Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Website] Social Impact Calculator

The Social Impact Calculator is “a new tool that allows you to put a dollar value on the benefits of things like an affordable home, a great school or access to transit.”

Screen Shot 2015-03-03 at 5.11.21 AM

From the 13 January 2015 blog post at Investing in Community Change

The Low Income Investment Fund (LIIF) has created the Social Impact Calculator – a tool that allows you to put a dollar value to the impact of capital investments.

LIIF is a community development financial institution (CDFI) that invests in capital projects in low income communities in an effort to provide families with access to healthy, green and economically strong places to live. Using the Social Impact Calculator, LIIF is able to monetize the impact of capital investments in communities — such as funding for housing, child care centers and charter schools — and assess how well its investments are creating opportunities and reducing inequities in communities.

How does it work? The Social Impact Calculator estimates social returns using research and translating data into monetary values. For example, investments in affordable housing can create discretionary income for families by reducing the burden of housing costs. Those savings can be used by families to cover additional needs, such as food and healthcare. Similarly, as suggested by research, investing in high-performing schools can increase a child’s lifetime earnings while also reducing costs associated with incarceration.

LIIF has made the Social Impact Calculator available to the public and invites communities to explore how they might use the calculator to assess their own efforts. In addition, LIIF invites you to provide feedback about the Social Impact Calculator.

 

 

March 3, 2015 Posted by | Public Health | , , , , | Leave a comment

[Repost] Investigating the health impacts of fracking

For anyone looking for in depth vetted resources.
From the 23 February 2015 post at Covering Health (Association of Health Care Journalists)

he fracking controversy has been high profile in recent years, and tempers are short on all sides of the subject. Some groups see natural gas and the process used to extract it – hydraulic fracturing, or “fracking” – as a boon to energy production in the U.S., while others see it as a pernicious threat to people and the environment.

As shown in this New York Times interactive infographic, fracking (sometimes called “unconventional gas drilling”) is a complicated process. It involves high-pressure injection of fluids into natural gas reserves that lie thousands of feet underground, trapped in layers of shale. In addition, there’s a landslide of conflicting information and anecdotal evidence.

So, as a reporter, how do you sift through the various interests and pull out a story that is relevant to your community?

…..

February 25, 2015 Posted by | Public Health | , , , | Leave a comment

[News article] Middle East Mystery Disease Triggers Early Resurgence

From the 20 February 2015 Scientific American article

English: Saudi Arabia

English: Saudi Arabia (Photo credit: Wikipedia)

International health experts head to Saudi Arabia to help determine why MERS cases are soaring again

Infectious disease watchers are again wondering what is going on in Saudi Arabia. Since the beginning of February the Saudis have reported 52 cases of Middle East respiratory syndrome—better known as MERS; 40 have come to light in the past week or so alone. Since the disease first hit the world’s radar in September 2012 only two months have racked up more cases than this one has. They were April and May 2014, when Saudi Arabia had rampantMERS outbreaks in several hospitals.*

An expert delegation from the United Nation’s human and animal health agencies began a three-day mission to the Arabian Peninsula’s geographically largest country Wednesday, trying to get to the bottom of why MERS cases are soaring.

This is the time of year in which the number of MERS cases has climbed in the past, although not enough time has elapsed to make clear whether that pattern will continue. In the past two springs large hospital outbreaks in Saudi Arabia have certainly created the appearance of a high season for MERS transmission, which some scientists believe exists and is linked to the birth and weaning of young camels. The animals are known to be susceptible to the virus and can transmit it to people.


According to the daily updates posted online by the Saudi health ministry, most of the recent cases—unlike during past surges—did not report contact with camels or with other people infected with MERS—either in the community or in a hospital setting. “It seems quite a few are not health care associated,” says Koopmans…

 

February 22, 2015 Posted by | Public Health | , | Leave a comment

[Reblog] Going Viral: The Re-Emergence of Preventable Diseases

From the 19 February 2015 post at Policy Interns

From an aging population to the growing threat of pandemic influenza and other emerging infectious diseases as well as the rapid growth of obesity and other chronic illnesses, the most persistent and costly challenges to American health and well-being fall increasingly on the public health system and on public health professionals at all levels. Unlike health care, which often intervenes when an individual is already sick with a costly disease, the focus of public health is prevention rather than treatment of diseases. Public health professionals, working with state and local health departments, laboratories, and other public health organizations, play a vital and increasingly central role in protecting a population’s health. Yet the Center for Disease Control (CDC) and other public health observers have repeatedly identified deficiencies in public health infrastructure and workforce.

Regional interstate planning, preparing for mass vaccination and the distribution of medical supplies, and development of adequate surge capacity are incomplete or insufficient. The Government Accountability Office concluded in 2004 that “no State is fully prepared to respond to a major public health threat,” an assessment that the CDC reiterated in 2008.

PH expenditures

One might look at Figure 1 and think, where are the lines for public health expenditures on federal, state, and local levels? They’re there, almost completely parallel to the x-axis. Federal public health spending underperformed a number of other U.S. health sector expenditure categories overall. As a percentage of all U.S. health expenditures, federal public health spending was lower in 2008 than it was in 1966. To make matters worse, the Fiscal Year 2015 request proposes a $51 million decrease for the immunization program due to an expectation of increased insurance coverage for immunization services in 2015. This is yet another cut to public health spending that will undoubtedly affect population health.

Program operations, which contribute to disease surveillance, public awareness and provider education, took a $14 million cut.

While proponents of the ACA said the majority of the proposed fiscal 2016 cuts again will go toward vaccine purchasing and won’t affect immunization infrastructure funds, this cannot be the whole picture. The families and children currently using these programs will be in jeopardy because insurance coverage alone is not enough to ensure high vaccination rates.

February 22, 2015 Posted by | Public Health | , , , , , | Leave a comment

[Report] Lifetime Job Demands, Work Capacity at Older Ages, and Social Security Benefit Claiming Decisions

From the Center for Retirement Research at Boston College  

We use Health and Retirement Study data linked to the Department of Labor’s O*Net classification system to examine the relationship between lifetime exposure to occupational demands and retirement behavior. We consistently found that both non-routine cognitive analytic and non-routine physical demands were associated with worse health, earlier labor force exit, and increased use of Social Security Disability Insurance. The growing share of workers in jobs with high levels of cognitive demand may contribute to growth in DI use.

February 19, 2015 Posted by | Public Health | , , , , , , , , , | Leave a comment

[Press release] Large numbers of teenage girls experience sexual coercion in relationships | EurekAlert! Science News

Large numbers of teenage girls experience sexual coercion in relationships 

Generic image of a teenage girl

From the 11 February 2015 from Bristol University

More than four in ten teenage schoolgirls in England* have experienced sexual coercion, new research by University of Bristol academics launched today [11 February] reveals. Most were pressured to have sex or other sexual activity, and in some cases, this included rape. And many of the 13-17-year-olds had also suffered physical attacks, intimidation or emotional abuse from their boyfriends.

The study also found that a high proportion of teenage boys regularly viewed pornography and one in five harboured extremely negative attitudes towards women.

The research in England was undertaken between 2013-2015 by a team of researchers from the Universities of Bristol and Central Lancashire. The study, was also carried out in Norway, Italy, Bulgaria and Cyprus as well as England.  It is one of the biggest of its kind ever undertaken in Europe, involving a school-based survey of 4,500 children and 100 interviews with young people

 

February 15, 2015 Posted by | Public Health | , , , , , | Leave a comment

[Report] Women and Girls at Risk of Female Genital Mutilation/Cutting in the United States

English: updated prevalence of FGM in Africa

English: updated prevalence of FGM in Africa (Photo credit: Wikipedia)

From the February 2015 Population Reference Bureau report

The Population Reference Bureau (PRB) data included in this data brief are preliminary. A new Centers for Disease Control and Prevention (CDC) report on female genital mutilation/cutting in the United States also will be released soon, providing additional information on women and girls at risk.

(February 2015) Female genital mutilation/cutting (FGM/C), involving partial or total removal of the external genitals of girls and women for religious, cultural, or other nonmedical reasons, has devastating immediate and long-term health and social effects, especially related to childbirth. This type of violence against women violates women’s human rights. There are more than 3 million girls, the majority in sub-Saharan Africa, who are at risk of cutting/mutilation each year. In Djibouti, Guinea, and Somalia, nine in 10 girls ages 15 to 19 have been subjected to FGM/C. Some countries in Africa have recently outlawed the practice, including Guinea-Bissau, but progress in eliminating the harmful traditional practice has been slow.1 Although FGM/C is most prevalent in sub-Saharan Africa, global migration patterns have increased the risk of FGM/C among women and girls living in developed countries, including the United States.

Increasingly, policymakers, NGOs, and community leaders are speaking out against this harmful traditional practice. As more information becomes available about the practice, it is clear that FGM/C needs to be unmasked and challenged around the world.

The U.S. Congress passed a law in 1996 making it illegal to perform FGM/C and 23 states have laws against the practice.2 Despite decades of work in the United States and globally to prevent FGM/C, it remains a significant harmful tradition for millions of girls and women. In the last few years, renewed efforts to protect girls from undergoing this procedure globally and in immigrant populations have resulted in policy successes. In Great Britain and in other European countries, a groundswell of attention has focused on eradicating the practice among the large immigrant populations of girls and women who have been cut or are at risk of being cut. Moreover, in 2012 the 67th session of the UN General Assembly passed a resolution urging states to condemn all harmful practices that affect women and girls, especially FGM/C. The UN resolution was a significant step toward ending the practice around the world.

In the United States, efforts to stop families from sending their daughters to their home countries to be cut led to a 2013 law making it illegal to knowingly transport a girl out of the United States for the purpose of cutting. FGM/C has gained attention in the United States in part because of the rising number of immigrants from countries where FGM/C is prevalent, especially sub-Saharan Africa. Between 2000 and 2013, the foreign-born population from Africa more than doubled, from 881,000 to 1.8 million.3

The Risk of FGM/C in the United States

In 2013, there were up to 507,000 U.S. women and girls who had undergone FGM/C or were at risk of the procedure, according to PRB’s preliminary data analysis. This figure is more than twice the number of women and girls estimated to be at risk in 2000 (228,000).4 The rapid increase in women and girls at risk reflects an increase in immigration to the United States, rather than an increase in the share of women and girls at risk of being cut. The estimated U.S. population at risk of FGM/C is calculated by applying country- and age-specific FGM/C prevalence rates to the number of U.S. women and girls with ties to those countries. A detailed description of PRB’s methods to estimate women and girls at risk of FGM/C is available.

February 10, 2015 Posted by | Consumer Health, Public Health | , , , , , | Leave a comment

[Report] Mortality Among Blacks or African Americans with HIV Infection (is declining) — United States, 2008–2012

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L0052223 A circle incorporating the words \’African American againstCredit: Wellcome Library, London. Wellcome Imagesimages@wellcome.ac.uki mages.wellcome.ac.uk A circle incorporating the words \’African American against AIDS\'; advertisement by the Sacramento County Department of Health and Human Services. Colour lithograph.

