Drug Patent Expirations Helped Lower Patient Spending for First Time in 55 Years
Per patient spending on medicine dropped 3.5 percent from 2012 to 2011, the first such drop since 1957, according to the IMS Institute of Healthcare Informatics. Spending was $325.8 billion overall and $898 per person in 2012. The main contributor to the decline was the expiration of patents on major drugs such as Lipitor and Plavix, allowing people to instead opt for cheaper generic versions. Michael Kleinrock, director of research development at IMS, said this is likely the first of several years in which spending on prescriptions won’t grow as quickly as overall health care spending. Read more on prescription drugs.

CDC Releases New Resources on Lyme Disease Prevention, Treatment
As across the country the weather is gradually getting warmer and kids are spending more time outdoors, the U.S. Centers for Disease Control and Prevention (CDC) has released new resources to help kids prevent tick bites that can lead to Lyme disease and a reference guide for health care providers. The kid-targeted comic strip includes tips for both kids and their parents. Tickborne Diseases of the United States includes information on types of ticks and the various diseases they can transmit. There were more than 24,000 confirmed cases of Lyme disease in 2011, according to the CDC. Read more on infectious diseases.

Study: Everyday Noises Can Effect Heart Health
Even basic, everyday background noises can affect heart function, according to a new study in the journal Environmental Health Perspectives. That includes increased heart rate as noises become louder than normal conversation levels and a decrease in natural, healthy heart beat variability. A decrease in heart bear variability, such as when someone is stressed, has been linked to a greater risk for heart attack. While these noise effects to individuals is minimal, they could provide greater insight into the health effects of community noise on the broader population level, according to Charlotta Eriksson, a researcher at the Karolinska Institute, in Stockholm, Sweden, who was not involved in the study. Read more on heart health.

HHS Makes Hospital Cost Information Available to Consumers
The U.S. Department of Health and Human Services (HHS) has announced a new initiative that, for the first time, gives consumers information on what hospitals charge for many procedures and services. The information will be posted on the website of the Centers for Medicare and Medicaid Services and will show comparative charges for services that may be provided during the 100 most common Medicare inpatient stays, such as knee replacements. The new data shows significant variation across the country and within communities in what hospitals charge for common inpatient services. The agency is also providing close to $90 million to states to collect, analyze, and publish health pricing and medical claims reimbursement data. To help show how the data can be used the Robert Wood Johnson Foundation has announced a data visualization challenge. Read more on access to health care.

CDC Issues Updated Hepatitis C Screening Guidelines
The U.S. Centers for Disease Control and Prevention (CDC) has issued new screening guidelines for Hepatitis C that recommend anyone born between 1945 and 1965 be screened for the infection, as well as anyone who received a blood transfusion or organ donation before 1992 when screening of the blood supply was improved, and anyone who has ever injected drugs. The CDC is making the new recommendations because only half of Americans identified as ever having had hepatitis C received follow-up testing to see if they were still infected, according to a new Vital Signs issued by the agency. CDC researchers looked at data from eight areas across the country and found that of the hepatitis C cases reported in those areas, follow-up testing was only done in 51 percent of the cases. “Complete testing is critical to ensure that those who are infected receive the care and treatment for hepatitis C that they need in order to prevent liver cancer and other serious and potentially deadly health consequences,” says said CDC Director Tom Frieden, MD, MPH. According to the CDC, about 3 million Americans are infected with hepatitis C and up to 3 out of 4 do not know they are infected. Read more on infectious disease.

Researchers Call for Independent Review Process for DSM-5 Updates
Arguing that that the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) missed “crucial population-level and social determinants of mental health disorders,” a group of researchers at the Columbia University Mailman School of Public Health and Columbia University Medical School are calling for an independent review for any future revisions of the American Psychiatric Association’s guidelines. The article appears in the journal Health Affairs. “As the DSM evolves, we must ensure the accuracy of psychiatric diagnoses and their equitable use in health care by systematically reviewing and applying the lessons in the population health and social science literature,” wrote the authors. The factors include various environmental factors, cultural perceptions and institutional pressures. Read more on mental health.

