The future of public health in the United States is difficult to predict, but the challenges public health has yet to overcome are much more certain. As Keck, Scutchfield, and Holsinger point out i…
From the 14 May 2014 Dartmouth College news release
A Dartmouth research laboratory is working to quantify the effects of playing games. In a study published online last month by the Games for Health Journal, Professor Mary Flanagan and her team found that attitudes toward public health issues shift to be more accepting and understanding after playing a game they developed calledRePlay Health.
“Sales of games have been steadily increasing for several years,” says Flanagan, the Sherman Fairchild Distinguished Professor in Digital Humanities at Dartmouth and the director of the Tiltfactor laboratory. “So economically, we have measured their impact, and now it’s time to measure their ability to change behaviors and attitudes.”
RePlay Health is a role-playing sport that requires players to assume different identities and carry out various activities to improve their health. The backdrop of the game is a fictional health care system, and the players learn how personal behaviors, workplace productivity, insurance (or lack of it), and all related health care costs are woven together within the system. Each player is presented with opportunities to not only improve their own health, but also the health of their community through policy initiatives that they vote on.
“We showed how active engagement with the game’s characters and events was crucial to the game’s ability to shift players’ mindsets and attitudes about health and health policy,” says Geoff Kaufman, a co-author of the study and Tiltfactor’s post-doctoral researcher in psychology.
The researchers asked a group of young adults to complete an online questionnaire two weeks prior to playing RePlay Health and again within a week after playing the game. Flanagan says that the results indicate that the game has the potential to have a lasting impact on the players.
RePlay Health was developed in collaboration with The Dartmouth Center for Healthcare Delivery Science and the Rippel Foundation. The game is part of a broad initiative to promote learning about public health policies and spending priorities. Flanagan and her team envision college students, medical students, doctors, local council leaders, government officials, and any other people interested broadly in public health playing the game to digest the issues and find ideas that resonate. “It’s not just students and public officials who can play this game, or benefit from playing,” says Flanagan.
From the article, Perspectives on Psychological Science, March 2015 vol. 10 no. 2 227-237
Several lifestyle and environmental factors are risk factors for early mortality, including smoking, sedentary lifestyle, and air pollution. However, in the scientific literature, much less attention has been given to social factors demonstrated to have equivalent or greater influence on mortality risk (Holt-Lunstad, Smith, & Layton, 2010). Being socially connected is not only influential for psychological and emotional well-being but it also has a significant and positive influence on physical well-being (Uchino, 2006) and overall longevity (Holt-Lunstad et al., 2010; House, Landis, & Umberson, 1988; Shor, Roelfs, & Yogev, 2013). A lack of social connections has also been linked to detrimental health outcomes in previous research. Although the broader protective effect of social relationships is known, in this meta-analytic review, we aim to narrow researchers’ understanding of the evidence in support of increased risk associated with social deficits. Specifically, researchers have assumed that the overall effect of social connections reported previously inversely equates with risk associated with social deficits, but it is presently unclear whether the deleterious effects of social deficits outweigh the salubrious effects of social connections. Currently, no meta-analyses focused on social isolation and loneliness exist in which mortality is the outcome. With efforts underway to identify groups at risk and to intervene to reduce that risk, it is important to understand the relative influence of social isolation and loneliness.
Living alone, having few social network ties, and having infrequent social contact are all markers of social isolation. The common thread across these is an objective quantitative approach to establish a dearth of social contact and network size. Whereas social isolation can be an objectively quantifiable variable, loneliness is a subjective emotional state. Loneliness is the perception of social isolation, or the subjective experience of being lonely, and thus involves necessarily subjective measurement. Loneliness has also been described as the dissatisfaction with the discrepancy between desired and actual social relationships (Peplau & Perlman, 1982).
CDC has released the updated Community Health Status Indicators (CHSI) online tool that produces public health profiles for all 3,143 counties in the United States. Each profile includes key indicators of health outcomes, which describes the population health status of a county and factors that have the potential to influence health outcomes, such as health care access and quality, health behaviors, social factors, and the physical environment.
Each profile includes key indicators of health outcomes, which describes the population health status of a county and factors that have the potential to influence health outcomes, such as health care access and quality, health behaviors, social factors, and the physical environment.
The re-designed online application includes updated peer county groups, health status indicators, a summary comparison page, and U.S. Census tract data and indicators for sub-populations (age groups, sex, and race/ethnicity) to identify potential health disparities. In this new version of CHSI, all indicators are benchmarked against those of peer counties, the median of all U.S. counties, and Healthy People 2020 targets. Organizations conducting community health assessments can use CHSI data to:
Assess community health status and identify disparities;
Promote a shared understanding of the wide range of factors that can influence health; and
Mobilize multi-sector partnerships to work together to improve population health.
Good study. However I would like to see how this compares with what researchers believe are causes/correlations of ill health and how best to address the causes/correlations.
Many believe their health has been impacted by negative childhood experiences
A new NPR/Robert Wood Johnson Foundation/Harvard T.H. Chan School of Public Health poll finds that more than six in ten people living in the U.S. (62%) are concerned about their future health. Nearly four in ten (39%) said that they had one or more negative childhood experiences that they believe had a harmful impact on their adult health.
Causes of ill health
“When the public thinks about the causes of ill health, it’s not just about germs. They also see access to medical care, personal behavior, stress, andpollution as affecting health,” said Robert J. Blendon, Richard L. Menschel Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health.
When given a list of 14 factors that might cause ill health, the top five causes cited by the public as extremely important are lack of access to high-quality medical care (42%), personal behavior (40%), viruses or bacteria (40%), high stress (37%), and exposure to air, water, or chemical pollution (35%).
Those rankings diverge, however, among ethnic groups.
…
Actions to improve health
Given the wide range of reasons given for why ill health occurs, it is not surprising that people in the U.S. have a very broad view of the actions that could be taken to improve people’s health. The top five things (from a list of 16) that the public believes would improve people’s health a great deal are: improving access to affordable healthy food (57%), reducing illegal drug use (54%), reducing air, water, or chemical pollution (52%), increasing access to high-quality health care (52%), and improving the economy and the availability of jobs (49%).
….The world is at a dire turning point in the fight against climate change. If the world doesn’t begin taking action to mitigate the impact of climate change the outcomes will be catastrophic (even though some research is saying that’s going to happen, regardless).
A growing discussion in the United States is how we are equipping future citizens, business leaders, health leaders, etc. to be part of the solution to reducing greenhouse gas emissions and mitigating those risks. But according to my preliminary research in climate change science being integrated into science curriculum, we aren’t doing that at all. From personal experience with a Bachelors of Science in Applied Sciences in Public Health, I have never had a professor talk about climate change nor talk about solutions and how we as public health professionals fit into different roles. If young adults and children aren’t aware of climate change, how is it ever going to be brought to the forefront of discussion? How is change going to happen? Sure, federal and state governments can use the power of public policy to control emissions, but what about the solutions to the inevitable problem looming? Solutions such as emergency preparedness planning (since we can safely assume this is going to be a needed expertise), green space, active transportation, infrastructure to prevent rising sea levels from flooding major cities, etc.
As progressive public health departments move towards allocating resources to chronic disease prevention (and obviously, rightfully so), it will be incredibly important to ensure emergency preparedness, epidemiology, and environmental health aren’t lost in the mix. Professionals in health communications and community engagement will be critical pieces, but ultimately don’t have the legal authority of an Environmental Health professional to enforce state and federal mandates, nor have the expertise in emergency preparedness. This is a call for sustained and increased funding for local health departments. The climate change discussion is happening internationally and on a federal level, but those discussions aren’t trickling down to the local level. I would attribute this to climate change being a backburner issue and one that doesn’t have an acute impact (like an Ebola outbreak). The impacts are longitudinal and over long periods of time.
First Amendment jurisprudence frequently pits societal ideals against free speech. A recent conference at Yale Law Schoolshowed that this is no less the case when commercial free speech protections conflict with public health regulatory objectives.
The conference, Public Health in the Shadow of the First Amendment, was co-sponsored by the Information Society Project, the Yale Global Health Justice Partnership, and the Yale Health Law and Policy Society on October 17 and 18, 2014. The event brought together public health advocates, medical professionals and First Amendment scholars to discuss the implications of recent controversial First Amendment case law. The panels highlighted several areas where courts have protected commercial speech in spite of unpopular consequences for public health policy. Hilary Richardson attended the conference on behalf of the Wikimedia Foundation legal team, given its interest in free speech law.
Professor Post provided insight into how we theorize the First Amendment and why we understand it to protect commercial speech at all. According to Post, the primary distinction between speech that is covered by the First Amendment and speech that is not comes down to our democratic value of self-governance: speech triggers First Amendment coverage when it participates in the formation of public opinion because we want the government to be responsive to public opinion. Generally, this creates a First Amendment right which is speaker-oriented. However, this changed when the Supreme Court invented the commercial speech doctrine. In Virginia Pharmacy,[3] the Court gave two rationales: we need efficient distribution of information in order to have efficient markets, and we protect commercial speech because it distributes information which is necessary for citizens to participate in public opinion formation. Post argued that in this sense, Virginia Pharmacy created a First Amendment right of the receiver to hear information rather than speak it. In the context of commercial speech, the Supreme Court conceives of the public as people capable of processing information. This suggests that it is up to the people to decide what information they need.
Professor Volokh echoed Post and Bambauer in his agreement that First Amendment protections are about protecting a free market, so that it is better for people to have more information when making decisions. Volokh stressed that the logic behind the commercial speech doctrine is that even though we may think that patients and doctors may make bad decisions, it is possible that government regulators might as well: “the First Amendment directs us to be especially skeptical of regulations that seek to keep people in the dark for what the government perceives to be their own good.”
From the 14 January 2015 Rice University press release
Neill: Approach minimizes harm associated with drug use for the individual and society
HOUSTON – (Jan. 14, 2015) – The United States’ law-and-order approach to reducing the supply of drugs and punishing sellers and users has impeded the development of a public health model that views drug addiction as a disease that is preventable and treatable. A new policy paper from Rice University’s Baker Institute for Public Policy advocates that a harm-reduction approach would more effectively reduce the negative individual and societal consequences of drug use.
