CDC Studies Find U.S. Smoking Cessation Rates Stalled; Wide State Variation on Second Hand Smoke Exposure

Just as we head toward the Great American Smokeout (an American Cancer Society program that encourages smokers to quit at least for a day, in the hopes that they will quit forever—November 19) the CDC has published two reports with some sobering news about smoking prevalence and second hand smoke exposure in November 13 edition of its weekly publication, Morbidity and Mortality Weekly Review (MMWR).

The first study found that the smoking rate for U.S. adults in 2008 was 20.6 percent, virtually unchanged since 2004, when the rate was 20.9 percent and trending slightly upwards from the 2007 rate of 19.8 percent.

According to the study, the people hardest hit by smoking’s effects are those among vulnerable populations, including people with lower levels of education. In 2008, 41.3 percent of persons with a General Education Development certificate smoked cigarettes, compared to 5.7 percent of persons with a graduate degree. An editor’s note in the study points out that no state funds smoking cessation programs at the levels recommended by CDC. The note also urges health providers to take education levels into account when speaking with patients about smoking cessation options.

Read the study here.

The second study is from the 2008 Behavioral Risk Factor Surveillance System, state-based health surveys coordinated by the CDC. The study found that current adult smoking prevalence varied substantially across 50 states, the District of Columbia, and the three U.S. territories. Among states, smoking prevalence was highest in West Virginia (26.6 percent), Indiana (26.1 percent), and Kentucky (25.3 percent) and lowest in Utah (9.2 percent), California (14 percent), and New Jersey (14.8 percent).

The study also includes data from suverys done by 11 states on the proportion of adults protected by smoke-free workplace policies and the proportion of adults who protect themselves and their families from secondhand smoke in their homes.

Among the 11 states there was large variation in indoor workplace exposure—from a high of 16 percent in Mississippi to a low of 6 percent in Connecticut and Tennessee. According to the CDC, smoke-free laws covering public places encourage people to adopt smoke-free policies in their homes; 21 states and D.C. have implemented comprehensive smoke-free laws covering workplaces, restaurants, and bars, according to the CDC.

Read the study here.

October 9, 2009

Easing H1N1 Vaccine Worries

A short piece in the New Yorker Magazine this week by science journalist Michael Specter does an excellent job of tackling what lies behind some of the worry citizens have about the H1N1 vaccines—well worth reading now that the first shipments have started to arrive. Among some of the factors spurring worry are Web site and twitter posts by writers—such as comedian Bill Maher—advising against the immunization. Read Specter’s excellent take on the subject here.

October 5, 2009

H1N1 Information All in One Place

Getting at all the different information on H1N1 can take quite a few swipes at Google. Now the Department of Health and Human Services has gathered much of it, in the form of fact sheets, into a single site that you can see here. You can information on a variety of topics, including: people with asthma, people with diabetes, health care providers, symptoms and basic steps, emergency warning signs and 10 ways to stay healthy at work.

September 30, 2009

Welcome to Facebook, American Medical Association

The American Medical Association has launched a Facebook page.

The page’s debut came late last month and for now, most of the postings tend to be about health reform (“AMA takes health reform on the road”), though the page has strayed from that topic for occasional postings on H1N1 and the death of Sen. Edward M. Kennedy.

According to an AMA spokesman, while their Facebook focus right now is largely the reform debate (which is also the case for the AMA’s new YouTube channel, and Twitter feed ), which launched April 1 of this year, once the reform issue is less front and center [here at the Public Health Page we have no predictions for when that might be] the tools will be used for health care health policy information for doctors and patients.

Be sure to follow the RWJF Public Health Twitter feed.

September 7, 2009

An NIH Primer on Infectious Disease Modeling

Information specialists at the National Institutes of Health, many of whom have a science degree in addition to a communications background, had a great idea earlier this month. Spurred on in part by an announcement at the Harvard School of Public Health about a new center for mathematic modeling of infectious diseases, NIH released an FAQ on infectious disease modeling and a number of shorter briefs on specific investigative disease-modeling projects—both do an excellent job explaining this important, emerging discipline.

And a press release announcing the new Center for Communicable Disease Dynamics at Harvard is also well worth reading.

The Center will focus on mathematical modeling of drug resistance, and seasonal infectious diseases and will be funded through the National Institutes of Health's Models of Infectious Disease Agent Study (MIDAS.)

"We are working on these newly emerging challenges, especially the new pandemic strain of influenza,” says Mark Lipsitch, professor of epidemiology at the Harvard School of Public Health and the head of the new center. “But, just as important,” says Lipsitch, “is the ongoing development of better models and statistical methods—the basic science of infectious disease epidemiology—that put us in a better position to respond when a new challenge emerges."

September 2, 2009

Some Bites of the Apple: New Report on New York City Senior Initiatives Offers Model Ideas for Other Cities

Health officials who yearn for the financial and infrastructure resources of a big city may just have gotten a bit of that wish: A new report called Age Friendly NYC: Enhancing our City’s Livability for Older New Yorkers, which was created in conjunction with the New York Academy of Medicine.

While the report was prepared to meet the needs of one of the world’s larger cities, it includes some initiatives that could work in even a smaller, more rural setting—such as a telephone application process for seniors who may qualify for food stamps.