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.

HUD Grants $72M to Improve Local Homeless Programs, Services
The U.S. Department of Housing and Urban Development (HUD) has announced $72 million in grants to strengthen more than 500 homeless housing and service programs. The grants, which are part of HUD’s Continuum of Care Program, will go toward local programs such as street outreach, client assessment and directing housing assistance. This is the second round of HUD funding this year; the agency gave more than $1.5 billion in grants in March and intends to give a third round later in the year. “We know these modest investments in housing and serving our homeless neighbors not only saves money, but saves lives,” said HUD Secretary Shaun Donovan. Read more on housing.

Survey: 90 Percent of Parents Admit to Driving Distracted with Kids in the Car
Approximately 90 percent of parents who drove a child between the ages of 1 and 12 in the past month admit they were distracted by some sort of technology while they were behind the wheel, according to survey findings discussed at the annual meeting of the Pediatric Academic Societies in Washington, D.C. The most common distraction was phone calls, with 70 percent. The survey also found that about that same percentage was distracted by either feeding or dealing with the child, or with self-grooming. "A lot of the attention on the distracted-driving issue has focused on teens and new drivers," said author Michelle Macy, MD, a clinical lecturer in the departments of emergency medicine and pediatrics at the University of Michigan. "But our study is showing that most parents say they were distracted an average of four times when driving their child in the last month, which is more frequent than I had expected.” Read more on safety.

Kids Routinely Injured, Killed by Gun Violence; Easy Access a Serious Issue
While it is often the biggest and scariest incidents that garner media coverage, youth are “routinely” injured or killed by gun violence, according to a new study in the Journal of the American Medical Association. Researchers looked at trauma admissions in two Colorado emergency departments over nine years, finding that 129 of the 6,920 children sought treatment for gunshot wounds. “In 14 percent of these cases children managed to get access to unlocked, loaded guns,” said author Angela Sauaia, MD, associate professor at the Colorado School of Public Health and the University of Colorado School of Medicine. “In an area with so much disagreement, I think we can all agree that children should not have unsupervised access to unlocked, loaded guns.” Sauaia noted that as this only includes kids who went to emergency rooms, the actual totals are likely much higher. Read more on violence.

CDC: Only 20 Percent of U.S. Adults Meet Aerobic, Muscle-strengthening Requirements
Only about one in five U.S. adults meet the aerobic and muscle strengthening components of the federal government's Physical Activity Guidelines for Americans, according to a new report in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report. The guidelines call for a minimum of 2.5 hours of moderate-intensity aerobic activity each week, or 1.25 hours of vigorous-intensity aerobic activity, as well as at least two days of muscle-strengthening activities. About half of adults meet the aerobic minimums and 30 percent meet the muscle-strengthening requirements, which Carmen D. Harris, MPH, epidemiologist in CDC's physical activity and health branch, called “encouraging.” "This is a great foundation to build upon, but there is still much work to do,” she said. “Improving access to safe and convenient places where people can be physically active can help make the active choice the easy choice." Read more on physical activity.

Hospital Programs Find Success in Cutting Antibiotic Prescriptions, Drug-resistant Bacteria
Hospital programs designed to decrease the number of prescriptions for antibiotics also successfully cut the number of drug-resistant bacteria, according to a new study in the Cochrane Library. Such bacteria, as well as the possibility of secondary infections, can leave patients especially at risk. "Antibiotic resistance is recognized worldwide as a public health problem that's just getting worse. Really around the world people are worried that we'll end up with bacteria that are resistant to the antibiotics we've got," said Peter Davey, MD, of the University of Dundee in Scotland. Researchers found that while persuasion/education programs were effective, actually restricting prescriptions saw more improved outcomes early on, which persuasion/education’s effectiveness catching up later. "We got good evidence that restrictive interventions work faster in terms of changing prescribing and microbial outcomes," he said. Read more on preventing antibiotic resistance.