According to the paper’s author, Katharine Neill, the rate of federal inmates incarcerated for drug offenses hovered at just under 50 percent in 2011, and in 2013 the Obama administration’s budget asked for $25.6 billion to fight the drug war, $15 billion of which was directed toward law enforcement. In addition, by some estimates, state and local governments spend a combined total of $51 billion per year on drug-related law enforcement efforts, which suggests they have a lot to gain by investing in treatment options, Neill said.
“That law enforcement efforts continue to dominate drug policy highlights the need to reframe the discourse on drug use and addiction,” said Neill, the Baker Institute’s Alfred C. Glassell III Postdoctoral Fellow in Drug Policy. “While emphasizing the cost-saving benefits of treatment is important, this should be coupled with more public conversations focusing on drug addiction as a disease requiring medical treatment, not politically based solutions. Reframing the issue in this way should increase the likelihood that a public health approach to drug policy will be adopted for the long term.”
The paper, “Tough on Drugs: Law and Order Dominance and the Neglect of Public Health in U.S. Drug Policy,” is published in the journal World Medical and Health Policy.
Emphasizing harm reduction is a popular public health approach to drugs, Neill said. “A harm-reduction approach recognizes the permanence of drugs in society and, instead of trying to eradicate drug use, focuses on minimizing harm associated with drug use for the individual and society,” she said. “This encompasses a variety of objectives, including preventing individuals from using drugs, treating individuals who want to stop using drugs, preventing drug use where it increases the chances of negative outcomes such as driving while on drugs, and helping individuals who want to continue using drugs do so in a way that does not further compromise their health or the health of others.” This last objective is often achieved through needle-exchange programs intended to prevent the spread of HIV and hepatitis C and is more controversial than other policies, Neill said.
Harm reduction is multidimensional and can include contradictory objectives, she said. For example, some proponents wish to decriminalize drug use and focus on helping drug users get the resources they need for treatment or to continue to use drugs safely, while others accept the illegality of drug use so long as treatment is more available. Others argue that distinctions should be made between drugs according to the risks they pose to the user and society and that policy should be based on these distinctions. “Still, most advocates of harm reduction agree on some basic tenets, including the view that addiction is a disease requiring medical assistance, the desire to minimize risky behavior without requiring abstinence and the need to protect the public from the consequences of drug use, which includes punishing individuals who commit acts that harm others,” Neill said.
Two-year study of urban teens & young adults shows high risk of additional violent injuries among assault victims, especially those with PTSD or drug use
ANN ARBOR, Mich. — Teens and young adults who get seriously injured in an assault are nearly twice as likely as their peers to end up back in the emergency room for a violent injury within the next two years, a new University of Michigan Injury Center study finds.
The study followed nearly 600 teens and young adults for two years after an emergency room visit for an assault injury or other condition. The assault group’s members were twice as likely to suffer another violent injury – most within 6 months.
The researchers call this repeating pattern of violent injury a reoccurring disease, but their landmark study also suggests potentially powerful opportunities to intervene in ways that could stop the cycle.
The first six months after a young person seeks care for a violence-related injury is an especially important time, the study shows.
Patients with post-traumatic stress disorder or drug abuse problems have the highest likelihood of suffering injuries in another violent incident, the researchers find.
The findings come from a unique effort that involved multiple interviews and medical record chart reviews conducted over two years with nearly 600 residents of the Flint, Mich. area between the ages of 14 and 24 — starting when each one sought emergency care at a single hospital. Nearly 350 of them were being treated for assault injuries at that first encounter.
Rebecca Cunningham, M.D., director of the U-M Injury Center and first author of the new paper, notes that it’s the first prospective study of its kind, and 85 percent of the young people enrolled were still in the study at 24 months. Five of the participants died before the study period ended, three from violence, one from a drug overdose, and one in a motor vehicle crash.
“In all, nearly 37 percent of those who qualified for this study because they were being treated for assault-related injuries wound up back in the ER for another violent injury within two years, most of them within six months,” says Cunningham, who is a Professor in the Department of Emergency Medicine at the U-M Medical School and the Department of Health Behavior and Health Education in the U-M School of Public Health.
“This ER recidivism rate is 10 percentage points higher than the rate for what we traditionally call chronic diseases,” she continues. “Yet we have no system of standard medical care for young people who come to us for injuries suffered in a violent incident. We hope these data will help inform the development of new options for these patients.”
The authors note that non-fatal assault-related injuries lead to more than 700,000 emergency visits each year by youth between the ages of 10 and 24. Fatal youth violence injuries cost society more than $4 billion a year in medical costs and $32 billion in lost wages and productivity.
Despite this costly toll, most research on how often the cycle of violent injury repeats itself, and in which young people, has relied on looking back at medical records. This has resulted in widely varying estimates of how big the problem is.
But through the Flint Youth Injury Study, based at U-M, the research team was able to study the issue prospectively, or starting with an index visit and tracking the participants over time.
The study was performed at Hurley Medical Center in Flint, where Cunningham holds an appointment and where U-M emergency physicians work with Hurley staff to provide care.
The study’s design allowed them to compare two groups — those whose index visit was for assault injuries and those seen for other emergency care. Each time a new assault victim was enrolled, the research team sought to enroll the next non-assault patient of the same gender and age range who was treated at the same ER.
Nearly 59 percent of the participants were male, and just over 58 percent were African American, reflecting the broader population of Flint. Nearly three-quarters of those in the study received some form of public assistance.
Among those whose first visit was for assault, nearly 37 percent wound up back in the ER for violent injuries in the next two years, compared with 22 percent of those whose first visit wasn’t for an assault injury. And a larger proportion of the “assault group” actually came back more than once for violent injuries, compared with the other group.
“Future violence interventions for youth sustaining assault-related injury may be most effective in the first six months after injury, which is the period with the highest risk for recidivism,” says Maureen Walton, MPH, Ph.D. senior author and associate professor in the U-M Department of Psychiatry. “These interventions may be most helpful if they address substance use and PTSD to decrease future morbidity and mortality.”
American Journal of Preventive Medicine supplement addresses critical challenges to public health
Ann Arbor, MI, October 16, 2014 – Although disease outbreaks and epidemics drawing worldwide attention emphasize the importance and acute need for public health professionals, the world faces a longer-term challenge—a public health workforce that is truly effective in the 21st century. In a new supplement to the American Journal of Preventive Medicine, ***experts address critical challenges to public health, from workforce development, capacity building, partnership and collaborations, and changes and needs in workforce composition.
As the U.S. healthcare system evolves and communities gain more access to care, diverse forces are driving change, and the practice of public health is adapting. Given the challenges to the public health system and those faced as a nation—including urgent health threats (e.g., antibiotic resistance, prescription drug use and overdose, global health security) and decreased funding for addressing public health concerns—having trust in public health practitioners, their scientific knowledge, and particularly the public health system, has never been more important.
“The public health workforce is now not only required to take a lead in protecting citizens’ health, but it also must provide the evidence base needed for linking public health information with clinical services and activities; offer targeted, scalable public health interventions; and support clinical services in a way that affects populations at large,” notes Guest Editor Fátima Coronado, MD, MPH, Deputy Associate Director for Science, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA. “This supplement is both timely and important because it reviews some of the critical challenges faced by the public health workforce, discusses selected changes under way, and highlights data-driven research to advance the field of public health services and systems research.”
This groundbreaking supplement, The Public Health Workforce, includes 22 articles from more than 30 institutions, agencies, foundations and public companies and covers two major areas: public health workforce capacity building and public health workforce size and composition.
Key topics in the Supplement include:
How to clearly define the public health workforce challenges using cause-and-effect diagrams and a concise roadmap.
Use of Massive Open Online Courses (MOOCs) by the School of Public Health at Harvard and concerns about retention of the knowledge gained using that method of instruction.
How the CDC conducts workforce development within its own organization.
Do students who receive adequate training in Public Health and Community Medicine tend to practice in areas with physician shortages?
How do we count public health workers? In the first study since 2000, 50% of all public health workers are employed at the local level, with 30% and 20% at the state and federal levels, respectively.
How can we define public health workers properly? A taxonomy has been developed which is a necessary step to continuously monitor the size and composition of the workforce to ensure sufficient capacity to deliver essential public health services.
Data show that part-time public health workers are a low percentage of the total workforce and the percentage has decreased over the last 5 years.
Despite relatively uncompetitive pay, local health departments experience lower rates of employee turnover than state health agencies and lower rates than state and local government in general.
How can we align public health workforce competencies with population health improvement goals?
How the Public Health Accreditation Board (PHAB) developed the standards and measures to encourage health departments to strengthen the current public health workforce and strategically develop the workforce of tomorrow.
Do Internal Medicine Residency Programs develop public health competencies?
How a training program for racial and ethnic minorities for careers in public health sciences has resulted in 60% of the students entering public health careers.
Will epidemiology education change rapidly enough to keep up with trends in communications and computing?
How the growth of cities, “Big Data,” and cognitive computing will change the public health workforce.
Building a Culture of Health – How the public health workforce will not only provide medical care but will help to establish a Culture of Health.
Nursing as a critical driver of the Culture of Health.
Guest Editors Dr. Coronado and Denise Koo, MD, MPH, Office of Public Health Scientific Services, CDC, Atlanta, GA, and Kristine Gebbie, DrPH, RN, Faculty of Health Sciences, Flinders University, Adelaide, South Australia, write that “we are buoyed by the increased efforts to meet workforce challenges and the valuable contribution of researchers and practitioners to strengthen the public health workforce. Efforts to strengthen the public health workforce should be a continuing priority involving well-planned, evidence based, and coordinated actions from decision makers undaunted by the mission of transforming public health and improving the population’s health while facing the complex landscape of the 21st century.”
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***The article may be available for free or low cost at your local public, academic, or hospital/medical center library. Call ahead and ask for a reference librarian.
