Category Archives: Public Health
Bithlo, Fla. is a town of 8,000 that is just 30 minutes outside Orlando and not much farther from the “happiest place on Earth” — but is beset by poverty, illiteracy, unemployment and toxic dumps that have infiltrated the drinking water. The water is so bad that it has eroded many residents’ teeth, making it that much harder for them to find jobs. Streets filled with trash, frequent road deaths and injuries from a lack of transportation options and safe places to walk, and dropping out before 10th grade were all the norm.
In just a short time, a collection of partners and volunteers have begun to reverse some of the decades-old problems Bithlo has faced. And earlier this week, the town that had been forgotten for almost a century was the scene of a hubbub of activity as hundreds of volunteers descended on the town to continue work on “Transformation Village,” Bithlo’s future main street, which will sport a combination library/coffee shop, schools, shops and many other services, all long missing from Bithlo.
Over the last few months, NewPublicHealth has reported on initiatives of the participating members of Stakeholder Health, formerly known as the Health Systems Learning Group. Stakeholder Health is a learning collaborative made up of 43 organizations, including 36 nonprofit health systems, that share innovative practices aimed at improving health and economic viability of communities.
>>Read more on the Stakeholder Health effort to leverage health care systems to improve community health.
One of the Stakeholder Health members is the Adventist Health System, a not-for-profit health care system that has hospitals across the country. Recently, Adventist’s flagship health care provider, Florida Hospital in Orlando, began supporting United Global Outreach (UGO), a non-profit group aimed at building up communities in need, in their four-year-long effort to transform the town of Bithlo.
NewPublicHealth recently spoke with Tim McKinney, executive vice president of United Global Outreach, and Verbelee Neilsen-Swanson, vice president of community impact at Florida Hospital, about the partnerships and commitment that have gone into Bithlo’s transformation into a town that is looking forward to new housing stock, jobs, stores, better education and improved health outcomes for the its citizens.
Atlantic Cities recently reported on a ride sharing program called Lyft, which requires riders to join up and input credit card information to be eligible for the carpool-like rides. Lyft’s licensed drivers are pinged to pick up passengers whom the system tracks as headed in the same direction as other riders already in the car.
The article focuses on the "cool" factor, and the potential for building social relationships, making it a great solution for college kids or young adults looking for a safe way to get home on nights out—a critical public health service, particularly when research released earlier this year found that more than one-third of designated drivers end up drinking.
But another potential future use could be to help alleviate massive transportation challenges in rural areas, particularly for those with limited income or no access to a car for other reasons. One Department of Transportation study found, "Close to 40 percent of all rural counties are not served by rural transit, while another 28 percent have limited service. And, nearly 57 percent of the rural poor do not own a car, while 1 in every 14 households in rural America has no vehicle." In the future, perhaps ride sharing programs could catch on as a viable transportation option in rural towns far away from the neon lights.
>>Bonus Link: A second transportation article in Atlantic Cities this week finds that despite the growth in ridership of bike share programs across the country, PBSC, a Montreal-based major supplier of city bikeshare equipment and software faces major transportation woes. PBSC bike share customers include London, D.C. and Chicago, the city with the largest bike-share program in the nation.
During a town hall meeting in Minnesota last month, the Target Corporation, one of the largest employers in the United States, announced that the company will remove the criminal history question from its initial employment application. While Target has already removed this question in states where it is legally prohibited, this announcement will apply to all U.S. Target locations, even in areas where asking the question is permitted by state or local law. In Minnesota, the Ban the Box law will go into effect January 1, 2014.
“Over the past year, members of the Target team have had many productive conversations with TakeAction Minnesota,” says Molly Snyder, a spokesman for the company. “Many of our discussions have focused on Minnesota’s racial jobs gap and the barriers individuals with criminal records face when seeking employment.”
The decision by Target is in part the result of efforts led by the TakeAction Minnesota Education Fund, a Robert Wood Johnson Foundation (RWJF) Roadmaps to Health community grantee, to address job discrimination based on criminal background. Often tied to significant unemployment throughout the country, studies show that having a criminal record is a barrier to employment opportunities and depresses wages. And data from Minnesota finds that half of all former offenders are unemployed, with the rate higher for ex-offenders of color who disproportionately make up the prison population.
