It was terribly sad listening to the bother of a “legal high” victim on the radio this morning. The now banned N-Bomb LSD copycat drug had left his brother severely brain damaged and dependent on 24 hour care for the rest of his life.
Surely it is time to stop using the incredibly misleading term ‘legal high’ with its safe, non-addictive, not-bad-enough-to-be-banned connotations. It’s a lie. The internet is littered with websites selling untold numbers of chemical compounds, blithely labelled with seductive names and proclaimed as legal, ‘quality research chemicals and herbal incense’, getting away with it through a bold disclaimer of “STRICTLY NOT FOR HUMAN CONSUMPTION”.
To try and start classifying them is financially and logistically possible, even though the All-Party Parliamentary Group for Drug Policy Reform (clue is in the name) calls for the Utopian solution of the an introduction of a new category for psychoactive substances whereby their supply can be ‘regulated’ and a review of the government lead for drugs to ensure a health focus. Yeah right.
The first step from the government surely has to be to a serious focus on deterrence. Insist on accurate labeling such as ‘high risk unclassified highs’ in all commentary – because there is never, ever anyway of the public being sure what is in the psychoactive substance. Possession should automatically incur a significant fine – pills, powder, whatever – you are potentially endangering yours and others lives. It may be herbs and talc but life is too short to test everything – the European Monitoring Centre for Drugs and Drug Addiction identified 73 new substances in 2012 alone - and it sends a message of principle. It is ridiculous that they can have ‘not fit for human consumption’ on the packet as a legal requirement alongside names such as gogaine, spellweaver, charlie and e-scape.
The American example of “analogue” legislation which simply automatically bans any new substance that has a similar chemical structure to an already banned drug is worth considering but it can never keep pace with new products coming to market. There are hundreds if not thousands of labs in Asia where new synthetic drugs are synthesised to imitate the effects of existing legal drugs. We have to keep this simple, and act now, if we are to prevent more tragic episodes of injury and death.
Chronic pain syndrome is an extremely complicated diagnosis and the treatment of its symptoms requires an interdisciplinary approach ranging from primary care physicians, physical therapists, anesthesiologists, and psychologists. Likewise, understanding the barriers to the treatment of chronic pain requires teasing out a similarly convoluted picture. Therefore, I’ve decided to write about the extremely complex and understudied relationship between poverty and pain. Not surprisingly, there are many components to this relationship because the American health care system is one that involves many players from the government, private sector, non-profits, and Medicare, Medicaid, TRICARE, Children’s Health Insurance Program, Social Security Administration, and the Veteran’s Administration, just to name a few. However my focus will be narrowed to concentrate on the relationship between living in poverty and efficacious treatment of chronic pain, the flip side of that relationship where individuals fall into poverty as a result of a life-altering, limiting, and costly diagnosis of chronic pain, and the stigma of poverty that consciously or unconsciously affects access to treatment for patients in pain.
Living in poverty increases an individual’s risk for pain on almost every level including musculoskeletal, sciatica, ulcer, and neuropathic. Poleshuck and Green suggest that an individual’s socioeconomic status permeates almost every level of why an individual may suffer with chronic pain including the ability to implement positive coping strategies, job type and satisfaction, access to quality health insurance, and even social support and interpersonal relationships.
too often research on chronic pain is conducted in areas that have significant financial resources instead of places such as churches, homeless shelters, and community centers. There are other things to consider here. People that live in poverty and suffer from pain may not have access to primary care givers, analgesics or pharmacies that carry analgesics, and pain specialists. As the U.S. population ages and increasingly more people are diagnosed with pain disorders, those on the fringe will suffer most. Of course, there is a moral argument to be made here but there is an economic one too. According to an article that came out in Science Daily in 2012, health economists at Johns Hopkins estimated that chronic pain cost as much as $635 billion a year which they found was higher than heart disease, diabetes, and cancer. This was a conservative estimate. Therefore, one could argue that it is a public health interest to employ strategies of risk management, access, and multidisciplinary approaches to pain to vulnerable groups who suffer disabling pain at a higher number and magnitude.
The Top Five Useless Chronic Pain Treatments (Psychology Today), What not to do to help the chronic pain patient.Published on January 31, 2014 by Dr. Mark Borigini, M.D. in Overcoming Pain
Total releases of toxic chemicals decreased 12 percent from 2011-2012, according to the U.S. Environmental Protection Agency’s (EPA) annual Toxics Release Inventory (TRI) report released today. The decrease includes an eight percent decline in total toxic air releases, primarily due to reductions in hazardous air pollutant (HAP) emissions.
“People deserve to know what toxic chemicals are being used and released in their backyards, and what companies are doing to prevent pollution,” said EPA Administrator Gina McCarthy. “By making that information easily accessible through online tools, maps, and reports, TRI is helping protect our health and the environment.”
The 2012 data show that 3.63 billion pounds of toxic chemicals were either disposed or otherwise released into the environment through air, water, and land. There was also a decline in releases of HAPs such as hydrochloric acid and mercury, which continues a long-term trend. Between 2011 and 2012, toxic releases into surface water decreased three percent and toxic releases to land decreased 16 percent.
This is the first year that TRI has collected data on hydrogen sulfide. While it was added to the TRI list of reportable toxic chemicals in a 1993 rulemaking, EPA issued an Administrative Stay in 1994 that deferred reporting while the agency completed further evaluation of the chemical. EPA lifted the stay in 2011. In 2012, 25.8 million pounds of hydrogen sulfide were reported to TRI, mainly in the form of releases to air from paper, petroleum, and chemical manufacturing facilities.
Another new addition to TRI reporting is a requirement for each facility located in Indian country to submit TRI reports to EPA and the appropriate tribe, and not the state where the facility is geographically located. EPA finalized this requirement in a 2012 rule aimed at increasing tribal participation in the TRI Program.
This year’s TRI national analysis report includes new analyses and interactive maps for each U.S. metropolitan and micropolitan area, new information about industry efforts to reduce pollution through green chemistry and other pollution prevention practices, and a new feature about chemical use in consumer products.
The annual TRI report provides citizens with critical information about their communities. The TRI Program collects data on certain toxic chemical releases to the air, water, and land, as well as information on waste management and pollution prevention activities by facilities across the country.
The data are submitted annually to EPA, states, and tribes by facilities in industry sectors such as manufacturing, metal mining, electric utilities, and commercial hazardous waste. Many of the releases from facilities that are subject to TRI reporting are regulated under other EPA program requirements designed to limit harm to human health and the environment.
Also available is the expanded TRI Pollution Prevention (P2) Search Tool, which now allows users to graphically compare facilities within the same industry using a variety of environmental metrics.
Toxics Release Inventory National Analysis
Under the Emergency Planning and Community Right-to-Know Act (EPCRA), facilities must report their toxic chemical releases to EPA by July 1 of each year. The Pollution Prevention Act of 1990 also requires facilities to submit information on waste management activities related to TRI chemicals.
More information on the 2012 TRI analysis, including metropolitan and micropolitan areas is available atwww.epa.gov/tri/nationalanalysis.
What tools are available to help me conduct my own analysis?
A variety of online tools available from the Data and Tools webpage will help you access and analyze TRI data.
Where can I get downloadable files containing the data used in the 2012 National Analysis?
- Basic Data Files: Each file contains the most commonly requested data fields submitted by facilities on the TRI Reporting Form R or the Form A Certification Statement.
- Basic Plus Data Files: These files collectively contain all the data fields submitted by facilities on the TRI Reporting Form R or the Form A Certification Statement.
- Dioxin, Dioxin-Like Compounds and TEQ Data Files: These files include the individually reported mass quantity data for dioxin and dioxin-like compounds reported on the TRI Reporting Form R Schedule 1, along with the associated TEQ data.
[Press release] CDC study shows that child passenger deaths have decreased 43 percent from 2002 – 2011
Research has shown that using age- and size-appropriate child restraints (car seats, booster seats, and seat belts) is the best way to save lives and reduce injuries in a crash. Yet the report found that almost half of all black (45 percent) and Hispanic (46 percent) children who died in crashes were not buckled up, compared to 26 percent of white children (2009-2010).
The Vital Signs report also found that:
- One in three children who died in crashes in 2011 was not buckled up.
- Only 2 out of every 100 children live in states that require car seat or booster seat use for children age 8 and under.
Child passenger restraint laws result in more children being buckled up. A recent study by Eichelberger et al, showed that among five states that increased the required car seat or booster seat age to 7 or 8 years, car seat and booster seat use tripled, and deaths and serious injuries decreased by 17 percent.
To help keep children safe on the road, parents and caregivers can:
- Use car seats, booster seats, and seat belts in the back seat—on every trip, no matter how short.
- Rear-facing car seat from birth up to age 2
Buckle children in a rear-facing seat until age 2 or when they reach the upper weight or height limit of that seat.
- Forward-facing car seat from age 2 up to at least age 5 When children outgrow their rear-facing seat, they should be buckled in a forward-facing car seat until at least age 5 or when they reach the upper weight or height limit of that seat.
- Booster seat from age 5 up until seat belt fits properlyOnce children outgrow their forward-facing seat, they should be buckled in a booster seat until seat belts fit properly. The recommended height for proper seat belt fit is 57 inches tall.
- Seat belt once it fits properly without a booster seatChildren no longer need to use a booster seat once seat belts fit them properly. Seat belts fit properly when the lap belt lays across the upper thighs (not the stomach) and the shoulder belt lays across the chest (not the neck).
- Install and use car seats according to the owner’s manual or get help installing them from a certified Child Passenger Safety Technician.
[Article] Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older: United States, 2014
From the 4 February 2014 Annals of Internal Medicine article by Carolyn B. Bridges, MD; Tamera Coyne-Beasley, MD, MPH, on behalf of the Advisory Committee on Immunization Practices
Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment | Full Text Reports…
From the Social Science Research Network
Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment by Dan M. Kahan
Yale University – Law School; Harvard University – Edmond J. Safra Center for Ethics
January 27, 2014
CCP Risk Perception Studies Report No. 17
Based on survey and experimental methods (N = 2,316), the Report presents two principal findings:
first, that vaccine risks are neither a matter of concern for the vast majority of the public nor an issue of contention among recognizable demographic, political, or cultural subgroups;
and second, that ad hoc forms of risk communication that assert there is mounting resistance to childhood immunizations themselves pose a risk of creating misimpressions and arousing sensibilities that could culturally polarize the public and diminish motivation to cooperate with universal vaccination programs.
Based on these findings the Report recommends that government agencies, public health professionals, and other constituents of the public health establishment
Number of Pages in PDF File: 82
The report may be downloaded for free at the above URL
Some excerpts from the report
1. There is deep and widespread public consensus, even among groups strongly divided on other issues such as climate change and evolution, that childhood vaccinations make an essential contribution to public health. …
2. In contrast to other disputed science issues, public opinion on the safety and efficacy of childhood vaccines is not meaningfully affected by differences in either science comprehension or religiosity. …
3. The public’s perception of the risks and benefits of vaccines bears the signature of a gen- eralized affective evaluation, which is positive in a very high proportion of the population. …
4. Among the manifestations of the public’s positive orientation toward childhood vaccines is the perception that vaccine benefits predominate over vaccine risks and a high degree of confi- dence in the judgment of public health officials and experts. …
B. Normative and prescriptive conclusions
1. Risk communicators—including journalists, advocates, and public health professionals— should refrain from conveying the false impression that a substantial proportion of parents or of the public generally doubts vaccine safety.
2. Risk communicators should avoid resort to the factually unsupportable, polemical trope that links vaccine risk concerns to climate-change skepticism and to disbelief in evolution as evi- dence of growing societal distrust in science.
Remember, correlation does not equal causation!
And the selection of variables (as gun ownership) may be questioned by some…
Still, an interesting graph
[Report] Adult illicit drug users are far more likely to seriously consider suicide | Full Text Reports…
From the 16 January SAMSHA news release ( US Substance Abuse & Mental Health Services Administration)
Adults using illicit drugs are far more likely to seriously consider suicide than the general adult population according to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report finds that 3.9 percent of the nation’s adult population aged 18 or older had serious thoughts about suicide in the past year, but that the rate among adult illicit drug users was 9.4 percent.
According to SAMHSA’s report, the percentage of adults who had serious thoughts of suicide varied by the type of illicit substance used. For example, while 9.6 percent of adults who had used marijuana in the past year had serious thoughts of suicide during that period, the level was 20.9 percent for adults who had used sedatives non-medically in the past year.
“Suicide takes a devastating toll on individuals, families and communities across our nation,” said Dr. Peter Delany, director of SAMHSA’s Center for Behavioral Health Statistics and Quality. “We must reach out to all segments of our community to provide them with the support and treatment they need so that we can help prevent more needless deaths and shattered lives.”
Those in crisis or who know someone they believe may be at immediate risk of attempting suicide are urged to call the National Suicide Prevention Lifeline 1-800-273-TALK (8255) or go to http://www.suicidepreventionlifeline.org. The Suicide Prevention Lifeline network, funded by SAMHSA, provides immediate free and confidential, round-the-clock crisis counseling to anyone in need throughout the country, every day of the year.
This report, “1 in 11 Past Year Illicit Drug Users Had Serious Thoughts of Suicide,” is based on the findings of SAMHSA’s 2012 National Survey on Drug Use and Health (NSDUH) report. The NSDUH report is based on a scientifically conducted annual survey of approximately 70,000 people throughout the country, aged 12 and older. Because of its statistical power, it is a primary source of statistical information on the scope and nature of many substance abuse and mental health issues affecting the nation.
The complete survey findings are available on the SAMHSA web site at: http://www.samhsa.gov/data/spotlight/spot129-suicide-thoughts-drug-use-2014.pdf
For more information about SAMHSA visit: http://www.samhsa.gov/.