Keeps you informed about news in public health, upcoming meetings, and new public health online resources
Partners in Information Access for the Public Health Workforce is a collaboration of U.S. government agencies, public health organizations and health sciences libraries. This comprehensive collection of online public health resources includes the following topic pages. Each has links to news items; links to relevant agencies, associations, and subtopics; literature and reports; data tools and statistics; grants and funding; education and training; conferences and meetings; jobs and careers; and more
Ebola virus and the dread factor August 25 2014 item from Musings of an Academic Family Physician (and department chair) about this (dysfunctional) healthcare world and how to fix it
As much as people may try to deny it, traditionally healthcare organizations are rarely early adopters of new technologies. The lack of electronic health systems, computerized methods of communication, filing, and overall resistance to change has left many health care organizations years behind other high tech industries.
Public health officials have used many different strategies to engage the general public, from billboards, radio PSAs, to the CDC’s unique “prepare for the zombie apocalypse” web campaign. Although some may dismiss Twitter as frivolous or silly, it is an excellent platform to educate and communicate with a large group of people in a succinct way (140 characters to be exact). Indeed, over the past five years, Twitter has become one of the most popular social media and sharing platforms in the world. According to the Twitter blog, more than 500 million tweets are…
“What we need,” Freudenberg said to me, “is to return to the public sector the right to set health policy and to limit corporations’ freedom to profit at the expense of public health.”
Bittman contributes to the ongoing discussion here at NobodyisFlyingthePlane about how certain industries deflect public discourse from what is best for our citizens to what makes the most profit, no matter the consequences.
The author he quotes poses a series of questions which get at the heart of the matter.
“Shouldn’t science and technology be used to improve human well-being, not to advance business goals that harm health?”
Similarly, we need to be asking not “Do junk food companies have the right to market to children?” but “Do children have the right to a healthy diet?”
Essentially its a PR game. Do we let whole industries spin how the conversation is framed or do we let the…
English: one high-quality “bud ” nugget of marijuana (Photo credit: Wikipedia)
On January 1st, 2014, Colorado enacted a law that legalized the recreational use of marijuana for adults. For long, discussions have gathered around the health risks involved with the legalization of marijuana.
Marijuana’s long term use can lead to addiction along with respiratory illnesses and cognitive impairment. The risks of addiction are most prominent amongst adolescents. The legalization of marijuana and its increased accessibility can lead to increased use and abuse of the drug. However, with decriminalizing the drug many see benefits arise.
#PubHT wants to discuss the public health implications of legalization of marijuana with you! Please join us on Monday, February 3 at 9 PM ET for a one hour discussion on this topic.
How Does Marijuana Affect the Brain?
Marijuana overactivates the endocannabinoid system, causing the “high” and other effects that users experience. These effects include altered perceptions and mood, impaired coordination, difficulty with thinking and problem solving, and disrupted learning and memory.Marijuana also affects brain development, and when it is used heavily by young people, its effects on thinking and memory may last a long time or even be permanent.
What Are the Other Health Effects of Marijuana?
Marijuana use may have a wide range of effects, particularly on cardiopulmonary and mental health.
Marijuana smoke is an irritant to the lungs, and frequent marijuana smokers can have many of the same respiratory problems experienced by tobacco smokers, such as daily cough and phlegm production, more frequent acute chest illness, and a heightened risk of lung infections.
Is Marijuana Medicine?
Many have called for the legalization of marijuana to treat conditions including pain and nausea caused by HIV/AIDS, cancer, and other conditions, but clinical evidence has not shown that the therapeutic benefits of the marijuana plant outweigh its health risks.
However, THC-based drugs to treat pain and nausea are already FDA approved and prescribed, and scientists continue to investigate the medicinal properties of other chemicals found in the cannabis plant—such as cannabidiol, a non-psychoactive cannabinoid compound that is being studied for its effects at treating pain, pediatric epilepsy, and other disorders. For more information, see DrugFacts – Is Marijuana Medicine?
Additionally, because it seriously impairs judgment and motor coordination, marijuana contributes to risk of injury or death while driving a car. A recent analysis of data from several studies found that marijuana use more than doubles a driver’s risk of being in an accident.
Research shows marijuana may cause problems in daily life or make a person’s existing problems worse. Heavy marijuana users generally report lower life satisfaction, poorer mental and physical health, more relationship problems, and less academic and career success compared to non-marijuana-using peers. For example, marijuana use is associated with a higher likelihood of dropping out of school. Several studies also associate workers’ marijuana smoking with increased absences, tardiness, accidents, workers’ compensation claims, and job turnover.
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
Abstract:
This Report presents empirical evidence relevant to assessing the claim — reported widely in the media and other sources — that the public is growing increasingly anxious about the safety of childhood vaccinations.
Based on survey and experimental methods (N = 2,316), the Report presents two principal findings:
first, that vaccine risks are neither a matter of concern for the vast majority of the public nor an issue of contention among recognizable demographic, political, or cultural subgroups;
and second, that ad hoc forms of risk communication that assert there is mounting resistance to childhood immunizations themselves pose a risk of creating misimpressions and arousing sensibilities that could culturally polarize the public and diminish motivation to cooperate with universal vaccination programs.
Based on these findings the Report recommends that government agencies, public health professionals, and other constituents of the public health establishment
(1) promote the use of valid and appropriately focused empirical methods for investigating vaccine-risk perceptions and formulating responsive risk communication strategies;
(2) discourage ad hoc risk communication based on impressionistic or psychometrically invalid alternatives to these methods;
(3) publicize the persistently high rates of childhood vaccination and high levels of public support for universal immunization in the U.S.;
and (4) correct ad hoc communicators who misrepresent U.S. vaccination coverage and its relationship to the incidence of childhood diseases.
1. There is deep and widespread public consensus, even among groups strongly divided on other issues such as climate change and evolution, that childhood vaccinations make an essential contribution to public health. …
2. In contrast to other disputed science issues, public opinion on the safety and efficacy of childhood vaccines is not meaningfully affected by differences in either science comprehension or religiosity. …
3. The public’s perception of the risks and benefits of vaccines bears the signature of a gen- eralized affective evaluation, which is positive in a very high proportion of the population. …
4. Among the manifestations of the public’s positive orientation toward childhood vaccines is the perception that vaccine benefits predominate over vaccine risks and a high degree of confi- dence in the judgment of public health officials and experts. …
…..
B. Normative and prescriptive conclusions
1. Risk communicators—including journalists, advocates, and public health professionals— should refrain from conveying the false impression that a substantial proportion of parents or of the public generally doubts vaccine safety.
2. Risk communicators should avoid resort to the factually unsupportable, polemical trope that links vaccine risk concerns to climate-change skepticism and to disbelief in evolution as evi- dence of growing societal distrust in science.
….
Remember, correlation does not equal causation!
And the selection of variables (as gun ownership) may be questioned by some…
Still, an interesting graph
The [2013] Prevention Status Reports (PSRs) highlight—for all 50 states and the District of Columbia—the status of public health policies and practices designed to prevent or reduce important public health problems.
Related Reports and Analyses
The Guide to Community Preventive Services
A compilation of the evidence-based findings of the Community Preventive Services Task Force showing what works to improve health
County Health Rankings
A collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute examining the health and well-being of people living in nearly every county in the United States
America’s Health Rankings
An annual comprehensive assessment of the nation’s health on a state-by state basis published jointly by the United Health Foundation, American Public Health Association, and Partnership for Prevention
Trust for America’s Health
Data on key health indicators and other indicators for each state and the District of Columbia
Healthy People 2020
Science-based, 10-year national objectives for improving the health of all Americans
CDC Vital Signs
Recent data and calls to action for important public health issues
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.”
Thousands of Britain’s poorest people “will be dead before they can retire” if sweeping pension reforms are not matched by urgent action on health inequalities between rich and poor, experts have said.
Plans to raise the basic state pension age to 70 for people currently in their twenties were laid out in the George Osborne’s Autumn Statement this week. But with male life expectancy at birth as low as 66 in some of the most deprived parts of the country, public health experts have warned that a “one size fits all” pension age risks condemning many to a life without retirement.
Average UK life expectancy at birth was 78.2 in 2010. Nationally, the figure is increasing, but huge variations exist and progress has been slower in deprived communities where poverty leads to poor diets, smoking rates are higher and alcohol abuse more common.
In Glasgow City, where male life expectancy at birth is 71.6, boys born in 2010 are expected to die on average 13.5 years earlier than those born in the London borough Kensington and Chelsea, where life expectancy is 85.1. Girls in born in the London borough in 2010 can expect 12 more years of life than those in Glasgow. Even these figures veil vast inequalities that exist within regions, with life expectancies as low as 66 years in some of Glasgow’s most deprived areas.
Martin McKee, professor of European Public Health at the London School of Hygiene and Tropical Medicine, and fellow of the Faculty of Public Health, said that if the Government wanted to raise the pension age, they must first tackle health inequalities.
“George Osborne is thinking about the average life expectancy. The average life expectancy is fairly meaningless if you’re living in a former coal mining village in Nottinghamshire or in inner-city Glasgow,” he toldThe Independent. “There are many parts of the country where people have nowhere near the average life expectancy and, crucially, nowhere near the average healthy life expectancy. It’s not just the fact people will be dead before they reach pensionable age, it’s that they will be unfit to work.”
David Walsh, a public health expert at the Glasgow Population Health Centre said that a single pension age across all areas of the country was “at the very least problematic”.
This image shows all countries classified as “Food Insecure” by the Food and Agriculture Organization of the United Nations, FAO, between 2003 and 2005. more than 5% of the people have insufficient food more than 15% of the people have insufficient food more than 25% of the people have insufficient food more than 35% of the people have insufficient food more than 50% of the people have insufficient food (Photo credit: Wikipedia)
The twitter chat was last year, still I’m posting this timely topic. Because it is that, timely.
