On 9 April, the 2015 Social Progress Index launched – it measures the social and environmental outcomes for 133 countries, covering 94% of the world’s population.
As a complement to economic measures such as GDP, the Social Progress Index provides a more holistic measure of country performance and helps to drive real and sustainable growth that is important for business and vital for building a prosperous society.
This illustration depicts the influenza virus. Graphic created by Dan J. Higgins, Division of Communication Services, CDC
The 13th Edition Epidemiology and Prevention of Vaccine-Preventable Diseases, a.k.a. the “Pink Book,” provides physicians, nurses, nurse practitioners, physician assistants, pharmacists, and others with the most comprehensive information on routinely used vaccines and the diseases they prevent.
Typical chapters include a description of the disease, pathogenesis, clinical features, laboratory diagnosis, medical management, epidemiology, vaccination schedule and use, contraindications and precautions, adverse reactions following vaccination, vaccine storage and handling, and references.
Six appendices contain a wealth of reference materials including: vaccine minimum ages and intervals, current and discontinued vaccines, vaccine contents, foreign vaccine terms, and more.
To view online or download to print specific sections, see links below.
Law would give family members and law enforcement tool to temporarily remove guns from someone believed dangerous
Gun violence restraining orders (GVROs) are a promising strategy for reducing firearm homicide and suicide in the United States, and should be considered by states seeking to address gun violence, researchers from the Johns Hopkins Center for Gun Policy and Research at the Johns Hopkins Bloomberg School of Public Health and the University of California, Davis, argue in a new report.
The article is being published online in Behavioral Sciences and the Law on May 20.
GVROs allow family members and intimate partners who believe a relative’s dangerous behavior may lead to violence to request an order from a civil court authorizing law enforcement to remove any guns in the individual’s possession, and to prohibit new gun purchases for the duration of the order.
Three states have laws that authorize law enforcement to remove guns from someone identified as dangerous: Indiana, Connecticut and Texas. In 2014, California became the first state in the nation to allow family members and intimate partners to directly petition a judge to temporarily remove firearms from a family member if they believe there is a substantial likelihood that the family member is a significant danger to himself or herself or others in the near future. The law, passed by the California legislature, takes effect Jan. 1, 2016.
“GVROs allow family members or intimate partners who identify a pattern of dangerous behavior to intervene in advance of something bad happening,” says lead author Shannon Frattaroli, PhD, MPH, an associate professor with the Johns Hopkins Center for Gun Policy and Research. “Currently under federal law, those who have been involuntarily committed to inpatient treatment for mental illness or those who have been convicted of felonies are prohibited from purchasing or possessing firearms, but there is no temporary prohibition based on dangerousness,” Frattaroli said. “The limitation of this approach is that firearm removals do not go into effect until an extreme event that results in a criminal justice or mental health system response has already occurred.”
Interaction of warming climate with a growing, shifting population could subject more people to sweltering conditions
NATIONAL CENTER FOR ATMOSPHERIC RESEARCH/UNIVERSITY CORPORATION FOR ATMOSPHERIC RESEARCH
BOULDER – U.S. residents’ exposure to extreme heat could increase four- to six-fold by mid-century, due to both a warming climate and a population that’s growing especially fast in the hottest regions of the country, according to new research.
The study, by researchers at the National Center for Atmospheric Research (NCAR) and the City University of New York (CUNY), highlights the importance of considering societal changes when trying to determine future climate impacts.
“Both population change and climate change matter,” said NCAR scientist Brian O’Neill, one of the study’s co-authors. “If you want to know how heat waves will affect health in the future, you have to consider both.”
Extreme heat kills more people in the United States than any other weather-related event, and scientists generally expect the number of deadly heat waves to increase as the climate warms. The new study, published May 18 in the journal Nature Climate Change, finds that the overall exposure of Americans to these future heat waves would be vastly underestimated if the role of population changes were ignored.
The total number of people exposed to extreme heat is expected to increase the most in cities across the country’s southern reaches, including Atlanta, Charlotte, Dallas, Houston, Oklahoma City, Phoenix, Tampa, and San Antonio.
he average annual exposure to extreme heat in the United States during the study period is expected to be between 10 and 14 billion person-days, compared to an annual average of 2.3 billion person-days between 1971 and 2000.
Of that increase, roughly a third is due solely to the warming climate (the increase in exposure to extreme heat that would be expected even if the population remained unchanged). Another third is due solely to population change (the increase in exposure that would be expected if climate remained unchanged but the population continued to grow and people continued to moved to warmer places). The final third is due to the interaction between the two (the increase in exposure expected because the population is growing fastest in places that are also getting hotter).
“We asked, ‘Where are the people moving? Where are the climate hot spots? How do those two things interact?'” said NCAR scientist Linda Mearns, also a study co-author. “When we looked at the country as a whole, we found that each factor had relatively equal effect.”
At a regional scale, the picture is different. In some areas of the country, climate change packs a bigger punch than population growth and vice versa.
For example, in the U.S. Mountain region–defined by the Census Bureau as the area stretching from Montana and Idaho south to Arizona and New Mexico–the impact of a growing population significantly outstrips the impact of a warming climate. But the opposite is true in the South Atlantic region, which encompasses the area from West Virginia and Maryland south through Florida.
Exposure vs. vulnerability
Regardless of the relative role that population or climate plays, some increase in total exposure to extreme heat is expected in every region of the continental United States. Even so, the study authors caution that exposure is not necessarily the same thing as vulnerability.
“Our study does not say how vulnerable or not people might be in the future,” O’Neill said. “We show that heat exposure will go up, but we don’t know how many of the people exposed will or won’t have air conditioners or easy access to public health centers, for example.”
Law would give family members and law enforcement tool to temporarily remove guns from someone believed dangerous
Gun violence restraining orders (GVROs) are a promising strategy for reducing firearm homicide and suicide in the United States, and should be considered by states seeking to address gun violence, researchers from the Johns Hopkins Center for Gun Policy and Research at the Johns Hopkins Bloomberg School of Public Health and the University of California, Davis, argue in a new report.