 

From the 6 February 2015 MMWR article

…The results of these analyses indicate that black persons living with HIV experienced higher numbers and rates of deaths during 2008–2012 than other races/ethnicities. However, the numbers and rates of death declined consistently during the same period. The death rate per 1,000 persons living with HIV among blacks decreased 28% during 2008–2012, more than the overall decline (22%) seen among all persons living with HIV. Other than among blacks, such a consistent decline was observed only among Hispanics or Latinos…

February 9, 2015 Posted by | Public Health | , , , , | Leave a comment

[Reblog] Climate Change – Public Health’s Next Challenge

 

Projected_impact_of_climate_change_on_agricultural_yields_by_the_2080s,_compared_to_2003_levels_(Cline,_2007)

EEA (14 December 2010): Projected impact of climate change on agricultural yields. European Environment Agency, Copenhagen, Denmark. Last modified September 5, 2011.

 

From the 7 February 2015 post at thefeverblog – what’s hot in public health

….The world is at a dire turning point in the fight against climate change. If the world doesn’t begin taking action to mitigate the impact of climate change the outcomes will be catastrophic (even though some research is saying that’s going to happen, regardless).

A growing discussion in the United States is how we are equipping future citizens, business leaders, health leaders, etc. to be part of the solution to reducing greenhouse gas emissions and mitigating those risks. But according to my preliminary research in climate change science being integrated into science curriculum, we aren’t doing that at all. From personal experience with a Bachelors of Science in Applied Sciences in Public Health, I have never had a professor talk about climate change nor talk about solutions and how we as public health professionals fit into different roles. If young adults and children aren’t aware of climate change, how is it ever going to be brought to the forefront of discussion? How is change going to happen? Sure, federal and state governments can use the power of public policy to control emissions, but what about the solutions to the inevitable problem looming? Solutions such as emergency preparedness planning (since we can safely assume this is going to be a needed expertise), green space, active transportation, infrastructure to prevent rising sea levels from flooding major cities, etc.

As progressive public health departments move towards allocating resources to chronic disease prevention (and obviously, rightfully so), it will be incredibly important to ensure emergency preparedness, epidemiology, and environmental health aren’t lost in the mix. Professionals in health communications and community engagement will be critical pieces, but ultimately don’t have the legal authority of an Environmental Health professional to enforce state and federal mandates, nor have the expertise in emergency preparedness. This is a call for sustained and increased funding for local health departments. The climate change discussion is happening internationally and on a federal level, but those discussions aren’t trickling down to the local level. I would attribute this to climate change being a backburner issue and one that doesn’t have an acute impact (like an Ebola outbreak). The impacts are longitudinal and over long periods of time.

February 9, 2015 Posted by | environmental health, Public Health | , , | Leave a comment

[Magazine article] Reducing Lifestyle Diseases Means Changing Our Environment

 

From the 5 February 2015 Scientific American article

How and why our bodies are poorly suited to modern environments—and the adverse health consequences that result—is a subject of increasing study. A new book The Story of the Human Body by Daniel Lieberman, chair of the Department of Human Evolutionary Biology at Harvard, chronicles major biological and cultural transitions that, over the course of millions of years, transformed apes living and mating in the African forests to modern humans browsing Facebook and eating Big Macs across the planet.

“The end product of all that evolution,” he writes, “is that we are big-brained, moderately fat bipeds who reproduce relatively rapidly but take a long time to mature.”

But over the last several hundred generations, it has been culture—a set of knowledge, values and behaviors—not natural selection, that has been the more powerful force determining how we live, eat and interact. For most of our evolutionary history, we were hunter-gatherers who lived at very low population densities, moved frequently and walked up to 10 miles a day in search of food and water. Our bodies evolved primarily for and in a hunter-gatherer lifestyle.

….

 

Read the entire article here

 

February 7, 2015 Posted by | Consumer Health, Public Health | , , , , | Leave a comment

How mobile is transforming healthcare: Report

Janice Flahiff:

Immediately thought of my Liberian FB friends, a nurse and dean at a community college, a healthcare screener upcountry in a small town (my Peace Corps site back in 1980/81), and a Methodist deacon (one of my former students). All went above and beyond the call of duty during the Ebola crisis.
Back in 2009 I participated in a service project group in Liberia. Was taken aback by noticing that at least half of those over 18 seemed to have cell phones. Believed this was quite good. The roads overall are pretty bad, unpaved, and nearly impassible during the 3 month rainy season. So the cell phones really keep people connected, and relay information well. I get rather irked when I read comments (FB, editorials, etc) that say poor people should not have cell phones. Well, I strongly disagree, overall I believe they save money (think transportation costs for many information needs at the least!). How arrogant for some of “the haves” to believe “the have nots” are not using their scarce resources wisely.
Not sure what I can do to advance mobile health in Liberia, but I will do what I can.
Thanks for posting this, I have forwarded this to my Liberian FB friends. Most likely stuff they already know. The deacon obtained his PhD in theology in DC, the nurse/deacon is very aware of technology, and the healthcare screener is from Nigeria and has a good education and is very much a world citizen.

Originally posted on ScienceRoll:

The Economist came up with a report about How mobile is transforming healthcare including infographics and analyses. You can download the report here.

According to a new survey, mobile technology has the potential to profoundly reshape the healthcare industry, altering how care is delivered and received.

Executives in both the public and private sector predict that new mobile devices and services will allow people to be more proactive in attending to their health and well-being.

These technologies promise to improve outcomes and cut costs, and make care more accessible to communities that are currently underserved. Mobile health could also facilitate medical innovation by enabling scientists to harness the power of big data on a large scale.

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February 7, 2015 Posted by | Public Health | , , , , , , | Leave a comment

[Medical Journal Editorial] Using Drugs to Discriminate — Adverse Selection in the Insurance Marketplace

From the Perspective article by Douglas B. Jacobs, Sc.B., and Benjamin D. Sommers, M.D., Ph.D.at the 5 Feburary edition of the New England Journal of Medicine

Eliminating discrimination on the basis of preexisting conditions is one of the central features of the Affordable Care Act (ACA). Before the legislation was passed, insurers in the nongroup market regularly charged high premiums to people with chronic conditions or denied them coverage entirely. To address these problems, the ACA instituted age-adjusted community rating for premiums and mandated that plans insure all comers. In combination with premium subsidies and the Medicaid expansion, these policies have resulted in insurance coverage for an estimated 10 million previously uninsured people in 2014.1

There is evidence, however, that insurers are resorting to other tactics to dissuade high-cost patients from enrolling. A formal complaint submitted to the Department of Health and Human Services (HHS) in May 2014 contended that Florida insurers offering plans through the new federal marketplace (exchange) had structured their drug formularies to discourage people with human immunodeficiency virus (HIV) infection from selecting their plans. These insurers categorized all HIV drugs, including generics, in the tier with the highest cost sharing.2

Insurers have historically used tiered formularies to encourage enrollees to select generic or preferred brand-name drugs instead of higher-cost alternatives. But if plans place all HIV drugs in the highest cost-sharing tier, enrollees with HIV will incur high costs regardless of which drugs they take. This effect suggests that the goal of this approach — which we call “adverse tiering” — is not to influence enrollees’ drug utilization but rather to deter certain people from enrolling in the first place.

We found evidence of adverse tiering in 12 of the 48 plans — 7 of the 24 plans in the states with insurers listed in the HHS complaint and 5 of the 24 plans in the other six states (see theSupplementary Appendix for sample formularies). The differences in out-of-pocket HIV drug costs between adverse-tiering plans (ATPs) and other plans were stark (seegraphAverage HIV-Related Costs for Adverse-Tiering Plans (ATPs) versus Other Plans.). ATP enrollees had an average annual cost per drug of more than triple that of enrollees in non-ATPs ($4,892 vs. $1,615), with a nearly $2,000 difference even for generic drugs. Fifty percent of ATPs had a drug-specific deductible, as compared with only 19% of other plans. Even after factoring in the lower premiums in ATPs and the ACA’s cap on out-of-pocket spending, we estimate that a person with HIV would pay more than $3,000 for treatment annually in an ATP than in another plan.

Our findings suggest that many insurers may be using benefit design to dissuade sicker people from choosing their plans. A recent analysis of insurance coverage for several other high-cost chronic conditions such as mental illness, cancer, diabetes, and rheumatoid arthritis showed similar evidence of adverse tiering, with 52% of marketplace plans requiring at least 30% coinsurance for all covered drugs in at least one class.3 Thus, this phenomenon is apparently not limited to just a few plans or conditions.

Adverse tiering is problematic for two reasons. First, it puts substantial and potentially unexpected financial strain on people with chronic conditions. These enrollees may select an ATP for its lower premium, only to end up paying extremely high out-of-pocket drug costs. These costs may be difficult to anticipate, since calculating them would require knowing an insurer’s negotiated drug prices — information that is not publicly available for most plans.

Second, these tiering practices will most likely lead to adverse selection over time, with sicker people clustering in plans that don’t use adverse tiering for their medical conditions.

Read the entire Perspective here

February 6, 2015 Posted by | Consumer Health, Public Health | , , , , , , | Leave a comment

[Report] Investing in the Health of Young Adults

From the 30 October 2014 Institute of Medicine Report

Young adulthood—ages approximately 18 to 26—is a critical period of development with long-lasting implications for a person’s economic security, health, and well-being.

Recognizing the need for a special focus on young adulthood, the Health Resources and Services Administration and the Office of the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services, the Robert Wood Johnson Foundation, The Annie E. Casey Foundation, and the Department of Defense commissioned the Institute of Medicine (IOM) and National Research Council (NRC) to convene a committee of experts to review what is known about the health, safety, and well-being of young adults and to offer recommendations for policy and research.

The resulting report, Investing in the Health and Well-Being of Young Adults, offers federal, state, and local policy makers and program leaders, as well as employers, nonprofit organizations, and other community partners’ guidance in developing and enhancing policies and programs to improve young adults’ health, safety, and well-being. In addition, the report suggests priorities for research to inform policies and programs for young adults.

 

Related report –> 2014 Consumer Health Mindset (Aon Hewitt,)
Excerpt from Full Text Reports

From press release:

A new analysis from Aon Hewitt, the global talent, retirement and health solutions business of Aon plc (NYSE:AON) finds that Millennials put a lower priority on medical care than other generations. However, they are the most likely to want employers to play an active role in supporting their overall health and wellbeing.

The analysis is based on data from the 2014 Consumer Health Mindset report, a joint survey of more than 2,700 U.S. employees and their dependents conducted by Aon Hewitt, the National Business Group on Health and The Futures Company. Aon Hewitt analyzed the perspectives, behaviors and attitudes of employees from different generations towards health and wellness.

According to the analysis, Millennials are the least likely to participate in activities focused on prevention and maintaining or improving physical health compared to other generations. About half (54 percent) have had a physical in the last 12 months, compared to 60 percent of Generation X and 73 percent of Baby Boomers. In addition, just 39 percent say preventive care is one of the most important things to do to stay healthy, compared to 49 percent of Generation X and 69 percent of Baby Boomers.

Millennials are also less likely to participate in a healthy eating/weight management programs (21 percent), compared to Generation X (23 percent) and Baby Boomers (28 percent). Interestingly, they are the most likely generation to engaging in regular exercise (63 percent), compared to 52 percent of Generation X and 49 percent of Baby Boomers.