The Roadmaps to Health Community Grants are collaborations that have received two year funding of up to $200,000 to work with diverse coalitions of policy-makers, business, education, health care, public health, and community organizations. The grantees and their partners are pursuing policies or system changes that address the social, economic, and environmental factors that influence how healthy people are and how long they live. The Roadmaps to Health Community Grants project is a major component of the County Health Rankings & Roadmaps program—a collaboration of RWJF and the University of Wisconsin Population Health Institute.
TakeAction Minnesota is using its grant to promote new statewide fair hiring standards for businesses, such as persuading prospective employers to consider criminal records only when they directly relate to the position rather than asking questions on applications that promote blanket rejections. Earlier this year, the Minnesota legislature passed the “ban the box” legislation and it was signed into law in May, making Minnesota the third state in the nation to adopt “ban the box” in both the public and private sectors. Under the new law, an employer will no longer be allowed to include a check box about criminal background on the initial employment application.
NewPublicHealth recently spoke with Justin Terrell, manager of the Justice 4 All program at TakeAction Minnesota, about the intersection of employment and health.
NewPublicHealth: What are the ways in which employment impacts health?
DOT and HUD Release Neighborhood Affordability Tool
The U.S. Departments of Housing and Transportation (HUD and DOT, respectively) have released a Location Affordability Portal, a new tool that lets users estimate housing and transportation costs for neighborhoods across the country.
“Many consumers make the mistake of thinking they can afford to live in a certain neighborhood or region just because they can afford the rent or mortgage payment. Housing affordability encompasses much more than that,” said HUD Secretary Donovan. “The combined cost of housing and transportation consumes close to half of a working family’s monthly budget, and the [Portal] will help to better inform consumers, help them save money, and provide them with a broader perspective of their housing and transportation options.”
The new tool was developed with the input of real-estate industry professionals, academics, and staff from HUD and DOT, and uses statistical models that were developed from various sources that capture key neighborhood characteristics including population density, transit and job access, average number of commuters and distance of commutes, average household income and size, median selected monthly owner costs. and median gross rent. Read more on housing and transportation.
Health Index May Reduce Hospital Readmissions
A health risk score used during hospital stays using routine data from hospital electronic medical records may be able to identify patients at high risk of unplanned hospital readmission, according to a study published in Medical Care.
The score is calculated automatically using patient data such as vital signs, nursing assessments, skin condition, heart rhythms and laboratory tests. Lower Rothman Index scores (from a maximum of 100) indicate a higher risk of readmission. The study evaluated the ability of the Rothman Index to predict hospital readmission, based on data from more than 2,700 patients hospitalized during 2011. The researchers found that patients whom the Index calculated as being high risk for readmission were 2.5 times as likely to be readmitted within 30 days of discharge as patients calculated by the Index to be low risk.
About 20 percent of Medicare patients are readmitted to the hospital within 30 days of discharge, at an estimated cost of $17 billion per year, according to the study authors. Medicare has begun reducing payments by up to 2 percent for hospitals with high readmission rates. Read more on community health.
Rapid Flu Testing in the ER Leads to More Effective Treatment
Using rapid influenza tests to diagnose flu in patients who come to the emergency room results in fewer unnecessary antibiotics, increased prescriptions for antiviral medicines, and fewer additional lab tests compared to patients diagnosed with influenza without testing, according to a new study the Journal of the Pediatrics Infectious Diseases Society.
Among patients diagnosed with influenza without rapid testing, 23 percent of the emergency department visits included a prescription for antibiotics, which are not effective in to treat influenza because it is a viral infection. However, for patients who were diagnosed by rapid testing, only 11 percent of visits resulted in the patient getting antibiotics. Additional laboratory tests, including chest X-rays, blood tests, and urinalysis, were also ordered less frequently for patients whose influenza illness was diagnosed with a rapid test.
"While other studies have shown that physicians can accurately diagnose influenza without testing, our results suggest that using an influenza test increases diagnostic certainty and leads to the physician providing more specific and appropriate care,” says Anne J. Blaschke, MD, PhD, of the University of Utah School of Medicine, the study’s lead author. Read more on infectious disease.
The Association of Schools and Programs of Public Health (ASPPH), like the American Public Health Association, held its annual meeting in Boston last week. NewPublicHealth spoke with Harrison Spencer, MD, MPH, executive director of the ASPPH, from Boston about the meeting and what’s ahead for students of public health.
NewPublicHealth: How was the meeting and what were some of the key sessions?