The article is being published online in Behavioral Sciences and the Law on May 20.
GVROs allow family members and intimate partners who believe a relative’s dangerous behavior may lead to violence to request an order from a civil court authorizing law enforcement to remove any guns in the individual’s possession, and to prohibit new gun purchases for the duration of the order. Three states have laws that authorize law enforcement to remove guns from someone identified as dangerous: Indiana, Connecticut and Texas. In 2014, California became the first state in the nation to allow family members and intimate partners to directly petition a judge to temporarily remove firearms from a family member if they believe there is a substantial likelihood that the family member is a significant danger to himself or herself or others in the near future. The law, passed by the California legislature, takes effect Jan. 1, 2016.
BLOOMINGTON, Ind. — Over nearly 15 years spent studying ticks, Indiana University’s Keith Clay has found southern Indiana to be an oasis free from Lyme disease, the condition most associated with these arachnids that are the second most common parasitic disease vector on Earth.
He has also seen signs that this low-risk environment is changing, both in Indiana and in other regions of the U.S.
A Distinguished Professor in the IU Bloomington College of Arts and Sciences’ Department of Biology, Clay has received support for his research on ticks from over $2.7 million in grants from the National Science Foundation-National Institutes of Health’s Ecology and Evolution of Infectious Diseases Program and others.
Clay’s lab has found relatively few pathogens in southern Indiana ticks that cause common tick-borne diseases compared to the Northeast and states like Wisconsin and Minnesota.
But Lyme disease has been detected just a few hours north of the region around Tippecanoe River State Park and Lake Michigan’s Indiana Dunes, and Clay said the signs are there that new tick species, and possibly the pathogens they carry, are entering the area.
“Just in the past 10 years, we’re seeing things shift considerably,” Clay said. “You used to never see lone star ticks in Indiana; now they’re very common. In 10 years, we’re likely to see the Gulf Coast tick here, too. There are several theories for why this is happening, but the big one is climate change.”
A vector for disease
The conclusions are drawn from years of work spent mapping tick boundaries and disease risks, but the exact cause of the shifting borders is not clear. In addition to changing temperatures, Clay references changes in animal populations, including deer, which provide large, mobile hosts for the parasites.
Findings confirm health risks to people living near oil and gas wells
FRISCO — Careful air sampling near active natural gas wells in Carroll County, Ohio showed the widespread presence of toxic air pollution at higher levels than the Environmental Protection Agency considers safe for lifetime exposure, according to scientists from Oregon State University and the University of Cincinnati.
The study reinforces the need for more extensive air quality monitoring in fracking zones around the country, where exposure to the poisonous emissions are likely to lead to increased risk of cancer and respiratory ailments.
“Air pollution from fracking operations may pose an under-recognized health hazard to people living near them,” said the study’s coauthor Kim Anderson, an environmental chemist with OSU’s College of Agricultural Sciences.
Anderson and her colleagues collected air samples during a three-week period last February in a highly fracked area, with more than one active well site per square mile. The study was spurred by local residents who wanted to know more about possible health risks.
The air samplers were placed on the properties of 23 volunteers living or working at sites ranging from right next to a gas well to a little more than three miles away. The samples were sent to Anderson’s lab at OSU, where the analysis showed high levels of PAHs across the study area. Levels were highest closest to the wells and decreased by about 30 percent with distance.
Even the lowest levels — detected on sites more than a mile away from a well — were higher than previous researchers had found in downtown Chicago and near a Belgian oil refinery. They were about 10 times higher than in a rural Michigan area with no natural gas wells.
The scientists said they were able to differentiate between pollution coming directly from the earth and from other sources like wood smoke or auto exhausts, supporting the conclusion that the gas wells were contributing to the higher PAH levels.
The researchers then used a standard calculation to determine the additional cancer risk posed by airborne contaminants over a range of scenarios. For the worst-case scenario (exposure 24 hours a day over 25 years), they found that a person anywhere in the study area would be exposed at a risk level exceeding the threshold of what the EPA deems acceptable.
The highest-risk areas were those nearest the wells, Anderson said. Areas more than a mile away posed about 30 percent less risk.
Anderson cautioned that these numbers are worst-case estimates and can’t predict the risk to any particular individual.
“Actual risk would depend heavily on exposure time, exposure frequency and proximity to a natural gas well,” she said.
“We made these calculations to put our findings in context with other, similar risk assessments and to compare the levels we found with the EPA’s acceptable risk level.”
The study has other caveats, Anderson said, the main one being the small number of non-random samples used. In addition, findings aren’t necessarily applicable to other gas-producing areas, because PAH emissions are influenced by extraction techniques and by underlying geology.
The study, which appears in the journal Environmental Science & Technology‘s online edition, is part of a larger project co-led by the University of Cincinnati’s Erin Haynes, OSU’s Anderson, her graduate student Blair Paulik and Laurel Kincl, director of OSU’s Environmental Health Science Center.
From the report (The 2015 World Happiness Report and supplemental files are available for download for free at this link)
The World Happiness Report is a landmark survey of the state of global happiness. The first report was published in 2012, the second in 2013, and the third on April 23, 2015. Leading experts across fields – economics, psychology, survey analysis, national statistics, health, public policy and more – describe how measurements of well-being can be used effectively to assess the progress of nations. The reports review the state of happiness in the world today and show how the new science of happiness explains personal and national variations in happiness. They reflect a new worldwide demand for more attention to happiness as a criteria for government policy.
The world has come a long way since the first World Happiness Report launched in 2012. Increasingly happiness is considered a proper measure of social progress and goal of public policy. A rapidly increasing number of national and local governments are using happiness data and research in their search for policies that could enable people to live better lives. Governments are measuring subjective well-being, and using well-being research as a guide to the design of public spaces and the delivery of public services.
Harnessing Happiness Data and Research to Improve Sustainable Development
The year 2015 is a watershed for humanity, with the pending adoption by UN member states of Sustainable Development Goals (SDGs) in September to help guide the world community towards a more inclusive and sustainable pattern of global development. The concepts of happiness and well-being are very likely to help guide progress towards sustainable development.