From the 16 January 2014 Tel Aviv University press release
AU research shows that some warning labels can make products like cigarettes more appealing
Many products, like cigarettes and medications, are stamped with warning labels alerting consumers to their risks. Common sense suggests these warnings will encourage safer choices.
But now Dr. Yael Steinhart of Tel Aviv University‘s Recanati Business School, along with Prof. Ziv Carmon of INSEAD in Singapore and Prof. Yaacov Trope of New York University, has shown that warning labels can actually have the opposite effect. When there is a time lag between reading a warning and then buying, consuming, or evaluating the associated products, the warnings may encourage trust in the manufacturers of potentially dangerous products, making them less threatening. Published in Psychological Science, the study findings could help improve the efficacy of warning labels.
“We showed that warnings may immediately increase concern and decrease consumption,” said Dr. Steinhart. “But over time, they paradoxically promote trust in a product and consequently lead to more positive product evaluation and more actual purchases.” The findings have important implications for regulators and managers in fields including consumer products, healthcare, and finance.
The best laid plans
The study is based on an idea called “the construal-level theory” (CLT), developed by Prof. Trope and Prof. Nira Liberman of TAU’s School of Psychological Sciences. When thinking about objects over a period of time, people tend to construe them abstractly, emphasizing what they describe as “high-level features” and suppressing “low-level features.” The high-level feature of warning labels is that they build trust in consumers by creating the impression that all the relevant information about the products is being presented. The low-level feature of warning labels is that they make consumers more aware of the products’ negative side effects.
The CLT holds that over long periods of time, consumers deemphasize side effects and emphasize the feeling of trust communicated by warnings over time. Ironically, this may increase the purchase, consumption, and assessment of the associated products.
Absence makes the heart grow fonder
From the 8 January 2014 ScienceDaily article
As people get older, their bodies wear down and become less resilient. In old age, it’s common for people to become “clinically frail,” and this “frailty syndrome” is emerging in the field of public health as a powerful predictor of healthcare use and death.
Now researchers Vicki Myers and Prof. Yariv Gerber of the Department of Epidemiology and Preventive Medicine at the School of Public Health at Tel Aviv University’s Sackler Faculty of Medicine and colleagues have found that poor people are more than twice as likely as the wealthy to become frail after a heart attack. The findings, published in the International Journal of Cardiology, could help doctors and policymakers improve post-heart-attack care for the poor.
“By defining frailty, which combines many areas of medicine, we can predict which people are at the highest risk after a heart attack,” said Ms. Myers. “And we found a strong connection between frailty and socioeconomic status.”
- 2012 Web Version | PDF Version [ - .8.74 MB] | State Snapshots
For the tenth year in a row, the Agency for Healthcare Research and Quality (AHRQ) has produced the National Healthcare Quality Report (NHQR) and theNational Healthcare Disparities Report (NHDR). These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care.
New this year are chapters on care coordination, and health system infrastructure. The reports present, in chart form, the latest available findings on quality of and access to health care.
The National Healthcare Quality Report tracks the health care system through quality measures, such as the percentage of heart attack patients who received recommended care when they reached the hospital or the percentage of children who received recommended vaccinations.
The National Healthcare Disparities Report summarizes health care quality and access among various racial, ethnic, and income groups and other priority populations, such as residents of rural areas and people with disabilities.
From the 14th January Science Daily article
School drug testing does not deter teenagers from smoking marijuana, but creating a “positive school climate” just might, according to research reported in the January issue of the Journal of Studies on Alcohol and Drugs.
An estimated 20 percent of U.S. high schools have drug testing; some target students suspected of abusing drugs, but often schools randomly test students who are going out for sports or clubs. The policies are controversial, partly because there is little evidence they work. And in the new study, researchers found no effects on high schoolers’ drug experimentation.
Of 361 students interviewed, one third said their school had a drug testing policy. Over the next year, those kids were no less likely than other students to try marijuana, cigarettes or alcohol.
“Even though drug testing sounds good, based on the science, it’s not working,” said Daniel Romer, Ph.D., of the University of Pennsylvania Annenberg Public Policy Center in Philadelphia.
At best, Romer said, the policies might convince kids to lay off the drug their school is testing for — which is most commonly marijuana. But even if that’s true, Romer added, students in school sports and clubs are actually not the ones at greatest risk of developing drug problems. “So as a prevention effort,” Romer said, “school drug testing is kind of wrong-headed.”
So what does work? In this study, there was evidence that a positive school climate might help.
MD-led study is first to link racism-related factors and cellular age
COLLEGE PARK, Md. – A new University of Maryland-led study reveals that racism may impact aging at the cellular level. Researchers found signs of accelerated aging in African American men who reported high levels of racial discrimination and who had internalized anti-Black attitudes. Findings from the study, which is the first to link racism-related factors and biological aging, are published in the American Journal of Preventive Medicine.
Racial disparities in health are well-documented, with African Americans having shorter life expectancy, and a greater likelihood of suffering from aging-related illnesses at younger ages compared to whites. Accelerated aging at the biological level may be one mechanism linking racism and disease risk.
“We examined a biomarker of systemic aging, known as leukocyte telomere length,” explained Dr. David H. Chae, assistant professor of epidemiology at UMD’s School of Public Health and the study’s lead investigator. Shorter telomere length is associated with increased risk of premature death and chronic disease such as diabetes, dementia, stroke and heart disease. “We found that the African American men who experienced greater racial discrimination and who displayed a stronger bias against their own racial group had the shortest telomeres of those studied,” Chae explained.
Even after adjusting for participants’ chronological age, socioeconomic factors, and health-related characteristics, investigators found that the combination of high racial discrimination and anti-black bias was associated with shorter telomeres. On the other hand, the data revealed that racial discrimination had little relationship with telomere length among those holding pro-black attitudes. “African American men who have more positive views of their racial group may be buffered from the negative impact of racial discrimination,” explained Chae. “In contrast, those who have internalized an anti-black bias may be less able to cope with racist experiences, which may result in greater stress and shorter telomeres.”
The findings from this study are timely in light of regular mediareports of racism facing African American men. “Stop-and-friskpolicies, and other forms of criminal profiling such as ‘driving orshopping while black’ are inherently stressful and have a real impact on the health of African Americans,” said Chae. Researchers found that racial discrimination by police was most commonly reported by participants in the study, followed by discrimination in employment. In addition, African American men are more routinely treated with less courtesy or respect, and experience other daily hassles related to racism.
Chae indicated the need for additional research to replicate findings, including larger studies that follow participants over time. “Despite the limitations of our study, we contribute to a growing body of research showing that social toxins disproportionately impacting African American men are harmful to health,” Chae explained. “Our findings suggest that racism literally makes people old.”
[Online Book] Subjective Well-Being: Measuring Happiness, Suffering, and Other Dimensions of Experience (2013)
Subjective well-being refers to how people experience and evaluate their lives and specific domains and activities in their lives. This information has already proven valuable to researchers, who have produced insights about the emotional states and experiences of people belonging to different groups, engaged in different activities, at different points in the life course, and involved in different family and community structures. Research has also revealed relationships between people’s self-reported, subjectively assessed states and their behavior and decisions. Research on subjective well-being has been ongoing for decades, providing new information about the human condition. During the past decade, interest in the topic among policy makers, national statistical offices, academic researchers, the media, and the public has increased markedly because of its potential for shedding light on the economic, social, and health conditions of populations and for informing policy decisions across these domains.
Subjective Well-Being: Measuring Happiness, Suffering, and Other Dimensions of Experienceexplores the use of this measure in population surveys. This report reviews the current state of research and evaluates methods for the measurement. In this report, a range of potential experienced well-being data applications are cited, from cost-benefit studies of health care delivery to commuting and transportation planning, environmental valuation, and outdoor recreation resource monitoring, and even to assessment of end-of-life treatment options.
Subjective Well-Being finds that, whether used to assess the consequence of people’s situations and policies that might affect them or to explore determinants of outcomes, contextual and covariate data are needed alongside the subjective well-being measures. This report offers guidance about adopting subjective well-being measures in official government surveys to inform social and economic policies and considers whether research has advanced to a point which warrants the federal government collecting data that allow aspects of the population’s subjective well-being to be tracked and associated with changing conditions.
- Data on people’s self-reported ‘experienced’ well-being could help inform policies (sciencedaily.com)
- Political economy of happiness (knrajlibrary.wordpress.com)
- Subjective Well-being (venitism.blogspot.com)
- Self-reported ‘experienced’ well-being could help inform policies (medicalnewstoday.com)
- ‘Gut instinct’ makes for happy relationship, researchers say (irishtimes.com)
- Mindfulness: State or trait? (mentalworkout.com)
[Press release] United Health Foundation’s America’s Health Rankings Finds Americans Are Making Considerable Progress in Key Health Measures
- Hawaii is the healthiest state
- Nationwide, Americans improved in the majority of the measures captured by the Rankings
- Improvements span key behavioral measures including smoking and physical inactivity
- 2013 marks the first time since 1998 that America’s obesity crisis did not worsen
- Serious challenges remain; maintaining momentum is keyMINNETONKA, Minn. (Dec. 11, 2013) – Americans are making considerable progress in their overall health, according to United Health Foundation’s 2013 America’s Health Rankings®: A Call to Action for Individuals & Their Communities.
Nationwide, Americans improved in the majority of the measures captured by the Rankings. The most notable gains came in key behavioral measures, including smoking, which dropped from 21.2 percent of the adult population to 19.6 percent. Seventeen states had significant drops in smoking, with the largest seen in Nevada, Maryland, Oklahoma, Kansas and Vermont.
Physical inactivity dropped from 26.2 percent of the adult population to 22.9 percent, and America’s obesity rate remained approximately the same as reported in 2012 (27.6 percent of the adult population in 2013 compared with 27.8 percent in 2012). This marks the first time since 1998 that obesity rates have not worsened.
Hawaii has taken the title of healthiest state. Vermont, last year’s reported No. 1 state, is ranked second this year and has ranked among the top five states for the last decade. Minnesota is third, followed by
Massachusetts and New Hampshire. Mississippi ranks 50th this year, and Arkansas (49), Louisiana (48), Alabama (47) and West Virginia (46) complete the list of the five least healthy states.
Top-seated Hawaii scored well along most measures particularly for having low rates of uninsured individuals, high rates of childhood immunization, and low rates of obesity, smoking and preventable hospitalizations. Like all states, Hawaii also has areas where it can improve: it has higher-than-average rates of binge drinking and occupational fatalities, and lower-than-average rates of high school graduation.
To see the Rankings in full, visit: http://www.americashealthrankings.org.
Despite progress, significant challenges remain
When it comes to improving the nation’s health, there is still much to be done. Obesity has leveled off; however, it must remain a top priority, as 27.6 percent of adults nationwide report being obese. With rates of physical inactivity, smoking and diabetes at 22.9 percent, 19.6 percent and 9.7 percent, respectively, there is still considerable room for improvement in key health measures.
“I am encouraged by the progress we’ve made this year and am hopeful that the leveling off we see in America’s obesity is a sign of further improvement to come,” said Reed Tuckson, M.D., external senior medical adviser to United Health Foundation. “We should certainly celebrate these gains. They encourage us to continue to identify and effectively implement best practices in these areas and in addressing diabetes, heart disease and other chronic health conditions that compromise Americans’ health and vitality.”
Georges Benjamin, M.D., executive director of the American Public Health Association, said: “Every year, the America’s Health Rankings report details the nation’s health successes and challenges on a state- by-state level, providing specific areas where citizens and states alike can focus to continue to improve the health of our nation. I am pleased to see the progress we’ve made and hope we can keep up the good work.”
United Health Foundation calls for sustained momentum
“United Health Foundation is committed to continuing to identify ways to improve state health in measurable, meaningful ways,” said Rhonda Randall, D.O., senior adviser to United Health Foundation and chief medical officer of UnitedHealthcare Retiree Solutions. “I hope we soon see the day when we are cheering year-over-year improvements in obesity, and I look forward to seeing our nation’s percentage of smokers continue to decline.”
“Those of us who dedicate our careers to public health know we can’t improve what we don’t measure,” said Eduardo Sanchez, M.D., chairman, Partnership for Prevention. “The America’s Health Rankings report and the online tools show us where we’ve made strides in promoting better health and, importantly, where we still have work to do.”
The America’s Health Rankings report and its tools – including analysis not only of state populations but also subpopulations within states – are designed to identify health opportunities in communities as well as
multi-stakeholder, multi-disciplinary approaches to address those opportunities. Through its programs and grants, United Health Foundation shines a spotlight on the health of America while promoting evidence- based solutions. As part of this commitment, United Health Foundation has partnered with the Association of State and Territorial Health Officials and the National Business Coalition on Health to create learning laboratories that identify and promote best practices and innovations in public health. To learn more about America’s Health Rankings – and to get information on how to help improve community health – visit http://www.americashealthrankings.org.
About America’s Health Rankings®
America’s Health Rankings is an annual comprehensive assessment of the nation’s health on a state-by state basis. It is published jointly by United Health Foundation, American Public Health Association and Partnership for Prevention.
The data in the report come from well-recognized outside sources, such as the Centers for Disease Control and Prevention, American Medical Association, FBI, Dartmouth Atlas Project, U.S. Department of Education and Census Bureau. The report is reviewed and overseen by a Scientific Advisory Committee, with members from leading academic institutions, government agencies and the private sector.
America’s Health Rankings is the longest-running report of its kind. For 24 years, the Rankings has provided an analysis of national health on a state-by-state basis by evaluating a historical and comprehensive set of health, environmental and socioeconomic data to determine national health benchmarks and state rankings. The Rankings employs a unique methodology, developed and annually reviewed by a Scientific Advisory Committee of leading public health scholars. For more information, visit http://www.americashealthrankings.org.