The 59 initiatives in the new report will be introduced over the next 12 months and aim to make life safer and easier for older citizens in four areas: community and civic participation; housing; public spaces and transportation; health and social services.

The initiatives, which include free bus transportation to supermarkets to help give seniors access to healthy food purchases as well as discounted gym memberships, were created because of projections that show New York City adding half a million seniors to its ranks in the next 20 years. Many of the ideas came out of focus groups city officials held with seniors and their family members, caregivers and health care professionals.

The report and its effort builds on the World Health Organization’s Global Age-Friendly Cities Project guidelines, according to John Beard, Ph.D., director of Aging and Life Course at the World Health Organization in Geneva.

Additional initiatives include: implementing a citywide fall prevention program, free air conditioners for at-risk seniors, a telephone application process for seniors who may qualify for food stamps, increased access to community based care and education about long term care insurance.

August 19, 2009

New Book on Disability and Public Health

The editors of “Disability and Public Health,” a collection of essays just published by the American Health Association, chose their topics by assembling a focus group of experts including an ethicist and a psychologist. We think the resulting chapters, which include “Health Promotion for People with Disabilities,” and “Public Health as a Change Agent for Disability,” go beyond the editors’ goal of creating a textbook on disability and public health and suspect the book will push readers to think well beyond simply providing some accessibility services to the 20 percent of Americans who have a disability of some kind.

The book’s editors include Gloria L. Krahn, Ph.D., M.P.H., director of the division of Human Development and Disability at the CDC. Krahn says the book was envisioned as a textbook, likely the first one in the field. But even readers long out of school will find valuable information, well written and engaging.

With the possibility of the return of H1N1 this fall, we especially recommend a particular chapter: “Nobody Left Behind: Disaster Preparedness and Public Health Response for People with Disabilities.” In addition, the chapters on the history of public health (credit Hippocrates) and government programs for people with disabilities are valuable additions to public health knowledge, and, despite the wonky subject matter, very readable.

“Disability and Public Health,” $35 for APHA members, $50 for non members; plus shipping and handling. Order by phone at 888-320-APHA or https://secure.apha.org/source/orders/index.cfm.

August 8, 2009

New Study First to Link UV Radiation to Autoimmune Diseases in Women

Editor’s note: Public health officials have yet more data to help bolster reminders to the public to seek protection from ultraviolet (UV) radiation. Researchers at the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health, have published the first study to evaluate and find a possible UV radiation association in autoimmune diseases in women.

The study, published in the August issue of Arthritis & Rheumatism, found that women who lived in areas with higher levels of UV exposure when they developed an autoimmune muscle disease called myositis were more likely to develop the form known as dermatomyositis, which weakens the muscles and causes distinctive rashes, instead of the form called polymyositis that does not have a rash.

Frederick W. Miller, M.D., Ph.D., chief of the Environmental Autoimmunity Group at NIEHS, and a lead author of the study, says that, “although we have not shown a direct cause and effect link between UV exposure and this particular autoimmune disease, this study confirms the association between UV levels and the frequency of dermatomyositis that we found in a previous investigation.”

NIEHS Director Linda Birnbaum, Ph.D., weighed in on the significance of the findings: "This study adds UV radiation to the growing list of environmental exposures possibly important in the development of autoimmune diseases.”

Read the study: Ultraviolet radiation intensity predicts the relative distribution of dermatomyositis and anti-Mi-2 autoantibodies in women Arthritis & Rheumatism, Volume 60, Issue 8, Pages 2499 - 2504 (Subscription Required.)

July 31, 2009

1) Birth Weights Slightly Up, Premature Births Slightly Down

From the editor: It’s nice to share a tiny bit of encouraging public health news: A report that found a small decline in the number of babies born preterm and with low birth weights. Researchers aren’t sure if this is a turning point in U.S. infant health or an anomaly, but they hope they can link best practices, such as early prenatal care, to the outcomes and continue the trend, says Duane Alexander, M.D., director of Eunice Kennedy Shriver National Institute of Child Health and Human Development (a division of the National Institutes of Health), which published the report.

Higher birth weights and longer gestation are important to the public health infrastructure because babies born early and underweight can suffer costly lifelong disabilities including blindness, deafness and cerebral palsy, requiring vast amounts of care. The percentage of infants born preterm (before 37 weeks of pregnancy instead of the normal 40 weeks) was 12.7%. The percentage of infants born with low birth weight (less than 5.5 pounds) was 8.2% in 2007, down from 8.3% in 2006.

Read the full report “America’s Children: Key National Indicators of Well-Being.”

2) Remember the Year We Got Swine Flu at Camp?

From the editor: Public health officers are desperately hoping it’s not H1N1 that makes 2009 a summer to remember for kids at camp. Cases of the virus have now been reported at over 50 sleep-away camps and even more day camps. The Centers for Disease Control and Prevention is reporting that almost all cases are mild and parents are generally advised to leave their kids at camp rather risk infecting people kids would meet on the way home.

The American Camp Association has created a video to answer possible parent questions that public health officers might want to review in case it generates questions for health departments. The video does a good job of letting parents know that camps have gotten their prevention instructions from the CDC and local health officials, but leaves open concerns for parents whose sleep-away camp kids develop a severe case or have underlying health conditions that could be exacerbated by the H1N1 flu.

Watch the video.