From June 19, 2012 PLoS Medicine have a new main series of seven articles on the next three weeks , titled “Big Food” , which examines the impact of the food and beverage industry in public health. An argument between PLoS and guest editors in new product launches reports writing the series in the fact that multinational food and beverage not been adequately discussed or raised skepticism regardless of their growing impact on the program global health and its role in the obesity crisis .According to the editors of PLoS Medicine :
” The food , unlike snuff and drugs, is necessary for life and is essential for health and disease , however, large multinational food companies control what people eat around the world , resulting an austere irony and sick . D’ billion people on the planet go hungry , while two billion are overweight or obese . “
The major food and beverage companies also play an important role in the global health scenario re -branding their companies as ” nutrition companies ” and market their people as experts in malnutrition , obesity . and even poverty in major conferences and meetings of the United Nations – but its main purpose is to improve profitability through the sale of food editors and posed the question: “Why do the global health community is this acceptable and how those conflicts play out ? “The series is three weeks to address these issues and discuss the role of food industry in the field of health.
Marion Nestle of New York University and David Stuckler of the University of Cambridge , the two guest editors of the series of the journal PLoS Medicine that the public health response created Food great so far as a “failure ” and state ” public health professionals must recognize the influence of the great food in the world food system is a problem, and take steps to reach a consensus on how to engage critically … [which ] alsoshould be given high priority to nutrition as they do on HIV , infectious diseases and other health threats . “
Nestler and Stuckler follow:
“They should support initiatives such as the restrictions on marketing to children , improved nutrition standards for school meals , and taxes on sugary drinks. The public health approach should be non-profit in alignment with Great Food public health goals . Without a concerted direct action to expose and regulate the interests of Great food , epidemics of poverty , hunger and obesity are likely to be more acute . “
The editors invite readers to join the debate on Twitter ( hashtag # plosmedbigfood ) and invite comments on your articles to be published over three weeks since the June 19, 2012 and collected http://www.ploscollections.org / Bigfood
People can join a chat on Twitter Wed 27 June at 13:00 ET .
Food Industry Needs Closer Monitoring By Public Health Authorities
Industry, diet, weightloss, slimming, Monitoring, Food, Authorities, health, Closer, fitness, Public Health
Once you know everything about a person, you can influence their behaviour. A thousand students with tattletale phones are going to find out how easy that is
THERE’S something strange about this year’s undergraduate class at the Technical University of Denmark – they all have exactly the same kind of phone.
The phones are tracking everywhere the students go, who they meet and when, and every text they send. Around 1000 students are volunteers in the largest-ever experiment of its kind, one that could change our understanding of how we interact in groups.
Sune Lehmann and Arek Stopczynski of DTU are using the data to build a model of the social network the students live in – who talks to who, where groups gather. They plan to test whether the results can be used for purposes like boosting student achievement, or even improving mental health. “We hope to be able to figure out how to make this work in terms of academic performance,” says Lehmann.
This is sociology on a different scale, gathering detailed data about an entire group and then using that information to “nudge” them into changing their behaviour. Used ethically, the results could improve the way society works, transforming everything from healthcare and public transport to education and governance. Used for the wrong reasons, it could be extremely dangerous.
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Used ethically, the results could improve the way society works, transforming everything from healthcare and public transport to education and governance. Used for the wrong reasons, it could be extremely dangerous.
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Used ethically, the results could improve the way society works, transforming everything from healthcare and public transport to education and governance. Used for the wrong reasons, it could be extremely dangerous. a 2010 study, participants were encouraged to boost their activity levels either through personal rewards, or rewards given to a buddy who was supposed to keep tabs on them. Being motivated by an incentivised buddy resulted in twice the activity increase of the direct reward.
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..nudges related to public health could be as simple as allowing doctors to ring up their patients when their activity levels start to follow patterns that correlate with, say, diabetes or depression, and asking them if they are feeling OK.
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But we shouldn’t lose sight of the potential dark side, says Evan Selinger, a technology ethicist at the Rochester Institute of Technology in New York. “There is extraordinary power in the access to data at a personal level – even predicting future behaviour,” he says. “There’s a lot to be gained, but there’s a lot of problems that scare the living ******** out of me.”
Despite the best intentions of those working in public health, some policies and practices inadvertently further disadvantage marginalized populations, according to a commentary by a researcher at St. Michael’s Hospital
Dr. Diego S. Silva, a scientist in the hospital’s Centre for Research on Inner City Health, said there’s an emphasis toward social justice in public health, particularly when it comes to people who are marginalized, disadvantaged or vulnerable.
“For example, despite evidence suggesting that people who are homeless are at greater risk of being infected with influenza and suffer greater morbidity than the general population, many pandemic influenza plans provide impracticable advice or otherwise fail to address their specific needs,” said Dr. Silva.
The commentary appears online today in the Canadian Journal of Public Health.
mplementation of national surveys where the population can estimate and assess their own health may give policy makers important insights into the different health interventions that should be implemented. According Siddhivinayak Hirve, PhD student at Umeå University, this may include a simple tool that harmonizes the assessment of health in developing countries with the rest of the world.
When the World Health Organization, WHO, conducted a study of aging in a global context and health among adults, in 2007, they asked the simple question “In general, how would you rate your health today?” The results showed that every other elderly person, over 50, who lived in rural areas in India said that they felt very bad, bad, or moderate.
In his thesis, Siddhivinayak Hirve has examined the factors that influence the assessment of own estimated health in older individuals in the population in rural India. The thesis shows that women report worse health than men. Self-reported health also deteriorated with age. The effect of age in terms of self-rated health was affected by participants’ ability to move, ability to see, hearing, relationships, pain, sleeping problems, and more.
“Smoking and use of tobacco were factors that could be linked to at least one chronic disease, which in turn affected the self-reported health effects,” says Siddhivinayak Hirve. “Our studies also demonstrate that a large social network results in better self-rated health and also a higher quality of life.”
A four-year follow-up study that Siddhivinayak Hirve has conducted showed that the risk of dying was larger in those who reported poorer health compared with those who reported that they had good or very good health at the start of the study
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Siddhivinayak Hirve concludes, based on his findings, that it is possible to use information on self-rated health from major national surveys, such as the planning of health care, even in small, isolated areas.
“My goal of this thesis has been to put aging on the agenda, both among scholars and policy makers,” says Siddhivinayak Hirve. “This is particularly important in countries where it has a rapidly aging population. The value of asking the simple question, “In general, how do you feel today?” Is very high and can be very helpful to identify health needs, and plan for targeted interventions in health. This is particularly true in developing countries.”
He also points out that measurements of self-rated health provides a driving force to strengthen research on health for the adult and aging populations in low-and middle-income countries that harmonize with international research.
rom the thesis abstract: “Gun violence in America must be addressed at the highest levels of society. Newtown, Aurora, and Virginia Tech were attacks on the very fabric of America. School shootings represent attacks on our nations’ future. A public health approach to gun violence focuses on prevention. Public safety professionals, educators and community leaders are squandering opportunities to prevent horrific acts of extreme violence. Preparedness is derived by planning, which is critical to mobilizing resources when needed. Rational public policy can work. Sensible gun legislation, which is accessible through a public health approach to gun violence, neither marginalizes nor stigmatizes any one group. University administrators must fully engage the entire arsenal of resources available to confront this pernicious threat. The academic community can create powerful networks for research, collaboration and information sharing. These collective learning environments are investments in the knowledge economy. In order for the police to remain relevant, they must actively engage the community they serve by developing the operational art necessary to cultivate knowledge, relationships and expertise. Police departments must emphasize strategies that improve performance. Police officers must understand the mission and meaning of ‘To Protect and Serve’ and the consequences of public safety, which often comes at their personal peril. Gun violence in America is a public health epidemic and preventing it requires a collective responsibility.”
Source: George Washington University School of Public Health
A new report by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services (SPHHS) examines the impact of health reform on community health centers (CHCs) and their patients. “Assessing the Potential Impact of the Affordable Care Act on Uninsured Community Health Center Patients: A Nationwide and State-by-State Analysis,” estimates that more than 5 million health center patients would have gained coverage had all states participated in a sweeping Medicaid expansion. However, nearly half of all CHCs are located in states that have opted out of the expansion. As a result, more than a million uninsured CHC patients who would have been covered under a nationwide Medicaid expansion will be left without the protection of health insurance, the report says.
Shin and his colleagues analyzed data from both the 2009 Health Center User Survey and the 2011 Uniform Data System to gauge the impact of the ACA on health center patients nationally and in all 50 states and the District of Columbia. Based on conservative assumptions, the analysis showed that over one million health center patients in the opt-out states who would have gained Medicaid coverage under an expansion will likely remain without insurance. These patients are very poor but do not qualify for the traditional Medicaid program and often cannot pay for health care – even at reduced fees, the study concludes. Ironically, these patients are also too poor to qualify for subsidies that would allow them to purchase health insurance at reduced rates on the new Health Insurance Exchanges.
The bottom line for the 518 health centers located in the opt-out states: the report says they’ll forgo approximately $555 million they would have received had their states expanded Medicaid, yet by law, they will still be treating all community residents, including those who lack health insurance or the means to pay for care.
“Health centers in the opt-out states will face an ongoing struggle to meet the need for care in medically underserved communities as a result of the potential loss of hundreds of millions of dollars in revenues in 2014 alone,” said Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy at SPHHS and a co-author of the report.
The report paints a very different picture for the 582 health centers in states that participate in the Medicaid expansion. Approximately 2.8 million patients at these health centers will gain coverage as a result of that decision. This added coverage will translate into a potential revenue increase of over $2 billion, which will support expanded staff and services.
States that have rejected the Medicaid expansion might reconsider and decide to expand coverage. Ohio’s just-announced Medicaid expansion is estimated to translate to over 63,000 residents gaining coverage and an additional $29 million in revenue gains in 2014 across 33 health centers. But in the near term, the report warns that many poor people living in the 25 opt-out states will continue to lack coverage and might find long wait times at clinics, long distances to find care, and other barriers that could translate to delays in treatment or no care at all. CHCs in those states will be unable to add much-needed services such as mental health or dental care, or to expand into remote or other seriously underserved areas—places where people have to travel for hours just to find a doctor.
“Community health centers represent the backbone of the nation’s safety net, providing high quality care to more than 20 million Americans who live in underserved neighborhoods,” says Feygele Jacobs, president and CEO of the RCHN Community Health Foundation. “Without the Medicaid expansion, CHCs in opt-out states will fall behind and will have trouble providing the kind of care that keeps people and communities healthy.”