Sustainable development is a normative concept, calling for all societies to balance economic, social, and environmental objectives. When countries pursue GDP in a lopsided manner, overriding social and environmental objectives, the results often negatively impact human well- being. The SDGs are designed to help countries to achieve economic, social, and environmental objectives in harmony, thereby leading to higher levels of well-being for the present and future generations.
The SDGs will include goals, targets and quantitative indicators. The Sustainable Development Solutions Network, in its recommendations on the selection of SDG indicators, has strongly recommended the inclusion of indicators of Subjective Well-being and Positive Mood Affect to help guide and measure the progress towards the SDGs. We find considerable support of many governments and experts regarding the inclusion of such happiness indicators for the SDGs. The World Happiness Report 2015 once again underscores the fruitfulness of using happiness measurements for guiding policy making and for helping to assess the overall well-being in each society.
From the 14 May 2014 Dartmouth College news release
A Dartmouth research laboratory is working to quantify the effects of playing games. In a study published online last month by the Games for Health Journal, Professor Mary Flanagan and her team found that attitudes toward public health issues shift to be more accepting and understanding after playing a game they developed calledRePlay Health.
“Sales of games have been steadily increasing for several years,” says Flanagan, the Sherman Fairchild Distinguished Professor in Digital Humanities at Dartmouth and the director of the Tiltfactor laboratory. “So economically, we have measured their impact, and now it’s time to measure their ability to change behaviors and attitudes.”
RePlay Health is a role-playing sport that requires players to assume different identities and carry out various activities to improve their health. The backdrop of the game is a fictional health care system, and the players learn how personal behaviors, workplace productivity, insurance (or lack of it), and all related health care costs are woven together within the system. Each player is presented with opportunities to not only improve their own health, but also the health of their community through policy initiatives that they vote on.
“We showed how active engagement with the game’s characters and events was crucial to the game’s ability to shift players’ mindsets and attitudes about health and health policy,” says Geoff Kaufman, a co-author of the study and Tiltfactor’s post-doctoral researcher in psychology.
The researchers asked a group of young adults to complete an online questionnaire two weeks prior to playing RePlay Health and again within a week after playing the game. Flanagan says that the results indicate that the game has the potential to have a lasting impact on the players.
RePlay Health was developed in collaboration with The Dartmouth Center for Healthcare Delivery Science and the Rippel Foundation. The game is part of a broad initiative to promote learning about public health policies and spending priorities. Flanagan and her team envision college students, medical students, doctors, local council leaders, government officials, and any other people interested broadly in public health playing the game to digest the issues and find ideas that resonate. “It’s not just students and public officials who can play this game, or benefit from playing,” says Flanagan.
From the 12 May 2015 British Medical Journal editorial
Criticism of the Israeli government does not necessarily equate with antisemitism
In April, Reed Elsevier, publishers of the Lancet, received a complaint written by Professor Mark Pepys and signed by 396 physicians and scientists, including five Nobel Laureates.1 They protested that the Lancet was being used for political purposes and for “publication of deliberately false material which deepens polarization between Israelis and Palestinians.”
The most recent example of what was termed this “political vendetta” was the July publication, during the latest Israeli assault on Gaza, of an “Open letter for the people in Gaza.”2 They wrote that the letter “contains false assertions and unverifiable dishonest ‘facts,’ many of them libellous,” and that its authors had failed to declare possible conflicts of interest. The complaint insisted that the July letter be retracted (disagreeing with the Lancetombudsman’s decision3) and that it contravened the code of the Committee on Publication Ethics (disagreeing with a former chair of the committee4). It asked for the support of all scientists and clinicians “on whom they [Reed Elsevier] depend for their business,” adding “none of us is under any obligation to submit and review material for publication in their journals or to serve on their editorial or advisory boards.”
An email chain soliciting support for this complaint was more explicit.5 In it Pepys accused the July letter of “viciously attacking Israel with blood libels echoing those used for a thousand years to create anti-Semitic pogroms” and being “written by dedicated Jew haters.” He suggested that the letter “would have made Goebbels proud” and that “anybody who was not a committed anti-Semite would firstly not have published Manduca [lead author of the July letter] and secondly would have retracted instantly when her long track record of blatant anti-Semitism were [sic] exposed.” Two days before the complaint, the title of the email chain was modified to read “DO NOT CITE The Lancet in your work—Their content includes fraudulent data.”6
The July letter included a UN estimate of the number of Gazan children killed up to that date during the Israeli bombardment,7 which the Pepys email implied was exaggerated.
Medicine cannot avoid politics
These events raise two issues. The first is the appropriateness of medical journals discussing political issues that have bearing on health, including civilian mortality and morbidity.
The second issue is the similarity between this complaint’s attempt to stifle coverage of the conflict in Gaza and previous examples of writing campaigns provoked by articles in medical journals critical of Israeli policies, including allegations of hyperbole, accusations of antisemitism, and threats of boycott.
The reports published by the UN and others all point to the need for an independent investigation into the conflict by international teams of humanitarian, arms, and legal experts to determine whether and by whom—from either side of the conflict—violations of international human rights and humanitarian law were committed. The effect of this war on civilian mental health, morale, and assets is magnified by the cumulative burden of still destroyed houses and livelihoods dating from previous conflicts. As a deputy editor of The BMJ has pointed out, “Future generations will judge the journal harshly if we avert our gaze from the medical consequences of what is happening to the occupants of the Palestinian territories and to the Israelis next door.
The National Library of Medicine (NLM) Tox Town Town neighborhood now has a new photo-realistic look. The location and chemical information remains the same, but the new graphics allow users to better identify with real-life locations.
The Town scene is available in HTML5, allowing it to be accessed on a variety of personal electronic devices, including cell phones (iphones and androids), ipads, ipad minis, and tablets.
Tox Town uses color, graphics, sounds and animation to add interest to learning about connections between chemicals, the environment, and the public’s health. Visit the updated Town neighborhood and learn about possible environmental health risks in a typical town.