About United Health Foundation
Guided by a passion to help people live healthier lives, United Health Foundation provides helpful information to support decisions that lead to better health outcomes and healthier communities. The Foundation also supports activities that expand access to quality health care services for those in challenging circumstances and partners with others to improve the well-being of communities. After its establishment by UnitedHealth Group [NYSE: UNH] in 1999 as a not-for-profit, private foundation, the Foundation has committed more than $210 million to improve health and health care. For additional information, please visit http://www.unitedhealthfoundation.org.
- Better blood pressure control, stop-smoking programs and faster treatment are a few of the reasons for a dramatic decline in U.S. stroke deaths in recent decades.
DALLAS, Dec. 5, 2013 — Stroke deaths in the United States have declined dramatically in recent decades due to improved treatment and prevention, according to a scientific statement published in the American Heart Association journal Stroke.
The American Stroke Association commissioned this paper to discuss the reasons that stroke dropped from the third to fourth leading cause of death.
“The decline in stroke deaths is one of the greatest public health achievements of the 20th and 21st centuries,” said Daniel T. Lackland, Dr. P.H., chair of the statement writing committee and professor of epidemiology at the Medical University of South Carolina, in Charleston, S.C. “The decline is real, not a statistical fluke or the result of more people dying of lung disease, the third leading cause of death.”
Public health efforts including lowering blood pressure and hypertension control that started in the 1970s have contributed greatly to the change, Lackland said.
Four-year trend in survival probability by periods 1987–1991, 1992–1996, 1997–2001, and 2002– 2006 among men and women aged 18 to 54 y with a first ischemic stroke.
Smoking cessation programs, improved control of diabetes and abnormal cholesterol levels, and better, faster treatment have also prevented strokes. Improvement in acute stroke care and treatment is associated with lower death rates.
“We can’t attribute these positive changes to any one or two specific actions or factors as many different prevention and treatment strategies had a positive impact,” Lackland said. “Policymakers now have evidence that the money spent on stroke research and programs aimed at stroke prevention and treatment have been spent wisely and lives have been saved.
“For the public, the effort you put into lowering your blood pressure, stopping smoking, controlling your cholesterol and diabetes, exercising and eating less salt has paid off with a lower risk of stroke.”
Stroke deaths dropped in men and women of all racial/ethnic groups and ages, he said.
“Although all groups showed improvement, there are still great racial and geographic disparities with stroke risks as well many people having strokes at young ages,” Lackland said. “We need to keep doing what works and to better target these programs to groups at higher risk.”
Co-authors are Edward J. Roccella, Ph.D., M.P.JN., committee chair; Anne F. Deutsch, R.N., Ph.D.; Myriam Fornage, Ph.D.; Mary G. George, M.D., M.S.P.H.; George Howard, Dr. P.H.; Brett M. Kissela, M.D., M.S.; Steven J. Kittner, M.D., M.P.H.; Judith H. Lichtman, Ph.D., M.P.H.; Lynda D. Lisabeth, Ph.D, M.P.H.; Lee H. Schwamm, M.D.; Eric E. Smith, M.D., M.P.H.; and Amytis Towfighi, M.D., on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Quality of Care and Outcomes Research, and Council on Functional Genomics and Translational Biology.
For the latest heart and stroke news, follow us on Twitter: @HeartNews.
For updates and new science from Circulation, follow @CircAHA.
The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at www.heart.org/corporatefunding.Darcy Spitz: (212) 878-5940; Darcy.Spitz@heart.orgJulie Del Barto (broadcast): (214) 706-1330; Julie.DelBarto@heart.orgFor Public Inquiries: (800) AHA-USA1 (242-8721)
- American Heart Association reports U.S. stroke deaths declining due to improved prevention, treatment (clarksvilleonline.com)
- U.S. Stroke Deaths Declining Due to Improved Prevention, Treatment (newsroom.heart.org)
- US stroke deaths declining due to improved prevention, treatment (eurekalert.org)
- Improved prevention, treatment leads to decline in U.S stroke deaths (medicalnewstoday.com)
- Decline in Stroke Death Among Americans: Study Confirms (scienceworldreport.com)
- Improved Prevention, Treatment Led to Significant Declines in US Stroke Death (counselheal.com)
- Blood pressure control tied to decline in stroke mortality over past 50 years (drsonnywong.wordpress.com)
- Blood pressure control tied to decline in stroke mortality over past 50 years (drkevincoy.wordpress.com)
In this one hour webinar which is part of the Hot Topics series, representatives from four health jurisdictions in Washington State discuss their experiences developing policies and enforcing laws to promote smoke-free air in public places.
Air date: December 17, 2013
[recording will be freely available after Dec 17]
- Describe how public health agencies are being challenged by the presence of hookah lounges, vapor-producing products, and possibly marijuana lounges.
- List effective public policy or enforcement strategies for combating hookah lounges, vapor-producing products, and potential marijuana lounges.
- List three considerations when deciding whether to take legal proceedings against an establishment for violating Smoking in Public Places laws.
Local, state, and tribal public health practitioners; board of health members; health department legal counsel
Slides and Resources
- Slides will be posted immediately before the session.
- An Introduction to E-Cigarettes for States and Locals, Tobacco Control Network
Use of prescription, over-the-counter medications also of concern in CAMH’s latest Ontario Student Drug Use and Health Survey (OSDUHS)
December 11, 2013 – Alcohol consumption and smoking among Ontario students in grades 7-12 is at an all-time low; however recreational use of over-the-counter drugs is on the rise. Prescription drug misuse and driving after using drugs also remain elevated according to the 2013 Ontario Student Drug Use and Health Survey (OSDUHS) released today by the Centre for Addiction and Mental Health (CAMH). The survey of 10,272 students from across Ontario is Canada’s longest-running systematic study of alcohol and other drug use among youth, and one of the longest-running surveys in the world
Over-the-counter and prescription drugs
The survey shows one in eight (representing 120,000 middle and high school students in Ontario) reported taking a prescription opioid pain medication recreationally in the last year, and the majority of these students said that they got the drugs from home. About one per cent (representing 13,500 students) reported using stimulant drugs (used to treat ADHD) without a prescription. There was an increase in the number of students who reported using over-the-counter cough medication to “get high,” with over 94,000 students (about 10%) engaging in this behaviour. This was the only drug to show an increase in recent years. One in six high school students reported symptoms of a drug use problem; this represents 132,700 students in grades 9-12.
Substance use and driving
Eighteen per cent of students reported being a passenger in a car driven by someone who had been drinking alcohol. Four per cent of students with a G-class driver’s license said they had driven a vehicle within one hour of consuming two or more drinks – this is an estimated 12,700 adolescent drivers in Ontario.
Cannabis smoking and driving levels were even higher. Despite the serious impact that smoking cannabis can have on psychomotor skills and the ability to drive safely, one in ten licensed students reported driving a car within one hour of smoking cannabis. This represents 31,500 adolescent drivers in Ontario. Fourteen per cent of students reported being a passenger in a car where the driver had been using drugs.
“The number of students who report using cannabis and driving has remained the same in recent years which tells us that students do not take the potential dangers of driving while under the influence seriously,” said Dr. Robert Mann, CAMH Senior Scientist and OSDUHS Principal Investigator. “The public health messages around the dangers of drinking and driving seem to have had an impact on our youth but the same can’t be said for cannabis use, which is worrisome.”
Alcohol use among Ontario students reached an all-time low with 50 per cent (representing 483,900 students) reporting drinking alcohol in the past year. “Though the overall decline shows promise, we see that the kids who are drinking are doing so in dangerous ways,” added Dr. Mann. “One in five (representing 193,400 students) reports binge drinking at least once in the past month and a similar percentage report blacking out on at least one occasion when drinking alcohol in the past year. Eight per cent report being injured or injuring someone else while they had been drinking.”
New this year
New in this year’s OSDUHS are questions on the use of waterpipes and electronic cigarettes. Almost 10 per cent (representing 88,400 students) reported smoking tobacco through a waterpipe in the past year. About 15 per cent of high school students (representing 99,800 students) reported smoking electronic cigarettes in their lifetime. For the first time the survey asked students whether they had used synthetic cannabis, commonly known by street names, “K2” or “spice.” Two per cent – representing over 17,000 students – had tried the drug.
“These new numbers give us some insight into the use of alternative and emerging drugs among young people,” said Dr. Hayley Hamilton, CAMH Scientist and Co-Investigator on the OSDUHS. “We see that while cannabis use among students is holding steady since our last survey at around one quarter of students, this new synthetic form has emerged and we will want to track its prevalence in future surveys. The same holds for smoking – while the rate of students smoking has leveled off over the past few years, we see that youth are still smoking cigarettes and tobacco, but in alternate ways.”
- Students in Toronto and Western Ontario reported the nonmedical use of opioid prescription pain medication at higher rates than the rest of the province (15 per cent and 13 per cent respectively)
- Students in the north were less likely to use prescription opioid pain medication (7 per cent) but reported higher rates of hazardous drinking than the provincial average (19 per cent and 16 per cent respectively)
- Students in the east reported higher rates of hazardous drinking than the provincial average (20 per cent and 16 per cent respectively)
For further information, please contact Michael Torres, Media Relations, CAMH at (416) 595-6015 or firstname.lastname@example.org
The Centre for Addiction and Mental Health (CAMH) is Canada’s largest mental health and addiction teaching hospital, and one of the world’s leading research centres in the field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues.
CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre.
OSDUHS is Canada’s longest-running systematic study of alcohol and other drug use among youth, and one of the longest-running surveys in the world. During the 2012-13 school year, 10,272 students from across Ontario in grades 7 to 12 participated in the survey, administered on behalf of CAMH by the Institute for Social Research at York University.
- Is driving high the new drinking and driving for Ontario teens? (globalnews.ca)
- Is smoking cannabis and driving the new drinking and driving? (medicalxpress.com)
- Prescription drug abuse among youth on the rise: Report (sunnewsnetwork.ca)
- Cough syrup, marijuana use up in Ontario high schools (cbc.ca)
- More Ontario teens drive after using marijuana than after drinking: study (globalnews.ca)
- Is driving high the new drinking and driving for Ontario teens? | Globalnews.ca (kimmiecats.wordpress.com)
[News article] Britain’s poor ‘will die before they retire’ if pension reforms aren’t matched by health improvements
Thousands of Britain’s poorest people “will be dead before they can retire” if sweeping pension reforms are not matched by urgent action on health inequalities between rich and poor, experts have said.
Plans to raise the basic state pension age to 70 for people currently in their twenties were laid out in the George Osborne’s Autumn Statement this week. But with male life expectancy at birth as low as 66 in some of the most deprived parts of the country, public health experts have warned that a “one size fits all” pension age risks condemning many to a life without retirement.
Average UK life expectancy at birth was 78.2 in 2010. Nationally, the figure is increasing, but huge variations exist and progress has been slower in deprived communities where poverty leads to poor diets, smoking rates are higher and alcohol abuse more common.
In Glasgow City, where male life expectancy at birth is 71.6, boys born in 2010 are expected to die on average 13.5 years earlier than those born in the London borough Kensington and Chelsea, where life expectancy is 85.1. Girls in born in the London borough in 2010 can expect 12 more years of life than those in Glasgow. Even these figures veil vast inequalities that exist within regions, with life expectancies as low as 66 years in some of Glasgow’s most deprived areas.
Martin McKee, professor of European Public Health at the London School of Hygiene and Tropical Medicine, and fellow of the Faculty of Public Health, said that if the Government wanted to raise the pension age, they must first tackle health inequalities.
“George Osborne is thinking about the average life expectancy. The average life expectancy is fairly meaningless if you’re living in a former coal mining village in Nottinghamshire or in inner-city Glasgow,” he toldThe Independent. “There are many parts of the country where people have nowhere near the average life expectancy and, crucially, nowhere near the average healthy life expectancy. It’s not just the fact people will be dead before they reach pensionable age, it’s that they will be unfit to work.”
David Walsh, a public health expert at the Glasgow Population Health Centre said that a single pension age across all areas of the country was “at the very least problematic”.
- Britain’s Poor Will Die Before They Retire (sorendreier.com)
- Britain’s poor ‘will die before they retire’ if pension reforms aren’t matched by health improvements (engineeringevil.com)
- Living Longer…and Longer…. (worthwhile.typepad.com)
- Work until you’re 70: Chancellor George Osborne accused of ‘living in fantasy land’ over Autumn Statement pension reforms (independent.co.uk)
- Ever receding retirement? (centrallobby.politicshome.com)
- State pension: age-old problems | Editorial (theguardian.com)
Measles Still Threatens Health Security
On 50th Anniversary of Measles Vaccine, Spike in Imported Measles Cases
Fifty years after the approval of an extremely effective vaccine against measles, one of the world’s most contagious diseases, the virus still poses a threat to domestic and global health security.
On an average day, 430 children – 18 every hour – die of measles worldwide. In 2011, there were an estimated 158,000 measles deaths.
In an article published on December 5 by JAMA Pediatrics, CDC’s Mark J. Papania, M.D., M.P.H., and colleagues report that United States measles elimination, announced in 2000, has been sustained through 2011. Elimination is defined as absence of continuous disease transmission for greater than 12 months. Dr. Papania and colleagues warn, however, that international importation continues, and that American doctors should suspect measles in children with high fever and rash, “especially when associated with international travel or international visitors,” and should report suspected cases to the local health department. Before the U.S. vaccination program started in 1963, measles was a year-round threat in this country. Nearly every child became infected; each year 450 to 500 people died each year, 48,000 were hospitalized, 7,000 had seizures, and about 1,000 suffered permanent brain damage or deafness.
People infected abroad continue to spark outbreaks among pockets of unvaccinated people, including infants and young children. It is still a serious illness: 1 in 5 children with measles is hospitalized. Usually there are about 60 cases per year, but 2013 saw a spike in American communities – some 175 cases and counting – virtually all linked to people who brought the infection home after foreign travel.
