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.

FDA’s New Food Defense Tool Helps Stop Intentional Contamination
The U.S. Food and Drug Administration (FDA) has developed a new Food Defense Plan Builder tool to help owners and operators of food facilities create plans to minimize intentional contamination. While rare, intentional contamination, intentional contamination can be a serious public health problem. For example more than 40 people in Kansas became sick in 2009 when an employee put pesticide in salsa. Based on FDA’s food defense guidance documents, the tool uses a series of pointed questions to develop a customized food defense plan, including a vulnerability assessment; broad and focused mitigation strategies; and an action plan. Read more on food safety.

Text4baby Programs Gives Pregnant Women, Mothers Critical Information
The 2013 Text4baby State Enrollment Content will promote the mobile health tool while providing pregnant women with important information on their pregnancy and their child’s first year of life. By texting “BABY” (or “BEBE” for Spanish) to 511411, they will receive three free weekly text messages addressing issues such as labor signs and symptoms; prenatal care; developmental milestones; immunizations; nutrition; birth defect prevention; and safe sleep. The program is supported by more than 950 health departments, academic institutions, health plans, businesses and the U.S. Department of Health and Human Services. Under the contest, the states with the highest enrollment percentages will be recognized at the American Public Health Association Annual Meeting in Boston, Mass. in early November. Read more on maternal and infant health.

Citing High Cancer Risk, Angelina Jolie Undergoes Preventive Double Mastectomy
A mutated BRCA1 or BRCA2 gene makes a woman five times more likely to develop breast cancer in her life. On Tuesday in an op-ed in The New York Times, Angelina Jolie — who carries a “faulty” BRCA1 — announced she has undergone a double mastectomy to reduce her risk of developing the cancer. Her physicians had estimated an 87 percent risk of breast cancer and 50 percent risk of ovarian cancer. "I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer,” she wrote. “It is my hope that they, too, will be able to get gene tested." A woman with one of the faulty genes is at an average 60 percent risk of developing breast cancer; a woman without a mutated gene is at an average 12 percent risk. Today CNN anchor Zoraida Sambolin also announced she is getting a double mastectomy. Read more on cancer.

RWJF Obesity Report Details Tactics that Could Save Billions in Health Care Costs
The medical costs of the ongoing U.S. obesity epidemic could be as high as $210 billion annually, according to James S. Marks, Senior Vice President for the Robert Wood Johnson Foundation Health Group. The loss of economic productivity likely adds even more billions to the toll. However, increasing the Congressional Budget Office’s time frame for estimating the cost of legislation from 10 years to 75 years would greatly improve the battle against obesity by enabling us to better estimate the true costs—and savings—of health care and public health efforts. The Campaign to End Obesity estimates that over 75 years, obesity screening by physicians would save $44 billion, the S-CHIP childhood obesity demonstration project would save $41 billion, the U.S. Centers for Disease Control and Prevention’s diabetes prevention program would save $18.4 billion and Medicare part D weight-loss drug coverage would save $11.4 billion. Read the full report.

Citing Cancer Risk, FDA Proposes New Rules for Youth and Indoor Tanning
The U.S. Food and Drug Administration (FDA) is proposing that sunlamp products used for tanning be reclassified as a moderate risk device—up from a low risk device—and made to carry recommendations warning against their use by young people. The ultraviolet radiation from indoor tanning increases the risk of melanoma by 75 percent, according to the American Academy of Dermatology. “Using indoor tanning beds can damage your skin and increase your risk of developing skin cancer,” said FDA Commissioner Margaret A. Hamburg, MD. “The FDA’s proposed changes will help address some of the risks associated with sunlamp products and provide consumers with clear and consistent information.” Read more on cancer.