Suicide Rate Up Significantly for Middle-aged Americans
Attempts to explain the dramatic increase in suicides by middle-aged Americans over the past decade have left many public health experts “dumfounded,” according to Lanny Berman, executive director of the American Association of Suicidology. "The best we can come up with is maybe this is the group most likely to be affected by the recession and unemployment and [home] foreclosure," he said. "It affected suicide rates both nationally and internationally." A new report from the U.S. Centers for Disease Control and Prevention reveals that suicides for people aged 35-64 rose by 28 percent from 1999 to 2010. For comparison’s sake, more Americans died by suicide in 2010 (38,364) than in car crashes (33,687). According to an agency news release: "Suicide is a tragedy that is far too common. The stories we hear of those who are impacted by suicide are very difficult. This report highlights the need to expand our knowledge of risk factors so we can build on prevention programs that prevent suicide,” said CDC Director Tom Frieden, MD. Read more on mental health.

NewPublicHealth is partnering with Grassroots Change: Connecting for Better Health to share interviews, tools, and other resources on grassroots public health. The project of the Robert Wood Johnson Foundation Health Group supports grassroots leaders as they build and sustain public health movements at the local, state and national levels.

In this Q&A, conducted by Grassroots Change, Shannon Frattaroli, PhD, Associate Professor at the Johns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy, shares her perspective on grassroots power and the future of public health. Her research helps answer two critical questions: Why are grassroots movements so important; and what is a public health movement, anyway?

>> Frattaroli’s interview has been edited for NewPublicHealth. View the full interview at GrassrootsChange.net.

Grassroots Change: What do you see as the role of grassroots movements in public health?

Shannon Frattaroli: There’s tremendous potential. Public health at its core is about the public. The public should have a voice in public health, and grassroots movements are one way for that to happen. The public has been very engaged in policy issues or problems throughout the history of public health. When people get engaged and are strategic with regard to policy change, things can happen quickly. And change can happen in a way that feels more legitimate. I think it’s where we should be moving in the future.

GC: What does “grassroots movement” mean? How are grassroots health movements different from other types of advocacy?

NIH Grants $40M to Combat Racial, Ethnic Disparities in Stroke Risk
The National Institutes of Health (NIH) has awarded $40 million in grants over five years to help four research centers investigate and develop strategies to reduce the risk of stroke in racial and ethnic minorities. The funds come from NIH’s National Institute of Neurological Disorders and Stroke (NINDS). Racial and ethnic minorities are at higher risk than non-whites due to higher prevalence of cardiovascular risk factors, according to said Walter J. Koroshetz, MD, deputy director, NINDS. "A few of the grantees are working closely with at-risk populations to develop interventions that give people tools to achieve blood pressure control," he said. "These research efforts will give us the traction we need to control the greatest modifiable stroke risk factor. Together, the Stroke Prevention /Intervention Research Programs represent a much needed effort to address stroke disparities in the United States." Read more on stroke.

People With Congenital Heart Disease Need Physical Activity
A new scientific statement from the American Heart Association serves to remind health professionals and patients that regular physical activity is important for people with congenital heart disease and should be promoted. Congenital heart disease (heart structural problems existing since birth) impacts close to 1 million children and 1 million adults in the United States. Specifics of the new statement include:

• While some irregular heart beat conditions may require a restriction in physical activity, “for most, physical activity can be unlimited and should be strongly promoted.”
• Most patients with congenital heart disease are relatively sedentary.  But the physical, psychological and social health benefits of physical activity are important for this population which is at risk for exercise intolerance, obesity and other diseases. .
• These are general recommendations and physicians may have to tailor some specific guidelines for individual patients.

