Category Archives: Public health
CDC: Mixed Progress in Food Safety Efforts
A new food safety progress report from the U.S. Centers for Disease Control and Prevention (CDC) shows mixed results for the country’s safety efforts. While the rate of salmonella infections was down approximately 9 percent in 2013 compared to the previous three years, campylobacter infections—often linked to dairy products and chicken—are up 13 percent since 2006-2008. The CDC also found that vibrio infections, which are often linked to raw shellfish, were at the highest level since tracking began in 1996. “This year’s data show some recent progress in reducing salmonella rates, and also highlight that our work to reduce the burden of foodborne illness is far from over,” said Robert Tauxe, MD, MPH, deputy director of CDC’s Division of Foodborne, Waterborne and Environmental Diseases. “To keep salmonella on the decline, we need to work with the food industry and our federal, state and local partners to implement strong actions to control known risks and to detect foodborne germs lurking in unsuspected foods.” The report’s data comes from the Foodborne Diseases Active Surveillance Network (FoodNet), a group of experts from CDC; ten state health departments; the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS); and the U.S. Food and Drug Administration (FDA). Read more on food safety.
FDA: Common Procedure to Remove Uterus, Uterine Fibroids Can Spread Cancer
A common procedure to remove the uterus or uterine fibroids can unintentionally spread cancerous tissue—such as uterine sarcomas—according to a new safety communication from the U.S. Food and Drug Administration (FDA), which is discouraging the use of laparoscopic power morcellation. The procedure divides the uterine tissue into smaller fragments in order to remove them via a small abdominal incision. “The FDA’s primary concern as we consider the continued use of these devices is the safety and well-being of patients,” said William Maisel, MD, MPH, deputy director for science and chief scientist at the FDA’s Center for Devices and Radiological Health. “There is no reliable way to determine if a uterine fibroid is cancerous prior to removal. Patients should know that the FDA is discouraging the use of laparoscopic power morcellation for hysterectomy or myomectomy, and they should discuss the risks and benefits of the available treatment options with their health care professionals.” Read more on cancer.
Approximately 12M U.S. Outpatients Misdiagnosed Each Year
Approximately 12 million U.S. adults are misdiagnosed each year in doctors’ office and other outpatient settings, with an estimated half of those mistakes potentially leading to serious harm, according to a new study set to be published in the journal BMJ Quality & Safety. The overall total means about one in every 20 patients are misdiagnosed. For the study researchers used data from three studies covering a sample pool of approximately 3,000 medical records. "It's important to outline the fact that this is a problem," said Hardeep Singh, MD, the study's lead author and a patient safety researcher at Baylor College of Medicine and at the Michael E. DeBakey VA Medical Center, both in Houston, according to Reuters. "Because of the large number of outpatient visits, this is a huge vulnerability. This is a huge number and we need to do something about it.” Read more on access to care.
Study: Banning Chocolate Milk in Elementary Schools Also Decreases Overall Sales, Increases Waste
Banning chocolate milk in 11 Oregon elementary schools and replacing it with healthier fat-free white milk had the unintended consequence of reducing milk consumption overall, according to a recent study in the journal PLOS One. The study determined that the chocolate milk ban led to a 10 percent overall drop in milk sales; a 29 percent increase in the amount of wasted milk; drops in calcium and protein intake; and a 7 percent decrease in the number of students taking part in the Eugene School District's lunch program. "Given that the role of the federal school meal program is to provide nutritious meals to students who may otherwise have no access to healthy foods, I wouldn't recommend banning flavored milk unless you have a comprehensive plan in place to compensate for the lost nutrients when kids stop drinking milk altogether,” said Nicole Zammit, former assistant director of nutrition services at the Eugene School District in Oregon, in a Cornell University news release. The study was conducted by the Cornell Food and Brand Lab. Read more on nutrition.
CDC: Significant Drops in Five Major Diabetes-related Complications
The last two decades has seen declines in five major diabetes-related complications, according to a new study in the New England Journal of Medicine. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found declining rates of lower-limb amputation (about 50 percent), end-stage kidney failure (about 30 percent, heart attack (more than 60 percent) , stroke (about 50 percent) and deaths due to high blood sugar (more than 60 percent). “These findings show that we have come a long way in preventing complications and improving quality of life for people with diabetes,” said Edward Gregg, Ph.D., a senior epidemiologist in CDC’s Division of Diabetes Translation and lead author of the study. “While the declines in complications are good news, they are still high and will stay with us unless we can make substantial progress in preventing type 2 diabetes.” A recent study determined that approximately one in 10 U.S. adults have either type 1 or type 2 diabetes. Read more on diabetes.