February 6, 2015 Posted by | Consumer Health, Public Health | , , , , , , , , , , | Leave a comment

[Reblog] Health is Life

From the 2 February 2015 post at the Health Care Blog by By ALEXANDRA DRANE

The literature is clear – when life goes wrong, health goes wrong. Case in point – it’s now estimated that workplace stress alone is causing additional expenditures of between $125 to $190 billion a year – representing 5 to 8 percent of national spending on health care…and even more importantly – 120,000 deaths a year.

There are growing examples of individuals and organizations that get this stuff – and that are fielding solutions to help. Companies like Health Leads (meeting us on the lowest rung of Maslow’s Hierarchy and getting us access to heat, water, safety…), and Iora Health (meeting us squarely where we are and getting us support for our caregiver stress, our divorce, our substance issue…). I recently got to be part of the latest Robert Wood Johnson Foundation’s Pioneering Ideas Podcast (link below) and in the process learned how broadly this idea is spreading…Dr. Paul Tang of linkAges from Palo Alto Medical Foundation(a project RWJF supports) talks about stress, and its effects – especially on seniors – and what we can do about it. Harvard economist/MacArthur Genius Grant winner Sendhil Mullainathan shares ideas for transforming health and healthcare in a world where ‘attentional real estate’ – given the messy realities of life – is scarce.  We double dog dare you to listen here:

As an industry with a mantra to heal, this is ground zero. We need to expand our definition of health to include life – and take this on not just as our obligation, but as our opportunity to address the fundamental drivers of health. And let’s not stop there. Let’s practice radical empathy with each other, and with ourselves. Let’s do it in the privacy of our homes, and let’s bring that raw authenticity with us to our work. Whatever you do to start acknowledging that health is life – start it now… maybe just by closing your eyes and inhaling a big fat breath of fresh air while reminding yourself, ‘I am not alone in this crazy world, because we all feel alone and on some level we are all crazy – but only in the very best of well-intentioned ways.’

February 6, 2015 Posted by | Consumer Health, Public Health, Workplace Health | , , | Leave a comment

[Reblog] Women’s Health Issues: Special Collection on Women’s Heart Health | Full Text Reports…

Women’s Health Issues: Special Collection on Women’s Heart Health | Full Text Reports….

Women’s Health Issues: Special Collection on Women’s Heart Health

February 3, 2015

Special Collection on Women’s Heart Health
Source: Women’s Health Issues

For American Heart Month 2015, the editorial team at Women’s Health Issues has assembled a special collection of research on women’s cardiovascular health published in the journal since mid-2011, following the release of updated American Heart Association guidelines on the prevention of cardiovascular disease in women. The articles address healthcare services for women at risk for cardiovascular disease; social determinants of health; and physical activity in specific populations of women.

These articles will be accessible for free during the month of February 2015 so that they are available to a wider interested audience.

February 5, 2015 Posted by | Consumer Health, Public Health | , | Leave a comment

[press release] One in three people would risk shorter life rather than take daily pill to avoid heart disease

Study does not address why, which I would really like to know!
My cholesterol is high, but I do not take a statin, against the advice of the doctor. Still not convinced they work after reading several evidence based biomedical journal articles. But I admit I am not consistent. Am exercising and watching what I eat.

heart_disease_1

From the 3 February 2015 American Heart Association press release

Study Highlights

  • In a survey, one in three adults say they would risk living a shorter life rather than taking a daily pill to prevent cardiovascular disease.
  • About one in five say they were willing to pay $1,000 or more to avoid taking a daily pill for the rest of their lives.
  • Most respondents weren’t willing to trade any weeks of life to avoid daily medication.

Embargoed until 3 p.m. CT/4 p.m. ET Tuesday, Feb. 3, 2015

DALLAS, Feb. 3, 2015 — One in three people say they would risk living a shorter life instead of taking a daily pill to prevent cardiovascular disease, according to new research inCirculation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

Researchers at the University of California San Francisco (UCSF) and the University of North Carolina at Chapel Hill surveyed 1,000 people (average age 50) via the Internet hypothetically asking how much time they were willing to forfeit at the end of their lives to avoid taking daily medication. They were also asked the amount of money they would pay and the hypothetical risk of death they were willing to accept to avoid taking medications to prevent cardiovascular disease.

The survey showed:

  • More than 8 percent of participants were willing to trade as much as two years of life to avoid taking daily medication for cardiovascular disease; while roughly 21 percent would trade between one week and a year of their lives.
  • About 70 percent said they wouldn’t trade any weeks of their lives to avoid taking a CVD pill daily
  • About 13 percent of participants said they would accept minimal risk of death to avoid taking a pill daily; 9 percent said they’d risk a 10 percent chance; and about 62 percent weren’t willing to gamble any risk of immediate death.
  • About 21 percent said they would pay $1,000 or more to avoid taking a pill each day for the rest of their lives, but 43 percent said they wouldn’t pay any amount.

 

February 4, 2015 Posted by | Public Health | , | Leave a comment

[Press release] SAMHSA’s new report tracks the behavioral health of America

From the press release, Monday, January 26, 2015

A new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) illuminates important trends — many positive — in Americans’ behavioral health, both nationally and on a state-by-state basis.

SAMHSA’s new report, the “National Behavioral Health Barometer” (Barometer), provides data about key aspects of behavioral healthcare issues affecting American communities including rates of serious mental illness, suicidal thoughts, substance use, underage drinking, and the percentages of those who seek treatment for these disorders. The Barometer shows this data at the national level, and for each of the 50 states and the District of Columbia.

Screen Shot 2015-02-03 at 7.12.56 AM

The Barometer indicates that the behavioral health of our nation is improving in some areas, particularly among adolescents. For example, past month use of both illicit drugs and cigarettes has fallen for youth ages 12-17 from 2009 to 2013 (from 10.1 percent to 8.8 percent for illicit drugs and 9.0 percent to 5.6 percent for cigarettes). Past month binge drinking among children ages 12-17 has also fallen from 2009 to 2013 (from 8.9 percent to 6.2 percent).

The Barometer also shows more people are getting the help they need in some crucial areas. The number of people receiving treatment for a substance use problem has increased six percent from 2009 to 2013. It also shows that the level of adults experiencing serious mental illness who received treatment rose from 62.9 percent in 2012 to 68.5 percent in 2013.

 

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The data in the Barometer is drawn from various federal surveys and provides both a snapshot of the current status of behavioral health nationally and by state, and trend data on some of these key behavioral health issues over time. The findings will be enormously helpful to decision makers at all levels who are seeking to reduce the impact of substance abuse and mental illness on America’s communities.

“The Barometer provides new insight into what is happening on the ground in states across the country,” said SAMHSA’s Administrator, Pamela S. Hyde. “It provides vital information on the progress being made in each state as well as the challenges before them.  States and local communities use this data to determine the most effective ways of addressing their behavioral healthcare needs.”

The Barometer also provides analyses by gender, age group and race/ethnicity, where possible, to further help public health authorities more effectively identify and address behavioral health issues occurring within their communities, and to serve as a basis for tracking and addressing behavioral health disparities.

For the first time, the Barometer provides analyses broken down by poverty level (above or below) and health insurance status. This data can help provide researchers, policy makers, public health authorities and others a better understanding of how income and insurance coverage affect access and utilization of behavioral healthcare services.

To view and download copies of the national or any state Behavioral Health Barometer, please visit the SAMHSA web site at http://www.samhsa.gov/data/browse-report-document-type?tab=46.

For more information, contact the SAMHSA Press Office at 240-276-2130.


The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (DHHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.

Last Updated: 01/26/2015

February 3, 2015 Posted by | Psychiatry, Psychology, Public Health | , , , , , , | Leave a comment

[Press release] Top 10 challenges facing global pharmaceutical supply chains

English: Value, supply and demand chains

English: Value, supply and demand chains (Photo credit: Wikipedia)

 

 

 

 

 

From the 2 February 2015 New York University press release

Ten years after the 2005 Paris Declaration on Aid Effectiveness reported on the need for better coordination in the global fight against disease, global pharmaceutical supply chains remain fragmented and lack coordination, facing at least 10 fundamental challenges, according to a newly published paper by professors at NYU Wagner and MIT-Zaragoza.

“Heroes may win battles, but it is capable supply chains that win wars [against disease],” write Natalie Privett, assistant professor of management and policy at the Robert F. Wagner Graduate School of Public Service at New York University, and David Gonsalvez, professor of supply chain management at the MIT-Zaragova International Logistics Program, and former global supply chain director with General Motors. Yet, they add, the global health pharmaceutical delivery (GHPD) supply chains are wanting.

The research article, entitled “The top ten global health supply chain issues: Perspectives form the field,” has been published in Operations Research for Health Care, an academic journal. It sheds light on the key areas of weakness and what specifically is needed to strengthen the pharmaceutical supply chains.

Privett and Gonsalvez interviewed and surveyed 22 individuals with various roles in supply chains and asked them to identify the “top ten” challenges as they see them. The areas of concern which were most often cited include: lack of coordination; inventory management; absent demand information; human resource dependency; order management; shortage avoidance; expiration; warehouse management; temperature control; and shipment visibility.

“Lack of coordination in the GHPD supply chain is a root cause issue whose existence aggravates nearly every other issue director or indirectly,” according to the article.

The paper draws attention to both the needs and opportunities in GHPD supply chains in an attempt to “drive future actions, policies, and research which can ultimately improve pharmaceutical delivery in developing regions and save lives.”

To read the article, please visit:http://www.sciencedirect.com/science/article/pii/S2211692314200002.

 

February 3, 2015 Posted by | Public Health | , , , , , , , | Leave a comment

[Research article] Cyberpsychology, Behavior, and Social Networking

Pornography is not a victimless crime, it affects all of us through dehumanization of women, children, and men.  Sex is distorted, people are viewed as objects. How can this not affect behaviors of the viewers in their everyday life, and thus victimize (or at the very least adversely effect us all? The brain cannot possibly just shut off and on when it comes to what it views.

English: Nations based on their laws involving...

English: Nations based on their laws involving pornography. Please see the legend for more details. Nederlands: Landen op basis van hun wetten over pornografie. Zie de legenda voor meer details. (Photo credit: Wikipedia) Legend at http://commons.wikimedia.org/wiki/File:Pornography_laws.svg#Legend

 

From the abstract at Cyberpsychology, Behavior, and Social Networking (14 January 2015)

The purpose of this review was to determine whether an association exists between sexual risk behaviors and pornography consumption. Consumption of pornography is common, yet research examining its link with sexual risk behaviors is in its infancy. Indicators of sexual risk behavior, including unsafe sex practices and a higher number of sexual partners, have been linked to poor health outcomes. A systematic literature search was performed using Medline, PsycINFO, Web of Knowledge, Pubmed, and CINAHL. Studies were included if they assessed the association between pornography use and indicators of sexual risk behaviors in an adult population. A total of 17 were included in the review, and all were assessed for research standards using the Quality Index Scale. For both Internet pornography and general pornography, links with greater unsafe sex practices and number of sexual partners were identified. Limitations of the literature, including low external validity and poor study design, restrict the generalizability of the findings. Accordingly, replication and more rigorous methods are recommended for future research.