From the 28 April 2015 article at The Conversation
Traffic death rates are falling in OECD countries, but generally rising elsewhere as mass car ownership spreads to other countries. For this reason, the WHO forecast traffic fatalities moving up to the fifth leading cause of death globally by 2030.
Paradoxically, fatality rates (deaths per 100,000 people) are far higher in low-income countries, despite their low levels of vehicle ownership. The main reason? Pedestrian and cyclist deaths can be as high as two-thirds of those killed, compared with 16% in Australia.
Tens of millions are also injured each year on the world’s roads. Particularly in low-income countries, this can mean a double catastrophe: loss of earnings and high medical costs for the affected families.
Air pollution also results in millions of premature deaths, especially in Asian megacities, and the rapid rise in vehicular traffic is an important cause. Further, a recent Chinese studyhas found that children’s school performance was adversely affected by living in traffic-polluted areas.
What’s the alternative?
For some time in OECD countries—and even elsewhere, when we consider traffic casualties and air pollution health effects—the societal costs of extra mobility have been rising faster than the benefits obtained. We must now focus on accessibility —the ease with which people can reach various activities — rather than vehicular mobility.
When access replaces mobility, we can finally start designing our cities for humans rather than cars. We’ll need to design our cities and towns to encourage an attachment to place, rather than endlessly trying to be someplace else. Excess mobility can destroy this sense of place.
Family income is associated with children’s brain structure, reports a new study in Nature Neuroscience coauthored by Teachers College faculty member Kimberly Noble. The association appears to be strongest among children from lower-income families.
“We can’t say if the brain and cognitive differences we observed are causally linked to income disparities,” said Noble, who currently is both a TC Visiting Professor and Director of the Neurocognition, Early Experience and Development Lab of Columbia University Medical Center, but will join TC’s faculty as Associate professor of Neuroscience and Education in July in the Department of Biobehavioral Sciences. “But if so, policies that target poorest families would have the largest impact on brain development.”
The authors discuss how the use of quarantine can unintentionally introduce secondary and tertiary effects. If individuals show symptoms but are not isolated immediately, they will contaminate the quarantine group, and if individuals without symptoms are cohorted with a group already symptomatic, the risk of transmission will increase. The other unintended consequence is to patients admitted to hospitals for other medical reasons, e.g., heart attacks, strokes, trauma, and cancer.
The issue of psychological stress during quarantine is also addressed. These include fear of the disease and possible confinement, and the effects on family, friends and colleagues.
Before civil liberties are suspended, decision-makers must use evidence-based data to support their decisions. Public health officials and political figures should avoid taking unnecessary harsh precautions in their effort to appear on top of the situation. Per Dr. Barbisch, Major General, US Army (ret): “Quarantine should only be used if the inherent restrictions will effectively reduce the spread of the disease.”
he National Center for Medical-Legal Partnership, part of Milken Institute School of Public Health at the George Washington University, will host its tenth annual conference on April 9-10, 2015, in McLean, Virginia to discuss how to better address the social and legal problems negatively impacting the health of 50 million low-income Americans. Leaders from law, health care, public health and government in 38 states will present research and strategies aimed at effectively integrating health and legal care.
With featured remarks from Lauren Taylor, co-author of The American Health Care Paradox, Jeffrey Levi, executive director of Trust for America’s Health, and Phillip Alberti, senior director for health equity research & policy at the Association of American Medical Colleges, participants will explore topics including:
The intersection of health and legal problems for veterans, children and chronically ill individuals;
The ways that providing integrated legal care for patients can help meet community benefit requirements for public hospitals; and
The ability of legal care to strengthen population health interventions.
In an editorial posted online today in the Annals of Emergency Medicine, two practicing emergency medicine physicians from the University of California, Davis, and Brown University — both thought leaders at the forefront of finding solutions to the public health crisis of gun violence — urge their colleagues to take direct action to protect the health and safety of patients and communities.
Their editorial follows the Feb. 24 call to action by eight health professional organizations, including the American College of Emergency Physicians, and the American Bar Association, to reduce firearm injuries and deaths in the U.S. — unprecedented support that suggests mobilization to prevent firearm violence may be underway.
“Firearm violence causes nearly as many deaths as motor vehicle crashes,” said Garen J. Wintemute, an emergency medicine professor at UC Davis and a national authority on evidence-based strategies to prevent firearm violence. “Firearms are involved in most homicides and suicides, and the number of suicides by firearm is increasing — especially among older white men.
“Emergency medicine physicians have limited opportunities to prevent a death once a shooting has occurred, because most people who die from their wounds do so where they are shot. Gun ownership or having a gun in the household is a well-documented risk factor for a violent death. For that reason, we believe physicians should also work to help prevent shootings,” he said.
The authors describe how America successfully reduced motor-vehicle-related deaths by better vehicle and roadway design and public policies that make driving under the influence a crime. Yet no comparable public-health campaign focused on reducing gun violence has been launched.
The authors particularly emphasize the need for a national policy requiring background checks on all transfers of firearms to help prevent access to firearms by those who are prohibited from having them. They recommend adding two other high-risk groups to the list of individuals who are prohibited from purchasing firearms. These include persons with a history of violent misdemeanor convictions, such as assault and battery and domestic violence, as well as those with a documented history of addiction and alcohol abuse.
“Controlled studies of felons, those who have committed violent misdemeanors and persons prohibited for mental-health reasons have all shown reductions in risk for future violence of 25 percent or more when these individuals are denied firearm purchases,” said Megan Ranney, an emergency medicine physician and director of the Emergency Digital Health Innovation program at Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
The authors also address mental illness and gun violence. While they agree with recommendations that focus on behavior and expanded access to treatment, they emphasize that serious mental illness directly accounts for only 4 percent of interpersonal violence. In contrast, mental illness is associated with between 47 and 74 percent of suicides. The risk of firearm injury increases when mental illness coexists with alcohol abuse, drug abuse and a history of prior violence.
“Physicians need to include questions about firearms when assessing risk of violence in their patients, and need to act on the information, especially when patients are expressing thoughts of dangerousness to themselves or others, are intoxicated or are in the emergency department for a violence-related injury,” Ranney said.