The information resources and service that you became accustomed to using while pursuing your public health training may not be freely available. Leverage the materials that are freely available to you as an employee, an association member, an alumnus/ae or a taxpayer. Contact the National Network of Libraries of Medicine (NN/LM) Staff for support with exploring any of the options and resources mentioned below, or other questions you might have.
Directory of Open Access Journals – Public Health Journals – Links to open access full text of 130+ journals that fit into a loose classification of public health. This multinational collection includes journals in a variety of languages.
PMC – (National Library of Medicine (NLM) U.S.) – PMC, formerly PubMed Central, is a free archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM).
Institutional Repositories from Universities with Schools of Public Health
Directory of Open Access Repositories – OpenDOAR – (Centre for Research Communications, University of Nottingham) – Search for the author’s institution or browse the 100 repositories in the Health and Medicine subject area.
Sponsored Special Issues or Open Access Individual Articles
Access Journal Special Issues – Active Living Research – (Robert Wood Johnson Foundation (RWJF)) – Funders will often support thematic special issues or supplements on a particular topic to make them available freely.
Public Health Finance and Public Health Accreditation Special Issues – (Journal of Public Health Management and Practice) – See issues marked “Free Access.” March/April 2007 – Volume 13- Issue 2 on public health finance and July/August 2007 – Volume 13 – Issue 4 on public health accreditation were sponsored by the Robert Wood Johnson Foundation (RWJF). However, other issues in other publications sponsored by RWJF are not open access.
Council on Education for Public Health – The list of accredited Schools of Public Health and Public Health Programs contains the website for each school. See if your school has special benefits for alumni by checking the public health program site or going directly to the academic library site.
Health Education and Behavior/Health Promotion Practice – (Society for Public Health Education (SOPHE)) – Be sure to activate the online access for the subscriptions to which you are entitled. Other related publications may be offered at discounted rates.
Continuing Education
Area Health Education Centers Directory – Area Health Education Centers (AHECs) provide continuing education based on the recent literature. Many AHECs also have libraries or resource centers.
Library Services – University of South Florida Area Health Education Center – The USF AHEC Program provides free library services to health care providers working with the medically underserved in Charlotte, Citrus, DeSoto, Hernando, Hillsborough, Pasco, Pinellas, Manatee and Sarasota counties. These services include interlibrary loan of journal articles and loan of AHEC-owned books and other materials and ability to access the USF Health Science Center Library electronic resources
International Public Health
Blue Trunk Libraries – (World Health Organization (WHO)) – The collection, which is organized according to major subjects, contains more than one hundred books on medicine and public health. Blue Trunk Libraries are available in English, French, Portuguese, and Arabic.
Global Health Library – (World Health Organization (WHO)) – Global and regional indexes tot he scientific and technical literature. Many of the articles found in searches are free online such as those in the Bulletin of the World Health Organization.
HINARI Access to Research Initiative – (World Health Organization (WHO)) – The HINARI Programme, set up by WHO together with major publishers, enables developing countries to gain access to one of the world’s largest collections of biomedical and health literature. Over 6200 journal titles are available to health institutions in 108 countries, areas and territories.
Libraries
College and University Libraries – Academic libraries generally are included in WorldCat or have their own online catalog on their website. State university or community college libraries are usually open to the public living or working within that state. Look for a community college with health training programs. Those with EMS Training Programs may have disaster preparedness journals, for example. Most libraries have print subscriptions or license electronic journals to allow on site use. Friends of the Library memberships may be available for a reasonable charge and may allow you to check out materials or receive other information services.
Directory of National Network of Libraries of Medicine Members – (National Network of Libraries of Medicine (NN/LM)) – Searchable directory of a nationwide network of health science libraries and information centers. The directory can be searched by state, type of library, and by services offered to the public including reference services, database search training, and delivery of full text journal articles.
Law Libraries – Law librarians are experts in finding legal information to support policy making and cases. Law libraries are often open to the public for legal research. Use of resources such as Lexis-Nexis and Westlaw is generally restricted, but a wealth of other information in environmental and occupational health, infectious disease control, animal control and other topics with legal components is available.
List of Public Health Libraries – (Medical Library Association, Public Health/Health Administration Section) – This website provides links to international, U.S. government, state and local public health libraries, and to libraries from schools of public health.
National Network of Libraries of Medicine NN/LM – Your regional medical library can help you locate any type of library of figure out what options you have to efficiently find access to the information you need. The NN/LM also provides training on how to use information resources such as PubMed.
Public Libraries – Public library subscriptions and services may include remote access to collections of full-text journals and newspaper articles. Interlibrary loan may be available at no charge or a minimal cost. Library cards are generally available to those who live or work in the jurisdiction at no charge.
State Libraries – State agency libraries may be designated to serve state public health workers. If not, they should at least be open to state residents. State libraries work with public libraries to ensure access to resources for users statewide. Find your state library.
WorldCat – See what libraries closest to you own the journal you need, just search on the title and include your zip code – one may be close enough to visit in person to print or copy the article. If not, follow the web links to the owning library to see if document delivery services are offered for a fee. Note: Most hospital libraries do not appear in Worldcat.org, so you may need to call your closest hospital library to see if they have what you need.
Organizational Partnerships and Staying Connected with Academia
College of Medicine Voluntary Faculty – (University of South Florida (USF)) – Example of library services available to voluntary faculty involved in teaching health professional students. Maintain an adjunct faculty role or offer to precept students. The students will have remote access to the university resources, and the academic institution may also be able to provide resources or services to you as a preceptor depending on their licensing arrangements.
Paying for Full Text Journal Articles
Ordering Journal Articles
Loansome Doc – (National Network of Libraries of Medicine (NN/LM)) – Arrangements may be made with a health sciences library to provide specific materials you request for a pre-arranged, per-item fee. Prices may be very low, or even free, when ordering from a library mandated to serve health workers in their area.
Using Loansome Doc® – (National Network of Libraries of Medicine (NN/LM)) – Learn how to order full-text articles through a local health sciences library.
Subscriptions to Individual Titles or Packages of Titles
Journal of Public Health Management and Practice (Example) – Most journals are available as either individual or institutional subscriptions. If you purchase the journal with organizational funds and intend for it to be used by multiple staff, then you should purchase an institutional subscription. Institutional subscriptions often allow you to set up online access using your organization’s IP addresses so that all on the organization’s network may access the publication. You may also buy individual articles on a pay per view or pay per download model.
Veterinary Information Network (VIN) – Fee-based knowledge resource center for animal health and infectious diseases that includes many full text journals, conference proceedings and electronic books, as well as online expert forums for veterinarians.
Cold and flu season is just around the corner. So what do grocery and retail workers have to do with public health? In a nutshell, they handle your food and if they don’t have adequate sick days from their employers, you may be more likely to get sick.
In addition to the common colds and flus that are passed along when an ill cashier touches every item that goes into a customer’s grocery bag, serious illnesses are spread as a result of people working while sick.
No caregiver wants to be in the position of choosing between staying home to care for a sick child and going to work so they can pay the bills. However, without adequate paid sick leave, many families must decide between caring for a sick child at home and losing needed pay or risking their jobs.
One in five workers in a recent survey we conducted of grocery and supercenter workers live with at least one child and do not have any other adults in their households.
In Washington, the majority of preschoolers and school-age children live in homes where all parents are employed.
Adequate paid sick days mean fewer children going to school sick. When parents can stay at home with their kids, recovery times are shorter and germs stay home too—ensuring healthier schools, families and communities. For more information read our policy brief on Paid Sick Days on our website. Also see our article on the results of our examination of paid sick leave for grocery and retail workers.
So be sure to cover your cough with your elbow, AND ask your local supermarket if they offer paid sick days to their employees!
The United States is among the wealthiest nations in the world, but it is far from the healthiest. For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This health disadvantage prevails even though the U.S. spends far more per person on health care than any other nation. To gain a better understanding of this problem, the NIH asked the National Research Council and the IOM to investigate potential reasons for the U.S. health disadvantage and to assess its larger implications.
No single factor can fully explain the U.S. health disadvantage. It likely has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions. Without action to reverse current trends, the health of Americans will probably continue to fall behind that of people in other high-income countries. The tragedy is not that the U.S. is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.
“The poorer outcomes in the United States are reflected in measures as varied as infant mortality, the rate of teen pregnancy, traffic fatalities, and heart disease. Even those with health insurance, high incomes, college educations, and healthy lifestyles appear to be sicker than their counterparts in other wealthy countries. The U.S. Council on Foreign Relations, a nonpartisan think tank, described the report as “a catalog of horrors.”
Findings that prompted this reaction include the fact that the rate of premature births in the United States is the highest among the comparison countries and more closely resembles those of sub-Saharan Africa. Premature birth is the most frequent cause of infant death in the United States, and the cost to the health care system is estimated to top $26 billion a year.
As distressing as all this is, much less attention has been given to the obvious question: Why is the United States so unwell? The answer, it turns out, is simple and yet deceptively complex: It’s almost everything.
Our health depends on much more than just medical care. Behaviors such as diet, physical activity, and even how fast we drive all have profound effects. So do the environments that expose us to health risks or discourage healthy living, as well as social determinants of health, such as education, income, and poverty.
The United States fares poorly in almost all of these. In addition to many millions of people lacking health insurance, financial barriers to care, and a lack of primary care providers compared with other rich countries, people in the United States consume more calories, are more sedentary, abuse more drugs, and shoot one another more often. The United States also lags behind on many measures of education, has higher child poverty and income inequality, and lower social mobility than most other advanced democracies.
The breadth of these causal factors, and the scope of the U.S. health disadvantage they produce, raises some fundamental questions about U.S. society. As the NRC/IOM report noted, solutions exist for many of these health problems, but there is “limited political support among both the public and policymakers to enact the policies and commit the necessary resources.”
One major impediment is that the United States, which emphasizes self-reliance, individualism, and free markets, is resistant to anything that even appears to hint at socialism. …”
Uruguay has it. So does Latvia, and Senegal. In fact, more than half of the world’s countries have some degree of a guaranteed, specific right to public health and medical care for their citizens written into their national constitutions.