FDA Sees Rising Number of Cases of Injuries Linked to E-cigarettes
The rising use of e-cigarettes has been accompanied by a rising number of injury complaints linked to e-cigarettes, including burns, nicotine toxicity, respiratory problems and cardiovascular problems, according to new data. From March 2013 to March 2014 there were more than 50 such complaints filed with the U.S. Food and Drug Administration (FDA), roughly the total reported over the previous five years. The findings come as the FDA prepares to regulate e-cigarettes and other "vaping" devices for the first time. Read more on injury prevention.
Future of Public Health is an ongoing series focused on the emerging faces in the world of public health. We spoke with Patrick Ten Eyck, MS, a PhD candidate in the Department of Biostatistics at the University of Iowa’s College of Public Health, about what helped lead him to the field, his work in biostatistics to determine the impact of anti-bullying policies and where he hopes to go from here.
NewPublicHealth: What encouraged you to pursue a degree and career in public health?
Patrick Ten Eyck: I received my undergraduate degree in math because it’s been an interest of mine and then I got my Master’s in statistics because I found it to be the most interesting. I wasn’t really interested so much in the theory of statistics as much as the application. So, when I decided to pursue my PhD I thought biostatistics would be the perfect route because it applied my knowledge of statistics to really practical applications in the real world, especially public health. It’s convenient that the Biostatistics Department is in the College of Public Health at the University of Iowa. I have the opportunity to collaborate with other departments and help share our knowledge of statistics. Together, we can make sense of large data sets and hopefully get some very useful results out of it.
NPH: Do you have primary interests on the public health side of biostatistics?
Ten Eyck: Actually, when I started at the program I really didn’t have any particular area that I was that interested in researching. Obviously, one of the big areas that the Biostatistics Department pursues is medical data, but we also work with more broad areas than just medical data. We help out with occupational, environmental, community and behavioral health topics, too. These topics opened many more doors as far as piquing my interest in different areas. So, I still don’t have a particular area that I’m focused on, but I like to get involved in a lot of different areas because it’s really interesting to see what’s going on in the different fields.
NPH: Tell us more about the work you’ve done to analyze the bullying data in the Iowa Youth Survey?
Ten Eyck: Obviously, bullying has been quite a large focus, especially in the media lately with many stories of students being bullied in schools. So, the Iowa Youth Survey looks at data from 2005, 2008 and 2010 and now we just got the data set for 2012. There was an anti-bullying law passed in 2007 in the state of Iowa that outlines what bullying is and helps teachers to recognize bullying and intervene to prevent it as best as possible. A survey was given to sixth-, eighth- and eleventh-grade students throughout the state of Iowa and more than 250,000 students filled out the survey and gave information.
Study: More ‘Masculine’ and ‘Feminine’ Youth at Higher Risk for Cancer-risk Behaviors
The most “feminine” girls and the most “masculine” boys are also the most likely to engage in behaviors that pose cancer risks, according to a new study in the Journal of Adolescent Health. Researchers at the Harvard School of Public Health (HSPH) analyzed data on 9,354 adolescents in the ongoing Growing Up Today Study, finding that cancer-risk behaviors such as tobacco use, indoor tanning and physical inactivity were significantly more common in adolescents who more closely adhered to the traditional societal norms of masculinity and femininity. "Our findings indicate that socially constructed ideas of masculinity and femininity heavily influence teens' behaviors and put them at increased risk for cancer,” said lead author Andrea Roberts, research associate in the Department of Social and Behavioral Sciences at HSPH. “Though there is nothing inherently masculine about chewing tobacco, or inherently feminine about using a tanning booth, these industries have convinced some teens that these behaviors are a way to express their masculinity or femininity." Read more on cancer.
