Legislation Would Dramatically Expand FDA’s Oversight of Compounding Pharmacies
New legislation proposed from Representative Edward Markey of Massachusetts would give the U.S. Food and Drug Administration (FDA) authority over compounding pharmacies that make and ship over state lines sterile and non-sterile products. This would be more significant than a bill recently approved by a Senate committee, which would give FDA authority only over sterile products, leaving states with the authority over non-sterile products. This has left some concerned that states would be overtaxed by the effort. “State pharmacy regulators vary widely in their ability to oversee large-scale non-traditional compounding," wrote the Pew Charitable Trusts in comments to the Senate health committee that drafted the legislation, according to Reuters. The calls for increased oversight come in response to a 2012 meningitis outbreak which killed 53 people and was linked to steroids produced by the Framingham, Massachusetts-based New England Compounding Center. Read more on infectious diseases.

Study: Diners Dramatically Underestimate Calories in Fast Food
Diners at fast food restaurants dramatically underestimate their caloric intake, according to a new study in BMJ. "Teens underestimate the number of calories in their meals by as much as 34 percent, parents of school-age children by as much as 23 percent, and adults by as much as 20 percent," study Jason Block, MD, in a release from the Robert Wood Johnson Foundation. Researchers found that the average adult meal was 836 calories—but they thought, on average, it was 175 fewer calories. As many as 1 in 4 of the people surveyed missed the mark by at least 500 calories. "These findings tell us that many people who eat at fast-food restaurants may not be making informed choices because they don't know how many calories they're consuming," Block said. "Having the information is an important first step for anyone wanting to make changes." Read more on nutrition.

FDA Approves Marketing of A1c Test for Diabetes
The U.S. Food and Drug Administration is for the first time allowing the marketing of an HbA1c (or A1c) test for the diagnosis of diabetes. A1c tests measure the percentage of hemoglobin A1c bound the glucose; people with diabetes are unable to properly convert glucose. Nearly 26 million Americans are estimated to have diabetes, which untreated can lead to heart disease, stroke and other serious medical conditions. “Providing health care professionals with another tool to identify undiagnosed cases of diabetes should help them provide patients appropriate guidance on treatment before problems develop,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Devices at FDA’s Center for Devices and Radiological Health. Read more on diabetes.

USDA and HUD Offer Housing Help for People Affected by the Tornadoes in Oklahoma
The U.S. Department of Agriculture (USDA) and the U.S. Department of Housing and Urban Development (HUD) have announced efforts to help find housing for Oklahoma residents displaced by the recent tornadoes. The USDA is offering help through its Rural Development portfolio, which has programs designed to help improve life in rural communities. HUD is offering help through foreclosure assistance, temporary housing, and federally guaranteed loans for repair. Click here for more information on HUD assistance following a disaster. Read more on disasters.

New CDC Campaign Encourages Smokers to Talk with their Doctor about Quitting
The U.S. Centers for Disease Control (CDC) and Prevention has launched a new campaign to urge smokers to speak with their doctors about strategies for quitting. CDC research finds that getting help from a physician can double the odds of quitting smoking. To help promote the campaign, CDC is partnering with five physician groups: the American Medical Association, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Congress of Obstetricians and Gynecologists. The campaign also encourages clinicians to ask patients if they smoke and offer assistance in helping them to quit. Almost 70 percent of smokers say they want to quit, according to the National Health Interview Survey. Through the physician group partnerships, doctors will be offered training on cessation interventions. Read more on tobacco.

DOT 2013 ‘Click It or Ticket’ Campaign Focuses on Night Time Driving
The annual Click It or Ticket Campaign to increase seat belt use from the U.S. Department of Transportation (DOT) takes place around Memorial Day weekend and this year will focus attention especially on night time driving—although police officers will be on the lookout for unbuckled drivers during the day and night this weekend. While DOT data shows that daytime seat belt use is up to 86 percent, night time use of seat belts continues to be lower. According to National Highway Traffic Safety Administration, the risk of being involved in a serious crash is greater at night than during the day. In 2011, 62 percent of motorists who died in a crash that occurred at night did not have their seat belts on, buckled compared to 43 percent of those who died in a crash during the day. Read more on safety.

Baltimore public schools are receiving a new $1 billion infrastructure investment—the first funding the school district has seen to actually build new schools in almost 40 years, according to a recent interview on the Tom Joyner Morning Show with Bishop Douglas Miles, co-chair of BUILD and co-founding member of Baltimore Education Council. Maryland Governor Martin O’Malley last week signed a law authorizing the funds for school construction and renovation. Eventually, 15 schools will be built and 35 will be repaired and renovated.

“The conditions in the schools have deteriorated,” said Miles. “Boilers breaking down annually in the middle of the winter, buildings lacking windows, water undrinkable because it’s lead-tainted—and our children deserve better than that.”