July 19, 2013 — Uruguay has it. So does Latvia, and Senegal. In fact, more than half of the world’s countries have some degree of a guaranteed, specific right to public health and medical care for their citizens written into their national constitutions.
The United States is one of 86 countries whose constitutions do not guarantee their citizens any kind of health protection. That’s the finding of a new study from the UCLA Fielding School of Public Health that examined the level and scope of constitutional protection of specific rights to public health and medical care, as well as the broad right to health.
The study examined the constitutions of all United Nations member states and found the results to be mixed, despite the fact that all U.N. members have universally recognized the right to health, which is written into the original foundational document establishing the international body in 1948.The researchers reviewed the constitutions of all the member states as amended to two points in time: August 2007 and June 2011.
The report appears in the July issue of the journal Global Public Health.
The study also calls for regular and long-term monitoring of all countries’ protection of health rights, whether or not such rights are written into specific country’s constitutions.
That’s because a constitutional definition of what health protection actually is varies widely between nations. Further, how such protections have been implemented varies widely, said the study’s first author, Dr. Jody Heymann, dean of the Fielding School of Public Health.
“With respect to specific rights to health, the status of the world’s constitutions can be described as either half empty or half full,” Heymann said.
The study found that 73 U.N. member countries (38 percent) guaranteed the right to medical care services, while 27 (14 percent) aspired to protect this right in 2011. When it came to guaranteeing public health, the global performance was even poorer: Only 27 countries (14 percent) guaranteed this right, and 21 (11 percent) aspired to it.
But doing the math doesn’t provide a comprehensive picture, said Heymann.
“There also exists gaps between individual countries that may have strong constitutional protections but poor records of implementing health rights on the ground,” she said. “On the other hand, there are countries that lack constitutional provisions that have excellent health care systems in place.”
The latter is particularly true in the case of older constitutions that have not been significantly amended since constitutional rights to health became common, she noted.
The good news, Heymann said, is the clear trend toward greater constitutional protection of health rights overtime……..
When I was in Liberia, West Africa a few years ago it was hard not to notice how many Liberians had cell phones.
Have read quite a few articles since then on how just basic cell phones without apps can facilitate better health services, better communication about health prevention, screening, and such, and better health stats
I saw this comment posted last week on a federal government health office group page in response to their announcement of their new app, the use of technology and the release of open data and big data on their website:
Posts like these are not unique. It is a common argument for not using any technology methods for some health communication campaigns because of limited reach in populations without Internet access. In the case of the example above, reaching migrant workers is a challenge, no argument there. But is it really technology’s fault?
I’m a big advocate of boots-on-the-ground campaigns, but coupling a digital presence is better, even if it takes on a minor role. Of course no one can reach 100% of a population, whether online or offline. But we can improve reaching communities outside of the Internet by using the Internet.
“Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care.”
My previous blog, adapted from the Institute of Medicine (IOM) report U.S. Health in International Perspective: Shorter Lives, Poorer Health, described how the U.S. compares in causes of mortality and years of life lost with other high income and OECD countries. Here, as outlined in the report, I explore some of the social determinants of health that may explain this. Social determinants of health, as opposed to biological determinants (biology and genetics), describe the…
Trust for America’s Health (TFAH) has released A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years – which provides high-impact recommendations to prioritize prevention and improve the health of Americans.
The Healthier America report outlines top policy approaches to respond to studies that show 1) more than half of Americans are living with one or more serious, chronic diseases, a majority of which could have been prevented, and 2) that today’s children could be on track to be the first in U.S. history to live shorter, less healthy lives than their parents.
“America’s health faces two possible futures,” said Gail Christopher, DN, President of the Board of TFAH and Vice President – Program Strategy of the W.K. Kellogg Foundation. “We can continue on the current path, resigning millions of Americans to health problems that could have been avoided or we invest in giving all Americans the opportunity to be healthier while saving billions in health care costs. We owe it to our children to take the smarter way.”
The Healthier America report stresses the importance of taking innovative approaches and building partnerships with a wide range of sectors in order to be effective. Some recommendations include:
Advance the nation’s public health system by adopting a set of foundational capabilities, restructuring federal public health programs and ensuring sufficient, sustained funding to meet these defined foundational capabilities;
Ensure insurance providers reimburse for effective prevention approaches both inside and outside the doctor’s office;
Integrate community-based strategies into new health care models, such as by expanding Accountable Care Organizations into Accountable Care Communities;
Work with nonprofit hospitals to identify the most effective ways they can expand support for prevention through community benefit programs;
Maintain the Prevention and Public Health Fund and expand the Community Transformation Grant program so all Americans can benefit;
Implement all of the recommendations for each of the 17 federal agency partners in the National Prevention Strategy; and
Encourage all employers, including federal, state and local governments, to provide effective, evidence-based workplace wellness programs…..
Some key policy changes that need to be made in the United States in order to prevent illness and improve the health of millions of Americans have just been outlined in the Trust for America’s Health (TFAH) latest Healthier Americareport.***
The report includes a range of suggestions that focus on the prevention of chronic diseases, which currently affect more than half of the U.S. population. This would also help address the health problems facing today’s youth who are set to be the first generation that are less healthy than their parents. …
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The recommendations involve some new and innovative approaches:
Implementing a series of foundational capabilities to improve the country’s health system as well as restructuring public health programs with sustained funding.
Establishing partnerships with nonprofit hospitals to develop new community benefit programs and expand support for prevention.
Encourage that insurance providers compensate for all types of prevention strategies
Ensuring that the Prevention and Public Health Fund continues and improve awareness of the Community Transformation Grant program.
Maintain workplace wellness programs with employers as well as local and state governments.
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The report also includes information about recommendations that are already in action:
The Accountable Care Community (ACC) brought more than 70 different partners to help patients with type 2 diabetes in and out of the doctor’s office. The ACC managed to reduce the cost of care by more than 10 percent per month for patients with type 2 diabetes – meaning savings of around $3,185 per person yearly.
The Boston Children’s Hospital implemented The Community Asthma Initiative (CAI) with the purpose of supporting children with asthma in the Boston area. The initiative helped reduce hospital admissions due to asthma-related causes by around 80 percent as well as reducing emergency visits due to asthma by 60 percent.
The report concludes that there are 10 main public health issues that need addressing:
The Ready or Not? report provides a snapshot of our nation’s public health emergency preparedness. Its indicators are developed in consultation with leading public health experts based on data from publicly available sources, or information provided by public officials. Some key findings from the report include:
29 states cut public health funding from fiscal years (FY) 2010-11 to 2011-12, with 23 of these states cutting funds for a second year in a row and 14 for three consecutive years. In addition, federal funds for state and local preparedness have decreased 38 percent from FY 2005-2012 (Centers for Disease Control and Prevention (CDC) funds, adjusted for inflation). States are reporting that gains in public health preparedness achieved in the past decade since September 11, 2001 are eroding, and since 2008, budget cuts have resulted in more than 45,700 job losses at state and local health departments;
Only two states have met the national goal of vaccinating 90 percent of young children, ages 19-36 months, against whooping cough (pertussis). This year Washington state has seen one of the most significant whooping cough outbreaks in recent history;
35 states and Washington, D.C. do not currently have complete climate change adaptation plans, which include planning for health threats posed by extreme weather events;
20 states do not mandate all licensed child care facilities to have a multi-hazard written evacuation plan; and
13 state public health laboratories report they do not have sufficient capacity to work five, 12-hour days for six to eight weeks in response to an infectious disease outbreak, such as novel influenza A H1N1.
“Public health preparedness has improved leaps and bounds from where we were 10 years ago,” said Paul Kuehnert, MS RN Director of the Public Health Team at the Robert Wood Johnson Foundation. “But severe budget cuts at the federal, state and local levels threaten to undermine that progress. We must establish a baseline of ‘better safe than sorry’ preparedness that should not be crossed.”
The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:
Reauthorize the Pandemic and All-Hazards Preparedness Act (PAHPA), which expires at the end of this year;
Assure sufficient, dedicated funds for public health preparedness to ensure basic capabilities to respond to threats public health departments face every day and also to have the trained experts and systems in place to act quickly in the face of major, unexpected emergencies;
Provide ongoing support to communities so they better cope and recover from emergencies;
Modernize biosurveillance to a real-time, interoperable system to better detect and respond to problems;
Seriously address antibiotic resistance;
Improve research, development and manufacturing of medical countermeasures;
Increase readiness for extreme weather events; and
….The ongoing public health burden caused by seasonal influenza and the potential global effect of a severe pandemic create an urgent need for a new generation of highly effective and cross-protective vaccines that can be manufactured rapidly. A universal vaccine should be the goal, with a novel-antigen game-changing vaccine the minimum requirement…
Since 60-70% of all emerging diseases are zoonotic, there will be plenty of work to go around for veterinarians, physicians and allied health professionals! Diseases that we should be particularly careful about are respiratory diseases with easy airborne transmission. Recent examples of diseases that circulated in animals and then jumped species to humans and then easily spread among humans are SARS and some influenzas such as H1N1 (pigs are origin) & H5N1 (birds are a source)….
…
Progressive
Many professionals and pre-professionals in the field of veterinary public health see the future of the discipline becoming more expansive and comprehensive. They predict that more veterinarians will turn to public health practice and that veterinary medicine will take a more prominent role in the field of public health. Currently at Ohio State, an example of progress in bridging the gap between veterinary medicine and human medicine is Dr. Armando Hoet’s research, which adds to the knowledge base of Methicillin-Resistant Staphylococcus aureas (MRSA) by demonstrating how animals and human-animal interactions can contribute to the spread of MRSA.
Intriguing
New terms like Zoobiquity (or Zoob for short) describing the One Health concept may feel awkward at first, but we’ll find our groove. We just have to remind or teach ourselves and our colleagues that animals and humans have coexisted for thousands of years, sharing germs and interacting on equal and unequal terms. We may look starkly different on the outside, but we have a shared biology and our medicines should reflect that similarity.
An insightful article about the high health risks associated with farm workers.
Something to ponder when thinking about and discussing who has a “right” to health care.
education, and a fair wage.