At a time when civilian fatalities from gunshot wounds for 2004 to 2013 have outnumbered combat fatalities from World War II, the authors welcome the unprecedented support from leading organizations of health and legal professionals for policy recommendations to reduce gun violence.
“Physicians can take direct action to protect the health and safety of patients and communities,” Wintemute said. “While we may not all agree on all the specifics, enough of us will agree on enough of them to make a difference for the better.”
The Violence Prevention Research Program is an organized research program of the University of California, Davis, that conducts leading-edge research to further America’s efforts to understand and prevent violence. Since its founding over 30 years ago, the program has produced a uniquely rich and informative body of research on the causes, nature and prevention of violence, especially firearm violence. Current areas of emphasis include the prediction of criminal behavior, the effectiveness of waiting period and background-check programs for prospective purchasers of firearms, and the determinants of firearm violence. For more information, visit www.ucdmc.ucdavis.edu/vprp
Founded in 1863, Rhode Island Hospital in Providence, R.I., is a private, not-for-profit hospital and is the principal teaching hospital of The Warren Alpert Medical School of Brown University. A major trauma center for southeastern New England, the hospital is dedicated to being on the cutting edge of medicine and research. Last year, Rhode Island Hospital received more than $55 million in external research funding. It is also home to Hasbro Children’s Hospital, the state’s only facility dedicated to pediatric care. For more information on Rhode Island Hospital, visitwww.rhodeislandhospital.org, follow us on Twitter @RIHospital or like us on Facebook http://www.facebook.com/rhodeislandhospitalpage.
While legislation expanding how and where Texans can carry weapons is dominating the Legislature this week, one state lawmaker is targeting the doctor’s office as a place to keep the federal government from learning who owns guns.
Over the objections of the medical community, state Rep. Stuart Spitzer, R-Kaufman, has filed a bill that would prohibit doctors from asking patients whether they own a firearm and makes the Texas Medical Board, which licenses physicians, responsible for doling out punishment.
Air pollution is linked to a higher risk of stroke, particularly in developing countries, finds a study published in The BMJ today. In a second article, new research also shows that air pollution is associated with anxiety.
Stroke is a leading cause of death and kills around 5 million people each year worldwide. Common risk factors include obesity, smoking and high blood pressure. But the effect of the environment, such as, air pollution is uncertain because evidence is lacking.
In a systematic review and meta analysis, a team of researchers from Edinburgh University looked at the association between short term air pollution exposure and stroke related hospital admissions and deaths. In total, they analysed 103 observational studies that covered 28 countries across the world.
Gaseous pollutants included in the analysis were carbon monoxide, sulphur dioxide, nitrogen dioxide and ozone. In addition, particulate matter was included: PM 2.5 (fine particles less than 2.5 µm in size) and PM 10 (coarse particles less than 10 µm in size).
Results showed an association between carbon monoxide (1.5% increased risk per 1 ppm), sulphur dioxide (1.9% per 10 ppb) and nitrogen dioxide (1.4% per 10 ppb) and stroke related hospital admissions or death. The weakest association was found for ozone.
Both PM 2.5 and PM 10 were associated with hospital admissions or deaths due to stroke, by 1.1% and 0.3% per 10 µg/m3 increment respectively. The first day of air pollution exposure was found to have the strongest association.
Low- to middle-income countries experienced the strongest associations compared to high-income countries. Only 20% of analysed studies were from low- to middle-income countries – mostly mainland China – despite these countries having the highest burden of stroke.
Both studies were observational and no definitive conclusions can be drawn about cause and effect, and the teams of researchers call for more research.
From the article below
““The study purporting to link air quality to anxiety is much less convincing. By far the most likely explanation, especially given that more recent exposure has a greater effect, is that the anxiety relates to traffic (noise, increased risk of accident) than to air pollutants themselves. Even though the authors say that living nearer to main roads was allowed for, this does not take away concern that having to walk/drive around in an area with greater traffic flows was not the major influence on this association. Other potential confounders such as green space were also not allowed for. There are also no real plausible mechanisms why this association shouldn’t be other than one which has arisen by chance. I am surprised that this was accepted for publication given these weaknesses and concerned that this will result in inappropriate anxiety in readers.””
Bacteria that cause many hospital-associated infections are ready to quickly share genes that allow them to resist powerful antibiotics. The illustration, based on electron micrographs and created by the Centers for Disease Control and Prevention, shows one of these antibiotic-resistant bacteria. Credit: CDC/James Archer
Antibiotic resistance is poised to spread globally among bacteria frequently implicated in respiratory and urinary infections in hospital settings, according to new research at Washington University School of Medicine in St. Louis.
The study shows that two genes that confer resistance against a particularly strong class of antibiotics can be shared easily among a family of bacteria responsible for a significant portion of hospital-associated infections.
Drug-resistant germs in the same family of bacteria recently infected several patients at two Los Angeles hospitals. The infections have been linked to medical scopes believed to have been contaminated with bacteria that can resist carbapenems, potent antibiotics that are supposed to be used only in gravely ill patients or those infected by resistant bacteria.
“Carbapenems are one of our last resorts for treating bacterial infections, what we use when nothing else works,” said senior author Gautam Dantas, PhD, associate professor of pathology and immunology. “Given what we know now, I don’t think it’s overstating the case to say that for certain types of infections, we may be looking at the start of the post-antibiotic era, a time when most of the antibiotics we rely on to treat bacterial infections are no longer effective.”
Over the last 30 years, short sight, or myopia, has become a global health problem. The most dramatic rise has been in Singapore, Taiwan, China’s cities and elsewhere in East Asia. Rates can be as high as 80-90 per cent among children leaving secondary schools in the region. As many as a fifth of them have severe myopia and so are at high risk of eye problems in later life. In Western countries rates are increasing; although not as rapidly as in East Asia.
The Myopia Mystery
Compensating for myopia using a corrective lens. (Photo credit: Wikipedia)
The cause of myopia, and the means to prevent it, are unclear despite more than 150 years of scientific research. Many theories have been put forward to explain why children’s eyesight gets worse as they go through school. Too much close work is one of the more popular ones, while heredity is another. Both have been hotly debated down the years.