February 3, 2015 Posted by | Public Health | , , , | Leave a comment

[News article] California declares electronic cigarettes a health threat

From the 28 January 2015 Met article

SACRAMENTO, Calif. – California health officials say electronic cigarettes are a health threat, especially to children, and should be strictly regulated like tobacco products.

A report released Wednesday by the California Department of Public Health says e-cigarettes emit cancer-causing chemicals and get users hooked on nicotine. California Health Officer Ron Chapman says new generations of young people will become nicotine addicts if the products remain largely unregulated.

E-cigarettes heat liquid nicotine from cartridges into inhalable vapour without tar and other chemicals found in traditional cigarettes. E-cigarette makers say their products are far safer than tobacco.

Other states including Oklahoma and Arkansas already have issued advisories cautioning the use of e-cigarettes. California’s advisory comes after a state lawmaker introduced legislation this week to ban e-cigarettes in public places.

January 29, 2015 Posted by | Public Health | , , , | Leave a comment

[Reblog] Calling all #Parents and #Carers – Do you have a child/care for a child aged 12 – 18 years

Hoping for the best for this community. A service worth looking into.
(If this is not an image of Warwickshire, please let me know!]

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THE RUPERT BROOKE WETHERSPOONS RUGBY WARWICKSHIRE AUG 2013

From the 27 January 2015 blog post at  safe in warwickshire

 

Sexual Exploitation is in the news a lot at the moment. The media often write about situations where a number of men, are exploiting girls in towns/cities. Children can be sexually exploited in different ways.

Warwickshire County Council is currently developing resources for parents and carers to help them keep their children and young people safe from abuse and exploitation.

To make the resources as useful as possible we would like to know what you, as parents and carers of young people would like to know and how you would like to receive this information. To do this we have created a short online survey, that should take no more than 5 minutes to complete.

…..

January 27, 2015 Posted by | Public Health | , | Leave a comment

[Press release]Health Canada Publishes Findings From Wind Turbine Noise and Health Study |

Icon of Wind Turbines

Icon of Wind Turbines (Photo credit: Wikipedia)

Health Canada Publishes Findings From Wind Turbine Noise and Health Study |

From the 2014-11-06  Health Canada press release

Today, Health Canada published findings from the Wind Turbine Noise and Health Study. Launched in 2012, in collaboration with Statistics Canada, this study explored the relationship between exposure to wind turbine noise and the health effects reported by, and measured in, people living near wind turbines.

In the effort of being more open and transparent, the findings are available on Health Canada’s website. The findings provide a more complete overall assessment of the potential impacts that exposure to wind turbines may have on health and well-being.

No evidence was found to support a link between exposure to wind turbine noise and any of the self-reported or measured health endpoints examined. However, the study did demonstrate a relationship between increasing levels of wind turbine noise and annoyance towards several features (including noise, vibration, shadow flicker, and the aircraft warning lights on top of the turbines) associated with wind turbines.

It is important to note that the findings from this study do not provide definitive answers on their own and must be considered in the context of a broader evidence base.

Health Canada has consulted the Wind Turbine Noise and Health Study Expert Committee on these findings. Detailed analysis and results will be shared with Canadians and the international (scientific) community over the next several months with updates provided on the Health Canada website.

Health Canada will hold a technical background briefing with interested media at 11:00 AM EST today (Dial-in information below).

Quick Facts

  • The study was conducted in Southwestern Ontario and Prince Edward Island and included 1238 households out of a possible 1,570 households living at various distances from 399 separate wind turbines in 18 wind turbine developments.
  • This study is the first study related to wind turbine noise to implement the use of both self-reported and physically measured health endpoints.
  • Measured health-related indicators included hair cortisol as a biomarker of stress, blood pressure, resting heart rate and sleep.

Related Products

Wind Turbine Noise and Health Study Results Pamphlet

Wind Turbine Noise

Frequently Asked Questions

Associated Links

Wind Turbine Noise and Health Study: Updated Research Design and Sound Exposure Assessment

January 27, 2015 Posted by | Public Health | , , , , , , | Leave a comment

[Press release] Model predicts public response to disease outbreaks

Model predicts public response to disease outbreaks

From the 14 January 2015  press release

David L. Chandler | MIT News Office
January 14, 2015

Sometimes the response to the outbreak of a disease can make things worse — such as when people panic and flee, potentially spreading the disease to new areas. The ability to anticipate when such overreactions might occur could help public health officials take steps to limit the dangers.

Now a new computer model could provide a way of making such forecasts, based on a combination of data collected from hospitals, social media, and other sources. The model was developed by researchers at MIT, Draper Laboratory, and Ascel Bio, and is described in a paper published in the journal Interface.

The research grew out of earlier studies of how behavior spreads through social networks, explains co-author Marta Gonzalez, an assistant professor of civil and environmental engineering at MIT. The spread of information — and misinformation — about disease outbreaks “had not been studied, and it’s hard to get detailed information on the panic reactions,” Gonzalez says. “How do you quantify panic?”

One way of analyzing those reactions is by studying news reporting on outbreaks, as well as messages posted on social media, and comparing those with data from hospital records about the actual incidence of the disease.

In many cases, the reaction to an outbreak can cause more harm than the disease itself: For example, the researchers say, curtailing travel and distribution of goods can create economic damage, or even lead to rioting and other behavior that can exacerbates a disease’s spread. Wide publicity of an outbreak can also cause health care facilities to be overrun by people concerned about minor symptoms, potentially making it difficult for those affected by the disease to obtain the care they need, the researchers add.

To study the phenomenon, the team looked at data from three disease outbreaks: the 2009 spread of H1N1 flu in both Mexico and in Hong Kong, and the 2003 spread of SARS in Hong Kong. The model they developed could accurately reproduce the population-level behavior that accompanied those outbreaks.

In these cases, public response was often disproportionate to actual risk; in general, the research showed, diseases that are rare or unusual frequently receive attention that far outpaces the true risk. For example, the SARS outbreak in Hong Kong produced a much stronger public response than H1N1, even though the rate of infection with H1N1 was hundreds of times greater than that of SARS.

This analysis did not specifically address the ongoing Ebola epidemic in West Africa — but once again, Gonzalez says, “The response [is] just not justified by the extent of the disease.”

 

January 27, 2015 Posted by | Public Health | , , , , , , , | Leave a comment

[Reblog] SurroundHealth – 2015 Top 10 Predictions in Public Health

SurroundHealth – 2015 Top 10 Predictions in Public Health.

Excerpt from the 6 January 2015 post

Ready or not, the Affordable Care Act (ACA) is once again heading to the Supreme Court. At stake is whether the law allows consumers purchasing insurance through the Federal portal to extend the same discounts that states provide. Eliminating the discount could gut the exchange’s value to federal consumers. In the meantime, it’s enrollment as usual for 2015. Share this this updated ACA enrollment guide from the IOM.

2. Defending Safety Net and Programs and Regulations

  • Medicare Private voucher program proposal. With a new GOP majority, I expect to revisit proposals to privatize Medicare. The American Public Health Association (APHA) is on record opposing such a policy move as undermining the foundation of Medicare’s guaranteed coverage. Brace yourselves for some ideological power-plays over health care access for seniors.
  • Access to Abortion Services. APHA supports Access to abortion and ensuring the availability of qualified practitioners. The access to safe and legal abortion services at the state level has narrowed rapidly across the majority of US states since 2013. Now, this sharply partisan issue is likely provoke both Congressional challenges and more states to seeking to restrict these services, especially for low-income women.
  • Environmental Protections. Expect attacks on environmental regulations and the Environmental Protection Agency (EPA). Republicans are candid that their goal is to end the EPA. Clean air standards and more may be threatened.

3. New Vaccines

  • Ebola Vaccine. Likely the most fast-tracked vaccine trials ever, I’m not the only one predicting that we’ll see an ebola vaccine in 2015. Together with infection control protocols established for the affected West African countries, this will hasten the end to what had seemed an intractable crisis—though we’re not likely to snuff out ebola completely within the year.
  • HPV Nonavalent Vaccine. Merck’s nine-valent HPV vaccine received FDA approval in 2014. It’s very likely that this will replace, or partially replace, their current quadrivalent (4-valent) version. The newer vaccine will increase the percentage of cancer-causing HPV types prevented from 70% to 90% and potentially prevent tens of thousands of cancers per year. It may only need 2 doses instead of the current 3. The Advisory Committee on Immunization Practices (ACIP) should make a recommendation in the first half of 2015 with rollout later in the year.

4. National Policy on Police Violence in Communities of Color

January 27, 2015 Posted by | Public Health | , , , , | Leave a comment

When free speech conflicts with public health objectives: Yale ISP Conference « Wikimedia blog

When free speech conflicts with public health objectives: Yale ISP Conference « Wikimedia blog.

The Public Health and First Amendment Conference took place at Yale University. Harkness Tower photo by Hilary Richardson, licensed under CC-BY-SA-4.0

 

 

 

 

 

 

 

 

 

 

 

First Amendment jurisprudence frequently pits societal ideals against free speech. A recent conference at Yale Law Schoolshowed that this is no less the case when commercial free speech protections conflict with public health regulatory objectives.

The conference, Public Health in the Shadow of the First Amendment, was co-sponsored by the Information Society Project, the Yale Global Health Justice Partnership, and the Yale Health Law and Policy Society on October 17 and 18, 2014. The event brought together public health advocates, medical professionals and First Amendment scholars to discuss the implications of recent controversial First Amendment case law. The panels highlighted several areas where courts have protected commercial speech in spite of unpopular consequences for public health policy. Hilary Richardson attended the conference on behalf of the Wikimedia Foundation legal team, given its interest in free speech law.

This conference was especially relevant to Wikipedia’s coverage of medical or health related topics. Since the content for pages on Wikipedia is entirely user-generated by thousands of volunteer editors, critics may argue that imperfection is inherent in the medical content pages. It is up to our community of editors to strike a balance between maximizing the total sum of freely available knowledge and removing information that could be misleading. If you think this sounds like an impossible task, here is some food for thought: in October alone, the New York Times wrote about how Wikipedia became one of the most trusted sources on the Internet for learning about Ebola, and four Wikipedians published a scholarly article on Dengue fever in a peer-reviewed journal based on a collaboratively edited Wikipedia article. In addition to meticulously curating the Ebola page on Wikipedia, Dr. James Heilman startedWikiProject Medicine in order to improve medical and health content on Wikipedia and “benefit the world by giving the general public and health care professionals a text they can all read, appreciate, and respect, free of charge.” Medical schools like UCSF have forged partnerships with WikiProject Medicine so that top medical students can identify gaps in information and update entries using their own knowledge and credible resources.

….

Professor Post provided insight into how we theorize the First Amendment and why we understand it to protect commercial speech at all. According to Post, the primary distinction between speech that is covered by the First Amendment and speech that is not comes down to our democratic value of self-governance: speech triggers First Amendment coverage when it participates in the formation of public opinion because we want the government to be responsive to public opinion. Generally, this creates a First Amendment right which is speaker-oriented. However, this changed when the Supreme Court invented the commercial speech doctrine. In Virginia Pharmacy,[3] the Court gave two rationales: we need efficient distribution of information in order to have efficient markets, and we protect commercial speech because it distributes information which is necessary for citizens to participate in public opinion formation. Post argued that in this sense, Virginia Pharmacy created a First Amendment right of the receiver to hear information rather than speak it. In the context of commercial speech, the Supreme Court conceives of the public as people capable of processing information. This suggests that it is up to the people to decide what information they need.