Harrison Spencer: Our meeting this year was the first one held since we formed our new organization, the Association of Schools and Programs of Public Health, on August 1. The new organization is now comprised of all accredited public health academic institutions, both schools and programs. We’ve got 93 members now, an increase from 57 members before, so this was a wonderful and exciting and dynamic annual meeting with lots of energy and lots of promise.
Among the highlights were Harvey Fineberg, MD, PhD, president of the Institute of Medicine, who gave us an inspirational talk about public health leadership, and Laura Liswood, Secretary General of the Council of Women World Leaders, who led a discussion on diversity as a way to make organizations and institutes stronger.
Public health professionals have very serious and important work to do—but that doesn’t mean they can’t poke a little fun at themselves in the process. Memes—essentially shared cultural statements—are all the internet rage these days, and the field of public health is not immune to their widespread appeal. A few collections of health-related memes have crossed our desks recently.
The U.S. Centers for Disease Control and Prevention (CDC) has launched an online campaign to build a community of public health “nerds” that uses social media graphics to spread the word. The campaign, as reported by Public Health Newswire, aims to mobilize the public health community and generate interest in the field’s careers. Since August, the CDC has posted four graphics to its Facebook page that acknowledge the important role of people in public health in a humorous way.
Jim Garrow, of The Face of the Matter, has created a Tumblr of public health memes so that you can get your daily dose of health puns and jokes. In addition, a recent post from Upworthy features 14 memes that use images of everything from Beyonce to Captain Jack Sparrow to depict an “unhealthy” love for public health. The memes on these pages cover a wide range of topics from the Affordable Care Act, to disease outbreaks, to mental health issues by incorporating images from popular television series, movies and internet GIFs.
A few of our favorites are included below.
Alarmed at recent surveys that show only about ten percent of young Americans who say they are very familiar with the Affordable Care Act (ACA), staff reporters at Kaiser Health News (KHN) have crafted a clever article—winsome graphics included—aimed at getting the attention of millennials about the new health law in time for them to sign up before looming deadlines.
Getting the attention of millennials on the state or federal health insurance exchanges, recently launched and going through overhauls, is crucial for two key reasons. One is that young adults no longer on their parents' plan (now allowed until age 26 under the ACA) often don’t bother with health insurance because they believe they’re invincible, so why shell out hundreds to thousands in premiums and deductibles? That works fine unless an accident or illness ensues, which can cost hundreds of thousands or more.
Electronic Laboratory Reporting Increasing
Federal agencies are reopening today after a 16 day shutdown and public health updates such as FluView from the Centers for Disease Control and Prevention are expected to come back online within the new few days. CDC’s last news release before the shutdown was on the increasing capability of laboratories to report findings to local and state health agencies electronically. The report was published in the most recent issue of Morbidity and Mortality Weekly Report (MMWR).
According to CDC, the number of state and local health departments receiving electronic reports from laboratories has more than doubled since 2005, however, progress is still needed. The MMWR report shows that only about a quarter of the nation’s labs are reporting electronically and that electronic reporting lags for some diseases behind others. For example, 76 percent of reportable lab results for general communicable diseases were sent electronically, compared to 53 percent of HIV results and 63 percent of results for sexually transmitted diseases. Read more on infectious disease.
District Laws and Policies Reduce Sugary Foods and Drinks at School Parties
Schools with a district policy or state law discouraging sugary foods and beverages were 2.5 times more likely to restrict those foods at school parties than were schools with no such policy or law, according to a new study published online in the Journal of Nutrition Education and Behavior.
Researchers at the University of Illinois at Chicago School of Public Health examined the linkages between state laws, district, and school-level policies for classroom birthday and holiday parties through surveys of more than 1,999 schools in 47 states.
About half the schools had either no restrictions or left the decision to teachers; one-third had school-wide policies discouraging sugary items; and fewer than 10 percent actually banned sweets during holiday parties or did not allow parties.
The study was supported by the Robert Wood Johnson Foundation. Read more on nutrition.
Children of Same Sex Marriages Less Likely to be Covered by Health Insurance
Children with same sex parents are less likely to have private health insurance than children with married opposite-sex parents, according to a recent study in Pediatrics. Using data from the 2008-2010 American Community Survey on children aged 0-17 years, the researchers found that 78 percent of children with married opposite-sex parents had private health insurance coverage, compared to 63 percent of children with same-sex fathers and 68 percent of those with same-sex mothers.