“A measles outbreak anywhere is a risk everywhere,” said CDC Director Tom Frieden, M.D., M.P.H. “The steady arrival of measles in the United States is a constant reminder that deadly diseases are testing our health security every day. Someday, it won’t be only measles at the international arrival gate; so, detecting diseases before they arrive is a wise investment in U.S. health security.
Eliminating measles worldwide has benefits beyond the lives saved each year. Actions taken to stop measles can also help us stop other diseases in their tracks. CDC and its partners are building a global health security infrastructure that can be scaled up to deal with multiple emerging health threats.
Currently, only 1 in 5 countries can rapidly detect, respond to, or prevent global health threats caused by emerging infections. Improvements overseas, such as strengthening surveillance and lab systems, training disease detectives, and building facilities to investigate disease outbreaks make the world — and the United States — more secure.
“There may be a misconception that infectious diseases are over in the industrialized world. But in fact, infectious diseases continue to be, and will always be, with us. Global health and protecting our country go hand in hand,” Dr. Frieden said.
Today’s health security threats come from at least five sources:
- The emergence and spread of new microbes
- The globalization of travel and food supply
- The rise of drug-resistant pathogens
- The acceleration of biological science capabilities and the risk that these capabilities may cause the inadvertent or intentional release of pathogens
- Continued concerns about terrorist acquisition, development, and use of biological agents.
“With patterns of global travel and trade, disease can spread nearly anywhere within 24 hours,” Dr. Frieden said. “That’s why the ability to detect, fight, and prevent these diseases must be developed and strengthened overseas, and not just here in the United States.”
The threat from measles would be far greater were it not for the vaccine and the man who played a major role in creating it, Samuel L. Katz, M.D., emeritus professor of medicine at Duke University. Today, CDC is honoring Dr. Katz 50 years after his historic achievement. During the ceremony, global leaders in public health are highlighting the domestic importance of global health security, how far we have come in reducing the burden of measles, and the prospects for eliminating the disease worldwide.
Measles, like smallpox, can be eliminated. However, measles is so contagious that the vast majority of a population must be vaccinated to prevent sustained outbreaks. Major strides already have been made. Since 2001, a global partnership that includes the CDC has vaccinated 1.1 billion children. Over the last decade, these vaccinations averted 10 million deaths – one fifth of all deaths prevented by modern medicine.
“The challenge is not whether we shall see a world without measles, but when,” Dr. Katz said.
“No vaccine is the work of a single person, but no single person had more to do with the creation of the measles vaccine than Dr. Katz,” said Alan Hinman, M.D., M.P.H., Director for Programs, Center for Vaccine Equity, Task Force for Global Health. “Although the measles virus had been isolated by others, it was Dr. Katz’s painstaking work passing the virus from one culture to another that finally resulted in a safe form of the virus that could be used as a vaccine.”
- Measles still poses threat to U.S. despite being “eliminated” (cbsnews.com)
- CDC: Rise in Imported Measles Cases Threatens US (health.yahoo.net)
- CDC: Measles Still A Threat (radio.foxnews.com)
- US Measles Cases This Year Are Triple The Annual Average: CDC – Huffington Post (huffingtonpost.com)
- Measles still a risk, 50 years after the introduction of the vaccine (theglobaldispatch.com)
- RT @Fischblog: “Before the measles vaccine was achieved 50 years ago, the disease killed 2.6 mio people around the world every year” http:/… (wired.com)
[Magazine article] Long-Term Disease Database Proves the Value of Vaccines | Observations, Scientific American Blog Network
To find out when whooping cough started making a comeback in Ohio, or how often measles kills in America, we turn to historical records. But those records aren’t very useful when they’re squirreled away in a distant office basement. The same goes for when they are embedded in a report—you can only look at them in the same way you might admire a painting, but you cannot drop the data into a spreadsheet and hunt for statistical significance. If you are only looking at a couple years’ worth of information that formatting dilemma is not such a big deal. You can scour the data and manually punch it into your analysis. It only becomes a huge problem when you are looking at hundreds or thousands of data points.
Such is the problem that public health experts at University of Pittsburgh encountered when they were exploring old medical data and developing models that predict future outbreaks. “We found ourselves going back and pulling out historical datasets repeatedly. We kept doing it over and over and finally got to the point where we thought it would be not only a service to ourselves but everybody if all the data was made digital and open access,” says Donald Burke, the dean of Pittsburgh’s graduate school of public health.
Four years ago, buoyed by funds from the National Institutes of Health and the Gates Foundation, they started the process of digitalizing 125 years worth of medical records. The endeavor was dubbed Project Tycho, named for the Danish nobleman Tycho Brahe who made the voluminous astronomical observations that Kepler later tapped to develop the laws of planetary motion. (But no pressure, right?)
The online, open-access resource now features accounts of 47 diseases between 1888 and today. It includes data from the weekly Nationally Notifiable Disease Surveillance reports for the United States, standardized in such a way that the data can be immediately analyzed.
In the research world, that’s a big accomplishment. Making this data usable takes more than casually monitoring a scanner while sipping coffee. The data has to be made uniform, a tedious process of manual input with unenviable tasks like removing periods, dashes and other inconsistencies while identifying data gaps.
Pittsburgh researchers also gave their new data trove a test drive to illustrate what could be done with the data. They mined Tycho for information on eight common diseases detailed in the records—polio, measles, rubella, mumps, hepatitis A, diphtheria and pertussis. Looking at available records before and after vaccines were discovered for those diseases, they estimated that 103 million cases of those contagious diseases have been prevented since 1924, (assuming the reductions were all attributable to vaccination programs). Their findings are published in this week’sNew England Journal of Medicine. The data also points to what can happen when communities become too lax about vaccinations (among other factors). They quantified the resurgence in recent years of pertussis throughout the country, particularly in the Midwest to Northwest and in the Northeast and also ongoing cases of mumps. “Reported rates of vaccine refusal or delay are increasing,” the authors write. “Failure to vaccinate is believed to have contributed to the reemergence of pertussis, including the large 2012 epidemic.”
When vaccines work well, sometimes “people no longer fear the disease and they undervalue the vaccine and in some ways that is what is going on right now,” says Burke, pointing to the discredited vaccine-autism link which prompted some parents to turn away from childhood vaccines. With this newly available data collection, more can be done than simply looking at where the disease is happening—or not happening. Researchers can begin looking for drivers of disease and identifying patterns about the burden of disease by say, climate or socioeconomic-status.
Flip through some of the data yourself here after it becomes searchable to the public on November 28.
[One has to register to view data, for institution I just entered private citizen and my registration was accepted. The database interface is very user friendly!]
- Vaccines work. Period. (sciencebasedmedicine.org)
- Researchers develop massive database to help fight deadly diseases… (medicalxpress.com)
- A rebuke to the antivaccine movement: A hundred million cases of disease prevented and millions of lives saved by vaccines [Respectful Insolence] (scienceblogs.com)
- Childhood vaccines prevent disease but risks remain (triblive.com)
- FDA scientist discusses recent pertussis vaccine study (theglobaldispatch.com)
- Trove of Public Health Data Unlocked by Pitt Researchers to Help Fight Deadly Contagious Diseases (medindia.net)
- Anti-Vaxxers Take Note: Vaccines Have Prevented 100 Million Serious Childhood Diseases In U.S. Since 1888 (reason.com)
- Katie Couric promotes dangerous fear mongering with show on the HPV vaccine (richarddawkins.net)
The release and publication of Project Tycho™ data has been featured in an article of the New York Times online and print version of Thursday November 28th entitled “The Vaccination Effect: 100 Million Cases of Contagious Disease Prevented”. It emphasizes that the large amount of data digitized by the project provides an invaluable resource for science and policy and the importance of vaccination programs in the United States.
Through a collaboration with the Open Government Initiative, Project Tycho™ data have been listed on HealthData.gov as new open access resource for governmental data. In addition on the listing, HealthData.gov has agreed to host Project Tycho™ level 1 and level 2 data that can each be downloaded from this site as a one CSV file with a single click. Comments on this release have been made in the HealthData.gov blog.
After four years of data digitization and processing, the Project Tycho™ Web site provites open access to newly digitized and integrated data from the entire 125 years history of United States weekly nationally notifiable disease surveillance data since 1888. These data can now be used by scientists, decision makers, investors, and the general public for any purpose. The Project Tycho™ aim is to advance the availability and use of public health data for science and decision making in public health, leading to better programs and more efficient control of diseases. Read full press release.
Three levels of data have been made available: Level 1 data include data that have been standardized for specific analyses, Level 2 datainclude standardized data that can be used immediately for analysis, and Level 3 data are raw data that cannot be used for analysis without extensive data management. See the video tutoral.
November 28, 2013 |A Project Tycho™ study estimates that 100 million cases of contagious diseases have been prevented by vaccination programs in the United States since 1924
In a paper published in the New England Journal of Medicine entitled “Contagious diseases in the United States from 1888 to the present,” aProject Tycho™ study estimates that over 100 million cases have been prevented in the U.S. since 1924 by vaccination programs against polio, measles, mumps, rubella, hepatitis A, diphtheria, and pertussis (whooping cough). Vaccination programs against these diseases have been in place for decades but epidemics continue to occur. Despite the availability of a pertussis vaccine since the 1920s, the largest pertussis epidemic in the U.S. since 1959 occurred last year. This study was funded by the Bill & Melinda Gates Foundation and the National Institutes of Health and all data used for this study have been released through the online Project Tycho™ data system as level 1 data.
“Historical records are a precious yet undervalued resource. As Danish philosopher Soren Kierkegaard said, we live forward but understand backward,” explained Dr. Burke, senior author on the paper. “By ‘rescuing’ these historical disease data and combining them into a single, open-access, computable system, we can now better understand the devastating impact of epidemic diseases, and the remarkable value of vaccines in preventing illness and death.” See an interview with the authors and an animation on the analysis.
Not sure if this is the right approach. I was brought unto be personally responsible for my actions and not rely on others to create ways to help me do the right things. Part of my thinks money spent on these grants could be better spent elsewhere. These ideas seem to be only shotgun approaches and do not really address underlying issues.
Still, I think their hearts are in the right place.
Through a series of small grants, we’re is exploring the utility of applying behavioral economic principles to perplexing health and health care problems—everything from getting seniors to walk more to forgoing low-value health care.
At a recent meeting in Philadelphia we challenged grantees to compete in an Innovation Tournament. The goal was to identify testable ideas that leverage behavioral economic principles to help make people healthier by working with commercial entities. Participants were assigned to groups and made their best pitches to their colleagues. And of course we used a behavioral economics principle (financial incentives) to increase participation: Each member of the first, second and third place teams received Amazon gift cards.
Eight teams made the finals:
1. Love Lock: This team addressed the issue of driving and texting by proposing an app that could be installed on your cell phone that would send reminders not to text while driving. This team would work with car insurance and mobile phone carrier companies and provide discounts to those who get it installed. The behavioral economics principles being tested are default choice and opt-out.
2. McQuick & Fit: Too many people eat unhealthy food. This team’s idea was to have a rewards card that can only be used to purchase healthy food. With each purchase, the customer would earn points toward free, healthy foods. Online orders would be placed through a website that would feature salient labeling and allow for defaults to order healthy meals. The behavioral economics principles at play include pre-commitment, default choice, labeling, and incentives.
3. Just Bring Me Water: The problem tackled by this team is “regrettable” calories—mindlessly consuming whatever is put in front of you, such as free bread at a restaurant, or soda on a plane. The innovation: when booking a table online or calling for a reservation, you could ask to “opt-out” of the complimentary bread or chips that are offered. This would reduce the consumption of regrettable calories.
4. Lunch Club: This group looked at addressing gluttony through a partnership with a chain restaurant. When going out for a meal, portions are typically bigger and diners consume more. But what if you had the option of doggy-bagging one third of the meal for another meal—framed as “buy dinner and get lunch free”? And, if you took this option, you would get a scratch off as an enhanced incentive and immediate reward. The behavioral economic principles being tested here include loss aversion, active choice, and incentives.
5. Snooze, But Don’t Lose: People don’t get enough good sleep, which leads to poor executive functioning and safety issues. To increase safety, productivity, and efficiency, this group proposed using a Fitbit to build in reminders to go to bed earlier and provide feedback on good sleep. The behavioral economic principles at play are pre-commitment and loss aversion.
6. Google Coach: This team’s idea was to create good habit formation, specifically commitment to a health plan, whether it was getting more sleep, adhering to a diet, or taking vitamins regularly. The group proposed partnering with Google and using its calendar and mobile phone platform to program smart defaults that are personalized to the individual. For example, people could actively schedule exercise or sleep based on their schedule on Google calendar. The group hypothesized that intelligent defaults are better than people planning themselves (without defaults).
7. The Basketeers: This team wanted to optimize consumers’ baskets at grocery stores and supermarkets, increasing the amount of healthy items purchased. The group suggested partnering with an online supermarket to create different packages of food for customers to purchase. For example, there could be the J-Lo package, which would bundle together food items that this aspirational star would most likely eat. In addition, when checking out, the website would assess the customer’s basket for healthier options, such as switching whole milk for skim milk. As a reward, consumers would get discounts and express delivery for choosing healthier options.
8. Team REV (Re-Engineering Vending): Soda and other sugar sweetened beverages lead to obesity. This team proposed partnering with beverage companies to make vending machines more fun, while optimizing them to help people make healthier beverage selections. For instance, the vending machine would have sensors and as you approach the unhealthy items, the healthier item buttons would light up. The behavioral economics principle applied here is choice architecture.
The participants voted for their top three choices. Lunch Club came in third while Love Lock and Google Coach tied for first place. And, you might wonder, how does a group of behavioral economists and psychologists break a tie? By playing rock, paper, scissors. Team Love Lock won.
This post originally appeared in the RWJF Pioneering Ideas Blog.