FDA Warns Pregnant Women of Migraine Drug Ingredient’s Risk to Children
Noting the link between the migraine medicine ingredient valproate and lower IQ scores in children, the U.S. Food and Drug Administration (FDA) is warning all pregnant women not to take medication containing the ingredient. "Valproate medications should never be used in pregnant women for the prevention of migraine headaches because we have even more data now that show the risks to the children outweigh any treatment benefits for this use," said Russell Katz, MD, director of the division of neurology products in the FDA's Center for Drug Evaluation and Research. FDA is also warning women who may become pregnant not to use valproate unless it is medically “essential” and that they make sure they are on effective birth control. Read more on maternal and infant health.

CDC: Cutting Smoking in Subsidized Housing Would Save $521M Annually
Eliminating the ability to smoke in U.S. subsidized housing would save approximately $521 million each year in health care, renovation and fire-related costs, according to the U.S. Centers for Disease Control and Prevention (CDC). This includes public housing and rental assistance programs. Secondhand smoke can be especially problematic in multi-unit buildings with at-risk populations and smoking in common rooms. "Many of the more than 7 million Americans living in subsidized housing in the United States are children, the elderly or disabled," said Tim McAfee, MD, MPH, director of the Office on Smoking and Health at CDC. "These are people who are most sensitive to being exposed to secondhand smoke. This report shows that there are substantial financial benefits to implementing smoke-free policies, in addition to the health benefits those policies bring." Read more on tobacco.

HHS Campaign to Promote Breastfeeding by African American Mothers
The new It’s Only Natural public education campaign from the U.S. Department of Health and Human Services will work to raise awareness of the importance of breastfeeding among African American women, according to Surgeon General Regina M. Benjamin, MD, MBA. “One of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed,” she said in a release. “By raising awareness, the success rate among mothers who want to breastfeed can be greatly improved through active support from their families, their friends and the community.” While overall 80 percent of U.S. women start out breastfeeding, that number is only 55 percent for African American women. The new campaign provides material specifically targeting African American women and giving them the information and encouragement they need to start and continue breastfeeding. Read more on maternal and health disparities.

U.S. Infant Mortality Rates Down; More Improvement Still Needed
Improvements in prenatal care and a reduction in elective deliveries helped cut the U.S. infant mortality rate by 12 percent from 2005 to 2011, according to a new study in the NCHS Data Brief. The National Center for Health Statistics (NCHS) said the rate was down to 6.05 deaths per 1,000 live births in 2011 from 6.87 in 2005. The rate of death from SIDS also dropped 20 percent over the period. Still, study author Marian MacDorman, PhD, an NCHS statistician, said more work is needed, noting that “preterm birth rates are much higher than in other countries, and the same is true with infant mortality" and that "[i]nfant mortality among blacks is about twice what it is for white women,” according to HealthDay. Jeffrey Biehler, MD, a pediatrician at Miami Children's Hospital, said that we "need to continue to advocate for prenatal care for every woman, and make sure they are educated so they know to seek care as early as possible and avoid smoking and alcohol and other things that put them and their babies at risk.” Read more on maternal and infant health.

Hospital-based Quality Improvement Programs Cut Early Elective Deliveries
Elective early term deliveries are down significantly in part due to multistate, hospital-based quality improvement programs, according to a new study in the journal Obstetrics & Gynecology. Labor inductions and Cesarean sections without a medical reason were down 83 percent from 27.8 percent to only 4.8 percent over a one-year program at 25 hospitals. Early term babies are at increased risk of a host of medical problems and even death, according to the March of Dimes. “Reducing unnecessary early deliveries to less than five percent in these hospitals means that more babies stayed in the womb longer, which is so important for their growth and development,” said Edward R.B. McCabe, MD, medical director of the March of Dimes. Read more on maternal and infant health.

Study: School Lunch Standards Help Kids Maintain Healthy Weight
States with strict school lunch standards may be helping students maintain healthier weights, according to a new study in JAMA Pediatrics. The U.S. Department of Agriculture’s National School Lunch Program standards include maximums calories for lunches and the serving of only skim or reduced-fat milk. Depending on grade level, school lunches are between 550 and 850 calories. The preliminary findings help refute the concern that students would simply compensate with unhealthy snacks, according to Daniel Taber, MD, lead author from the Institute for Health Research and Policy at the University of Illinois at Chicago. Nutritionist Marion Nestle of New York University said that this “is important work and should stimulate government agencies to take a closer look at what they might do to make the food environment a lot healthier for children and adults.” Read more on obesity.