Study: Casual Marijuana Use Can Cause Dangerous Changes in Youths’ Brains
Casual marijuana use in young people can lead to potentially harmful changes in the brain, according to a new study in the Journal of Neuroscience. Researchers from Northwestern University's medical school, Massachusetts General Hospital and Harvard Medical School determined that casual marijuana smoking—defined as one to seven joints per week—could lead to changes to the nucleus accumbens and the nucleus amygdale, which help regulate emotion and motivation. "What we're seeing is changes in people who are 18 to 25 in core brain regions that you never, ever want to fool around with," said co-senior study author Hans Beiter, PhD, professor of psychiatry and behavioral sciences at Northwestern University, according to Reuters, adding, "Our hypothesis from this early work is that these changes may be an early sign of what later becomes amotivation, where people aren't focused on their goals.” Read more on substance abuse.
CDC: ‘Herd Immunity’ Helped Reduce H1N1 Flu Strain’s Impact This Season
While the H1N1 influenza strain was the predominant strain in the United States this past flu season, prior widespread exposure and its inclusion in the current flu vaccine meant it did not have nearly the impact it did in 2009, according to the U.S. Centers for Disease Control and Prevention (CDC). According to Michael Jhung, MD, a medical officer in the CDC’s influenza division, an overall “herd immunity” helped stop this season from turning into the worldwide pandemic seen in 2009. "This year, not only do we have a vaccine that works well, but millions of people have already been exposed to the H1N1 virus," he said, according to HealthDay. The flu strain also hit differently this season, peaking earlier, although once again younger adults were affected more than the elderly. Read more on the flu.
Urban Gardeners May Be Unaware of Harmful Soil Contaminants
In their quest to consume healthier foods, urban gardeners may actually be unaware of the presence of soil contaminants and how to deal with the issue, putting both gardeners and consumers at risk, according to a new study in PLOS One. Potential contaminants include heavy metals, petroleum products and asbestos, which can result when urban soil is near pollution sources, such as industrial areas and roads with heavy traffic. “Our study suggests gardeners generally recognize the importance of knowing a garden site’s prior uses, but they may lack the information and expertise to determine accurately the prior use of their garden site and potential contaminants in the soil,” said Keeve Nachman, PhD, senior author of the study and director of the Food Production and Public Health Program with the Johns Hopkins Center for a Livable Future. “They may also have misperceptions or gaps in knowledge about how best to minimize their risk of exposure to contaminants that may be in urban soil.” Read more food safety.
Study: 1 in 10 U.S. Adults Have Diabetes
Nearly one in 10 U.S. adults had diabetes in 2010, nearly double the percentage a little more than two decades ago, in 1988, according to a new study in the Annals of Internal Medicine. The study determined that 21 million American adults—or 9.3 percent of all American adults—had either type 1 or type 2 diabetes in 2010. As many as 95 percent of diabetes cases are type 2 cases. "This study also highlights that the increase in diabetes really tracks closely with the epidemic of obesity,” said Elizabeth Selvin, the study's lead author and an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “The diabetes epidemic is really a direct consequence of the rise in obesity.” However, the report did find that cases of undiagnosed diabetes were down, indicating new screen techniques are effective. It also found that overall blood sugar control was improved. Read more on obesity.
U.S. Health Care Costs Climbed 3.2% in 2013, to $329.2 Billion
The cost of new medicines, price increases on some branded drugs and patent expirations helped cause the first rise in the overall cost of health services in the United States in three years, according to a new report from IMS Health Holdings Inc., a health care information company. Americans spent a total of $329.2 billion on health services in 2013, up from 3.2 percent from 2012, which had seen a 1 percent decline. However, the report noted that expanded use of cheaper generic drugs—86 percent of all prescription drugs—did help costs from rising even higher. Read more on access to health care.
Study: Mean Devices Approved for Pediatric Use Never Tested on Kids
The majority of medical devices recently approved for pediatric use were never actually tested on kids, but rather only on people ages 18 and older, according to a new study in the journal Pediatrics. Researchers analyzed the clinical data used to get each device approved, finding that 11 of 25 examined devices were not tested on any patient age 21 and younger, and that only four had been tested on patients under the age of 18; three devices were specifically approved for patients under age 18, while the test were approved for people ages 18 to 21. "Children are not simply 'small adults,' and a device found to be safe and effective in adults may have a very different safety and effectiveness profile when used in a pediatric population," said Brigham and Women's Hospital and Harvard Medical School research fellow Thomas J. Hwang, one of the study’s authors, according to Reuters. "Without this data, it is difficult for clinicians and parents to make informed treatment decisions that weigh the risks and benefits of a particular treatment.” Read more on pediatrics.