- How a behavioral economist eats Thanksgiving dinner (washingtonpost.com)
- What behavioral economics is and what it is not.. (mostlyeconomics.wordpress.com)
- Meet the ‘Genius’ Whose Ideas About Behavioral Economics Could (Someday) Change Lives (psmag.com)
- Decisions, Decisions…Behavioral Economics and Behavioral Change (rwjfblogs.typepad.com)
- Eight Innovative Ideas to Influence Health Behavior (rwjfblogs.typepad.com)
- Next challenges in behavioral economics (alessandroinnocenti.wordpress.com)
- Lose weight, Get Gold in Dubai (blogs.wsj.com)
Twelve ideas to help you stay healthy during flu season
The 2013 flu season has begun, and while it is still early in the season, cases have already been reported in the U.S. Winter gatherings can bring together people who are vulnerable to the cold & flu virus.
People who get together for the winter holidays can be exposed to viruses from other parts of the region and can pick up and spread the illness from wherever they’ve been. Here are some small, individual changes you can make lending to a healthy winter season.
- Drink black or green tea with lemon and honey. Drinking hot tea while breathing in the steam stimulates the cilia – the hair follicles in the nose – to move out germs more efficiently. Lemon thins mucus and honey is antibacterial.
- Consume enough protein. Diets that are too low in protein can deplete the immune system. The current recommendation for protein intake is at least 60 grams per day for adult women and at least 75 grams per day for adult men, depending on age, activity level and if they need to gain/lose weight.
- Slowly exhale. When walking past a person who is sneezing or coughing, slowly exhale until you’re past them. This avoids you inhaling contaminated air.
- Try Zinc lozenges. If you get a scratchy throat, zinc lozenges can relieve cold symptoms faster.
- Eat your fruits and vegetables. Eating 5 or more fruits and vegetables each day will provide many vitamins and minerals necessary for your immune system to function properly. Try to choose more vegetables than fruit.
- Sanitize your space. You can sanitize commonly touched items (cell phones, grocery carts, keyboards, gym equipment) to help the spread of germs. Remember, rhinoviruses causing cold & flu symptoms can live on surfaces for up to 48 hours!
- Pamper your nose. The job of your nose is to filter allergens, bacteria, and viruses floating in the air. By using saline nasal rinses, you can help flush germs and clear secretions in your upper airway.
- Consume enough water. The urge to drink water can decrease in colder months, but the need for water is still important. Consuming enough fluids will eliminate toxins from your lymph system which keeps your immune system functioning properly.
- Get a massage for your immune system! Massage increases circulation which boosts immunity by nourishing cells with more oxygen filled blood. Click here to learn about our massage services.
- Sanitize your brushes. Think about the items you may reuse every day and consider cleaning or replacing them (cosmetics and make up brushes, toothbrushes, hair brushes, hand towels). A quick swipe of an alcohol wipe on a tube of lipstick or washing make up brushes in an antibacterial soap can support a healthy immune system.
- Sleep. Research shows that adults need 7-8 hours of sleep to stimulate an immune response from our natural killer cells which are the cells that attack viruses.
- Humidity. Dry air in the winter can cause your lips, mouth, & nose to become dry and cracked. Cracked skin can be an entry point for bacteria and viruses. Consider a humidifier to help keep moisture in the air.
Homemade Sani Wipes:
Fold or cut paper towels or napkins and put them into a wipe container. Use 1 1/2 cup of warm water, add 1 Tbsp. of coconut oil, and 1 tsp. of alcohol. Add 3 drops of lavender oil if you like. Then mix well and pour the mixture into the container of napkins to saturate them. Makes 2 containers.
Your health and wellness crew in WELLAWARE wish you a healthy winter season.
- Patz, A. (2013, December). Live healthy. Health 27(10).
- CDC. (2013, November 22). Seasonal Influenza. Retrieved fromhttp://www.cdc.gov/flu/
- CDC. (2012, October). Nutrition for everyone: protein. Retrieved fromhttp://www.cdc.gov/nutrition/everyone/basics/protein.html
- Beyond an Apple a Day: 10 Germ-Busting Tips for Cold and Flu Season (redtri.com)
- Study Finds How Flu Evolves to Escape Immunity (medindia.net)
- Above the inFLUence > If you’re sick, don’t work. If your work requires you to come in sick, let us know. (newsreview.com)
- Tip of the Week: Cold and Flu Season (pacusher.wordpress.com)
- Personalized Flu Vaccines Approved By FDA: New, Unique Options For The Elderly, Children, And People With Allergies (medicaldaily.com)
- 5 Tips on How to Stay Flu Free (roserenea91.wordpress.com)
- Vaccines, Flu & Other Seasonal Ailments: What You Need To Know (whnt.com)
“This season the forecasts will be more readily available to the public on a website hosted by Columbia’s Mailman School of Public Health expected to launch in the coming weeks.”
Researchers take a page from weather forecasting to predict seasonal influenza outbreaks in 108 cities across the country
Scientists were able to reliably predict the timing of the 2012-2013 influenza season up to nine weeks in advance of its peak. The first large-scale demonstration of the flu forecasting system by scientists at Columbia University’s Mailman School of Public Health was carried out in 108 cities across the United States.
Results are published online in the journal Nature Communications.
The flu forecasting system adapts techniques used in modern weather prediction to turn real-time, Web-based estimates of influenza infection into local forecasts of the seasonal peak by locality. Influenza activity peaked in cities in the southeast as early as December 2012, but crested in most of the country in the first weeks of 2013.
Year to year, the flu season is highly variable. It can happen anywhere from December to April. But when it arrives, cities can go from practically no cases to thousands in a very short time. “Having greater advance warning of the timing and intensity of influenza outbreaks could prevent a portion of these influenza infections by providing actionable information to officials and the general public,” says first author Jeffrey Shaman, PhD, assistant professor of Environmental Health Sciences at Columbia University’s Mailman School of Public Health.
For the public, the flu forecast could promote greater vaccination, the exercise of care around people sneezing and coughing, and a better awareness of personal health. For health officials, it could inform decisions on how many vaccines and antiviral drugs to stockpile, and in the case of a virulent outbreak, whether other measures, like closing schools, are necessary.
The new study builds on the researchers’ 2012 study that used the system to retrospectively predict the peak of the flu in New York City for the years 2003-2008. That research was limited to one city and performed as a test of the system. The current study is the first to make predictions in actual real-time and for the whole country.
Beginning in late November of 2012, the researchers used the flu forecasting system to perform weekly estimates for 108 cities. They shared the results with the CDC and posted them online in an academic archive. Near the end of 2012, four weeks into the flu season, the system had predicted 63% of cities accurately. As the season progressed, the accuracy increased. By week four, it successfully predicted the seasonal peak in 70% of the country. It was able to give accurate lead-times up to nine weeks in advance of the peak; most lead-times were two to four weeks.
The flu forecasts were also much more reliable than those made using alternate, approaches that rely on historical data. “Our method greatly outperformed these alternate schemes,” says Dr. Shaman.
The researchers saw regional differences in the accuracy of the system, but they were likely within normal variation. “As an example, retrospectively, we’ve been able to predict the flu in Chicago very well; this year we did a terrible job in that city. For other cities, the opposite held. It averages out. On the whole the system performed very well,” Dr. Shaman says. However, there were hints of geographical differences. “We were able make better predictions in smaller cities. Population density may also be important. It suggests that in a city like New York, we may need to predict at a finer granularity, perhaps at the borough level. In a big sprawling city like Los Angeles, we may need to predict influenza at the level of individual neighborhoods.”
Google Flu Trends Goes “Off the Rails”
The researchers designed the flu forecasting system to use combined data from 1) Google Flu Trends, which makes estimates of outbreaks based on the number of flu-related search queries, and 2) region-specific reports from the Centers for Disease Control on verified cases of flu. The system approach is analogous to weather forecasting, which employs real-time observational data to reduce model forecasts error. In the last year, the researchers slightly modified the system to be more representative of flu rather than flu and other respiratory problems. Nevertheless, there was unusual level of “noise” in the data related to problems with Google Flu Trends.
How did this happen? One explanation is the high number of media stories about the flu, including some about the flu forecasting system itself. The result was a spike in people using Google to research the flu, which could have overloaded the Flu Trends algorithm. It’s an irony not lost on Dr. Shaman. “There was a tremendous amount of media attention accorded to the flu last year. I was part of the problem myself,” he says. Another factor may have been the particular strain of flu in circulation. “The flu was very virulent and was making people very sick, more so than previous seasons,” says Dr. Shaman. Again this could have led to spike in flu-related Google search queries. (In October, Google announced that it has revised the Flu Trends, which Dr. Shaman hopes will make flu forecasting more accurate.)
The system will be put back in action as soon as the flu season begins again. “Right now there are few cases of the flu, but as soon as the needle starts to move, we will start making predictions,” says Dr. Shaman. This season the forecasts will be more readily available to the public on a website hosted by Columbia’s Mailman School of Public Health expected to launch in the coming weeks.
Worldwide, influenza kills an estimated 250,000 to 500,000 people each year, according to the World Health Organization. In the U.S. 3,000-49,000 die from the flu every year, and about 45% of Americans were vaccinated for the flu, according to the CDC.
Co-authors include Wan Yang and James Tamerius, post-doctoral students of Dr. Shaman (Dr. Tamerius is currently at the University of Iowa); Alicia Karspeck at the National Center for Atmospheric Research; and Marc Lipsitch at the Harvard School of Public Health.
Funding was provided by the National Institutes of Health (GM100467, ES009089) and the Department of Homeland Security. Dr. Lipsitch discloses consulting or honorarium income from the Avian/Pandemic Flu Registry (Outcomes Sciences; funded in part by Roche), AIR Worldwide, Pfizer and Novartis. All other authors declare no competing financial interests.
- Will You Get the Flu? This Real-Time Flu Forecaster Could Tell You (healthland.time.com)
- Flu predictions get more accurate (philedufutureboytech.wordpress.com)
- Flu predictions get more accurate (news.cnet.com)
- Flu predictions get more accurate (news.cnet.com)
- First real-time flu forecast successful (eurekalert.org)
- Scientists Use Weather Forecasting Methods to Predict Flu Season Peak (usnews.com)
- Real-Time Flu Forecast Predicts Outbreaks in Each US City (livescience.com)
- Flu Forecast: Scientists Develop Predict Influenza By Utilizing Weather Forecasting Ideas (wonderfultips.wordpress.com)
After years of state spending cuts, mental health budgets increased in 37 states this year, according to a new report by the National Alliance on Mental Illness.
“Arguably the most notable development was that Texas increased mental health spending by $259 million over two years, the largest increase in its history,” NAMI said in a statement accompanying the report. South Carolina, which had cut mental health programs the deepest in recent years, was also among those states to increase funding this year.
Overall, the increased investment in mental health, spurred in part by the deadly shootings last year in Aurora, Colo., and Newtown, Conn., represents a dramatic reversal from recent years. Between 2009 and 2012, state spending in mental health services dropped by $4.35 billion.
According to NAMI, only six states decreased mental health funding this year – Alaska, Wyoming, Nebraska, Louisiana, North Carolina and Maine.
Aside from money, the NAMI report said states enacted other measures related to mental health. Five states passed legislation to improve the early identification of mental illness in children and youth. Seventeen states adopted laws to tighten restrictions on gun ownership by those considered dangerously mentally ill. And 19 states tinkered with laws pertaining to court-ordered treatment of those with mental illness.
- Newtown shooting prompts increase in mental health funding, not gun control – CTV News (knlive.ctvnews.ca)
- Funding cuts puts Atlanta mental health program at risk (onlineathens.com)
- Gov. McDonnell launches investigation into mental health policies (wtvr.com)
- Newtown Prompts Flood of Mental-Health Spending by U.S. States (bloomberg.com)
- Study examines delivery of outpatient mental health treatment (medicalnewstoday.com)
- NAMI co-hosting mental health discussion (mercedsunstar.com)
- Increasing Access to Psychotropic Medications | Mental Health Summit (pharmaceuticalintelligence.com)
- Mental health conditions cause greater stigma in families than physical problems (psypost.org)
About three years ago, the nation’s top public health agency picked its battles. Now, it’s issuing its own report card on reaching those goals: Pretty good but needs improvement.
The seven “winnable battles” singled out by the Centers for Disease Control and Prevention set goals for 2015, such as cutting adult smoking to 17 percent and pushing childhood obesity down to about 15 percent.
The agency released its first progress report Thursday, and CDC officials said they’re mostly pleased.
To keep pace with emerging public health challenges and to address the leading causes of illness, injury, disability, and death, the Centers for Disease Control and Prevention (CDC) initiated an effort to achieve measurable impact on selected Winnable Battles. These Winnable Battles were chosen based on the magnitude of the health problems and our ability to make significant progress to improve outcomes.
There are evidence-based strategies available now to address the critical health challenges presented by each of the Winnable Battles areas. We have established important indicators and targets for measuring progress. Together with our partners, we can have a meaningful impact on health through a dedicated focus on these Winnable Battles.
In 2010, CDC identified the following Winnable Battles:
- Tobacco – Tobacco use is the leading preventable cause of disease, disability, and death in the U.S.
- Nutrition, Physical Activity, and Obesity – More than 72 million adults and 12 million youth in the U.S. are obese
- Food Safety – Foodborne diseases sicken 1 out of 6 Americans each year
- Healthcare-Associated Infections (HAIs) – 1 out of 20 hospitalized patients contracts an HAI
- Motor Vehicle Safety – Motor vehicle crashes are a leading cause of death among Americans ages 1 to 54
- Teen Pregnancy – The U.S. has one of the highest rates of teen pregnancy of any developed nation in the world
- HIV – More than 1 million people in the U.S. are living with HIV
- CDC report card on priorities: Pretty good, needs improvement (globalnews.ca)
- How The CDC Did On Its Most Recent Report Card (wonderfultips.wordpress.com)
- CDC report card: Good, bad marks on target battles (boston.com)
- CDC report card: Good, bad marks on target battles (star-telegram.com)
Antibiotics aren’t doing what they’re supposed to do anymore. You know, kill infections. Since Alexander Fleming invented penicillin 75 years ago, nearly all bacteria have mutated into strains impervious to antibiotics. Those souped up bacteria now kill hundreds of thousands of people, at a minimum, each year. And according to a new issue of medical journal The Lancet focused on antibiotic-resistant bacteria, things could soon get a whole lot scarier.+
“Rarely has modern medicine faced such a grave threat. Without antibiotics, treatments for minor surgery to major transplants could become impossible…,” argue a team of UK medical experts in one article in a series on antibiotic resistance (paywall) in The Lancet. ”Infection-related mortality rates in developed countries might return to those of the early 20th century,” they say.
