patients with diabetes….
Original source —>healthcaremanagementdegree.com
Jennica Rhee is a graduate of the University of Washington with degrees in Political Science and Communication.
She may be found at LinkedIn and Twitter.
- Bicycle Commuting (Library Guide by Librarian Michael Unsworth at Michigan State Univerity)
- Urban Design and Planning – Bicycle Commuting (Library Guide by Librarian Alan Michelson at the University of Washington)
- National Report Ranks Cities and States for Bicycling and Walking (2012 Benchmarking Report reveals new information on levels, safety, funding)
“The report compiles persuasive evidence that bicycle and pedestrian projects create more jobs than highway projects, and provide at least three dollars of benefit for every dollar invested. The report also highlights the health benefits of active transportation, showing that states with the highest rates of bicycling and walking are also among those with the lowest rates of obesity, diabetes, and high blood pressure. “The data points to one conclusion: Investing in biking and walking projects creates jobs, leads to more people biking and walking, and improves safety and public health,” Miller says.”
Related Articles/Blog Items
From the Blog…Health Data Tools and Statistics on PHPartners.org | Health Information Literacy – for health and well being.
The following was posted on the BHIC Blog; Sep 11, 2011 10:26 PM by Cheryl Rowan
The Health Data Tools and Statistics page (http://phpartners.org/health_stats.html) on the PHPartners website (http://phpartners.org) website has been reorganized to make public health data and statistics easier to find and use.
The page has been reorganized so that links to County and Local Health Data now appear at the top of the page. In addition, several new categories have been added.
The Partners in Information Access for the Public Health Workforce (PHPartners) is a collaboration of U.S. government agencies, public health organizations, and health science libraries.
Before and after example of greened vacant lots. (Credit: Image courtesy of University of Pennsylvania School of Medicine)Rehabilitating vacant lots improves urban health and safety.
ScienceDaily (2011-11-17) — Greening of vacant urban land may affect the health and safety of nearby residents. In a decade-long comparison of vacant lots and improved vacant lots, greening was linked to significant reductions in gun assaults across most of Philadelphia and significant reductions in vandalism in one section of the city. Vacant lot greening was also associated with residents in certain sections of the city reporting significantly less stress and more exercise.
Read the entire article at Rehabilitating vacant lots improves urban health and safety.