Professor Volokh echoed Post and Bambauer in his agreement that First Amendment protections are about protecting a free market, so that it is better for people to have more information when making decisions. Volokh stressed that the logic behind the commercial speech doctrine is that even though we may think that patients and doctors may make bad decisions, it is possible that government regulators might as well: “the First Amendment directs us to be especially skeptical of regulations that seek to keep people in the dark for what the government perceives to be their own good.”

January 26, 2015 Posted by | Health News Items, Public Health | , , , , , , | Leave a comment

[Journal article] What the Agency for Healthcare Research and Quality Forgets to Tell Americans about How to Protect Their Sexual and Reproductive Health

What the Agency for Healthcare Research and Quality Forgets to Tell Americans about How to Protect Their Sexual and Reproductive Health 

From the January/February 2015 journal article abstract

If there is one thing that health care experts seem to agree on, it is the importance of preventive care. Anything that can help the American public to do a better job of understanding, accessing, and affording effective preventive care and thereby helping them to avoid potential threats to their health should be indisputably a good thing for individuals, families, and society.

Recommendations for the public about what preventive care services an individual might need at different points in his or her life can be one important tool in this tool box, and that goes double for recommendations that speak with the imprimatur of the U.S. Department of Health and Human Services (DHHS). So, a series of fact sheets on “staying healthy” from the Agency for Healthcare Research and Quality (AHRQ)—a branch of DHHS devoted to evidence-based improvements to the provision of U.S. health care—should be a welcome and valued resource (Agency for Healthcare Research and Quality (AHRQ), 2014a, Agency for Healthcare Research and Quality (AHRQ), 2014b).

In this light, it is disappointing to find the AHRQ fact sheets falling short of the mark in some critical ways related to their recommendations on sexual and reproductive health care. The four fact sheets—for women of all ages, women at age 50 and older, men of all ages, and men at age 50 and older—contain a wealth of good advice about screenings and preventive medicine that a patient might need. However, they leave out many effective sexual and reproductive health-related preventive services—perhaps most notably any mention of contraceptive services and supplies—that have been endorsed by other agencies in the DHHS and by the medical establishment more broadly, and that have been promoted through the Affordable Care Act’s (ACA) requirements for private health plans to cover preventive services without patient out-of-pocket costs (HealthCare.gov, 2014, Sonfield, 2012). The AHRQ fact sheets compound those oversights by seeming to imply that they embody the sum total of DHHS’s preventive care recommendations, when in reality they seem to be based almost exclusively on the recommendations of a single body, the U.S. Preventive Services Task Force.

Full text of the article here

January 26, 2015 Posted by | Public Health | , , , , , , , | Leave a comment

[Press release] US needs harm-reduction approach to drug use, researcher says

US needs harm-reduction approach to drug use, researcher says 

From the 14 January 2015 Rice University press release

Neill: Approach minimizes harm associated with drug use for the individual and society    

HOUSTON – (Jan. 14, 2015) – The United States’ law-and-order approach to reducing the supply of drugs and punishing sellers and users has impeded the development of a public health model that views drug addiction as a disease that is preventable and treatable. A new policy paper from Rice University’s Baker Institute for Public Policy advocates that a harm-reduction approach would more effectively reduce the negative individual and societal consequences of drug use.

According to the paper’s author, Katharine Neill, the rate of federal inmates incarcerated for drug offenses hovered at just under 50 percent in 2011, and in 2013 the Obama administration’s budget asked for $25.6 billion to fight the drug war, $15 billion of which was directed toward law enforcement. In addition, by some estimates, state and local governments spend a combined total of $51 billion per year on drug-related law enforcement efforts, which suggests they have a lot to gain by investing in treatment options, Neill said.

“That law enforcement efforts continue to dominate drug policy highlights the need to reframe the discourse on drug use and addiction,” said Neill, the Baker Institute’s Alfred C. Glassell III Postdoctoral Fellow in Drug Policy. “While emphasizing the cost-saving benefits of treatment is important, this should be coupled with more public conversations focusing on drug addiction as a disease requiring medical treatment, not politically based solutions. Reframing the issue in this way should increase the likelihood that a public health approach to drug policy will be adopted for the long term.”

The paper, “Tough on Drugs: Law and Order Dominance and the Neglect of Public Health in U.S. Drug Policy,” is published in the journal World Medical and Health Policy.

Emphasizing harm reduction is a popular public health approach to drugs, Neill said. “A harm-reduction approach recognizes the permanence of drugs in society and, instead of trying to eradicate drug use, focuses on minimizing harm associated with drug use for the individual and society,” she said. “This encompasses a variety of objectives, including preventing individuals from using drugs, treating individuals who want to stop using drugs, preventing drug use where it increases the chances of negative outcomes such as driving while on drugs, and helping individuals who want to continue using drugs do so in a way that does not further compromise their health or the health of others.” This last objective is often achieved through needle-exchange programs intended to prevent the spread of HIV and hepatitis C and is more controversial than other policies, Neill said.

Harm reduction is multidimensional and can include contradictory objectives, she said. For example, some proponents wish to decriminalize drug use and focus on helping drug users get the resources they need for treatment or to continue to use drugs safely, while others accept the illegality of drug use so long as treatment is more available. Others argue that distinctions should be made between drugs according to the risks they pose to the user and society and that policy should be based on these distinctions. “Still, most advocates of harm reduction agree on some basic tenets, including the view that addiction is a disease requiring medical assistance, the desire to minimize risky behavior without requiring abstinence and the need to protect the public from the consequences of drug use, which includes punishing individuals who commit acts that harm others,” Neill said.

– See more at: http://news.rice.edu/2015/01/14/us-needs-harm-reduction-approach-to-drug-use-baker-institute-researcher-says/#sthash.2OCJoKRU.dpuf

January 23, 2015 Posted by | Public Health, Uncategorized | , , , , , , , , | Leave a comment

[Press release] Penn Medicine Bioethicists Call for Return to Asylums for Long-Term Psychiatric Care

Bioethicists call for return to asylums for long-term psychiatric care 

From the 20 January 2015 Penn Medicine press release

JAMA Viewpoint Characterizes Current Model for Treating Mentally Ill as “Ethically Unacceptable and Financially Costly”

PHILADELPHIA — As the United States population has doubled since 1955, the number of inpatient psychiatric beds in the United States has been cut by nearly 95 percent to just 45,000, a wholly inadequate equation when considering that there are currently 10 million U.S. residents with serious mental illness. A new viewpoint in JAMA,written by Dominic Sisti, PhDAndrea Segal, MS, and Ezekiel Emanuel, MD, PhD, of the department of Medical Ethics and Health Policy in the Perelman School of Medicine at theUniversity of Pennsylvania, looks at the evolution away from inpatient psychiatric beds, evaluates the current system for housing and treating the mentally ill, and then suggests a modern approach to institutionalized mental health care as a solution.

English: Pilgrim Psychiatric Center

English: Pilgrim Psychiatric Center (Photo credit: Wikipedia)

“For the past 60 years or more, social, political and economic forces coalesced to move severely mentally ill patients out of psychiatric hospitals,” write the authors. They say the civil rights movement propelled deinstitutionalization, reports of hospital abuse offended public consciousness, and new drugs gave patients independence. In addition, economics and federal policies accelerated the transformation because outpatient therapy and drug treatment were less expensive than inpatient care, and the federal legislation like the Community Mental Health Centers Act and Medicaid led to states closing or limiting the size of so-called institutions for mental diseases.

However, the authors write, “deinstitutionalization has really been transinstitutionalization.” Some patients with chronic psychiatric diseases were moved to nursing homes or hospitals. Others became homeless, utilizing hospital emergency departments for both care and housing. But “most disturbingly, U.S. jails and prisons have become the nation’s largest mental health care facilities. Half of all inmates have a mental illness or substance abuse disorder; 15 percent of state inmates are diagnosed with a psychotic disorder.” According to the authors, “this results in a vicious cycle whereby mentally ill patients move between crisis hospitalization, homelessness and incarceration.”

Instead, the authors suggest that a better option for the severely and chronically mentally ill, and the most “financially sensible and morally appropriate way forward includes a return to psychiatric asylums that are safe, modern and humane.”  They argue that the term ‘aslyum’ should be understood in its original sense — a place of safety, sanctuary and healing.

“Asylums are a necessary, but not sufficient component of a reformed spectrum of psychiatric services,” write the authors. Reforms need to expand the role of these institutions to address a full range of integrated psychiatric treatment services — from providing care to patients who cannot live alone or are a danger to themselves and others, to providing care to patients with milder forms of mental illness who can thrive with high-quality outpatient care. These fully-integrated, patient-centered facilities do exist in the U.S. today, but more are needed to provide 21st century care to patients with chronic, serious mental illness.

 

January 23, 2015 Posted by | Public Health | , , , , , , , , | Leave a comment

[Press release] Equation helps identify global disparities in cancer screening and treatment | EurekAlert! Science News

Equation helps identify global disparities in cancer screening and treatment | EurekAlert! Science News.

From the 20 January 2015 press release

Disparities in cancer screening, incidence, treatment, and survival are worsening globally. In a new study on colorectal cancer, researchers found that the

Age-standardised death rates from Colon and re...

Age-standardised death rates from Colon and rectum cancers by country (per 100,000 inhabitants). (Photo credit: Wikipedia)

mortality-to-incidence ratio (MIR) can help identify whether a country has a higher mortality than might be expected based on cancer incidence. Countries with lower-than-expected MIRs have strong national health systems characterized by formal colorectal cancer screening programs. Conversely, countries with higher-than-expected MIRs are more likely to lack such screening programs.

The findings suggest that the MIR has potential as an indicator of the long-term success of global cancer surveillance programs. “The MIR appears to be a promising method to help identify global populations at risk for screenable cancers. In this capacity, it is potentially a useful tool for monitoring an important cancer outcome that informs and improves health policy at a national and international level,” said Dr. Vasu Sunkara, lead author of the Cancerstudy. Senior author Dr. James Hébert, who had used the MIR previously at the state and national level within the US, added that the use of the MIR internationally opens new possibilities for testing the relationship between this important indicator of cancer outcome and characteristics of countries’ health care delivery systems.

 

January 23, 2015 Posted by | Public Health | , , , , , | Leave a comment

[Reblog] A ‘birth lottery’ still determines who gets to live longest, healthiest life

A ‘birth lottery’ still determines who gets to live longest, healthiest life | joe rojas-burke.

From the 16 June 2014 post at JOE ROJAS-BURKE- Science Writer

The latest data suggest that lack of social mobility remains as significant a problem as it was decades ago. In the generation entering the U.S. workforce today, those who started life in the bottom fifth of income distribution have about a 9 percent chance of reaching the top fifth. That compares with an 8.4 percent chance for kids born in 1971, according to research by economists Raj Chetty of Harvard, Emmanuel Saez of the University of California, Berkeley, and colleagues.