Every time we sit at a table at night or in the morning to enjoy the fruits and grain and vegetables from our good earth, remember that they come from the work of men and women and children who have been exploited for generations. -Cesar Chavez
Of the three to five million U.S. migrant and legal immigrant workers, about 600,000 of them are children. It’s difficult to ascertain an accurate count, because they are under-reported.
Most industries allow minors to work from the age of 16, but for agriculture the minimum age drops to 12. The migrant field worker families often have several children whom each year they uproot from their homes and schools to travel sometimes many states away, to work in endless fields 10-14 hours per day from the age of 12. Sometimes as young as 7 because there is no childcare. And they do this because they feel they have no other choice.
North Carolina’s regional coordinator of Association of Farmworker Opportunity Programs, Emily Drakage’s, mission is to document the amount of child labor in the agricultural sector, educate the public and local leaders about the conditions in which the children work and seek support from other organizations to get these minors out of the fields.
“It’s a very tough problem. There are cultural and linguistic barriers, economic interests, immigration, educational and health problems, but someone has to speak for these workers who have no voice and are unaware of their rights,” Drakage said.
Farm workers earn an average of just $7,000 a year and must pay part of their salary to their employer to cover transport and housing costs. Children earn $1,000 a year.
Usual migrant housing is filthy, rusted and cramped. Poverty levels are extremely high. Little to no access to health care is common. Health insurance is unheard of. One hundred thousand children are injured by sharp blades and other farm machinery each year.
Farmworkers are among the highest risk groups for:
Poverty–among 97% of migrant workers
Lack of basic education, literacy and language skills, job training
Poor health: respiratory and dermatological illnesses, dehydration, heat stroke and heat illness, chronic muscular and skeletal pain, direct exposure to sanitation chemicals and pesticides, infectious disease, chronic disease, work-related injuries, depression and substance abuse, lack of sanitation
Death
Sexual abuse
Gang activity
Marginalization
Slave wages and wage fraud
Failure to thrive under provisions of the Fair Labor Standards Act and child labor laws
In 1960, Edward R. Murrow’s “Harvest of Shame” aired the day after Thanksgiving. Fifty years later, CBS News revisits the very topic and details again the deplorable working conditions of the migrant family.
Feeling grateful this month as you prepare the bounty for your Thanksgiving table? In a nation where 2/3 of adults and 1/3 of children are overweight or obese from making poor choices about food, one-fifth of our farm workforce is children. These workers drive the agricultural sector and provide fresh food the millions of the rest of us enjoy everyday.
As the world’s climate continues to change, hazards to human health are increasing. The Atlas of health and climate, published today jointly by WHO and the World Meteorological Organization (WMO), illustrates some of the most pressing current and emerging challenges.
Droughts, floods and cyclones affect the health of millions of people each year. Climate variability and extreme conditions such as floods can also trigger epidemics of diseases such as diarrhoea, malaria, dengue and meningitis, which cause death and suffering for many millions more. The Atlas gives practical examples of how the use of weather and climate information can protect public health.
Climate risk management
“Prevention and preparedness are the heart of public health. Risk management is our daily bread and butter. Information on climate variability and climate change is a powerful scientific tool that assists us in these tasks,” said Dr Margaret Chan, Director-General of WHO. “Climate has a profound impact on the lives, and survival, of people. Climate services can have a profound impact on improving these lives, also through better health outcomes.”
Until now, climate services have been an underutilized resource for public health.
“Stronger cooperation between the meteorological and health communities is essential to ensure that up-to-date, accurate and relevant information on weather and climate is integrated into public health management at international, national and local levels. This Atlas is an innovative and practical example of how we can work together to serve society,” said WMO Secretary-General Mr Michel Jarraud.
Links between health and climate
Numerous maps, tables and graphs assembled in the Atlas make the links between health and climate more explicit:
In some locations the incidence of infectious diseases such as malaria, dengue, meningitis and cholera can vary by factors of more than 100 between seasons, and significantly between years, depending on weather and climate conditions. Stronger climate services in endemic countries can help predict the onset, intensity and duration of epidemics.
Case studies illustrate how collaboration between meteorological, emergency and health services is already saving lives. For example, the death toll from cyclones of similar intensity in Bangladesh reduced from around 500 000 in 1970, to 140 000 in 1991, to 3 000 in 2007 – largely thanks to improved early warning systems and preparedness.
Heat extremes that would currently be expected to occur only once in 20 years, may occur on average every 2-5 years by the middle of this century. At the same time, the number of older people living in cities (one of the most vulnerable groups to heat stress), will almost quadruple globally, from 380 million in 2010, to 1.4 billion in 2050. Cooperation between health and climate services can trigger measures to better protect people during periods of extreme weather.
Shifting to clean household energy sources would both reduce climate change, and save the lives of approximately 680 000 children a year from reduced air pollution. The Atlas also shows how meteorological and health services can collaborate to monitor air pollution and its health impacts.
In addition, the unique tool shows how the relationship between health and climate is shaped by other vulnerabilities, such as those created by poverty, environmental degradation, and poor infrastructure, especially for water and sanitation.
Wednesday, October 24 is Food Day. Join in this second annual national event where thousands of businesses, coalitions and other participants are holding Food Day celebrations to promote healthy, affordable and sustainable food.
Our nation’s food system is not focused on promoting health, but maintaining agribusiness and food production as cheaply as possible. Fellow blogger, Ellice Campbell of Enlightened Lotus Wellness, just published a worthwhile post, Corn And It’s Stranglehold on the Food Industry. Also, have a look at The Trouble With Corn Subsidies. About 75% of all grocery store food products contain some form of corn (not the sweet kind that we enjoy during the summer) and high fructose corn syrup. This is creating a sugar addiction among our children and is one factor contributing to increased diagnoses of diabetes in adults and children, not to mention obesity. I find this to be an outrage.
What we put into our bodies is 100% up to us! Just because cheap and processed foods are available everywhere we look, does not mean we must succumb to eating them. As one of my blog readers previously commented, “Eat what you want–no one is forcing you not to.” Every time we eat and every thing we eat is completely our choice. I feel this is too fundamental to even blog about, but as a nation, we are clearly not making the best choices.
Of course this has implications beyond personal diet and disease. According to CSPI, only minor amounts of Farm Bill funding support organic and sustainable farms, while the unhealthiest farm producers reap the major funds. We have allowed our government to carry on this way for decades. Food production methods are harmful to workers, animals and the environment.
How will you celebrate Food Day? Click the link for inspiration, activities, recipes and a zip code map to see what is offered in your area. Or, take a page from their school curriculum, eat real around your dinner table and discuss healthy eating and where your food comes from.
Eat Real, y’all. Practice mindful eating and the world will be better off. Really.
As part of a project funded by the Illinois Coalition for Immigrant and
Refugee Rights (ICIRR) and the State of Illinois, Department of Human
Services, a number of multilingual educational materials are being
developed.
They cover nutrition and health during and after pregnancy,
as well as during infancy and early childhood. These resources may be
especially helpful for WIC programs who serve refugee populations. These
free materials are available as web-videos and audio files in English,
Nepali and Burmese. Arabic and Bhutanese versions are under
development. Written handouts for all languages are also under
development.
While I am still a bit wary of legalizing drugs, I am beginning to see substance abuse as more a public health issue rather than a criminal issue.
At the very least, the current war on drugs needs re-examination.
Count the Costs: 50 Years on the War on Drugs includes related reports in the areas of public health, environment, human rights, crime, and economics.
There is a growing recognition around the world that the prohibition of drugs is a counterproductive failure. However, a major barrier to drug law reform has been a widespread fear of the unknown – just what could a post-prohibition regime look like?
For the first time, ‘After the War on Drugs: Blueprint for Regulation’ answers that question by proposing specific models of regulation for each main type and preparation of prohibited drug, coupled with the principles and rationale for doing so.There is a growing recognition around the world that the prohibition of drugs is a counterproductive failure. However, a major barrier to drug law reform has been a widespread fear of the unknown – just what could a post-prohibition regime look like?
For the first time, ‘After the War on Drugs: Blueprint for Regulation’ answers that question by proposing specific models of regulation for each main type and preparation of prohibited drug, coupled with the principles and rationale for doing so.
Published: September 10, 2012OKLAHOMA CITY — Like a missionary, Michael Bailey, a county health worker, spends his days driving his beat-up Nissan around this city’s poorest neighborhood, spreading the word in barber shops and convenience stores about the benefits of healthy diet and exercise. “Look at the kids,” he said. “Overweight, huffing andwheezing. Their lives will be miserable if this doesn’t change.”
Mike Bailey visited James Harris at his barbershop in Oklahoma City. Mr. Bailey has persuaded residents to enroll in a heart disease prevention program.
Mr. Bailey believes that food is slowly killing his community here, and signing people up for a program to prevent heart disease is his way of saving souls.Local governments across the country are creating dozens of such experiments with money from the Obama administration’s Affordable Care Act. It is part of a broad national effort set in motion by the law to nudge a health care system geared toward responding to illness to one that tries to stop people from getting sick in the first place. To that end, the law created the $10 billion Prevention and Public Health Fund, the largest-ever federal investment in community prevention.Supporters say the effort is long overdue in an age where preventable disease is the single largest cause of death. Indeed, unhealthy behaviors, like smoking and poor diet, account for 40 percent of premature deaths in the United States, while poor health care and limited access to the health care system accounted for a tenth of such deaths, according to an analysis of federal data and mortality studies by J. Michael McGinnis, a senior scholar at theInstitute of Medicine
But critics say efforts to influence behavior will have only a modest effect without policy measures like taxes on soda and restrictions on marketing to children to change the food environment.
Oklahoma City, run by a Republican mayor, Mick Cornett, has with little notice won federal prevention money through the new law, a surprising source of financing in this deeply conservative Republican state. The governor, Mary Fallin, turned away $54 million in federal money to help prepare for the new law last year.