CDC: Many Skipping Medications to Save on High Health Care Costs
Lack of insurance and other factors are leading many Americans to request cheaper medications or even skip taking prescribed drugs, according to a new report from the U.S. Centers for Disease Control and Prevention. "Adults who do not take prescription medication as prescribed have been shown to have poorer health status and increased emergency room use, hospitalizations and cardiovascular events," said Robin Cohen of the NCHS's Division of Health Interview Statistics. About 20 percent of U.S. patients ages 18 to 64 requested cheaper medications from their health care providers; the uninsured in that group was also twice as likely—23 percent total—as those ages 65 and older to simply skip the medications entirely. Read more on prescription drugs.

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CDC Vital Signs: 1 in 5 Teen Births is a Repeat Birth
Although teen births have fallen over the past 20 years, nearly one in five is a repeat birth, according to a Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). More than 365,000 teenage girls ages 15-19 years gave birth in 2010, and almost 67,000 (18.3 percent) of those were repeat births. A repeat birth is a second (or more) pregnancy resulting in a live birth before the mother turns 20. “Teen birth rates in the United States have declined to a record low, which is good news,” said CDC Director Tom Frieden, MD, MPH. “But rates are still far too high. Repeat births can negatively impact the mother’s education and job opportunities as well as the health of the next generation. Teens, parents, health care providers, and others need to do much more to reduce unintended pregnancies.” Data from CDC’s National Vital Statistics System show that repeat teen births in the United States decreased by more than 6 percent between 2007 and 2010. Despite this decline, the number of repeat births remains high and there are substantial racial/ethnic and geographic differences. Repeat teen births were highest among American Indian/Alaska Natives (21.6 percent), Hispanics (20.9 percent), and non-Hispanic blacks (20.4 percent), and lowest among non-Hispanic whites (14.8 percent). Read more on maternal and child health.

Health Impact Project Announces Eight New Funded Projects
The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, has recently added eight more grantees who will receive funding to conduct health impact assessments, or HIAs. The projects will bring health considerations into upcoming decisions on topics including education, sanitation infrastructure, and energy. “Our new grantees will use health impact assessments to uncover opportunities to improve health in a wide range of policy decisions, as well as to identify and avoid potential unintended consequences,” said Aaron Wernham, MD, director of the Health Impact Project. “These eight HIAs are the latest in a fast-growing field, as more cities and states find them a useful way to bring health into decisions in other sectors.” By the end of 2007, there were 27 completed HIAs in the United States. There are now more than 225 completed or in progress, according to the Health Impact Project map of HIA activity in the United States. Read more on health impact assessment.

Post-ER Visit for Chest Pain Reduces Heart Attack Risk
Seeing a doctor within a month of an emergency room visit for chest pain significantly reduced the risk of a heart attack or death among high risk patients, according to a recent study in the journal Circulation. Researchers analyzed data on 56,767 adults (average age 66, 53 percent men) in Ontario, Canada, who were diagnosed with chest pain in an emergency room between April 2004 and March 2010 and had been previously diagnosed with heart disease or diabetes. They tracked data for a median 3.7 years and accounted for differences in key patient characteristics such as age, gender, health status and location. According to the study, only 17 percent of high risk chest pain patients seen in the emergency room were evaluated by cardiologists within a month; 58 percent saw a primary care physician and 25 percent had no physician follow-up within a month. Patients who followed up with a cardiologist within 30 days were 21 percent less likely to have a heart attack or die within one year, compared with patients who failed to seek additional care within that time. Patients seen by a primary care physician were 7 percent less likely to have a heart attack or die compared to those patients who sought no follow up care. Read more on heart health.