What’s astonishing are the huge differences in mobility depending on where you grow up, The odds of escaping poverty and gaining prosperity are less than 3 percent for kids in many places across the South and Rust Belt states. But in some parts of the Great Plains, more than 25 percent of kids born to the poorest parents move into the upper-income strata as adults, the economists found. The datasets are available here.

The probability that a child born in the bottom fifth of the income distribution will reach the top fifth of the income distribution, based on data for those born from 1980-85. (Source:   Raj Chetty, Nathaniel Hendren, Patrick Kline, and Emmanuel Saez)

I don’t think it’s a coincidence that the places on this map with the lowest social mobility also tend to have the worst health outcomes. Lack of mobility is strongly correlated with worse segregation, greater income inequality, poor local school quality, diminished social capital, and broken family structure – factors that are also linked to poor health.

Even when poor children manage to escape poverty, a “birth lottery” may still determine who gets to live longest and healthiest. Exposure to adverse conditions during fetal development and early infancy appears to be capable of causing irreversible consequences decades later, such as increased vulnerability to weight gain, diabetes, heart disease, and premature death.

January 22, 2015 Posted by | Public Health | , , , , , | Leave a comment

Imprisonment and Public Health | thefeverblog

Imprisonment and Public Health | thefeverblog.

Excerpt from the 8 December 2014 post

Mass incarceration in the United States goes beyond the logistical issues of overcrowded prisons. A shallow mindset wouldn’t identify the connection between mass incarceration and public health, but it’s prevalent and significance is being recognized. An article published in the New York Times briefly discusses the impact mass incarceration has on public health. It touches on a report published by the Vera Institute of Justice, which is an organization that focuses on making justice systems fairer through research and innovation. Most people in prisons come from impoverished communities, and therefore have low health-status.  Specifically, people in prisons have higher rates of chronic disease, mental illness, and substance abuse.

But that’s really the obvious part of the mass incarceration-public health relationship. Overcrowding exacerbates health problems, especially communicable diseases such as flu and other viral infections. In a previous post, I shared how social reform in Russia led to mass incarceration and in turn one of the largest outbreaks of tuberculosis in history. Mental illness  and substance abuse are major problems in jails, and the problem isn’t being addressed adequately. Although over 45% of incarcerated people have a mental illness and over 68% have substance abuse issues, only 15% receive proper treatment.

But that’s not even the  real problem. [My emphasis] Our justice system is focused on penalizing, so vulnerable people coming out of prison are unable to receive any assistance because their actions have removed their eligibility. On first glance, the conservative argument would be that felons shouldn’t be privy to housing, medical, and financial assistance. But the whole picture has to be taken into consideration. Families can be easily torn apart by a family member being incarcerated, especially when parents are taken away from children.

 

Mass incarceration in the United States goes beyond the logistical issues of overcrowded prisons. A shallow mindset wouldn’t identify the connection between mass incarceration and public health, but it’s prevalent and significance is being recognized. An article published in the New York Times briefly discusses the impact mass incarceration has on public health. It touches on a report published by the Vera Institute of Justice, which is an organization that focuses on making justice systems fairer through research and innovation. Most people in prisons come from impoverished communities, and therefore have low health-status.  Specifically, people in prisons have higher rates of chronic disease, mental illness, and substance abuse.

But that’s really the obvious part of the mass incarceration-public health relationship. Overcrowding exacerbates health problems, especially communicable diseases such as flu and other viral infections. In a previous post, I shared how social reform in Russia led to mass incarceration and in turn one of the largest outbreaks of tuberculosis in history. Mental illness  and substance abuse are major problems in jails, and the problem isn’t being addressed adequately. Although over 45% of incarcerated people have a mental illness and over 68% have substance abuse issues, only 15% receive proper treatment.

January 22, 2015 Posted by | Public Health | , , , , , , , | Leave a comment

[Reblog] Imprisonment and public health

From the   post at thefeverblog

Mass incarceration in the United States goes beyond the logistical issues of overcrowded prisons. A shallow mindset wouldn’t identify the connection between mass incarceration and public health, but it’s prevalent and significance is being recognized. An article published in the New York Times briefly discusses the impact mass incarceration has on public health. It touches on a report published by the Vera Institute of Justice, which is an organization that focuses on making justice systems fairer through research and innovation. Most people in prisons come from impoverished communities, and therefore have low health-status.  Specifically, people in prisons have higher rates of chronic disease, mental illness, and substance abuse.

But that’s really the obvious part of the mass incarceration-public health relationship. Overcrowding exacerbates health problems, especially communicable diseases such as flu and other viral infections. In a previous post, I shared how social reform in Russia led to mass incarceration and in turn one of the largest outbreaks of tuberculosis in history. Mental illness  and substance abuse are major problems in jails, and the problem isn’t being addressed adequately. Although over 45% of incarcerated people have a mental illness and over 68% have substance abuse issues, only 15% receive proper treatment.

But that’s not even the  real problem. Our justice system is focused on penalizing, so vulnerable people coming out of prison are unable to receive any assistance because their actions have removed their eligibility. On first glance, the conservative argument would be that felons shouldn’t be privy to housing, medical, and financial assistance. But the whole picture has to be taken into consideration. Families can be easily torn apart by a family member being incarcerated, especially when parents are taken away from children.

Suicides and violence are also common in prisons. In the Vera Institute study it was found that 1/3 of deaths in prisons are due to suicide. Everything considered, mass incarceration is an epidemic and it’s public health ramifications are significant. The justice system in the United States needs to work with public health agencies to improve services, education, and awareness in prisons. The system needs to consider cases of penalizing on an individual by individual basis when evaluating eligibility for financial, housing, and medical assistance.

January 21, 2015 Posted by | health care, Public Health | , , , | Leave a comment

[Press release] ‘Patients-in-waiting’: Even the perceived risk of disease prompts intention to act

From the 3 December 2014 Yale press release

Bubble_rev01_YaleNews(Photo via Shutterstock)

With so much focus on risk factors for disease, we are living in an era of surveillance medicine, in which the emphasis on risk blurs the lines between health and illness, argue researchers at Yale and Syracuse universities in a study published in the December issue of the Journal of Health and Social Behavior.

Co-authors Rene Almeling, assistant professor of sociology at Yale, and Shana Kushner Gadarian, assistant professor of political science at Syracuse University, conducted a nationwide survey of American adults to determine if healthy people react to hypothetical genetic risk information by wanting to take action.

The main finding of the study was that as the level of risk increases from 20% to 80%, people are more likely to want to take action of all kinds, including seeking information about the disease, managing risk by taking medications or undergoing surgery, consulting family members, organizing finances, and participating in community and political events.

The results of the survey showed the importance of risk information even to healthy people, suggesting that the experience of living between health and disease is not just limited to those who are already patients. “Social scientists have argued that we are now treating risk as if it were a disease, and these results provide strong evidence for that claim,” says Almeling.

Participants were asked if they have a family member or close friend with the disease to which they had been assigned to assess whether experience with the disease increased their interest in taking action. The researchers were startled to find that seeing a disease up close did not make much difference; across the board, people responded to the hypothetical risk information by wanting to take action.

The survey questions were hypothetical, but the issues that the study raises are real, note the researchers, adding that people use risk information to make significant medical decisions, such as whether to increase the frequency of cancer screenings or undergo prophylactic surgery.

“It is extremely important for social scientists and clinicians to understand how people respond to these risk numbers and how they are being used to make important life decisions,” says Almeling. She added, “Studies like this can aid health care providers in offering genetic information with sufficient context to insure that people make the best decisions for themselves.”

Given that people throughout the population — from the healthy to the sick and those with and without a family history of disease — had largely identical reactions suggests that normality has indeed become precarious and that we are all patients-in-waiting, say the researchers.

 

December 9, 2014 Posted by | Psychology, Public Health | , , , , , | Leave a comment

[Press release] How important is long-distance travel in the spread of epidemics?

How important is long-distance travel in the spread of epidemics?.

Three scenarios depicting the simulated spread of a simple epidemic from a single point outbreak. Long-range jumps — mimicking air travel, for example — lead to sub-outbreaks. If long-distance jumps are rare, the main outbreak will quickly merge with the satellite outbreaks, leading to a rippling, wave-like growth (left). As the likelihood of long-distance jumps increases, the epidemic spread exhibits a super-linear power-law growth (center) or a stretched exponential or “metastatic” growth. (Simulations by Oskar Hallatschek, UC Berkeley, and Daniel Fisher, Stanford. Video editing by Christian Collins.)

From the 4 November 2014 UC Berkely press release

Robert Sanders, Media Relations

BERKELEY —

The current Ebola outbreak shows how quickly diseases can spread with global jet travel.

Yet knowing how to predict the spread of these epidemics is still uncertain, because the complicated models used are not fully understood, says a UC Berkeley biophysicist.

Using a very simple model of disease spread, Oskar Hallatschek, assistant professor of physics, proved that one common assumption is actually wrong. Most models have taken for granted that if disease vectors, such as humans, have any chance of “jumping” outside the initial outbreak area – by plane or train, for example – the outbreak quickly metastasizes into an epidemic.

Hallatschek and co-author Daniel Fisher of Stanford University found instead that if the chance of long-distance dispersal is low enough, the disease spreads quite slowly, like a wave rippling out from the initial outbreak. This type of spread was common centuries ago when humans rarely traveled. The Black Death spread through 14th-century Europe as a wave, for example.

But if the chance of jumping is above a threshold level – which is often the situation today with frequent air travel –the diseases can generate enough satellite outbreaks to spread like wildfire. And the greater the chance that people can hop around the globe, the faster the spread.

“With our simple model, we clearly show that one of the key factors that controls the spread of infection is how common long-range jumps are in the dispersal of a disease,” said Hallatschek, who is the William H. McAdams Chair in physics and a member of the UC Berkeley arm of the California Institute for Quantitative Biosciences (QB3). “And what matters most are the rare cases of extremely long jumps, the individuals who take plane trips to distant places and potentially spread the disease.”

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

[Press release] Is violent injury a chronic disease? Study suggests so & may aid efforts to stop the cycle

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.”

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

[Press release] Can social media help stop the spread of HIV?

Pinmap of Tweets Related to HIV

Caption: This is a map showing the origins of tweets related to HIV.

Credit: Sean Young

Usage Restrictions: Credit required.
[Sean Young, Center for Digital Behavior at the University of California,
http://www.uclahealth.org/main.cfm?id=2341, scroll down for short bio]

 

From the 30 October 2014 UCLA press release

In addition to providing other potential benefits to public health, all of those tweets and Facebook posts could help curb the spread of HIV.

Although public health researchers have focused early applications of social media on reliably monitoring the spread of diseases such as the flu, Sean Young of the Center for Digital Behavior at the University of California, Los Angeles, writes in an October 29th article in the Cell Press journal Trends in Microbiology of a future in which social media might predict and even change biomedical outcomes.

“We know that mining social media will have huge potential benefits for many areas of medicine in the future, but we’re still in the early stages of testing how powerful these technologies will be,” Young said.

With the right tools in place, he says, social media offers a rich source of psychological and health-related data generated in an environment in which people are often willing to share freely.

His recent work on Behavioral Insights on Big Data (BIBD) for HIV offers the tantalizing possibility that insights gleaned from social media could be used to help governments, public health departments, hospitals, and caretakers monitor people’s health behaviors “to know where, when, and how we might be able to prevent HIV transmission.”

