Archive for the ‘Prevention’ category

FDA Approves Painkiller Overdose Field Treatment

April 14th, 2014

EIt’s no secret that misuse and abuse of opiate painkillers like OxyContin and Vicodin are a large and growing public health threat in Arizona-  misuse and abuse of these medicines are now killing more Arizonans than car crashes.

Last week the FDA approved a prescription treatment called Evzio that can be used in medical emergencies caused by prescription opiates or heroin.  It’s approved to approved to rapidly deliver a single dose of the drug naloxone using a hand-held auto-injector.  The goal is to put this in the hands of non-medical folks who might encounter overdose patients.  Our EMS agencies and hospitals have used naloxone for decades- but this new approval potentially opens administration opportunities to other first-responders as well.

There’s some concern in the medical community about using naloxone in the field because it can cause some pretty bad side effects in folks that have been using opiates for a long time…  but given the increase in deaths related to overdoses, the FDA has taken a pretty bold move.

Epidemiologists: Public Health’s Smoke-Jumpers

April 10th, 2014

MeaslesLike a hotshot team, a rapid response by public health is essential to stopping the spread of measles in unvaccinated persons… and disease detectives in Maricopa County are currently working to squash a measles outbreak right now.

Last week a person with measles visited a restaurant, church and airport in Arizona, exposing over a thousand people to measles.  Press releases and health alerts have gone out- and epidemiologists, public health nurses, and healthcare providers have been dispatched by Maricopa County Public Health to identify, isolate and control further cases.  Time will tell if their efforts pay off.  We should know in a couple of weeks (the incubation period for measles is 10 – 18 days).

Measles seeks out the unvaccinated like fire seeks a dry branch – the chance of an unvaccinated contact getting measles is 90% once exposed.   If you’re not vaccinated against measles, you can get it just by being in a room with someone who has measles.  A measles vaccine can prevent infection if given within 72 hours of exposure as an emergency control measure for unvaccinated folks…  but herd immunity is what keeps the community from getting burned.

Let’s Get Screened

April 10th, 2014

letsgetscreenedColorectal cancer is the second leading cause of cancer-related deaths in Arizona.  Across men and women, all age groups, races, and ethnicities, about ½ of all colorectal cancer diagnoses in Arizona are late-stage, which are more difficult to treat. Our Fit at Fifty HealthCheck Program screens about 1,500 Arizonans per year by providing Fecal Immunochemical Tests and colonoscopies for individuals who qualify. For more information about the Fit at Fifty program, contact Emily Wozniak or Virginia Warren.

The CDC, the American Cancer Society, National Colorectal Cancer Roundtable, and Health Resources Services Administration have kicked off the “80% by 2018” initiative to prioritize colorectal cancer screenings nationwide. This movement aims to get 80% of Americans screened for colorectal cancer by 2018. This is a result of the facts surrounding the status of colorectal cancer screening nationwide: not enough Americans are up-to-date on their screenings, and too many are being diagnosed with colorectal cancer at late stages. According to the American Cancer Society, the lifetime risk of developing colorectal cancer is about 1 in 20.

Medicare Cost Transparency

April 9th, 2014

I’ve always believed that transparency improves the efficiency of any system.  Health care costs are no exception- and health care reimbursement costs are probably at the top of the list of systems that could be improved by applying a healthy dose of cost transparency.

Today the federal government took a giant step forward when they released a public data set called the “Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File”.  It’s a huge database that contains information on utilization, payment, and submitted charges organized by Provider Identifier, Code, and place of service.

Placing this data in the public domain will give researchers around the country access to critical data that can be used to determine where additional system efficiencies can be found and to propose new evidence-based solutions to improve public health outcomes- while making the Medicare and healthcare delivery system more cost effective.

Prom Tools for Parents

April 3rd, 2014

PromIn the next few weeks many AZ teens will be attending proms.  While proms can have positive memories, the experiences can turn tragic when alcohol is part of the mix.  Alcohol impairs judgment…  potentially leading to sexual assault, unplanned pregnancies, sexually transmitted infections and deadly car crashes.  Car crashes are the leading cause of death among teens… and 1/3 of traffic deaths of 15 to 20 year olds are alcohol-related.

A national survey of more than 1,000 adolescents by the Guttmacher Institute found that 80% of first sexual experiences occurred under the influence of alcohol and about ½  of all nonconsensual sexual experiences involve alcohol use by the perpetrator, the victim or both.  Another recent report called Girls and Drugs found that 1/3 of girls and young women 14 to 21 years old with unplanned pregnancies were drinking when they had sex, and 91% said they hadn’t planned to have sex.