A growing wealth of data shows a positive relationship between the quality of school buildings and student outcomes. Also, about 85 percent of the 85,000 students in Baltimore schools receive free or reduced-cost lunch, the city has the lowest graduation rates in the state and nearly 140 of its 162 public schools are in very poor condition.

This infusion of funds will help promote academic success for the city’s students by decreasing education disparities. In the long-term it also has the potential to help improve the health of all Baltimore residents, as better education leads to better jobs, higher incomes, and longer, healthier lives. NewPublicHealth has previously illustrated the connection between education and health outcomes in an infographic.

>> Listen to the Tom Joyner Morning Show interview.

March of Dimes Establishes Research Collaborative on Causes of Preterm Births
Three universities and four hospitals in Ohio have joined with the March of Dimes Foundation to establish a collaborative research program aimed at finding the unknown causes of premature birth. According to the March of Dimes, preterm birth is the most common and costly newborn health problem in the United States, affecting nearly half a million babies each year. It is also the leading cause of newborn death, and babies who survive an early birth often face the risk of lifelong health issues, including vision and breathing problems. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants. “The transdisciplinary approach will increase dramatically the rate of progress in understanding why some babies are born too soon. Ultimately our goal is to use this knowledge to develop effective therapies to prevent preterm birth and enable all pregnancies to proceed to full term,” said ” said Sam Mesiano, PhD, Site Director for the Case Western Reserve University, University Hospitals, and MetroHealth component of the collaborative. One of the focus aims of the research includes the sociobiology of racial disparities in preterm birth. African-American and Hispanic mothers have higher rates of preterm births than do whites. Read more on maternal and infant health.

House, Senate Consider Cuts to SNAP in Farm Bill Reauthorization
The U.S. House and Senate are each considering versions of the five-year Farm Bill reauthorization that would save money in part by cutting the budget for the supplemental Nutrition Assistance Program (SNAP), which helps nearly 48 million Americans purchase food each year. The House version would cut $2 billion and the Senate version would cut $400 million, according to The Washington Post. The House version would also stop certain forms of automatic SNAP benefits. James S. Marks, Senior Vice President of the Robert Wood Johnson Foundation Health Group, said cutting SNAP benefits would violate the fundamental tenet of medicine to “first, do no harm.” “Cutting SNAP is precisely the wrong prescription for our children and the nation's economic recovery. The notion that SNAP benefits are an overly generous handout could not be further from the truth,” he wrote in The Huffington Post, adding “SNAP has the potential to be a public health tool that can help address the complex problems of hunger and obesity.” Read more on nutrition.

CDC: High Rates of Unhealthy Behavior Persist
A new report from the U.S. Centers for Disease Control and Prevention finds that, overall, Americans aren’t making much improvement in their health. About 60 percent are overweight or obese, about 60 percent drink, about 20 percent smoke and about 80 percent don’t meet federal guidelines for exercise. "Changes have not been enormous," said report author Charlotte Schoenborn, a health statistician at the CDC's National Center for Health Statistics. "It's been a very, very slow process of changing awareness of personal choices for healthier ways of life.” Added Rich Hamburg, deputy director of Trust for America's Health: "I think we're in a situation now where we're at a crossroads. We have two paths to go. We're hopeful that if we continue to invest in community-based prevention, if we promote healthy eating and active living, these rates will begin to decrease." Read more on CDC.

Devastation in Oklahoma, More Storms Possible
Following tornadoes in Oklahoma yesterday that killed and injured scores of people and leveled whole communities, the National Weather Service is warning that that severe weather could move eastward as far as the Gulf Coast and Northeast on Tuesday and Wednesday. “These are dangerous storms and we urge people to monitor the situation closely and be alert for severe weather warnings in their community,” said Trevor Riggen, vice president of Disaster Operations and Logistics for the Red Cross. The Red Cross has created a free tornado app, available in English or Spanish, whose features include a high-pitched siren tornado warning alert that signals when an alert from a National Oceanic and Atmospheric Agency (NOAA) tornado warning has been issued. The app, found in the Apple App Store and the Google Play Store for Android by searching for American Red Cross, also includes an all-clear alert that lets users know when a tornado warning has expired or has been cancelled. The app also includes one-touch “I’m safe” messaging to alert family and friends through social media outlets. Read more on preparedness.

Cost, Other Factors May Keep African-Americans from Calling 911 when they have Stroke Symptoms
African-Americans often know the signs of stroke, but concerns about medical cost, ambulance response time and lack of familiarity with the need for prompt hospital care impacted whether they called 9-1-1 immediately, according to a new study of 77 African American community members in Flint, Michigan by researchers at the University of Michigan. The study was published in Circulation: Cardiovascular Quality and Outcomes. To encourage 9-1-1 calls even if a stroke victim is concerned about cost, the study authors recommended highlighting the reduction in post-stroke disability if treatment is given quickly. Read more on access to health care.