The reason antibiotics are no longer doing what they’re supposed to is mainly that they’re being given to the wrong patient. Instead of people with severe infections or risk of infection, the majority of antibiotics are consumed by animals and people who aren’t sick enough to justify their use.
Pigs, chickens, cows, fish and other animals consume the majority of the 100,000-200,000 tonnes (110,000-220,000 tons) of antibiotics manufactured each year, as farmers try to keep growing large and healthy animals under unsanitary conditions. The bacterial strains created in these conditions can spread to humans.
At the same time, perverse incentives in poor countries encourage overuse. People often take antibiotics available over-the-counter, says The Lancet’s report on global resistance, and self-medication by consumers is common. The lack of sound medical care in some areas means that pharmaceutical companies are the chief source of information on when to take antibiotics and in what dose.
- Superbugs are spreading in Europe as antibiotics are overused (qz.com)
- IL Expert: Antibiotic-Resistant Superbugs a Growing Threat (publicnewsservice.org)
- Guess What Happens When The Antibiotics Stop Working (theawl.com)
- ‘Re-engineer healthcare to develop antibiotic resistance’ (thehindu.com)
- New warning says ‘superbugs’ could erase century of medical advances (foxnews.com)
- Worldwide Antibiotics Warning: Resistance ‘Growing’ (prayingforoneday.wordpress.com)
- Antibiotics Warning: Resistance ‘Growing’ (news.sky.com)
According to recent news reports, the city of Edinburgh is getting tough on those who seek sensual pleasures outside of the confines of their own homes. The police have asked that condoms be banned from saunas as a way of trying to prevent sexual activity on the premises, and city Councillors have been asked to stop issuing licenses for saunas and massage parlours.
Besides being a naïve and impractical way to prevent people from having sex, there has been, unsurprisingly, a strong condemnation of such a move on the grounds of its potential negative effect on public health. The charity Scot-pep, for instance, has warned that implementing the police proposal on condoms could lead a HIV epidemic, as well as the proposal to limit establishments where sex workers can meet clients puts them at greater risk from some of the inherent hazards of plying their trade outdoors.
There has been a long history in the United Kingdom of a connection between the criminal justice system and public health. In some cases, it has been a beneficial relationship in which everything from firearms restrictions, requirements for seat belts, motorcycle helmets and child safety seats and restrictions on intoxicating substances, provide examples where the criminal justice system has been used to mitigate or prevent behaviours that are harmful to individual and population health. Nevertheless, not all intersections of criminal justice and public health are mutually beneficial. What is most notable is the distinct progression that has been made from a so-called “policing model of public health”, that often focused on ideas of moral hygiene and legal moralism, which remained influential in Britain into the 19th century, towards more social models of public health that focus on health promotion, harm reduction and social justice.
HUNTSVILLE, TX (11/13/13) — The Crime Victims’ Institute (CVI) at Sam Houston State University initiated a new series of reports to help victim advocates translate the latest research in the field into practical services and resources for victims, beginning with a study on firearms and intimate partner violence.
The report provides a summary of laws and policies that can be used to better protect victims of domestic violence.
In 2012, 114 women were killed by current or former intimate partners in Texas. Sixty percent of these victims were killed with firearms, and many of the incidents resulted in the death or injury of bystanders, including children.
Research has consistently demonstrated a link between firearms and lethal intimate partner violence. One study showed the most significant factor for predicting homicide in domestic violence cases was gun ownership by the abuser. Another study found that women living with a gun in the home have a significantly higher risk of being murdered, and that risk is 20 times higher when there is a history of abuse combined with gun ownership.
To protect victims of domestic violence, several laws and policies have been enacted. They include:
- The federal Gun Control Act of 1968 makes it illegal to purchase or possess firearms or ammunition by a person who has been convicted of a felony, who is the subject of a protective order, or who has been convicted of misdemeanor domestic violence.
- For protective orders to fall under this federal law, several factors have to be met, including a qualifying relationship, a hearing process, and a specific prohibition against the threat or use of force against the petitioner or child. There is an exception for government employees who use firearms to perform their duties, such as law enforcement officers or military personnel.
- Under the Lautenberg Amendment of 1996, the weapons prohibition was added to the federal law for a misdemeanor domestic violence conviction. Under this provision, the charge must include the threat or use of physical force or a deadly weapon against a spouse, co-habitant, parent or guardian. The law is retroactive, there are no exemptions for those who use weapons in their official duties, and the ban on gun ownership is effective for a lifetime.
- Texas law is similar to federal statues, but also prohibits concealed handgun licenses.
- Several Texas judges have required the surrender of firearms in domestic violence cases, verification of compliance by county attorneys, and notification of victims if weapons are returned. Many of these steps are identified in Texas Family Violence Bench Book.
- A manual published by the National Center on Protective Orders and Full Faith & Credit, “Enforcing Domestic Violence Firearms Prohibitions,” includes a firearms checklist for advocates, law enforcement, prosecutors and judges. It is available at http://www.fullfaithandcredit.org.
- As part of safety planning, advocates should discuss issues with victims about the ownership or use of weapons by the abuser.###
A copy of the report is available at http://www.crimevictimsinstitute.org/publications/.
- Putting research into practice on firearms and domestic violence (medicalnewstoday.com)
- Study: Doctors undertrained on diagnosing domestic violence injuries (kmov.com)
- Contextualizing Domestic Violence (beyondbinaries.org)
- Study: Domestic Violence Stays In Families Through Generations (houston.cbslocal.com)
- Speaking up to stop domestic violence (wpri.com)
- Study: Domestic Violence Costs Tennessee Nearly $1 Billion Annually (wreg.com)
- Every Domestic Violence Survivor Deserves Safe Housing (washingtonlegalclinic.wordpress.com)
- Survey Finds Significant Link Between Chronic Health Conditions and Domestic Violence (prnewswire.com)
Local health departments (LHDs) can play pivotal roles in U.S. communities by helping to link people with medical services and assuring access to care when it is otherwise unavailable. However, a new study in the American Journal of Preventive Medicine finds that many LHDs aren’t able to meet these goals, which could spell trouble for the uninsured and underinsured.
“Our report shows that in 2010, about 28 percent of LHDs had not conducted any of the three targeted activities in our study,” which looked at how LHDs assessed gaps in care, increased access to health services and used strategies to meet the health needs of the underserved, said lead author Huabin Luo, Ph.D, former research fellow with the Centers for Disease Control and Prevention and assistant professor in the department of public health at the Brody School of Medicine at East Carolina University.
In recent years, deep funding cuts have impacted local health departments. For example, between 2008 and 2009 alone, over 23,000 LHD jobs were eliminated. This combined with an increase in demand for health care services can mean an increase in health disparities for those who rely on community health care.
The study found that LHDs with larger budgets in bigger population centers were more likely to provide access to health services compared to smaller LHDs with fewer financial resources, where they may be needed more.
Hanen noted that as health insurance coverage becomes more widespread, LHDs will continue to identify and link people without health insurance to programs that provide health care services. “It cannot be overstated enough that poor housing, education, low income, unemployment and lack of transportation in a neighborhood are all interconnected and are all factors that determine health.”
- Cuts to Local Health Departments Hurt Communities (publichealthwatch.wordpress.com)
- Health cuts hurt inspections, but flu programs OK (news-journalonline.com)
- Health department warns of scam targeting restaurants (wkyt.com)
- Erie County Council discusses merging health, human services departments (goerie.com)
Yes to Calories on Menus, No to Soda Limits
Most Americans (69%) see obesity as a very serious public health problem, substantially more than the percentages viewing alcohol abuse, cigarette smoking and AIDS in the same terms. In addition, a broad majority believes that obesity is not just a problem that affects individuals: 63% say obesity has consequences for society beyond the personal impact on individuals. Just 31% say it impacts the individuals who are obese but not society more broadly.
Yet, the public has mixed opinions about what, if anything, the government should do about the issue. A 54% majority does not want the government to play a significant role in reducing obesity, while 42% say the government should play a significant role. And while some proposals for reducing obesity draw broad support, others are decidedly unpopular.
(The survey was conducted before the Food and Drug Administration’s proposal last Thursday to severely restrict trans fats nationwide.) 1
- When should we start addressing obesity in America? (consumersresearch.org)
- Roadmap to treat adults affected by obesity, overweight (medicalnewstoday.com)
The International Diabetes Federation released a report Thursday that said that 10% of the global population will have diabetes by 2035.
The report, which was released on International Diabetes Day, said that 382 million people will have diabetes by the end of this year, and that 592 million will be diabetic by 2035, CBS news reports. Many of those millions will be living in developing countries.
The IDF report also estimates that the percentage of diabetic Americans will jump from 8% to 11% by 2035. One person dies from diabetes every six seconds, which amounts to 1.5 million annual deaths.
IDF points out that the number of people with diabetes, especially the Type 2 form, has increased in every country. The number of total diabetes cases have increased 4.4 percent over the last two years, now affecting more than 5 percent of the global population.
“We haven’t seen any kind of stabilizing, any kind of reversal,” Leonor Guariguata, an epidemiologist and project coordinator for IDF’s Diabetes Atlas, said to Businessweek. “Diabetes continues to be a very big problem and is increasing even beyond previous projections.”
According to the report, despite better treatments and improving education strategies, the battle to protect people from diabetes and its complications “is being lost.”
Dr. Juliana Chan, a professor of medicine and therapeutics at the Chinese University of Hong Kong, told the BBC that in China, she feels the rising rates of diabetes are due to different genetic, lifestyle and environmental factors not helped by the fact that the country is becoming modernized rapidly.
China had the highest total number of citizens with the disease, with an estimated 98.4 million to be diagnosed by the end of 2013.
“It is typically an ageing disease, but the data shows that the young and middle-aged are most vulnerable. It is prevalent in obese people but emerging data suggests that for lean people with diabetes the outcome can be worse,” she explained.
- One in Ten People Could Suffer from Diabetes by 2035, Reveals Report (medindia.net)
- Diabetes: Asia’s ‘silent killer’ (bbc.co.uk)
Although a number of my posts voice my concerns about “Big Pharm”, I still get an annual flu shot and keep up with vaccines.
Why? Overall I believe they are good public health measures. Still believe in herd immunity and my responsibility to others.
From the 14 November 2013 post by at KevinMD.com
(Please read the comments also for good additional information.)
Dr. Google, you’ve let a whole lot of people down.
If you Google a vaccine question, and many parents have, you’re very likely to find a good, science-based answer — but it will be buried among dozens of sites with anti-science, pro-disease propaganda. The mountain of misinformation is staggering, with multiple anti-vaccine sites repeating each other in a seemingly endless loop of worry and dread. Let neither facts nor truth nor glimmer of honesty stay them from the swift completion of their self-appointed fear mongering rounds.
Fortunately, there are ways to make sure you’re getting reliable answers to your questions.
Start with the CDC’s vaccine home page, which leads to comprehensive information about just about any vaccine health topic.
Prefer an academic center over a government site? The Children’s Hospital of Philadelphia (perhaps the best children’s medical center in the world) has their own very comprehensive vaccine site, and even their own vaccine information app.
Looking for a more global view? Try the World Health Organization’s vaccine page.
Willing to put up with a little snark? Several good science bloggers frequently discuss vaccine topics, no holds barred, and end up with some robust back-and-forth in the comments. Try Respectful Insolence, The Skeptical Raptor, or Neurologica.
Finally, if what you’d like is a meta-search that looks at only the best vaccine information sources, and weeds out the crap, try this science based vaccine search engine.
Parents don’t have the time to wade through the idiocy — they want real, genuine information to help make decisions. Google won’t do that for you, but these links will.
Roy Benaroch is a pediatrician who blogs at The Pediatric Insider. He is also the author of Solving Health and Behavioral Problems from Birth through Preschool: A Parent’s Guide and A Guide to Getting the Best Health Care for Your Child.
This author is spot on in addressing a real problem: these mercola-type internet sites are very harmful. They have the right to free speech but we must combat what is clearly destructive and unsubstantiated ‘health’ information. These sites have found a niche and strike a nerve for a lot of people who have come to the realization that western medicine doesn’t always have a cure for what ails them.
These sites play off this reality and work to trump up a sense of conspiracy which we as humans seem to have a weakness for.
Some people are distrustful of major ‘government’ websites like CDC.
On my site, I am honest about each vaccine’s effectiveness and potential side effects. I also explain why I support their use, one at a time:
I hope it helps
- May Wright Along the same lines: what would be handy for people who want to try to refute anti-vaccine memes on social media (FB, Twitter, blogs) is a resource page which features some of the most popular “arguments” against vaccines, all in one place, and then has links to science-based refutations on various sites. So, for instance, it would have the meme I saw doing the rounds of Facebook this morning, that “Gardasil has killed and injured more women than the disease it’s meant to protect!!11!!”, or the one about “I’m not injecting aborted fetuses into my baby, #ProLife SAY NO TO VACCINES!!” and then a few links to credible sources of information which provide the relevant facts?
Maybe such a page or site already exists, if so I’d love a link to it.