National Public Health Week Events: ‘Public Health is ROI: Saves Lives, Saves Money’
"Public Health is ROI: Saves Lives, Saves Money" is the theme of this year’s National Public Health Week, from April 1 to 7. By emphasizing prevention and ensuring strong public health systems, public health helps to saves lives and stop diseases before they have a chance to happen. The end result is improved public health and reduced health care spending, meaning those valuable financial resources can go toward strengthening other aspects of a community. Communities and public health schools across the county are celebrating the week and spreading the messages of public health. Read more about National Public Health Week.

WHO: Strain of Bird Flu Kills Two in China; Third Person Infected
While a strain of bird flu has taken the lives of two Chinese men, there is at the moment no evidence to show it can be transmitted from person to person, according to the World Health Organization. The men died in February; a third person, a woman, is in critical condition. The H7N9 virus had previously infected only animals. "At this point, these three are isolated cases with no evidence of human-to-human transmission", said Michael O'Leary, MD, the WHO representative in China. "A new virus tends to be more virulent in the beginning. Either it is going to become a truly human virus, in which case we have to start dealing with it regularly, or it is going to be primarily an animal virus with just a rare human case." Read more on infectious disease.

Given Disease Labels for Children, Many Parents Push for Ineffective Medications
When it comes to doctors insisting sick infants don’t need medication, many parents refuse to take that “no” as an answer, according to a new study in the journal Pediatrics. Instead when given a simple disease label they often push for medications that won’t actually have any effect. Researchers say this demonstrates how simple disease labels can influence parents’ decision-making and shows the importance of good communication. "The disease label seems to send the message that there is an illness that requires medical treatment," said lead author Laura Scherer, an assistant professor in the department of psychological sciences at the University of Missouri. "But, depending on the situation, medical treatments may be necessary, or not. In the case of [gastroesophageal reflux disease], an otherwise healthy infant probably will not benefit from medication. So in this case [that] label can be misleading." Read more on infant and maternal health.

Color-coding Helps Tobacco Companies Get Around Marketing Restrictions
Tobacco manufacturers are essentially getting around the ban on descriptors such as “light,” “mild” and “low” by adding color-coding to cigarette packages, according to a new study in Tobacco Control. The study also found that tobacco companies trying to differentiate light cigarettes from “regular” cigarettes—implying they’re safer—did not file legal applications to have them approved as new products. “After a new federal law was passed in 2009 to end the tobacco industry’s deceptive marketing practices, the industry has apparently circumvented it by using new and sophisticated ways to deceive consumers and has not sought Food and Drug Administration approval for these products as required by law,” said study co-author Gregory N. Connolly, DMD, MPH, director of the Center for Global Tobacco Control at the School and professor of the practice of public health in the department of social and behavioral sciences. Read more on tobacco.

Study: 40 Percent of Parents Give Kids Solid Foods Too Early
Despite the recommendations of child development experts, about 40 percent of parents feed their infants solid food before they are 4 to 6 months old, according to a new study in the journal Pediatrics. Parents who formula-feed their infants rather than breastfeed were more likely to give solid foods too early, which has been linked to childhood obesity, celiac disease, diabetes and eczema. Researchers found one of the main reasons for the switch to solids was parents saying their children were getting hungrier. The researchers also said that health care providers should provide clear, accurate information on an infant’s dietary needs. Read more in infant and maternal health.

FDA’s Hamburg Proposes Improved Oversight of Compounding Facilities
The meningitis outbreak linked to tainted steroids produced at the Framingham, Massachusetts-based New England Compounding Center has led U.S. Food and Drug Administration (FDA) Commissioner Margaret A. Hamburg, MD, to propose the FDA be given greater authority to oversee high-risk sterile compounding facilities that distribute drug products in advance of or without receiving a prescription. Her proposal was posted on the FDAVoice blog. According to Hamburg, a Senate committee is drafting a proposed framework that would include requiring:

• Compliance with federal quality standards
• Federal registration of the compounding facilities
• Compounding pharmacies to report to FDA serious adverse drug reactions

Read more on infectious disease.