Report: High SPF Sunscreens Not Any More Effective
Just in time for the Memorial Day Weekend, the Environmental Working Group has released its 7th annual Sunscreen Guide,  which rates the safety and efficacy of more than 1,400 sunscreens, lotions, lip products and makeups that advertise sun protection. EWG researchers found that only 25 percent of products on the market in 2013 offer strong and broad protection and pose few safety concerns. “The vast majority of sunscreens available to the consumer aren’t as good as most people think they are, but there are a handful of products that rise above the rest,” said Sonya Lunder, senior research analyst at EWG and lead author of the report. Lunder says that’s important because “despite an increasing awareness of the sun’s risks, rates of melanoma have tripled over the past 35 years, with an annual increase of 1.9 percent per year since 2000.” EWG says it thinks the U.S. Food and Drug Administration (FDA) should push companies to stop selling high-SPF sunscreens (above 50+), which account for 1 in 7 products on the market. The FDA has said that it cannot vouch for any sunscreen above 30. According to Lunder, as a result of misleading and confusing marketing claims, consumers frequently misuse sunscreens and spend more time in the sun than they should, putting them at greater risk. Read more on cancer.

CDC Issues First Comprehensive Report on Children’s Mental Health in the United States
As many as one in five American children under the age of 17 has a diagnosable mental disorder according to a new report from the Centers for Disease Control and Prevention. The report is the first expansive report on children's mental health ever done by the U.S. government and looked at six conditions:

• attention-deficit/hyperactivity disorder (ADHD)
• behavioral or conduct disorders
• mood and anxiety disorders
• autism spectrum disorders
• substance abuse
• Tourette syndrome

The most common disorder for children age 3 through 17 is ADHD (7 percent) followed by behavioral or conduct problems (3.5 percent), anxiety (3 percent), depression (2 percent), and  autism spectrum disorders (1 percent).

Five percent of teens reported abusing or being dependent on illegal drugs, 4 percent abused alcohol and 3 percent reported smoking cigarettes regularly. Boys were more likely than girls to have the disorders. Read more on mental health.

New PSAs Help Parents Talk to Younger Kids about the Dangers of Underage Drinking
“Talk. They Hear You,” is a new national public service announcement (PSA) campaign from the Substance Abuse and Mental Health Services Administration (SAMHSA) to empower parents to talk to children as young as nine about the dangers of underage drinking. SAMHSA research shows that more than a quarter of American youth engage in underage drinking, and  though there has been progress in reducing the extent of underage drinking in recent years, particularly among those aged 17 and younger, the rates of underage drinking are still unacceptably high, according to SAMHSA. A report from late last year shows that 26.6 percent of 12-20 year-olds report drinking in the month before they were surveyed and 8.7 percent of them purchased their own alcohol the last time they drank, despite the fact that all fifty states and the District of Columbia currently have laws prohibiting the purchase and use of alcoholic beverages by anyone under age 21.  

“Even though drinking is often glamorized, the truth is that underage drinking can lead to poor academic performance, sexual assault, injury, and even death,” said said SAMHSA Administrator Pamela S. Hyde.

The goal of the new PSA is to help parents start a conversation about alcohol before their children become teenagers. Read more on addiction.

Advocacy Groups Petition FDA to Ban Menthol Flavored Cigarettes
In response to a Citizen Petition by close to twenty health and tobacco control advocacy groups, the Food and Drug Administration has opened a docket for public comment on banning menthol in cigarettes. In 2009, according to the Tobacco Control Legal Consortium, the lead group on the petition, Congress banned all flavors in cigarettes except menthol, and directed the FDA to decide whether continued sale of menthol cigarettes is “appropriate for public health." According to the petition, menthol cigarettes are the source of addiction for nearly half of all teen smokers. Read more on tobacco.

Psychiatrist "Bible" Gets a Numeric Overhaul
The American Psychiatric Association will release the latest version of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) this Saturday at its annual meeting, according to Reuters. The current version is the DSM-IV, which was released a full 10 years ago -- the new version will be recast as DSM-5 (not DSM-V), with an eye toward updating the catalog of psychiatric conditions much more frequently with intermediate versions (DSM-5.1, DSM-5.2 and so on). The newest version also aims to introduce more scientific rigor and clinical confirmation of mental illness, such as, "using neuroscience in particular to tell the difference between, say, normal sadness and major depression." Though some criticize that the science just isn't there yet, and that the current version could lead to overdiagnosis. Read more on mental health.