Is Myopia Like Rickets?
The new study compares the history of school myopia with the bone disease rickets. During the 17th century, rickets was common among children in England and then reached epidemic levels through northern Europe and North America. In some cities, 80 per cent of children were affected. The remedy proved elusive until the 1920s, when scientists found that a lack of sunlight, resulting in vitamin D deficiency, was the cause of rickets. Myopia, like rickets, is a seasonal condition which seems to get worse in the winter. Recent research on myopia has revived an old theory from the 1890s, that school children who spend more time outdoors have lower levels of myopia. However, unlike rickets, low ambient light levels rather than low vitamin D levels seem to be the deciding factor in myopia.
Population growth could cause global demand for water to outpace supply by mid-century if current levels of consumption continue. But it wouldn’t be the first time this has happened, a Duke University study finds.
Using a delayed-feedback mathematical model that analyzes historic data to help project future trends, the researchers identified a regularly recurring pattern of global water use in recent centuries. Periods of increased demand for water — often coinciding with population growth or other major demographic and social changes — were followed by periods of rapid innovation of new water technologies that helped end or ease any shortages.
Based on this recurring pattern, the model predicts a similar period of innovation could occur in coming decades.
“Researchers in other fields have previously used this model to predict earthquakes and other complex processes, including events like the boom and bust of the stock market during financial crises, but this is the first time it’s been applied to water use,” said Anthony Parolari, postdoctoral research associate in civil and environmental engineering at Duke, who led the new study.
“What the model shows us is that there will likely be a new phase of change in the global water supply system by the mid-21st century,” Parolari said.
“This could take the form of a gradual move toward new policies that encourage a sustainable rate of water use, or it could be a technological advancement that provides a new source of water for us to tap into. There’s a range of possibilities,” he said.
Data on global water use shows we are currently in a period of relatively stagnant growth, he said. Per-capita water use has been declining since 1980, largely due to improved efficiency measures and heightened public awareness of the importance of conserving Earth’s limited supply of freshwater. This has helped offset the impacts of recent population growth.
“But if population growth trends continue, per-capita water use will have to decline even more sharply for there to be enough water to meet demand,” he said. The world’s population is projected to surge to 9.6 billion by 2050, up from an estimated 7 billion today.
“For every new person who is born, how much more water can we supply? The model suggests we may reach a tipping point where efficiency measures are no longer sufficient and water scarcity either impacts population growth or pushes us to find new water supplies,” Parolari said.
Water recycling, and finding new and better ways to remove salt from seawater, are among the more likely technological advances that could help alleviate or avoid future water shortages, he said.
Date:March 19, 2015
Summary:Wireless sensors recording human interactions explain the transmission of germs, such as MRSA, in hospitals, according to new research.
The results indicate that the study of individuals contact may help identify increased risk of transmission situations and ultimately reduce the burden of nosocomial S. aureus transmission.
The researchers say: “Contact networks have been increasingly used in modeling the spread of infectious diseases. Yet, the contacts collected were often incomplete or used proxies that were thought to capture situation at risk. In this unique experiment, the joint analysis of contact and carriage validates the use of close-proximity interactions recorded by electronic devices, and opens a new field for prevention measures in hospitals.”
Previous research has demonstrated that investing in publicly funded family planning services enables women to avoid unwanted pregnancies and space wanted ones, which is good not only for women and families, but also for society as a whole. In the absence of the current U.S. publicly funded family planning effort, the public costs of unintended pregnancies in 2010 would have been 75% higher.
Sonfield and Kost report that the total gross savings from averting all unintended pregnancies in 2010 would have been $15.5 billion. This is less than the total public cost of all unintended pregnancies, because even if all women had been able to time their pregnancies as they wanted, some still would have had planned births that were publicly funded. These potential savings do not account for the cost of providing family planning services and other interventions that might be required to prevent the unintended pregnancies.
“Reducing public expenditures related to unintended pregnancies requires substantial new public investments in family planning services,” says Sonfield. “That would mean strengthening existing programs, such as the Title X family planning program, as well as working to ensure that the Affordable Care Act achieves its full potential to bolster Medicaid and other safety-net programs. We know we can prevent unintended pregnancies and the related costs. There are public programs in place that do it already, but as these data show, there is significantly more progress to be made.”
The new research also highlights the central role played by Medicaid and other public insurance programs in providing critical pregnancy-related care—including prenatal care, labor and delivery, postpartum care and infant care—that help keep women and babies healthy. Fifty-one percent of the four million births in the United States in 2010 were publicly funded, including 68% of unplanned births and 38% of planned births.
“These findings demonstrate the continuing importance of Medicaid and other public health insurance programs in preserving maternal and child health, and in supporting pregnancy-related care,” says Adam Sonfield, coauthor of the new report.
Denmark’s largestresearch project on chemical cocktail effects infood, spearheaded by the National Food Institute, Technical University of Denmark, has just been completed. Ithas established that even smalldoses of chemicals can have significantnegative effectsif they are present together. A reliablemethod for calculating the effects of chemical cocktails has been developed in the project. The projecthas also showna need forlimiting the Danish population’s exposure to certain substances.
The fact that the traditional way of assessing potential harmful effects of chemicals only takes the individual chemicals into account has long been of concern. Especially since this approach does not take into account the effects that can occur in humans when the chemicals are present at the same time in a cocktail. A serious concern is that substances can amplify each other’s effects, so that their combined effect becomes greater than what can be predicted by looking at the individual chemicals.
“Our research shows that indeed, little strokes fell great oaks also when it comes to chemical exposure. Going forward this insight has a profound impact on the way we should assess the risk posed by chemicals weare exposed to through the foods we eat.”
A recently completed, four-year research project on cocktail effects in foods, led by the National Food Institute, has established that when two or more chemicals appear together, they often have an additive effect. This means that cocktail effects can be predicted based on information from single chemicals, but also that small amounts of chemicals when present together can have significant negative effects.