Young details a social-media-based intervention in which African American and Latino men who have sex with men shared a tremendous amount of personal information through social media, including when or whether they had ‘come out,’ as well as experiences of homelessness and stigmatization. What’s more, they found that people who discussed HIV prevention topics on social media were more than twice as likely to later request an HIV test.

In the context of HIV prevention, tweets have also been shown to identify people who are currently or soon to engage in sexual- or drug-related risk behaviors. Those tweets can be mapped to particular locations and related to actual HIV trends.

What’s needed now is the updated infrastructure and sophisticated toolkits to handle all of those data, Young said, noting that there are about 500 million communications sent every day on Twitter alone. He and a team of University of California computer scientists are working to meet that challenge now.

Although privacy concerns about such uses of social media shouldn’t be ignored, Young says there is evidence that people have already begun to accept such uses of social media, even by corporations looking to boost profits.

“Since people are already getting used to the fact that corporations are doing this, we should at least support public health researchers in using these same methods to try and improve our health and well being,” he said. “We’re already seeing increased support from patients and public health departments.”

November 4, 2014 Posted by | Medical and Health Research News, Public Health | , , , , , , , , | Leave a comment

[Journal Supplement] Public health in the 21st century

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.

October 17, 2014 Posted by | Public Health | , , | Leave a comment

[Reblog] Connections between housing, health: Finding stories and getting the reporting right

Connections between housing, health: Finding stories and getting the reporting right | Association of Health Care Journalists.

Excerpt

People who are homeless face many health threats and are among the heaviest users of hospital services. Safe and affordable housing, some experts assert, is a necessary first step to care effectively for people with chronic mental health and substance abuse problems who live on the streets. And there is some evidence that this approach may, in some circumstances, even save taxpayers money (but probably not as much as is often claimed).

In an influential 2009 study in Seattle, researchers analyzed medical and law enforcement costs for 91 people given supportive housing and found that costs dropped to about half the level seen among 35 comparable homeless people on a waiting list. But note that this savings estimate doesn’t include the capital costs of building and refurbishing apartments. Raising capital is likely to be a tall hurdle for many communities and this issue often gets ignored in news reports about the promise of supportive housing.

Read the rest of the core topic on this issue here

 

August 26, 2014 Posted by | Public Health | , , , , | Leave a comment

[Reblog] The unidentified cause of one man’s hypertension: Racism

The unidentified cause of one man’s hypertension: Racism.

From the 20 January 2014 Kevin MD post

Meet Damien, my Facebook friend, photographer, and IT guy.

This morning, he messages me: “I would like to make an appointment.”

I reply: “For?”

“High blood pressure.”

 

I offer to see him, but he never comes in. Weeks later, he writes, “I got busy Pam. How are you? High blood pressure pills keep making me sick. I am doing the best I can. On bad days it is like 208/118.”

Friends don’t let Facebook friends die. And 208/118 is incompatible with life. I’m a family doc–a-sleuth. It’s my job to spy on people. On Damien’s page, I find a dozen photos of lynchings — his reaction to today’s Trayvon Martin verdict. A black boy murdered in a land where killers roam free. Trayvon died a senseless death, but Damien shouldn’t have to. I suspect today is a bad day for Damien’s arteries. So I call him up. “I’m worried about you, man. I’m coming over to check on you tonight.” An hour later, I’m in his living room.

…..

July 20, 2014 Posted by | Public Health | , , , | Leave a comment

Global Health: Time to Pay Attention to Chronic Diseases

Screen Shot 2014-07-02 at 4.42.38 AM

From the 1 Ju;ly 2014 blog post

…While infectious diseases remain a significant problem in the developing world, cancer, heart disease, obesity, diabetes, and other non-communicable diseases are now among the fastest growing causes of death and disability around the globe. In fact, nearly three-quarters of the 38 million people who died of chronic diseases in 2012 lived in low- or middle-income countries [1].

The good news is that many NCDs can be prevented by making lifestyle changes, such as reducing salt intake for hypertension, stopping smoking for cancer and heart disease, or venting cookstove fumes for lung disease. Other NCDs can be averted or controlled by taking medications, such as statins for high cholesterol or metformin for diabetes.

 

July 2, 2014 Posted by | Public Health | , , , , , , , , , , | Leave a comment

States’ Apps Target Health and Safety

States’ Apps Target Health and Safety.

Excerpts from the 26 June 2014 article at Pew Chartitable Trust

Among the state apps focused exclusively on health or public safety:

  • The Minnesota Air app provides real-time information about air quality conditions in 10 reporting areas across the state, as well as pollution forecasts for the Twin Cities and Rochester.
  • The Every Woman Counts app in California lets women know when it’s time to make an appointment for mammograms and Pap tests.  Users enter information about their screening history and select a schedule for their exams, and the app sends them reminders.
  • The MyVaxIndiana app enables parents to keep track of their children’s vaccination records. The information comes from a state immunization system and is updated by health care workers, schools and doctors.
  • The NMWatch app in New Mexico uses GPS mapping to allow residents, emergency managers and responders to monitor up-to-date wildfire activity. It not only helps people who need to know whether to evacuate, but it alerts those with respiratory problems who might be affected by thick smoke in their neighborhood.

Connected Citizens

More state agencies that oversee health or emergency management have recognized that they need to embrace mobile technology to stay connected with citizens.

“It’s a natural progression,” said Theresa Pardo, director of the Center for Technology in Government at the University at Albany, a research center that focuses on innovation in government technology. “I think these new apps are really powerful. What underlies them is a massive effort to identify and integrate in sophisticated ways data that is relevant to an individual, particularly in the event of a crisis.”

Communicating critical, life-saving information during emergencies and directing the public to services after disasters is an enormous challenge for states, said Karen Cobuluis, spokeswoman for the National Emergency Management Association, the professional association for state emergency management directors.

 

…..

A Long Way to Go

While states are moving rapidly to make advances in digital technology, they still have a long way to go when it comes to overseeing their apps and mobile device projects.

In an October 2013 survey of state chief information officers, 58 percent called their state’s efforts to manage apps and mobile device projects “mostly” or “totally” fragmented and uncoordinated.

The association’s Robinson said that most states today don’t have an “enterprise-wide, well-coordinated roadmap” for investing in and deploying mobile technology. “It’s serious for the states because of the implications. There’s no shared strategic direction,” he said. “We need to address how we’re managing mobile devices.”

Robinson of NASCIO said that in many states, apps are being launched agency by agency, which creates more complexity. Plus, states often lack the in-house technical expertise to develop their own apps, so they’re forced to use outside contractors.

 

 

 

June 28, 2014 Posted by | Consumer Safety, Public Health | , , | Leave a comment

State of the Air 2014 ( American Lung Association)

 State of the Air 2014 | American Lung Association.

                    Sources of Pollution

 

From the Web site

The State of the Air 2014 shows that the nation’s air quality worsened in 2010-2012, but remains overall much cleaner than just a decade ago.
More than 147.6 million people—47 percent of the nation—live where pollution levels are too often dangerous to breathe, an increase from last year’s report.
Despite that risk, some seek to weaken the Clean Air Act, the public health law that has driven the cuts in pollution since 1970.

Web site includes the following

  • Options to
    • Search air quality by zip code (for “grades”)
      and state (for “report cards”)
    • Compare your air
  • Health Effects of Ozone and Particle Pollution
  • Key Findings
    • Ozone Pollution — More than 4 in 10 people lived in areas with unhealthful levels of ozone in 2010-2012. See which cities with the worst ozone had even more unhealthy air days.
    • Year-round Particle Pollution — More than 46.2 million people live in an area burdened year-round by unhealthful levels of deadly particle pollution. See which cities saw continued progress in cleaning up sources and which suffered even more pollution.
    • Short-term Particle Pollution — Many cities endured more days where particle pollution spiked during this period. Fourteen percent (14%) of people in the United States live where they suffered too many days with unhealthful levels of particle pollution.
    • Cleanest Cities — Only four cities made the cleanest list in all three categories, but several were among the cleanest in two.
    • People at Risk — Nearly half of the people in the U.S. live in counties that have unhealthful levels of either ozone or particle pollution. Learn more about people who face the greatest risk—probably someone you know is one of them.
    • What Needs to be Done to Get Healthy Air— What do we need to do as a nation? How can you help clean up the air?

 

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

[Press Release] National Prevention Week – Substance Abuse and Mental Health Administration

From the press release

National Prevention Week is a SAMHSA-supported annual health observance dedicated to increasing public awareness of, and action around, substance abuse and mental health issues. National Prevention Week 2014 is about Our Lives. Our Health. Our Future. We’ll be highlighting the important role each of us has in maintaining a healthy life and ensuring a productive future.

There are many ways to make a difference. Explore the National Prevention Week website to learn more about how you can get involved, from planning a community event to participating in the “I Choose” Project.

Learn more about National Prevention Week.

 

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May 17, 2014 Posted by | Psychology, Public Health | , , , | 1 Comment

[Press release] Released prisoners are more likely to suffer early death

From the 13 May press release at Georgia State News

Men who have been incarcerated and released are more than twice as likely to die prematurely as those who have not been imprisoned, according to a new study published by Georgia State University criminologist William Alex Pridemore.

Portrait of William Alex Pridemore

Former prisoners are more likely to die early from infectious and respiratory diseases, drug overdoses and homicides. Causes of this “mortality penalty” include increased exposure to diseases like TB and HIV, the prolonged stress of the prison environment, the disruption of important social bonds and, upon release, the struggle to reintegrate into society and employment.

“We know that stress can weaken immune systems,” Pridemore said. “And in a very unpleasant twist of events, at the precise moment when these men are most vulnerable to a compromised immune system due to stress – that is, when they are incarcerated – they are most exposed to a host of communicable diseases whose rates are much higher in the prison population.”

Pridemore’s empirical analysis of the Izhevsk (Russia) Family Study, was published online this month in the Journal of Health and Social Behavior. Titled “The Mortality Penalty of Incarceration: Evidence from a Population-based Case-control Study of Working Age Males,” it is among the first sociological studies to look at the short- and long-term impacts of incarceration on the mortality of prisoners after their release.

More than 2.5 million people are incarcerated in the United States – 95 percent of whom will eventually be released. Incarceration rates in the United States and Russia, at 730 and 519 per 100,000 residents, are among the highest in the world.

MEDIA CONTACT

Jennifer French Giarratano
404-413-0028
jgiarratano@gsu.edu

“Earlier research looked at the collateral consequences of mass imprisonment that started in the 1970s, when the U.S. went on an incarceration binge. Most focused on incarceration’s limits on job prospects and earnings, marriages and its impact on communities,” he said. “Now research is turning to its impact on health.

“Ironically, prisons provide an opportunity to screen and treat a population that may be unlikely or unable to take advantage of community-based health care,” he continued. “Prisons should work with inmates, prior to their release, and provide health screenings and treatment and help them plan for their short-term and long-term health care needs. This investment will benefit not only the individual health of current and former prisoners, but also taxpayers and the broader community by way of improved population health.

Pridemore’s findings are timely given the recent release of the National Research Council’s report, The Growth of Incarceration in the United States, which has politicians and the public reconsidering mass incarceration.