However, in states with legal same-sex marriage or civil unions, or in states that allowed second-parent adoptions, the disparities in private health insurance was lower for children of same-sex parents, suggesting that children of gay and lesbian households benefited from these policies. The American Academy of Pediatrics endorsed same-sex marriage in March. Read more on access to health care.
At the recent Place Matters: Exploring the Intersections of Health and Economic Justice conference in Washington, D.C., David J. Erickson, PhD, was a key member of a panel called “What Works for America’s Communities?” Dr. Erickson, who is director of the Center for Community Development Investment at the Federal Reserve Bank of San Francisco, has been a key leader in a Healthy Communities collaboration between the Federal Reserve and the Robert Wood Johnson Foundation. The joint effort has convened more than ten conferences around the country and released numerous publications, including an article in Health Affairs about partnerships to improve the wellbeing of low-income people.
>>Read more reporting from the Place Matters conference, in a Q&A with David Williams of the Harvard School of Public Health and the RWJF Commission to Build a Healthier America.
NewPublicHealth spoke with Dr. Erickson at the Place Matters meeting.
NewPublicHealth: Are the Healthy Communities conferences continuing?
David Erickson: We still have what we call “consciousness raising” meetings planned in Ohio, Florida, Louisiana and other cities, and these are initial meetings that get together the health and community development world. But then there is another phase, we call it phase two—how do you operationalize this idea? What do we do tomorrow? Who do I call? How do I structure the transaction? Who’s my partner? And that’s harder to answer so we’re trying to figure that out. So we need phase two meetings to get hospitals together with banks to talk about how they might blend some of their community benefit dollars with community reinvestment dollars to help alleviate some of the upstream causes of bad health [like poverty and poor housing].
NPH: What would be examples of such a collaboration?
American Heart Association: Doctors Should Routinely Ask About Physical Activity
A new scientific statement from the American Heart Association says that doctors should evaluate their patients’ physical activity habits as routinely as checking blood pressure and other risk factors for cardiovascular diseases. The statement was published in the journal Circulation.
The statement says that an exercise checkup should cover types, frequency, duration and intensity of physical activity at work, home and during leisure time.
The American Heart Association recommends at least 30 minutes of moderate-intensity aerobic activity five days a week or more, or at least 20 minutes of vigorous aerobic activity three days a week or more and moderate- to high-intensity muscle strengthening at least two days a week. Read more on heart health.
People with Mental Health Problems More Likely to be Uninsured
A new University of Minnesota study published in Health Affairs finds that people with mental health problems are more likely to be uninsured and rely on public insurance than people without mental health problems. The study reviewed national insurance coverage rates from 1999 to 2010. The study authors say the implementation of the Affordable Care Act will give many more people with mental health problems access to health insurance – particularly in states such as Minnesota that have that have opted to expand their Medicaid programs. The researchers also say that people with mental health problems on public insurance have better access to care and lower cost barriers than the uninsured or those with private health insurance coverage.
Kathleen Rowan, the lead author of the study and a doctoral student in health services research, policy, and administration at the University of Minnesota School of Public, says, “unfortunately, most persons with mental illness do not receive needed care due in part to a lack of health insurance coverage and the cost of treatment.” Read more on mental health.
Study: Research to Delay Aging is a Better Investment Than Cancer, Heart Disease Research
A new study in current issue of Health Affairs finds that research to delay aging and the infirmities of old age would produce better health and economic returns than advances in some fatal diseases such as cancer or heart disease.
The study found that even modest gains in the scientific understanding of how to slow the aging process would result in an additional 5 percent of adults over the age of 65 remaining healthy rather than disabled every year from 2030 to 2060, or 11.7 million more healthy adults over age 65 remaining healthy by 2060.
The analysis was conducted by scientists from a consortium of research centers. “Even a marginal success in slowing aging is going to have a huge impact on health and quality of life. This is a fundamentally new approach to public health that would attack the underlying risk factors for all fatal and disabling diseases,” said S. Jay Olshansky, professor of epidemiology at the UIC School of Public Health and one of the study’s authors. “We need to begin the research now. We don’t know which mechanisms are going to work to actually delay aging, and there are probably a variety of ways this could be accomplished, but we need to decide now that this is worth pursuing.” Read more on aging.