Read more on heart health.

DOT Announces Funds to Help Improve Road Safety on Tribal Lands
The U.S. Department of Transportation (DOT) has announced the availability of more than $8.6 million in Tribal Transportation Program Safety Funds from the Federal Highway Administration (FHWA). According to Transportation Secretary Ray LaHood, the funds will help improve roads on tribal lands, which have consistently ranked among the nation’s highest road fatality rates. DOT will hold a webinar on May 8 from 4-5 p.m. EDT to provide information on the grants to potential applicants. Find a link to the webinar here. Read more on transportation.

FDA Approves Plan B One-Step for Women 15 and Older
The U.S. Food and Drug Administration (FDA) has approved over-the-counter use of the Plan B One-Step emergency contraceptive for women age 15 years or older. The single dose pill previously required a prescription. “Research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States,” said FDA Commissioner Margaret A. Hamburg, MD “The data reviewed by the agency demonstrated that women 15 years of age and older were able to understand how Plan B One-Step works, how to use it properly, and that it does not prevent the transmission of a sexually transmitted disease.” Last month a federal judge in New York ordered the FDA to make Plan B available to all women and/or make Plan B One-Step available “without age or point of sale restrictions,” according to an FDA release. Read more on teen pregnancy.

Study: Amusement Rides Injure 4,000 U.S. Kids Annually
As the weather warms and families start to plan summer vacations, it’s important for parents to remember to use caution when selecting amusement park rides. More than 4,000 kids are injured on an amusement ride each year in the United States, according to researchers at the Center for Injury Research and Policy at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio. Injuries sent about 93,000 children to emergency rooms between 1990 and 2010, with about 70 percent of those coming May through September. Researchers say the numbers demonstrate the need for standardized safety regulations. "Although the U.S. Consumer Product Safety Commission has jurisdiction over mobile rides, regulation of fixed-site rides is currently left to state or local governments, leading to a fragmented system," said senior author Gary Smith, MD, director of the Center for Injury Research and Policy, in a release. "A coordinated national system would help us prevent amusement-ride-related injuries through better injury surveillance and more consistent enforcement of standards." The study includes safety tips for parents. Read more on safety.

Prevention App Wins HHS Challenge
The winner of the a recent mobile app challenge from U.S. Department of Health and Human Services (HHS) Office of Disease Prevention and Health Promotion is the myfamily app developed by Lyfechannel, a company that translates evidence-based health behavior and adherence studies into mobile applications. App users can find prevention information and tips for each member of their family; create personal health alerts; and keep track of medical check-ups and vaccinations. HHS research shows that patients who are better engaged in their own health care have better health outcomes and that electronic tools can help them be better health consumers. Read more on prevention.

In recent years many bacteria have become resistant to drugs that commonly vanquished them, depleting a natural resource—antibiotics—that has saved millions of lives around the globe. Using these drugs only when necessary, and using the right drug for the right infection will help ensure that the medications are available and effective when they’re needed.

>>Watch a new, three-minute animated video that tells the story of how antibiotic-resistant “superbug” bacteria have become a serious public health threat that affects everyone. The video frames the problem uniquely: We must treat antibiotics as a natural resource that can be depleted with overuse, just like water, trees, and other resources on which we all depend. The video lays out specific steps that everyone – including doctors, hospitals, and consumers – can take to tackle the problem.

Extending the Cure (ETC), a project of the Center for Disease Dynamics, Economics & Policy based in Washington, D.C., and New Delhi, released the Superbugs video this week, along with a new report on trends in antibiotic resistance.

Last year, the organization also released research showing that certain types of bacteria responsible for causing urinary tract infections (UTIs) are becoming more difficult to treat with current antibiotics. ETC released the research via its online ResistanceMap, an online tool created to track changes in antibiotic drug use and resistance. A new, added feature of the ResistanceMap is ETC’s Drug Resistance Index, a way for non-experts to track changes in antibiotic effectiveness.