“Careful research shows that many of the consequences of contact with the penal system – especially the mortality penalty of incarceration – go well beyond what we consider just punishment,” he said.
###

William Alex Pridemore is a Distinguished University Professor in the Andrew Young School of Policy Studies at Georgia State University. His research focuses on the social structure and violence and the sociology of health.

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May 14, 2014 Posted by | Health Statistics, Public Health | , , | Leave a comment

[Reblog] Mesoamerica’s Mystery Killer

Structures of the kidney: 1.Renal pyramid 2.In...

Structures of the kidney: 1.Renal pyramid 2.Interlobar artery 3.Renal artery 4.Renal vein 5.Renal hilum 6.Renal pelvis 7.Ureter 8.Minor calyx 9.Renal capsule 10.Inferior renal capsule 11.Superior renal capsule 12.Interlobar vein 13.Nephron 14.Minor calyx 15.Major calyx 16.Renal papilla 17.Renal column (no distinction for red/blue (oxygenated or not) blood, arteriole is between capilaries and larger vessels (Photo credit: Wikipedia)

Interesting blog posting highlighting a few challenges epidemiologists face with kidney complications

From the 13 May 2014 post at robertbryan22

I’m catching up on my stack of periodicals. The 11 April issue of Science featured some fascinating articles related to public health [attn: Lexi].

The first, Mesoamerica’s Mystery Killer, focuses on chronic kidney disease of unknown etiology (CKDu) in Central America and it reads like a novel:

A young doctor in training at the hospital, Ramón García Trabanino, first brought CKDu to light. “The whole hospital was flooded by renal patients,” remembers García Trabanino, who began working at the hospital in the late 1990s. “I thought, ‘Why are all these people here with kidney disease? It’s not normal.’ ” An adviser suggested he do a study.

Over 5 months, García Trabanino interviewed 202 new patients with end-stage renal disease. Medical records and personal histories uncovered an obvious cause for CKD in only one-third of the patients, equally split between men and women. Of the rest, 87% were men and the majority worked in agriculture and lived in coastal areas, he and his co-authors reported in September 2002. Their report in the Pan American Journal of Public Health speculated that patients who had CKD with características peculiares might have developed the disease after exposure to herbicides and insecticides.

Health officials took little interest in this greenhorn’s findings. “I spoke with PAHO and I remember them laughing at me,” García Trabanino says. “They thought I was crazy.” The Ministry of Health in El Salvador took no action, but it did give him an award for his study. “The judges must have been drunk that night,” he says.

,,,

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May 14, 2014 Posted by | Public Health | , | Leave a comment

[Press release] New CDC study finds dramatic increase in e-cigarette-related calls to poison centers | Press Release | CDC Online Newsroom | CDC

New CDC study finds dramatic increase in e-cigarette-related calls to poison centers | Press Release | CDC Online Newsroom | CDC.

Rapid rise highlights need to monitor nicotine exposure through e-cigarette liquid and prevent future poisonings

Infographics: Poison center calls involving e-cigarettes have risen. 

Poison center calls involving e-cigarettes have risen.
Entire infographic Adobe PDF file

The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014, according to a CDC study published in today’s Morbidity and Mortality Weekly Report. The number of calls per month involving conventional cigarettes did not show a similar increase during the same time period.

More than half (51.1 percent) of the calls to poison centers due to e-cigarettes involved young children under age 5, and about 42 percent of the poison calls involved people age 20 and older.

The analysis compared total monthly poison center calls involving e-cigarettes and conventional cigarettes, and found the proportion of e-cigarette calls jumped from 0.3 percent in September 2010 to 41.7 percent in February 2014.  Poisoning from conventional cigarettes is generally due to young children eating them. Poisoning related to e-cigarettes involves the liquid containing nicotine used in the devices and can occur in three ways: by ingestion, inhalation or absorption through the skin or eyes.

“This report raises another red flag about e-cigarettes – the liquid nicotine used in e-cigarettes can be hazardous,” said CDC Director Tom Frieden, M.D., M.P.H.  “Use of these products is skyrocketing and these poisonings will continue.  E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children.”

E-cigarette calls were more likely than cigarette calls to include a report of an adverse health effect following exposure. The most common adverse health effects mentioned in e-cigarette calls were vomiting, nausea and eye irritation.

Data for this study came from the poison centers that serve the 50 states, the District of Columbia, and U.S. Territories. The study examined all calls reporting exposure to conventional cigarettes, e-cigarettes, or nicotine liquid used in e-cigarettes.  Poison centers reported 2,405 e-cigarette and 16,248 cigarette exposure calls from September 2010 to February 2014. The total number of poisoning cases is likely higher than reflected in this study, because not all exposures might have been reported to poison centers.

“The most recent National Youth Tobacco Survey showed e-cigarette use is growing fast, and now this report shows e-cigarette related poisonings are also increasing rapidly,” said Tim McAfee, M.D., M.P.H., Director of CDC’s Office on Smoking and Health.  “Health care providers, e-cigarette companies and distributors, and the general public need to be aware of this potential health risk from e-cigarettes.”

Developing strategies to monitor and prevent future poisonings is critical given the rapid increase in e-cigarette related poisonings. The report shows that e-cigarette liquids containing nicotine have the potential to cause immediate adverse health effects and represent an emerging public health concern.

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

[Podcast] Early Stress Gets Under the Skin: Promising Initiatives to Help Children Facing Chronic Adversity

From the 7 May 2014 item at the Brookings Institute

Disadvantaged children who often experience deep poverty, violence, and neglect simultaneously are particularly vulnerable to the pernicious effects of chronic stress. New research reveals that chronic stress alters childrens’ rapidly developing biological systems in ways that undermine their ability to succeed in school and in life. But there is good evidence that specialized programs can help caretakers learn to be more supportive and responsive. High-quality childcare can offer a safe, warm, and predictable environment amid otherwise chaotic lives, and home visiting programs can help both parents and foster parents learn to provide an environment of greatly reduced stress for their children.

On May 7, Princeton University and the Brookings Institution released the Spring 2014 volume and accompanying policy brief of the Future of Children. The release event featured researchers and policy experts who explained how chronic stress “gets under the skin” to disrupt normal development and how programs can provide the support so urgently needed by children who face chronic stress.

 

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May 8, 2014 Posted by | Educational Resources (Health Professionals), Health Education (General Public), Public Health | , , , , , | Leave a comment

[Press release] Regulating legal marijuana could be guided by lessons from alcohol and tobacco, study says

From the 24 April 2014 EurkAlert

 

 

As U.S. policymakers consider ways to ease prohibitions on marijuana, the public health approaches used to regulate alcohol and tobacco over the past century may provide valuable lessons, according to new RAND Corporation research.

Recent ballot initiatives that legalized marijuana in Colorado and Washington for recreational uses are unprecedented. The move raises important questions about how to best allow the production, sales and the use of marijuana while also working to reduce any related social ills.

A new study published online by the American Journal of Public Health outlines how regulations on alcohol and tobacco may provide guidance to policymakers concerned about the public health consequences of legalizing marijuana.

Among the issues outlined in the study are how to reduce youth access to marijuana, how to minimize drugged driving, how to curb dependence and addiction, how to restrict contaminants in marijuana products, and how to discourage the dual use of marijuana and alcohol, particularly in public settings.

“The lessons from the many decades of regulating alcohol and tobacco should offer some guidance to policymakers who are contemplating alternatives to marijuana prohibition and are interested in taking a public health approach,” said Beau Kilmer, co-director of the RAND Drug Policy Research center and a co-author of the paper. “Our goal here is to help policymakers understand the decisions they face, rather than debate whether legalization is good or bad.”

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The analysis details some of the questions policymakers must confront when consideringless-restrictive marijuana laws. Those questions include: Should vertical integration be allowed, or should there be separate licenses for growing, processing and selling marijuana? What rules are needed to make sure a marijuana product is safe? Should marijuana be sold in convenience stories or only in specialized venues? Should taxes be assessed per unit of weight, as a percent of the price or on some other basis, such as the amount of psychoactive ingredients in marijuana?

“Based on the national experience with alcohol and tobacco, it seems prudent from a public health perspective to open up the marijuana market slowly, with tight controls to test the waters and prevent commercialization too soon while still making it available to responsible adults,” said Rosalie Liccardo Pacula, co-director of the RAND Drug Policy Research Center and a co-author of the paper. “Of course, perspectives other than public health objectives might motivate policymakers to adopt different or fewer regulations. These are simply lessons learned from a public health perspective.”

The article discusses a variety of strategies used to control alcohol and tobacco that also may be appropriate for regulation of marijuana. Those include keeping prices artificially high to curb use, adopting a state-run monopoly on sales and distribution, limiting the types of products sold, restricting marketing efforts, and restricting consumption in public spaces.

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Support for the study was provided by the Robert Wood Johnson Foundation’s Public Health Law Research Program and RAND. Other authors of the report are Alexander C. Wagenaar of the University of Florida College of Medicine, Frank J. Chaloupka of the University of Illinois, Chicago, and Jonathan P. Caulkins of the Heinz School of Public Policy at Carnegie Mellon University.

Since 1989, the RAND Drug Policy Research Center has conducted research to help policymakers in the United States and throughout the world address issues involving alcohol and other drugs. In doing so, the center brings an objective and data-driven perspective to an often emotional and fractious policy arena.

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May 3, 2014 Posted by | Public Health | , , | Leave a comment

[Web site review] WHO: Public Health and Environment

     WHO: Public Health and Environment
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http://www.who.int/phe/en/

The World Health Organization (WHO) has crafted this site that is dedicated to “public health, social and environmental determinants of health (PHE).” On the site, visitors can look over the WHO’s publications and news releases, along with multimedia features and event listings. Guests should start by browsing the Publications which contain timely reports on pharmaceuticals in drinking-water and children’s environmental health. The Health Topics area contains information about how WHO is working to reduce indoor air pollution, outdoor pollution, and chemical safety. The site also contains links to its overall global strategy via working papers and policy statements. [KMG]

 

 

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May 3, 2014 Posted by | Public Health | , , , , , | Leave a comment

[Report] Is Violent Radicalisation Associated with Poverty, Migration, Poor Self-Reported Health and Common Mental Disorders?

Originally posted on Full Text Reports...:

Is Violent Radicalisation Associated with Poverty, Migration, Poor Self-Reported Health and Common Mental Disorders?
Source: PLoS ONE

Background
Doctors, lawyers and criminal justice agencies need methods to assess vulnerability to violent radicalization. In synergy, public health interventions aim to prevent the emergence of risk behaviours as well as prevent and treat new illness events. This paper describes a new method of assessing vulnerability to violent radicalization, and then investigates the role of previously reported causes, including poor self-reported health, anxiety and depression, adverse life events, poverty, and migration and socio-political factors. The aim is to identify foci for preventive intervention.

Methods
A cross-sectional survey of a representative population sample of men and women aged 18–45, of Muslim heritage and recruited by quota sampling by age, gender, working status, in two English cities. The main outcomes include self-reported health, symptoms of anxiety and depression (common mental disorders), and vulnerability to violent…

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May 2, 2014 Posted by | Psychiatry, Psychology, Public Health | , , , , , , | Leave a comment

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