”Our research shows that indeed, little strokes fell great oaks also when it comes to chemical exposure. Going forward this insight has a profound impact on the way we should assess the risk posed by chemicals we are exposed to through the foods we eat,” Professor Anne Marie Vinggaard from the National Food Institute says.
Danes’ exposure to chemicals via foods
In order to assess the risk posed by various chemicals, it is essential to know what the typical human exposure to a particular chemical is. The cocktail project has created an overview of the amount of pesticides and other contaminants that humans are exposed to via foods.
This work has shown that Danes’ intake of pesticides through foods is relatively limited. However, there is a need for reducing exposure to substances such as lead, cadmium, PCBs and dioxins.
The endocrine disrupting effects of chemicals have generally not been adequately studied. However, in cases where knowledge about the effects is available, the results show a need to reduce the intake of endocrine disrupting chemicals from current levels, such as phthalates and fluorinated chemicals.
From the article, Perspectives on Psychological Science, March 2015 vol. 10 no. 2 227-237
Several lifestyle and environmental factors are risk factors for early mortality, including smoking, sedentary lifestyle, and air pollution. However, in the scientific literature, much less attention has been given to social factors demonstrated to have equivalent or greater influence on mortality risk (Holt-Lunstad, Smith, & Layton, 2010). Being socially connected is not only influential for psychological and emotional well-being but it also has a significant and positive influence on physical well-being (Uchino, 2006) and overall longevity (Holt-Lunstad et al., 2010; House, Landis, & Umberson, 1988; Shor, Roelfs, & Yogev, 2013). A lack of social connections has also been linked to detrimental health outcomes in previous research. Although the broader protective effect of social relationships is known, in this meta-analytic review, we aim to narrow researchers’ understanding of the evidence in support of increased risk associated with social deficits. Specifically, researchers have assumed that the overall effect of social connections reported previously inversely equates with risk associated with social deficits, but it is presently unclear whether the deleterious effects of social deficits outweigh the salubrious effects of social connections. Currently, no meta-analyses focused on social isolation and loneliness exist in which mortality is the outcome. With efforts underway to identify groups at risk and to intervene to reduce that risk, it is important to understand the relative influence of social isolation and loneliness.
Living alone, having few social network ties, and having infrequent social contact are all markers of social isolation. The common thread across these is an objective quantitative approach to establish a dearth of social contact and network size. Whereas social isolation can be an objectively quantifiable variable, loneliness is a subjective emotional state. Loneliness is the perception of social isolation, or the subjective experience of being lonely, and thus involves necessarily subjective measurement. Loneliness has also been described as the dissatisfaction with the discrepancy between desired and actual social relationships (Peplau & Perlman, 1982).
Raising Minimum Wage Good for Public Health, Not Just Wallets: Advocates Call for Federal Increase http://thenationshealth.aphapublications.org/content/45/2/1.1.full
For a growing chorus of public health practitioners, raising the minimum wage is a fundamental step in addressing two key determinants of health: income and poverty.
CDC has released the updated Community Health Status Indicators (CHSI) online tool that produces public health profiles for all 3,143 counties in the United States. Each profile includes key indicators of health outcomes, which describes the population health status of a county and factors that have the potential to influence health outcomes, such as health care access and quality, health behaviors, social factors, and the physical environment.
Each profile includes key indicators of health outcomes, which describes the population health status of a county and factors that have the potential to influence health outcomes, such as health care access and quality, health behaviors, social factors, and the physical environment.
The re-designed online application includes updated peer county groups, health status indicators, a summary comparison page, and U.S. Census tract data and indicators for sub-populations (age groups, sex, and race/ethnicity) to identify potential health disparities. In this new version of CHSI, all indicators are benchmarked against those of peer counties, the median of all U.S. counties, and Healthy People 2020 targets. Organizations conducting community health assessments can use CHSI data to:
Assess community health status and identify disparities;
Promote a shared understanding of the wide range of factors that can influence health; and
Mobilize multi-sector partnerships to work together to improve population health.
Massive health program: $34 billion spent on women and children since 2010; New goal: End preventable deaths of women and young children
An ambitious 2010 initiative to improve the health of women and children around the world has turned into the fastest growing global public health partnership in history, attracting $60 billion in resources. Some $34 billion, nearly 60 percent of the total, has already been disbursed.
The Every Woman Every Child movement has now gathered more than 400 commitments by more than 300 partners around the world, ranging from governments and foundations to business, civil society and low-income countries themselves.
The movement stems from the Global Strategy for Women’s and Children’s Health, launched by United Nations Secretary-General Ban Ki-moon in 2010 to accelerate progress towards the Millennium Development Goals (MDGs) for health.
Every Woman Every Child has set off a major wave in attention to improving essential health care for millions of poor women and children. Major gains in the past five years include greater professional maternity care, family planning, prenatal and postnatal care, childhood vaccinations, oral rehydration therapy and improving access to drugs to prevent mother-to-child transmission of HIV.
The result of such increased care is that maternal and child death rates have fallen in every one of the Global Strategy’s 49-targeted countries in the latest four years.
“The synergy between education and health is evident. Education and health are, quite simply, the drivers of change and development. Education empowers women and girls to live healthier lives and as a result, fewer children are dying. The evidence is clear, better education leads to better health outcomes.
“One of the most important lessons we have learned through the Millennium Development Goals is that to make progress we need an integrated and multifaceted approach,” says Kathy Calvin, president of the UN Foundation. “Effective partnerships are not just about financing; they also tap into partner expertise, innovation, and resources to deliver results. Every Woman Every Child has shown that when each sector contributes its unique strengths and capacities, we can save lives.”
Keys to progress
Significant improvements in key health indicators mainly in 49-targeted countries during its five-year history of Every Women Every Child include:
870,000 new health care workers.
193 percent increase in prevention of mother-to-child HIV treatment.
49 percent increase in oral rehydration therapy for treating infant diarrhea.