Most Adults Enforce Smoke-Free Rules in Homes, Cars
Four out of five U.S. adults report having voluntary smoke-free rules in their homes and three out of four report having voluntary smoke-free rules in their vehicles, according to a study published in the journal Preventing Chronic Disease, a publication of the Centers for Disease Control and Prevention. Despite the high prevalence of voluntary smoke-free rules in homes and vehicles, the study found that almost 11 million non-smoking adults continue to be exposed to secondhand smoke in their home, and almost 17 million non-smoking adults continue to be exposed to secondhand smoke in a vehicle. The study also showed that voluntary smoke-free rules were more prevalent in states with comprehensive smoke-free laws and tobacco control programs. Read more on tobacco.

Living Near Fast-Food Outlets Might Boost Obesity Risk
Black Americans who live within two miles of a fast food outlet have a higher body-mass index than those living farther away -- and that link especially holds true for those with lower incomes, according to a new study published in the American Journal of Public Health. The study involved more than 1,400 black adults divided into two groups: those making less than $40,000 per year and those making $40,000 or more per year. Read more on what it takes to create healthy communities.

How can we put a stop to violence? Gary Slutkin, MD, believes the key is treating it as we would any contagious disease. The epidemiologist and Founder/Executive Director of Cure Violence recently spoke at TEDMED 2013 about utilizing public health and science-based strategies to prevent violence in communities.

“The greatest predictor of a case of violence is a preceding case of violence,” said Slutkin.

And as with an epidemic such as cholera, the way to stop violence is to find those “first cases” and interrupt the transmission. Cure Violence’s model involves violence interrupters who play a similar role as health workers during epidemics, going into communities to help re-frame issues and cool down situations that could lead to violence. At the same time, outreach workers help people change their behavior and—in time—change the social norms of a community.

>> Watch the full TEDMED presentation.

>>Read more about the public health approach to public safety from Cure Violence.

WHO Reports First Patient-to-Nurse Transmission of SARS-like Virus
The World Health Organization (WHO) is reporting that two health care workers in Saudi Arabia have become infected with a potentially fatal new SARS-like virus after catching it from patients, which represents the first case of the virus spreading this way within a hospital. Novel coronavirus, or nCoV, is thought to be spread through close contact, but, "scientists are on the alert for any sign that nCoV is mutating to become easily transmissible to multiple recipients, like SARS -- a scenario that could trigger a pandemic," according to Reuters. Read more on infectious disease.

Repeated Head Injuries Raise Soldiers' Suicide Risk
Soldiers who sustain multiple traumatic brain injuries, even if they are mild, are at greater risk for suicide, according to a study published in the journal JAMA Psychiatry. Researchers found that the risk for suicidal thoughts or behaviors increased for soldiers with such injuries over the course of a lifetime -- not just in the short term after the injuries occur. Suicide is the second-leading cause of death among U.S. military personnel, and researchers say this study provides further guidance on assessing risks and supporting wounded soldiers. Read more on military health.

HHS Announces $1 Billion to Fuel Health Care Innovation
The U.S. Department of Health and Human Services (HHS) launched a nearly $1 billion initiative -- the Health Care Innovation Awards -- that will fund work to transform the health care system by demonstrating better care and lower costs. This is the second round of the award. In the first round, the Centers for Medicare & Medicaid Services awarded 107 Awards out of nearly 3,000 applications. Round one awardees included a medical home for people with disabilities that showed a 71 percent reduction in hospitalization rates. Read more on access to health care.

The Three Rivers district health department in Owenton, Kentucky was one of three health departments in that state and eleven in the country to receive national public health accreditation from the Public Health Accreditation Board. NewPublicHealth has been speaking with directors from accredited health departments about the value of the credential; how it can change their operations and outcomes; and what they’d like to share with departments considering applying for the credential. We recently spoke with Georgia Heise, DrPH, Three Rivers’ health director and a vice president of the National Association of County and City Health Officials, about the benefits she sees from both the application process and the new status accreditation confers.

NewPublicHealth: What has the reaction been from community members and policymakers to the news that you’re now accredited?

Georgia Heise: It has been wonderful. Our health department has talked about accreditation from the day we started working on it, so people have been waiting to see what the decision was going to be. We’ve gotten flowers, cards, letters, and emails and there have been celebrations hosted by us and by others. And we did get some attention from policymakers, which was wonderful.

We have, for the past three years now, introduced into the Kentucky legislative process a bill that would require health departments in Kentucky to be accredited by 2020. We haven’t got that bill approved yet, but we continue to work on it and we think we will eventually. But that effort means that the legislators are familiar with the concept of accreditation. While maybe they haven’t paid that much attention to it before, they’re paying more attention now because Kentucky had three health departments receive accreditation in the first round and that’s gotten some attention statewide.

NPH: In terms of the process, what has been harder than you thought and what was easier