Kaiser Report Examines Employer-Sponsored Retiree Health Benefits
A new report from the Kaiser Family Foundation on employer-sponsored retiree health benefits for pre-65 and Medicare-eligible retirees finds that the percentage of employers sponsoring retiree health coverage has declined, while employers that offer coverage are redesigning their plans almost annually in response to rising health care costs. The report, Retiree Health Benefits At the Crossroads, also examines the effect of recent legislation on retiree health coverage, such as the Medicare drug benefit and the Affordable Care Act. Read more on aging.
Study: Fewer Blood Transfusions Would Mean Fewer Infections
The increased use of blood transfusions in hospitals also leads to the increased risk of infection, according to a new study in the Journal of the American Medical Association. In a review of 21 randomized control trials, researchers from the University of Michigan School of Public Health determined that for every 38 patients considered for a red blood cell transfusion, the reduction of transfusions would mean one patient did not develop a serious infection, with the elderly undergoing hip and knee surgeries benefiting the most. “The fewer the red blood cell transfusions, the less likely hospitalized patients were to develop infections, “ says lead author Jeffrey M. Rohde, MD, assistant professor of internal medicine in the division of general medicine at the U-M Medical School, in a release. “This is most likely due to the patient’s immune system reacting to donor blood (known as transfusion-associated immunomodulation or TRIM). Transfusions may benefit patients with severe anemia or blood loss; however, for patients with higher red blood cell levels, the risks may outweigh the benefits.” Read more on prevention.
Sebelius to Step Down as Head of HHS
Kathleen Sebelius is resigning as secretary of the U.S. Department of Health and Human Services (HHS). The formal announcement is expected to come at 11 a.m. this morning, with President Obama to name Office of Management and Budget Director Sylvia Mathews Burwell as the replacement for the former Kansas governor. Sebelius assumed the HHS position in April 2009. Read more on the HHS.
FDA Expands Approved Use of Certain Pacemakers, Defibrillators
The U.S. Food and Drug Administration (FDA) has expanded the approved application of certain pacemakers and defibrillators, allowing them to also be used for patients with atrioventricular (AV) block and less severe heart failure. Previously the devices—which provide electrical impulses to the heart through implanted leads in the ventricles—were approved only for people with more severe heart failure as evaluated by their physician using specific criteria. The expansion covers two cardiac resynchronization pacemakers (CRT-P) and eight cardiac resynchronization defibrillators produced by Medtronic. Approximately 5.1 million people in the United States have heart failure. Read more on heart health.
Study: Doctor’s ‘Bedside Manner’ Has Real Effect on Patient Health
The doctor-patient relationship can have a real and significant impact on patient health, with doctors with better “beside manner” also having patients who fare better in efforts to lose weight, lower their blood pressure or manage pain, according to a new study in the journal PLOS One. Researchers reviewed 13 clinical trials, finding that improved patient outcomes were linked directly to doctors who had undergone training to hone their people skills. "I think that intuitively, people think that if you have an open, caring relationship with your provider, that's beneficial," said Helen Riess, the senior researcher on the new study, according to HealthDay. Read more on access to health care.
HHS Releases Data Giving Consumers Greater Transparency on Costs of Medical Procedures
The U.S. Department of Health and Human (HHS) services has released of new, privacy-protected data on services and procedures provided to Medicare beneficiaries by physicians and other health care professionals. The new data—which includes payment and submitted charges, or bills, for those services and procedures by provider—provides consumers with more information on how physicians and other health care professionals practice medicine, according to HHS Secretary Kathleen Sebelius. “This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice,” she said. “The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns.” The release includes information for more than 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program. Read more on access to care.
HUD Grants $1.6B to Support 7,100 Local Homeless Housing and Service Programs
The U.S. Department of Housing and Urban Development (HUD) has announced approximately $1.6 billion in grants to continue support for 7,100 local homeless housing and service programs in all 50 states, as well as Puerto Rico, Guam and the U.S. Virgin Islands. The grants, which come through HUD’s Continuum of Care Program, support programs such as street outreach; client assessment; and direct housing assistance to individuals and families with children who are experiencing homelessness. "Whether it's helping to rapidly re-house families with young children or finding a permanent home for an individual with serious health conditions, HUD is working with our local partners to end homelessness as we know it," said HUD Secretary Shaun Donovan. Read more on housing.