Republicans in Congress derided the prevention program as “a slush fund to build sidewalks, jungle gyms and swing sets,” but Mr. Cornett has embraced its approach, turning this city — labeled one of the fattest in America in 2007 by Men’s Fitness magazine — into a laboratory for healthy living. In recent years, he has transformed it with bike lanes, walking paths and an Olympic rowing complex. He started a drive called “This City Is Going on a Diet.” He even accepted an invitation from Michelle Obama, who has made childhood obesity her signature cause, to attend the 2010 State of the Union address.
“We don’t believe in individual freedom to the extent of letting people make poor health decisions and just wither away without help,” Mr. Cornett said in an interview.
Many scientists doubt such programs actually work. Only a handful of the dozens of published studies on obesity interventions have produced results, and only when participants were intensively engaged, said Tom Baranowski, a professor of pediatrics at Baylor College of Medicine. “Sending newsletters and calling is not enough,” he said.
But some public health experts say that the kinds of things being tried under the law could help bring a cultural shift. The single biggest behavioral success of the last century — the dramatic reduction in the share of Americans who smoke — took 50 years of education, regulation and medical intervention. Likewise, only a mixture of approaches has a chance of eventually reducing rates of obesity, these experts say.
“Over time all of this effort builds up so people come to think about the problem and their own behavior in a different way,” said Bruce Link, a professor of epidemiology and sociology at the Mailman School of Public Health at Columbia University.
In Oklahoma City, county officials have focused on the least healthy ZIP code — 73111 — a sun-seared stretch of one-story bungalows, fast food restaurants and minimarts. Heart disease mortality rates are 10 times as high as in the healthiest neighborhood, which is next to one of the biggest medical complexes in the state, including a teaching hospital with a large share of charity care.
In addition to the heart program, which offers free medicine and checkups in exchange for taking a health class, the area is getting a new health complex with sports fields and walking trails, and a physical education coordinator for city schools. Public messages against sugary drinks are plastered on buses and benches. Health workers will identify the area’s highest-risk patients, connect them with doctors, and follow up with them after checkups, a measure Gary Cox, director of the county health department, said was designed to reduce emergency room visits.
Thousands of fliers for the heart program were mailed out last year, but there were few takers until Mr. Bailey, the health department worker, began persuading people to sign up in the spring….
Using the County Health Rankings and the Georgia Department of Community Affairs county economic rankings, Georgia’s “Partner Up! For Public Health” advocacy campaign has developed a research project and presentation that visually illustrates how Georgia’s economic vitality and population health go hand in hand.
The still-evolving, data-driven narrative has already been presented, along with key observations and policy suggestions from the report, to more than 30 audiences throughout Georgia, including the Georgia Public Health Association, Georgia Rural Health Association, the Georgia Association of Regional Commissions, and a meeting of key state legislative leaders.
AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Care
From a recent email update rec’d from AHRQ (US Agency for Healthcare Research and Quality)
The July 3 issue of AHRQ’s Health Care Innovations Exchange features two profiles of partnerships between clinical practices and community organizations that leverage health provider teams and lay health advisors to improve the management of chronic diseases. One profile describes a public-private initiative that worked with community health teams to improve the delivery of preventive, health maintenance, and chronic care services in Vermont. The pilot program included incentive payments to providers who met National Committee for Quality Assurance-determined care standards, access to an insurer-funded team of community-based health providers, health information incorporated into a Web-based clinical tracking system, and interfaces with other State care coordination initiatives. Over a 4-year period, the pilot program experienced a 6 percent decrease in inpatient admissions and a 10 percent decrease in emergency department visits among participating practices. Select to read more profiles related to clinical-community linkages, including innovations and tools, on the Health Care Innovations Exchange Web site, which contains more than 700 searchable innovations and 1,500 QualityTools.
Most people call it the “art” of persuasion, but public health researchers at the University of Southern California (USC) are trying to pinpoint the “science” behind social influence….
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Valente, whose research focuses on social networks and influence, has compiled a collection of methods that public health advocates use to stimulate changes in behavior and explains why certain methods may be more effective than others in particular situations. The analysis appears in the July 6 edition of the peer-reviewed journal Science, the world’s leading outlet for scientific news, commentary and research.
Due to the large number of interventions available to researchers — Valente identifies 24, each with at least several variations — the researcher says a more robust framework is needed for deciding which tactics are best used in particular settings.
Word-of-mouth interventions, for example, depend on the social network to succeed. In some cases, word of mouth is used to spread the word and in other cases to create groups of like-minded friends.
“Existing evidence indicates that network interventions are quite effective,” Valente writes. “Yet, the science of how networks can be used to accelerate behavior change and improve organizational performance is still in its infancy. Research is clearly needed to compare different network interventions to determine which are optimal under what circumstances.”
Valente notes that behavioral research is often used in marketing and business arenas; the public health sector is just beginning to implement that information as tools like Facebook and Twitter have made it easier to collect data and spread information, he says…
A new study confirms that doing short journeys on foot rather than taking the car or motorbike would avoid the death of 108 men and 79 women a year in Catalonia alone. This would imply annual savings of more than 200 million euros.
Researchers from the World Health Organisation (WHO) and the Barcelona Public Health Agency (ASPB), headed by Catherine Pérez from the Healthcare Information Systems Service, have estimated the yearly economic benefits from a reduction in death rates by substituting at least one short vehicle journey for a walk….
Resilient communities prepare for, respond to, and recover from natural and man-made disasters. RAND has implemented and evaluated community resilience-building activities worldwide and identified opportunities to integrate governments with the nonprofit and for-profit sectors in public health and emergency preparedness, infrastructure protection, and development of economic recovery programs.
Overall, very good news about one facet (of many I am sure) of Mexico coming into its own..
Hopeful that cooperative efforts as this can reduce mistrust (and often terrible fallouts) among nations.
In my humble opinion, global security is best addressed through cooperation to meet basic human needs as food, potable water, living wages, and access to decent health care. (Pardon, my Peace Corps experience is showing!).
Health and Human Services (HHS) Secretary Kathleen Sebelius and Mexico Secretary of Health Salomón Chertorivski today announced a series of new steps to strengthen health security cooperation between the two countries. The health secretaries outlined these efforts during the 65th World Health Assembly in Geneva, Switzerland.
“The United States and Mexico have had a long and close relationship in supporting and improving our ability to respond to public health events and emergencies of mutual interest when they arise,” Secretary Sebelius said. “The trade links between our two countries, our common border, and the high degree of trade in food products speak to the need for close bilateral cooperation in health security for both of our nations.”
“It is important to strengthen the programs of regulation and surveillance of medical products and health services on behalf of public health. International collaboration and the development of new strategies will create a more effective process that protects against health risks,” Secretary Chertorivski said. “Mexico is committed to continue working to develop the best tools and procedures for the care and control necessary to maintain the best health possible for the population.”
The two health secretaries signed a declaration formally adopting a shared set of technical guidelines that both countries will follow to respond to public health events and emergencies of mutual interest when they arise. The guidelines describe how the two nations will coordinate the exchange of information, and they complement the International Health Regulations, which call for neighboring countries to develop accords and work together on shared epidemiologic events and public health issues. …
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Secretaries Sebelius and Chertorivksi also renewed an agreement between the United States and Mexico that strengthens existing scientific and public health activities related to the regulation of food safety, including products and feed for food-producing animals. This arrangement recommits the two countries to communicate on food safety and to identify areas for coordination and collaboration between several U.S. and Mexican agencies..
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Finally, Secretary Sebelius presented Secretary Chertorivksi with a plaque welcoming the Mexican Secretariat of Health’s National Institute of Epidemiological Diagnosis and Reference as a member of CDC’s Laboratory Response Network. Mexico is the fourth country to join the LRN along with Canada, Australia and the United Kingdom. This achievement is a result of Mexico’s upgraded capabilities to respond quickly to acts of biological threats, emerging infectious diseases, and other public health threats and emergencies.
” . . . it is no longer sufficient to expect that reforms in the medical care delivery system (for example, changes in payment, access and quality) alone will improve the public’s health.”
The Institute of Medicine has issued the third and final report of a series on public health that focuses on how altering the fundamental physical and social environment will lead to improved health in the general population, an essential requirement of any effective reform of the system that delivers health care services.
For the Public’s Health: Investing in a Healthier Future addresses its thesis in four chapter:
Introduction and Context
Reforming Public Health and Its Financing
Informing Investment in Health
Funding Sources and Structures to Build Public Health
The committee responsible for the report also propose ten recommendations, among which are the following:
Greater legislative/regulatory flexibility in the allocation of funds by state and local health agencies in pursuit of public health improvement initiatives;
Reduction in the provision of clinical care services by public health agencies so that they can focus on the delivery of population-based services, such as nurse home visits and health promotion activities;
Development of a model chart of accounts for use by public health agencies to improve their tracking of funds and measuring program effectiveness;
Doubling the current federal appropriation for public health, with periodic adjustments to ensure public health agencies’ ability to deliver a minimum package of services;
Reallocation of state and local funds from paying for services currently reimbursed through Medicaid or state health insurance exchanges to financing population-based prevention and health promotion initiatives conducted by public health departments.
Source: Institute of Medicine. For the Public’s Health: Investing in a Healthier Future. Washington, DC: National Academies Press, 2012. Free online edition at:http://books.nap.edu/openbook.php?record_id=13268.
The two previous reports are also available online.
” . . . it is no longer sufficient to expect that reforms in the medical care delivery system (for example, changes in payment, access and quality) alone will improve the public’s health.”
The Institute of Medicine has issued the third and final report of a series on public health that focuses on how altering the fundamental physical and social environment will lead to improved health in the general population, an essential requirement of any effective reform of the system that delivers health care services.
For the Public’s Health: Investing in a Healthier Future addresses its thesis in four chapter:
Introduction and Context
Reforming Public Health and Its Financing
Informing Investment in Health
Funding Sources and Structures to Build Public Health
The committee responsible for the report also propose ten recommendations, among which are the following:
Greater legislative/regulatory flexibility in the allocation of funds by state and local health agencies in pursuit of public health…
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner.
Do you have an informational question in the health/medical area? Email me at jmflahiff@yahoo.com I will reply within 48 hours.
My professional work experience and education includes over 15 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news, I subscribe to the following to glean entries for this blog.
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Health and Medical News and Resources 