Understanding Conflict Research Cluster Critical Studies Research Group
Keynotes: Prof Elaine Scarry and Prof Joanna Bourke
The year 2015 marks the thirtieth anniversary of Elaine Scarry’s The Body in Pain. In this seminal text, Scarry offers a radical and original thesis on the relationship between embodiment, pain, wounding and imagining, arguing that pain is central to “the making and unmaking of the world”. Widely regarded as a classic, the text has influenced work on notions of the body, war, torture and pain in a variety of academic disciplines – from philosophy, to anthropology, to cultural geography, to political theory, to many others – as well as informing debates and discussions in medical science, NGOs, charities and other parts of society. In the years since its publication the text has only become…
Many believe their health has been impacted by negative childhood experiences
A new NPR/Robert Wood Johnson Foundation/Harvard T.H. Chan School of Public Health poll finds that more than six in ten people living in the U.S. (62%) are concerned about their future health. Nearly four in ten (39%) said that they had one or more negative childhood experiences that they believe had a harmful impact on their adult health.
Causes of ill health
“When the public thinks about the causes of ill health, it’s not just about germs. They also see access to medical care, personal behavior, stress, andpollution as affecting health,” said Robert J. Blendon, Richard L. Menschel Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health.
When given a list of 14 factors that might cause ill health, the top five causes cited by the public as extremely important are lack of access to high-quality medical care (42%), personal behavior (40%), viruses or bacteria (40%), high stress (37%), and exposure to air, water, or chemical pollution (35%).
Those rankings diverge, however, among ethnic groups.
Actions to improve health
Given the wide range of reasons given for why ill health occurs, it is not surprising that people in the U.S. have a very broad view of the actions that could be taken to improve people’s health. The top five things (from a list of 16) that the public believes would improve people’s health a great deal are: improving access to affordable healthy food (57%), reducing illegal drug use (54%), reducing air, water, or chemical pollution (52%), increasing access to high-quality health care (52%), and improving the economy and the availability of jobs (49%).
To be presented at the 2015 APS March Meeting in San Antonio, Texas, March 5
From the press release
A team of Cornell University researchers focusing on a fictional zombie outbreak as an approach to disease modeling suggests heading for the hills, in the Rockies, to save your brains from the undead.
Reading World War Z, an oral history of the first zombie war, and a graduate statistical mechanics class inspired a group of Cornell University researchers to explore how an “actual” zombie outbreak might play out in the U.S.
During the 2015 American Physical Society March Meeting, on Thursday, March 5 in San Antonio, Texas, the group will describe their work modeling the statistical mechanics of zombies–those thankfully fictional “undead” creatures with an appetite for human flesh. (See the abstract: http://meeting.aps.org/Meeting/MAR15/Session/S48.8)
Why model the mechanics of zombies? “Modeling zombies takes you through a lot of the techniques used to model real diseases, albeit in a fun context,” says Alex Alemi, a graduate student at Cornell University.
A patient in a hospital in Cambodia is given some pain killers. Photo: World Bank/Masaru Goto
3 March 2015 – Three quarters of the world population has no access to proper pain relief treatment, according to a report by the United Nations body charged with overseeing Governments’ compliance with international drug control treaties, which was released in London today.
Around 5.5 billion people still have limited or no access to medicines containing narcotic drugs such as codeine or morphine the Vienna-based International Narcotics Control Board (INCB) says in its Annual Report for 2014, which went on to point out that around 92 per cent of all morphine used worldwide is consumed by only 17 per cent of the world population, primarily living in the United States, Canada, Western Europe, Australia and New Zealand.
The report, which calls on Governments to address the discrepancy in order to comply with International Drug Control Conventions, notes that natural disasters and armed conflicts around the world can further limit access to essential medicines and the Board stressed that in cases of emergency medical care, simplified control measures can be applied.
For example in the Philippines following the destruction by Typhoon Haiyan in 2013, the Board pointed out to all countries as well as to providers of humanitarian assistance the simplified procedures for the export, transportation and delivery of medicines containing substances under international control.
In its Report, the INCB notes that drug control measures do not exist in a vacuum and that, in their implementation of the drug control conventions, States must also comply with obligations under other treaties, including international humanitarian law and their international human rights obligations, such as allowing civilians to have access to medical care and essential medicines during armed conflicts.
Additionally, the INCB noted that States were charged with deciding specific sanctions for drug-related offences, but should avoid application of the death penalty for such cases.
To achieve a balanced and integrated approach to the drug problem, Governments also should ensure that demand reduction is one of the first priorities of their drug control policies, while they should put greater emphasis on and provide support and appropriate resources to prevention, treatment and rehabilitation, the Report says.
Among the rest of the Report’s findings were an increase in the number of new psychoactive substances (NPS) by 11 per cent and a 66 per cent increase in global consumption of methylphenidate, a stimulant primarily used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD).
The Report also pointed out that the legalization of production, distribution, sale and consumption of cannabis and its derivatives for recreational purposes in Uruguay, together with the moves by States in the United States to legalise sale and distribution of cannabis for non-medical purposes, ran counter to article 4 of the 1961 Single Convention on narcotic drugs, which requires States to limit the use of narcotic drugs to medical and scientific purposes.
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.
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?
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…
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.
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.
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.
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
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.
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.
…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…
….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.
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 Bodyby 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.
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.
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.
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.
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.
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.
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.’
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.
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.
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.
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.
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.
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.
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.
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.”
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner. (For those wishing to see pictures of a 2009 Friends of Liberia service trip to this West African country, please visit www.fol.org. My photo album is included).
Do you have an informational question in the health/medical area?
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My professional work experience and education includes over 10 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news,
I subscribe to the following to glean entries for this blog
Krafty (Medical)Librarian,” a collection of writings from Michelle Kraft on items of interest to medical librarians. She tends to write on technology and medical libraries but she also writes about things in general on librarianship, medicine and health”
Research Buzz, “news about search engines, digital archives, online museums, databases, and other Internet information collections since 1998″
Free Government Information, a “place for initiating dialogue and building consensus among the various players (libraries, government agencies, non-profit organizations, researchers, journalists, etc.) who have a stake in the preservation of and perpetual free access to government information”
Scout Report, a “weekly publication offering a selection of new and newly discovered Internet resources of interest to researchers and educators”