NIH: Cardiovascular Benefits Outweigh Small Weight Gain for Former Smokers
When it comes to health, the small amount of weight someone can gain after quitting smoking is inconsequential compared to the improvement in cardiovascular health, according to a new study in the Journal of the American Medical Association. Researchers from the National Institutes of Health found that current smokers were at twice the risk of developing cardiovascular disease as were former smokers without diabetes. “Our findings suggest that a modest weight gain, around 5-10 pounds, has a negligible effect on the net benefit of quitting smoking,” said study co-author Caroline Fox, MD, MPH, senior investigator in the Laboratory for Metabolic and Population Health at the NIH’s National Heart, Lung, and Blood Institute (NHLBI). “Being able to quantify to some degree the relationship between the benefits and side effects of smoking cessation can help in counseling those who have quit or are thinking about quitting.” Read more on tobacco.

FDA: Antibiotic Azithromycin Can Cause Fatal Irregular Heart Rhythm
The antibiotic azithromycin, also known as Zithromax, can lead to a potentially fatal irregular heart rhythm by changing the heart’s electrical activity, the U.S. Food and Drug Administration (FDA) has warned. The FDA is cautioning physicians to be wary of certain risk factors when prescribing the antibiotic, including low levels of potassium or magnesium, a slower-than-normal heart rate and the presence or other drugs to treat abnormal heart rhythms. Read more on heart health.

Study: Breast-feeding has No Effect on Weight Later in Life
Despite previous studies suggesting a possible link, breast-feeding does not reduce the chances that a child will grow up to be overweight or obese, according to a new study in the Journal of the American Medical Association. Still, breast-feeding does bring several health benefits, including a reduced risk of gastrointestinal and respiratory infections; a higher IQ; and lower incidence of eczema. It also reduces the risk of breast and ovarian cancer in the mother. "Although breast-feeding is unlikely to stem the current obesity epidemic, its other advantages are amply sufficient to justify continued public health efforts to promote, protect and support it," said the study's lead author, Richard Martin, a professor of clinical epidemiology at the University of Bristol in England. Read more on infant and maternal health.

"When the day comes that we’re not able to respond in the way that we think we should, that there will be a price to pay."

The U.S. Centers for Disease Control and Prevention and the National Association of County and City Health Officials (NACCHO) are among the partners hosting this week’s 2013 Public Health Preparedness Summit, which provides a national forum for public health and health care professionals, emergency managers, and other leaders to collaborate, learn, and share best practices—especially as budget cuts threaten strides that have been made to better prepare communities for disasters.

Conferences sessions include presentations on catastrophic preparedness, community resilience, biosurveillance, volunteer management, mass prophylaxis, public health law, and crisis standards of care.

NewPublicHealth will be on the ground at the Preparedness Summit in Atlanta this week covering sessions, exploring new tools at the conference expo and talking with plenary speakers and other leaders. Follow the conversation on Twitter at #PHPS13 and follow our coverage here.

In advance of the conference NewPublicHealth spoke with Jack Herrmann, senior advisor for public health preparedness at NACCHO.

NewPublicHealth: How do disasters that happen during the course of the year—such as Superstorm Sandy and the past year’s mass shootings in Colorado and Connecticut—impact the sessions at the Summit?

Jack Herrmann: Unfortunately over the last number of years we’ve always had some kind of event that we’ve had to focus on during the summit, some disaster that has occurred, so this year really is not unique. Last year we also had hurricanes and major tornadoes, and so we found ourselves having to rally around major disasters and pointing out how poignant the Preparedness Summit is because of the events that unfolded. This year, the Aurora shooting, the Newtown shooting, Hurricane Sandy and other events that have occurred really define why we all come together each year for this summit.

It is an opportunity to reflect back and remember how important it is for us to be able to prepare for events every day. I suspect many of the people who have sat in the audience never expected a disaster to occur in their community. So, it is a lesson for all of us in that we never know when disaster is going to strike and that it’s critically important that we’re always on our toes and looking for ways that we can enhance and build the preparedness efforts across our communities and across our nation.