This research was funded by the Robert Wood Johnson Foundation. Urinary tract infections account for about 8.6 million visits to health care providers each year, according to the Centers for Disease Control and Prevention. More than half of U.S. women will get a UTI in their lifetime.

“Without proper antibiotic treatment, UTIs can turn into bloodstream infections, which are much more serious and can be life-threatening,” said Ramanan Laxminarayan, director of Extending the Cure (ETC). “These findings are especially disturbing because there are few new antibiotics to replace the ones that are becoming less effective,” says Laxminarayan. 

Read a previous NewPublicHealth interview with Ramanan Laxminarayan about ETC’s research and Drug Resistance Index.

USPSTF Recommends HIV Screening for All Americans 15-65
The U.S. Preventive Services Task Force (USPSTF) now recommends that all Americans ages 15 to 65 be screened for HIV, according to new guidelines appearing in the Annals of Internal Medicine. USPSTF’s previous 2005 guidelines recommended screening for only those people categorized as high-risk. The U.S. Centers for Disease Control and Prevention already recommends this course of action. "We do hope the fact that the guidelines are all very similar will provide an impetus for people to offer screening because it is a very critical public-health problem,” said task force member Douglas Owens, MD, a medical professor at Stanford University. Experts noted that the change will likely mean that testing will be covered as a preventive service under the Affordable Care Act. Read more on HIV/AIDS.

HUD’s $1.83B Plan Will Help Rebuild New Jersey, Prepare for Future Disasters
The U.S. Department of Housing and Urban Development’s (HUD) $1.83 billion New Jersey disaster recovery plan will help residents continue to recover from the damage caused by Hurricane Sandy and better prepare for future extreme weather events. “This infusion of federal funding will help New Jersey continue to recover from Superstorm Sandy and ensure that our state is rebuilt stronger and better prepared for future storms,” said Senator Frank Lautenberg (D-NJ). “Families that are rebuilding their homes, small businesses that are getting back on their feet, and communities that are repairing damaged public infrastructure will all benefit from this federal grant program.” The plan is funded through HUD’s Community Development Block Grant Program. The infrastructure restoration efforts will including elevating some homes to guard against future flooding. Read more on Hurricane Sandy.

Early Obesity Dramatically Increases Men’s Risk of Poor Health, Death
Obesity in the early 20’s can dramatically increased a man’s chance of suffering from serious health problems or even dying by the age of 55, according to a new study in the journal BMJ Open. A study tracking Danish men found that approximately half of the participants who were obese at the age of 22 had developed diabetes, developed high blood pressure, had a heart attack, had a stroke, or experienced blood clots or died by age 55. Men of a normal weight at age 22 saw only a 20 percent risk of developing these problems by age 55. Each unit increase in body mass index raised the risk of heart attack by 5 percent; high blood pressure and clots by 10 percent; and diabetes by 20 percent. In the United States approximately 35.7 percent of adults and 17 percent of children are obese, according to the U. S. Centers for Disease Control and Prevention. Read more on obesity.

Survey: Many Americans Still Unaware of or Confused About the Affordable Care Act
Signup for the Affordable Care Act (ACA) Health Insurance Marketplace begins in October, but a new poll from the Kaiser Family Foundation finds that many Americans are still confused about the law, which will require virtually all Americans to sign up for health insurance coverage that will take effect January 1, 2014.

Key poll findings include:

• More than 40 percent of Americans aren’t aware that the ACA is the law of the land.
• Of those who aren’t aware that the ACA is now law, 12 percent think the law was repealed by Congress and 7 percent think the law was overturned by the Supreme Court.
• About half of the respondents said they did not have enough information about the health reform law to understand how it will impact their family.

The poll findings also showed that people who are currently uninsured and those in low-income households were the most likely groups to say they did not understand how the ACA benefits them and their families. Read more on access to health care.