- Vaccinations, “For the Greater Good” (vaccinesforchildren.wordpress.com)
- Vaccines: how they work & why they’re important (wgno.com)
- Homecoming week offers flu vaccine for first time (digitalbullpen.com)
[Journal Article] Public Engagement with Biotechnologies Offers Lessons for the Governance of Geoengineering Research and Beyond
In this paper, we reflect on our involvement in one of the first major research projects in the emerging area of geoengineering (the deliberate intervention in the planetary climate). The project, Stratospheric Particle Injection for Climate Engineering (SPICE), proposed an outdoor experiment that attracted substantial public scrutiny despite a strong consensus that the experiment posed no direct environmental risk. A programme of stakeholder engagement took place that sought a deep understanding of the views about the proposed experiment. The lessons from this experiment build on insights from public engagement with the biosciences and biotechnology. In particular, we see the importance of questions of context and purpose for scientific research. This has important implications for the governance of geoengineering research. Efforts to detach areas of research from public scrutiny by using thresholds, whether these are drawn at a particular level of environmental effect or at the doors of a laboratory, will encounter problems of public credibility. Geoengineering is unavoidably entangled in a political discussion that scientists should seek to understand and engage with.
The progress of biotechnology brings the potential for ever more intimate and disruptive interventions into human bodies and the natural environment. As previous papers in this series have described, there have been various attempts, especially in the last decade, to improve engagement between scientists and public groups on issues involving biotechnology . Engagement exercises, whether with particular non-science stakeholders or members of the general public, reveal layers of societal concern with these technologies. There is typically concern with the eventual downstream risks and the ethical implications of technologies. But these things are hard to assess in advance due to the profound uncertainty that surrounds emerging technology. Public engagement typically also reveals a set of “upstream” concerns.
When brought into dialogue about emerging technologies, before it is clear what the risks are likely to be, members of the public will typically express concern about the trajectory of technological pathways. A report of one large public dialogue exercise on Synthetic Biology drew out five questions for scientists that characterised public concerns about this nascent technology:
- What is the purpose?
- Why do you want to do it?
- What are you going to gain from it?
- What else is it going to do?
- How do you know you are right?
These questions get to the heart of the politics of emerging technologies and the foundations of public trust in scientific research. Conventional technology assessment considers the downstream products of research and innovation with a focus on technological risk and ethics. More recent anticipatory governance approaches, such as “constructive technology assessment” , “real-time technology assessment” , and “responsible innovation” , attempt to broaden the debate to include consideration of the processes and purposes of research, in line with the five questions above. Such approaches emphasise the importance of democratic deliberation in “opening up” the technological options and trajectories for appraisal. Geoengineering in general and the SPICE project in particular have become important test cases for this new mode of governance .
- New Study: ‘Geoengineering to Cause Drought Worldwide’ (intellihub.com)
- Retooling the Planet: The False Promise of Geoengineering (resilience.org)
- We Don’t Geoengineer the Planet But We Have to Continue! (freeasthysweetmountainair.wordpress.com)
- Playing God: 4 Geoengineering Projects Doomed To Fail While Polluting The Earth (wakingtimes.com)
- Climate Change and Geoengineering (therebel.org)
- Strange Bedfellows? Climate Change Denial and Support for Geoengineering (yaleclimatemediaforum.org)
Seems to be a very humane law, even though it is controversial.
Oklahoma House Bill 1782 allows a medical provider to prescribe naloxone to a family member of someone who has a chance of overdosing. The drug helps restart breathing of someone who has overdosed.
Gail Box said she knows it can be difficult for parents to have conversations with their children about drug use.
But parents should consider talking to their children and also carrying naloxone if they think it could help save their children’s lives, she said.
“I wish, if I could go back, I would try to act on those feelings that I had at that time,” she said. “You can tell me anything you want, but I will always shoulder a great deal of guilt as a result of what happened to my son because as a parent, as a mother, it’s my job to protect him, and I didn’t.”
“There are people who have complete unintentional overdose who think they’re taking the right amount of pain medication, or they legitimately have a prescription but it’s not working so they take a little bit more,” White said. “This can also be critical in saving lives of people who are trying to use their pain medication appropriately.”
The law comes at a time when Oklahoma continues to see high rates of prescription drug abuse and overdose deaths.
Oklahoma ranks among the top five states with the highest rate of prescription overdose deaths. And prescription drug abuse is one of the fastest growing types of drug abuse in the state.
Prescription drug overdoses kill more people in Oklahoma than car accidents.
Oklahoma leaders plan to release the state’s strategy for combating prescription drugs in the next few months.
“It’s really good that we’re addressing this now as opposed to 10 years from now,” White said.
Before House Bill 1782 passed, naloxone was carried on many, if not all, paramedic ambulances and fire engines across Oklahoma, said Dr. Jeffrey Goodloe, the medical director for the emergency medical services system for Oklahoma City and Tulsa metros.
However, the law expands who can administer the drug. That’s where Goodloe’s concern comes in. Goodloe said he’s concerned about whether people who aren’t trained in medicine, such as law enforcement officers, will be able to deliver the drug appropriately.
“The first tenet of medicine … is do no harm, so in the process of helping people, we take an oath not to purposely harm them, and my concern with this bill is that, while its intent is nothing but admirable, the end result is I truly believe we will harm some people in fully executing its authority in the commission of trying to help people,” Goodloe said.
Goodloe said when people are given naloxone, they can wake up into a life-threatening withdrawal situation, suffering from horrific vomiting, extreme sweating and dangerously high heart rate and blood pressure.
Not every person given naloxone will go into this type of withdrawal, he said. However, it does occur.
- [Press Release] Prescription Drug Abuse: Strategies to Stop the Epidemic (jflahiff.wordpress.com)
- Oklahoma ranks 5th in drug overdose, expert explains how to lower that rank (kfor.com)
- Report says states are failing to curb prescription drug abuse (wqad.com)
- NM senator takes on prescription drug abuse (kansascity.com)
- Five more laws to help stop Maine’s prescription drug epidemic (bangordailynews.com)
- Prescription drug legislation unveiled (krqe.com)
- Report: W.Va. has highest rate of fatal overdoses (kansascity.com)
[News article] More Research Needed Into Substitution Principle and Regulation of Potentially Hazardous Chemical Materials, Experts Urge
Professor Ragnar Lofstedt, Professor of Risk Management and the Director of the King’s Institute for Risk Research, King’s College London and Editor of the Journal of Risk Research, has published a paper suggesting that the substitution principle is not the “white knight” as described by a number of regulatory agencies and NGOs and proposes that chemical substitution can only work effectively on a case-by-case basis.
The paper, published in the Journal of Risk Research, highlights how the Chemical Substitution Principle (where a potentially harmful chemical used in manufacturing or industry, is substituted for less dangerous alternative) has grown in popularity with chemical governing bodies and organizations in recent years. It highlights how a number of bodies are currently working on ‘substitution databases’ to aid companies in reducing the amount of harmful chemicals they use. The paper draws on three key case studies and states that the chemical substitution principle is a ‘blunt and imprecise regulatory instrument’ that is ‘surprisingly under-researched’ and ‘in need of further rigorous academic and regulatory analysis before it can be further used and promoted satisfactory in the chemical control area.’
Lofstedt uses evidence discussed in the paper to make recommendations for the future use of the chemical substitution principle, including the abolition of numerical targets set by regulatory bodies such as the European Chemical Agency for listing chemical substances of very high concern (SVHCs), and that, if the substitution principle is to be properly implemented, there is a need to do ‘comparative risk evaluations or risk-ranking exercises, to uncover how great the risk profile of the chemical in question actually is’.
The paper further suggests that greater support for evidence-based substitution and academic research into the scientific underpinnings of the chemical substitution principle is needed, along with a need for clear case studies and scientifically informed debates to help politicians become better informed about the pros and cons of the substitution principle.
- OSHA Releases New Resources to Help Employers Protect Workers from Hazardous Chemicals (workers-compensation.blogspot.com)
- The Future of the Toxic Substances Control Act: A Look at How Reform is Measuring Up (gielr.wordpress.com)
- Making regrettable substitution a thing of the past (blogs.edf.org)
- Stand Up For Safer Chemicals (workers-compensation.blogspot.com)
- Toxic Chemical Reform Must Help, Not Hinder, States and Victims’ Rights (huffingtonpost.com)
- EPA Web Tool Expands Access to Scientific, Regulatory Information on Chemicals (jflahiff.wordpress.com)
- [Repost] Getting Real About Chemical Risks (jflahiff.wordpress.com)
International Council on Clean Transportation / by Sarah Chambliss, Josh Miller, Cristiano Façanha, Ray Minjares and Kate Blumberg
[Green Car Congress] Although many countries have adopted emission control regulations patterned on the European regulations, the significant majority of these have not implemented the latest and most stringent Euro 6/VI stage. A study by a team at the the International Council on Clean Transportation (ICCT) finds that if that lag persists and present trends in vehicle activity continue, early deaths from vehicle-related PM2.5 exposure in urban areas will increase 50% by 2030, compared to 2013.
Conversely, the report finds, if all countries were to follow an accelerated roadmap to Euro 6/VI-level regulations, in tandem with fuel-quality regulations limiting sulfur content to 10 to 15 parts per million (ppm), early deaths globally from road vehicle emissions would fall by 75% (200,000) in the year 2030, representing a cumulative savings of 25 million additional years of life…
- ICCT report finds global implementation of advanced emissions and fuel-quality regs could cut early deaths from vehicle emissions by 75% in 2030 (greencarcongress.com)
- Tsinghua study concludes existing regulations for diesel trucks and buses insufficient to reach NOx reduction target by 2015 (greencarcongress.com)
- MIT Study: Vehicle Emissions Cause 58,000 Premature Deaths Yearly in U.S. (dc.streetsblog.org)
- Study finds biodiesel use in HD trucks in Canada will result in very minimal changes in air quality and health benefits (greencarcongress.com)
- Five Bad Arguments From the Coal Industry – Bloomberg (bloomberg.com)
- Region to implement new law on fuel sulphur emissions in 2015 (theeastafrican.co.ke)
- Lawsuit Accuses EPA Of Not Doing Enough To Regulate Toxic Soot (thinkprogress.org)
- Air pollution death rate up in half of boroughs (standard.co.uk)
- Air pollution death rate up in half of London boroughs (standard.co.uk)
[Magazine Article] Can the Defense Budget Shrink Without Risking National Security? (and yes, this is a public health issue)
Why is this related to public health? Because wasteful and duplicate military spending is a drain on the economy. Some of the duplicate spending could be spent in areas affecting public health as public transportation, basic health care, and education.
Of all the services that critics complain the Pentagon needlessly duplicates—from schools and rec centers to scientific research and grocery stores—the most expensive is health care. Ten percent of the Pentagon’s non-war budget—$53 billion—goes to health care. As with civilian health care, savings are achievable here but face implacable opposition from military retirees. But as no less a military enthusiast than John McCain said last year on the Senate floor, “We are going to have to get serious about entitlements for the military just as we are going to have to get serious about entitlements for nonmilitary.”
Fortunately, there are ways to cut defense spending without hurting military capabilities. Besides maintaining its war-fighting capability, DoD, like any entity, maintains a back-office bureaucracy to oversee its business functions. That overhead accounts for roughly 40 percent of its budget. It’s hard to compare different industries, or even government agencies, but one examination of 25 industries showed average overhead rates ranging from 13 to 50 percent, with the average across all industries being 25 percent. A RAND study of overhead and administration costs among defense contractors found them to be “tremendous drivers” of weapon costs at 35 percent. The largest domestic programs—Social Security and Medicare—get by with costs in the single-digits.
Cutting Pentagon overhead to the average would save roughly $80 billion a year. Looked at another way, the department employs 800,000 civilians. Not only is that more than the population of four states, it’s not quite half of all civilian federal employees, more than twice as many as the next-largest agency (Veterans Affairs), four times the number of civilian employees at the Department of Homeland Security and basically the size of all the remaining federal agencies combined. Think there might be some savings possible there?
- How to Cut Defense Spending Without Hurting the Military (defenseone.com)
- Pentagon leaning toward cutting troops, beefing up tech (stripes.com)
- Military Must Do More With Less (fortunascorner.wordpress.com)
- Ralph Nader: Giant Pentagon Budget Is Unauditable Year After Year (huffingtonpost.com)
- Pentagon offset budget cut impact in key areas -watchdog (reuters.com)
..Taking trans fats off the GRAS list won’t remove them from the food supply. Manufacturers can still petition the FDA for exceptions. But it goes a long way toward getting them out.
what the announcement really shows is how public health works: slowly, based on mounting scientific evidence, against constant and mounting headwinds of public ridicule and, much more important, industry lobbying and advertising.
..Companies seldom change unless they have to, which they say means unless consumers ask them to. If you don’t want trans fats or gluten or genetically modified organisms, fine with us! Just tell us with your food dollars! This is of course a way of saying that they don’t want government telling them what to do, and gives them a chance to shape the public opinion they say they simply obey, with millions of dollars in ad campaigns and lobbying.
The lesson, though, is not that the public shouldn’t trust science, because one year’s saturated-fats-are-evil message will eventually become next year’s hey-butter-is-great-when-you-look-at-Crisco. The road to strong public recommendations isn’t clear, as scientific research is slow and zigzags. Both food makers and scientists can be guilty of jumping the gun, depending on what they think they can sell or who they can get to fund big studies and endowed chairs.
The analogy I’m building toward is, of course, sugar-sweetened drinks. Scientific consensus has built to practically the bursting point that sodas make kids fat. Soda makers deride the officials who try to do something about it, and work as hard as they can to cast doubt on science. Mayor Bloomberg, though fairly trim, was their fattest target, in the Mrs. Doubtfire costume they dressed him up in when he tried to impost a portion limit on sodas in restaurants and movie theaters. Now that he’s leaving, they’ll find another target.