Study: Concussion Symptoms May Be Worse For Girls than for Boys
Concussions may have a more severe and longer-lasting effect for girls than they do for boys, according to new research. Shayne Fehr, MD, a pediatrician at Children's Hospital of Wisconsin, tracked 549 patients who sought treatment at a pediatric concussion clinic, finding that girls on average reported more severe symptoms than boys and needed an additional 22 days to recover (56 days for girls, compared to 34 for boys). Approximately 76 percent of the injuries were sports related and the top five reported symptoms were headache, trouble concentrating, sensitivity to light, sensitivity to sound and dizziness. More research is needed to determine the cause of the disparity. Read more on injury prevention.
One in Four Teen Births Are Among Younger Teens Ages 15 to 17
While births to younger teens ages 15 to 17 years have declined, they still represent over a quarter of teen births and nearly 1,700 births a week, according to this month’s Vital Signs, the monthly health indicator report from the U.S. Centers for Disease Control and Prevention (CDC). “Although we have made significant progress reducing teen pregnancy, far too many teens are still having babies,” said CDC Director Tom Frieden, MD, MPH. “Births to younger teens pose the greatest risk of poor medical, social and economic outcomes. Efforts to prevent teen childbearing need to focus on evidence-based approaches to delaying sexual activity and increasing use of the most effective methods of contraception for those teens who are sexually active.” Read more on sexual health.
Study: Rural Girls Get More Daily Exercise than Those in Suburban, Urban Communities
While the level of urbanicty—whether they live in rural, suburban or urban communities—does not seem to affect boys’ levels of moderate-to-vigorous physical activity, there is a noticeable effect for girls, according to a new study in the American Journal of Preventive Medicine. Researchers determined that girls from rural areas are 4.6 times more likely than those in suburban areas and 2.8 times more likely than those in urban areas to exceed the national physical activity recommendation of 60 or more minutes of moderate-to-vigorous physical activity each day. The study tracked the daily activity of a random selection of 1,354 youth in 20 counties in North Carolina. Read more on physical activity.
Study: Mentions of Alcohol Brands in Popular Music Increase Youth Alcohol Use
The average young person in the United States hears approximately eight alcohol brand names each day while listening to music, increasing the risk they will use and abuse alcohol, according to a new study in the journal Alcoholism: Clinical & Experimental Research. Using information collected from more than 3,400 males and females ages 15 to 23, researchers determined that the average youth in that age group listens to 2.5 hours of music per day, with 3-4 brand mentions each hour. Lisa Henriksen, senior research scientist at the Stanford Prevention Research Center, called the findings “worrisome” in a release. "It would be foolish to think that the alcohol industry is unaware of and uninvolved with alcohol-brand mentions in music," said Henriksen. "The strategy of associating products with hip culture and celebrities who are attractive to youth comes straight from a playbook written by the tobacco industry." Approximately 39 percent of U.S. teens are current drinkers and about 22 percent are binge drinkers, according to the U.S. Centers for Disease Control and Prevention. Read more on alcohol.
At this year’s Preparedness Summit, which met last week in Atlanta, the American Red Cross was a first-time partner for the annual event which brings together more than 1,000 preparedness experts from around the country.
“It was important for us to partner with the American Red Cross because they have a major role and responsibility in disasters,” said Jack Herrmann, the Summit chair and Chief of Public Health Preparedness at the National Association of County and City Health Officials (NACCHO), the lead partner for the Summit. “We felt that it was important that the public health and health care communities understand the Red Cross’ role and authority during a disaster and look for ways to foster and build partnerships [among] local health departments, state health departments and American Red Cross chapters across the country.”
Just prior to the Summit, NewPublicHealth conducted an interview by email with Russ Paulsen, Executive Director, Community Preparedness and Resilience Services of the American Red Cross.
NewPublicHealth: What are the key issues that communities should focus on now to get themselves better prepared for a disaster should it occur?
Russ Paulsen: Everyone has a role to play in getting communities better prepared for disasters.
As a first step, individuals, organizations and communities should understand the problem: What hazards are in their area? How likely are any of these hazards to become actual disasters? What have people already put in place to deal with them? Local Red Cross chapters can help with this assessment.
Once people understand the problem, the next step is to make a plan. Plan what to do in case you are separated from your family or household members during an emergency, and plan what to do if you must evacuate your home. Coordinate your household plan with your household members’ schools, daycare facilities, workplaces and with your community’s emergency plans.