But opinion will change, national bodies start to fall into line as they did on trans fats and are doing with sugary drinks. The most outspoken enemies of sugar, like Robert Lustig, are trying to take it off the GRAS list–something that CSPI petitioned the FDA to do last February, asking it to study and determine safe levels of high-fructose corn syrup. The chance of an FDA announcement of that in six years seems pretty unlikely now. But soda makers already have more than dozens of low-sugar and sugar-free drinks: they have scores and scores of them. They’ve quietly been working to solve the problem, while spending (often literally) untold sums not to risk their core products. The advocates against trans fats who seemed so crazy even six years ago, when the New York trans fat ban went into effect, are seeming a lot less crazy today.
- NYC’s Bloomberg led the way on trans fats ban (miamiherald.com)
- Trans fat doesn’t stir much ‘nanny state’ debate (fngnutrition.ca)
- FDA’s Proposed Trans Fat Ban: An Attack on Freedom (heritage.org)
- No more trans fat: FDA banning the artery-clogger (webpronews.com)
- No more trans fat: FDA banning the artery-clogger (conservativeread.com)
- FDA to ban trans fats (cbs6albany.com)
- Trans Fat Ban?; Bullying and Bonding; Ask an Astronaut (wnyc.org)
- FDA To Ban Trans Fats (nycfitfoodfashion.com)
From the OECD (Organization for Economic Co-operation and Development]**
Every person aspires to a good life. But what does “a good or a better life” mean? The second edition of How’s Life? paints a comprehensive picture of well-being in OECD countries and other major economies, by looking at people’s material living conditions and quality of life across the population. In addition, the report contains in-depth studies of four key cross-cutting issues in well-being that are particularly relevant: how has well-being evolved during the global economic and financial crisis?; how big are gender differences in well-being?; how can we assess well-being in the workplace?; and how to define and measure the sustainability of well-being over time?
Read the book by chapter
What drives people’s and nations’ well-being and where do countries need to improve to achieve greater progress for all? The OECD Better Life Initiative launched in 2011 addresses these questions by measuring well-being outcomesin 11 dimensions.
This chapter shows that OECD countries have made considerable progress in many well-being areas over the past 20 years or so, although progress has been uneven across the 11 dimensions included in the OECD well-being framework. Similarly, there is great diversity in patterns amongst different countries as well as disparity in well-being achievements of different groups of the population within a country.
This chapter analyses how well-being has changed during the global economic and financial crisis. Even though some effects of the crisis may become visible only in the long-term, the report finds that the crisis has had large implications for some economic and non-economic aspects of people’s well-being. Clear negative trends have emerged in subjective well-being and civic engagement, with increasing levels of stress, lower life satisfaction and decreasing trust in national governments.
The chapter looks at gender differences in well-being, showing that the traditional gender gap in favour of men has narrowed but has not disappeared. It also finds that women and men do well in different areas of well-being and that they are increasingly sharing tasks and roles.
This chapter looks at the quality of employment and well-being in the workplace. The report presents evidence on the main factors that drive people’s commitment at work and are key to strengthening their capacity to cope with demanding jobs.
The last chapter of the report studies the links between current and future well-being. It looks at ways to define and measure sustainability of well-being over time. This chapter focuses on four types of resources (or “capital”) that can be measured today, and that matter for future well-being: economic, natural, human, and social capital.
Our origins date back to 1960, when 18 European countries plus the United States and Canada joined forces to create an organisation dedicated to global development. Today, our 34 member countries span the globe, from North and South America to Europe and the Asia-Pacific region. They include many of the world’s most advanced countries but also emerging countries like Mexico, Chile and Turkey. We also work closely with emerging giants like China, India and Brazil and developing economies in Africa, Asia, Latin America and the Caribbean. Together, our goal continues to be to build a stronger, cleaner, fairer world.
- UK a great place to live and work, says OECD (theguardian.com)
- OECD says young Irish are among main victims of the crisis (independent.ie)
- Euro zone crisis bearing heavy human toll – OECD (dnaindia.com)
- OECD: Well-Being in Euro Zone Has Suffered Since Crisis (online.wsj.com)
- Britons happier than before financial crisis as contentment plummets in Europe – OECD (telegraph.co.uk)
- UK scores highly in world quality of life rankings, says OECD (oddonion.com)
- Mixed Praise For Chile’s Economic Performance – Analysis (eurasiareview.com)
- Canadians among top seven nations for living well, says OECD ranking (canadianbusiness.com)
Behavioral Health United States 2012
SAMHSA’s newly-released publication, Behavioral Health, United States, 2012, the latest in a series of publications issued by SAMHSA biannually since 1980, provides in-depth information regarding the current status of the mental health and substance abuse field. It includes behavioral health statistics at the national and State levels from 40 different data sources. The report includes three analytic chapters:
- Behavioral Health Disorders across the Life Span
- Mental Health and Substance Use Disorders: Impairment in Functioning
- Mental Health and Substance Use Disorders: Treatment Landscape
The volume also includes 172 tables, which are organized into four sections:
- Behavioral Health of the Population: the mental health status of the U.S. population and prevalence of mental illness;
- Behavioral Health Service Utilization: providers and settings for behavioral health services; types of behavioral health services provided; and rates of utilization;
- Behavioral Health Treatment Capacity: number of facilities providing mental health and substance abuse services; numbers of qualified specialty mental health and substance abuse providers; and
- Payer and Payment Mechanisms: expenditures and sources of funding for behavioral health services.
No other HHS publication provides this type of comprehensive information regarding behavioral health services delivery in the U.S. This publication is the only available comprehensive source of national-level statistical information on trends in both private and public sector behavioral health services, costs, and clients. Drawing on 40 different data sources, this publication also includes State-level data, and information on behavioral health treatment for special populations such as children, military personnel, nursing home residents, and incarcerated individuals.
- Two behavioral health nonprofits agree to repay $4.2 million (abqjournal.com)
- Mental health providers to pay NM for overbilling (kansascity.com)
- Innovation in behavioral health (whyy.org)
- A public health approach for mental health (jsonline.com)
- Judges and Psychiatrists Discuss Mental Health Treatment in the Judicial System (namisouthbay.com)
- Reports possible soon on some mental health fraud (miamiherald.com)
- NH schools awarded behavioral health grants (mysanantonio.com)
The 2007-2008 food price crisis was a wake-up call for the international community, reigniting the discussion about the need to refocus attention on agricultural development. In sub-Saharan Africa, however, member governments of the African Union (AU) had already been grappling with the issue for several years. In 2001, AU members agreed to establish a process to help spur economic growth and political transformation on the continent. The majority of poor people in Africa— approximately 75 percent—live in rural areas and depend on
agriculture for their livelihood.1 Yet between 1995 and 2003, most African countries spent very little public money on agriculture—well below 1 percent of their Gross Domestic Products (GDP).2
Realizing this contradiction, the AU’s New Partnership for Africa’s Development (NEPAD) launched the Comprehensive Africa Agriculture Development Program (CAADP). African heads of state met in Maputo, Mozambique, in 2003, and agreed in the Maputo Declaration both to begin devoting 10 percent of their national budgets to agriculture by 2008, and to set a goal of achieving an average annual growth rate of 6 percent in the agricultural sector by 2015.3 Nonetheless, donor funding for agriculture was very limited until 2009.
CAADP, an ambitious and comprehensive vision for agricultural reform in Africa, is an example of how initiatives with effective local ownership are making strides toward the U.N. Millennium Development Goals (MDGs).
A good example of what is possible is Tanzania, whose economy has been growing steadily over the past 10 years. On average, the economy expanded by 6.9 percent a year. Five sectors were the source of almost 60 percent of Tanzania’s economic growth between 2008 and 2012:
- CommunicationGDPalmostdoubledinlessthanfour years, growing on average more than 20 percent a year.
- Banking and financial services, which has expandedby 11 percent a year since 2008.
- Retail trade, which increased by almost 40 percentbetween 2008 and 2012.
- Construction,withaverageannualgrowthof9percentover the same period.
- Manufacturing, which grew by 8.4 percent annuallyduring the past four years.Agriculture also contributed to Tanzania’s economic growth, but this was a given because it makes up a significant share of GDP, about 25 percent. In fact, during the period 2008-2012, agriculture’s growth rate was consistently below the overall economic growth rate.
Nutrition: Investing in nutrition is extremely cost-effective yet critically underfunded. In fact, of the “10 best buys in development” identified by a group of top economists, five are nutrition interventions.15 But although relatively simple, very affordable interventions to treat malnutrition are available, nutrition remains the “forgotten MDG.” Both overseas development assistance for nutrition, and national budget allocations have been very low.
Since 2009, the United States has worked through its global food security initiative, Feed the Future, to emphasize the urgent need to improve nutrition in the “1,000 Days” window between pregnancy and age 2.16 Because malnutrition in this critical age group causes irreversible physical and cognitive damage, countries with a high proportion of malnourished babies and toddlers pay the price in diminished productivity and economic growth. On the other hand, research shows that $1 invested in nutrition generates as much as $138 in better health and increased productivity.17 In sub-Saharan Africa, an estimated 41 percent of all children younger than 5 are malnourished.18 It is the only world region where the number of child deaths is increasing, and the only one expected to see further increases in food insecurity and absolute poverty.19
In spite of the currently tight budget climate, the United States and other development partners should not back off. Rather, they should press forward to support and help strengthen county-led initiatives such as CAADP. As the African Union prepares for the January 2014 African Union summit, which marks the start of “the Year of Agriculture in Africa,” there is real opportunity for this renewed commitment to have an impact on hunger. On July 1, 2013, African heads of state and government of AU Member States, together with representatives of international organizations, civil society organizations, the private sector, cooperatives, farmers, youths, academia, and other partners unanimously adopted a Declaration to End Hunger in Africa by 2025. This High Level Meeting, Renewed Partnership for a Unified Approach to End Hunger in Africa by 2025 within the CAADP Framework, took place at the initiative of the African Union, FAO, and the Lula Institute along with a broad range of non-state actors.22 With this renewed commitment to end hunger, African countries still have a chance to fulfill their Maputo commitments since that deadline coincides with the MDG deadline, two years away in 2015.
- Ten Years of Transforming Agriculture in Africa (drbausman.wordpress.com)
- Zambia agro-sector given $31.5 million (daily-mail.co.zm)
- African leaders to tackle malnutrition in Niger forum (nation.co.ke)
- Sub Saharan Africa to Meet Only 25% of Food Demand by 2030-gap Report Reveals (modernghana.com)
- 4 Things the FAO says nations must do to reach global hunger MDG by 2015 (one.org)
- Africa Land Grab Unacceptable (developmentpublications2011.wordpress.com)
- Global hunger down, but millions still chronically hungry / 842 million people undernourished in 2011-13 – Developing countries make progress but more efforts needed to reach MDG target (appablog.wordpress.com)
- Poor Numbers: How We Are Misled by African Development Statistics (independentsciencenews.org)
- Governments in Africa fail to reduce poverty despite economic progress (irishtimes.com)
- Half of population face malnutrition in Madagascar (vancouverdesi.com)
[Brookings Institute report] Isabel V. Sawhill and Quentin Karpilow – Three Facts about Birth Control and Social Mobility
The ability to control our fertility, to have children when—and with whom—we want, is a precious gift of modern science. For women in particular, birth control has also been a boost for social mobility. But there is still progress to be made.
1. The Pill Transformed Women’s Life Chances
The Pill gave American women something genuinely new: a convenient and highly effective means of controlling their own fertility. Although the Pill was licensed by the by the FDA (as Enovid) in 1960, state and federal laws limited the access of young single women to oral contraception. But as those laws changed in the late 60s and early 70s, oral contraceptive use jumped among young single women. And look what happened to the gender mix of professional college courses:
Of course this could be coincidence. But the best researchers in the field don’t think so. Using sophisticated research designs, that isolate the causal effects of the Pill, scholars have shown that the diffusion of the Pill raised women’s college attendance and graduation rates (Hock, 2007), increased the representation of women in professional occupations (Goldin and Katz, 2002), and boosted female earnings (Bailey et al., 2012).
2. Unintended Pregnancies Still Too Common
But unintended pregnancy rates – 3 million or more a year - remain stubbornly high in the U.S. The benefits of birth control are being only partially realized. Half of all pregnancies are mistimed or unwanted – and 95 percent of all unintended pregnancies occur among women who either aren’t using contraception at all or aren’t using their contraceptive method consistently:
It is time for a new revolution in family planning, with even better contraception than the pill. Long-acting reversible contraceptives (LARCs) such as intra-uterine devices (IUDs) have a big role to play in solving America’s contraception deficit. Because these highly effective methods don’t require the daily maintenance that the Pill does, LARCs could potentially eliminate the problems of inconsistent use, as a study conducted in St Louis suggests.
3. Most Disadvantaged Need More To Lose
Early, unwed pregnancy rates are highest in the most disadvantaged communities. Recent research suggests that for those with starkly limited opportunities, better family planning may do little to improve their life trajectories. The impact of better contraception for this cohort is small for the depressing reason that they have so little to lose in the first place. These women need better family planning, but they also need better educational and work opportunities. In short, they need more to lose.
Earlier this week, I talked about these issues at an event sponsored by AEI and the Institute of Family Studies. In tomorrow’s blog post, I’ll set out the gains we could realize from getting better at birth control.
Senior Fellow, Economic Studies
A nationally known budget expert, Isabel Sawhill focuses on domestic poverty and federal fiscal policy. She is also co-director of the Center on Children and Families and the Budgeting for National Priorities Project at Brookings.
Senior Research Assistant, Center on Children and Families
- Family structure’s impact on children’s education and social mobility (aei-ideas.org)
- An Anti-Birth Control Employer Just Beat Obamacare in Federal Court (theatlanticwire.com)
- Obamacare Birth Control Mandate Struck Down By Appeals Court Over Religious Freedom Concerns (huffingtonpost.com)
- Birth Control Options: Think Outside the Pill (spreadthehealthbu.com)