Despite knowing all the reasons why teens shouldn’t drink, it can be challenging for them to stay clear-headed when all  their friends are drinking. No one likes to feel left out, and teenagers especially feel the need for acceptance by their peers. So what can we do as parents?

You can help by finding effective ways to say no in a peer pressure situation.  Self-esteem is critically important because it gives kids confidence in themselves and decisions.  Talking to them leading up to the prom and graduation is also important.   Take a look at the website 15 Ways a Teen Can Say No to Alcohol to learn how you can play a role in helping your teen make responsible decisions.  You can also find great tips about talking to teens about alcohol use from the National Institute on Alcohol Abuse and Alcoholism.

 

Farm Bill Provides Public Health Intervention Options

April 1st, 2014

farmbillThe passage of the Farm Bill  (the  Agricultural Act of 2014)  includes some changes and reforms to the Supplemental Nutrition Assistance Program (SNAP or food stamps) and the Commodity Supplemental Food Program.  In Arizona, SNAP benefits help put healthy food on the table for more than one million people each month, with more than half of the benefits going to children and teens.

The new Farm Bill promotes healthier options by requiring SNAP retailers to provide healthy choices.  When fully implemented, any store that accepts SNAP must offer at least seven foods in each of the USDA’s four categories of staple foods.  The law also provides grant programs to encourage people that receive SNAP benefits to buy more fruits and vegetables, provide funding for loan programs for healthy food retailers, and create opportunities for schools to add different kinds of vegetables as part of school menus.

In terms of education funding for SNAP… we’ll be able to promote physical activity in addition to nutrition education. This is great news because the combination of healthier foods and physical activity are powerful tools in fighting the obesity epidemic.  And it fits so well with our Winnable Battle to promote nutrition and physical activity to reduce obesity.  Many studies show there’s a link between obesity and low-income families, so adding nutritional criteria to SNAP is a significant improvement on the status quo and a positive springboard for improving health outcomes moving forward.

Tuberculosis & Mankind

March 24th, 2014

Tuberculosis and mankind share a dramatic and intertwined history.  TB has caused millions of deaths every year for centuries, been found in Egyptian mummies, has placed patients into sanatoriums, and has  even has a folklore link relating it with vampires,  The drama continues into this decade: in 2012, there were 8.8 million new cases of TB diagnosed worldwide and around 1.2 million deaths. 

Public health departments have been fighting for TB elimination since their creation.  Efforts in the 1950s decreased mortality by nearly 90%, but a resurgence in cases and deaths occurred after drug-resistant strains emerged in the ‘80s.  Soon after, the WHO declared TB a global health emergency, and the next decade saw TB control targets developed in an attempt to eliminate TB. 

Arizona continues to strive to hit these targets.  In 2013, there were 184 TB cases reported in the state, a 13% decrease from the year before.  Arizona also has a lower case rate compared to the nationwide average.  Our programs use “directly observed therapy”, evidence-based policies, and partnerships with counties and Cure TB to ensure patients are completing treatment and reducing their risk of developing drug-resistant TB

Our Arizona State Public Health Laboratory also supports TB control.  In 2013, we adopted the Cepheid GeneXpert, a test that detects TB in only 2 hours while identifying mutations associated with drug-resistant TB.  Specimens found to have these mutations are forwarded to the CDC for a full battery of molecular tests to confirm drug resistance. 

World TB Day is coming up on March 24th, which is commemorated annually to bring global awareness about the effects of TB.  You can join us for a Twitter Chat at 10 a.m., March 24, 2014 to discuss TB in Arizona.  Follow us on Twitter and follow the chat using #azhealthchat.

Improving Newborn Screening Turn-around Times

March 24th, 2014

Last December I wrote about an investigation done by a reporter from the Milwaukee Journal Sentinel about newborn screening program turn-around times across the country.  When I saw where Arizona stood relative to the other states in the article, we set a new goal of making sure that our Lab gets 95% of all newborn screening bloodspots from hospitals within 3 days of collection.  Our Lab team immediately responded to the challenge, creating a task force to help the 43 Arizona birth hospitals reach the statewide goal.  For the past 3 months the task force developed an aggressive project plan including educational webinars, hospital site visits, increased courier services and a new webpage.

This week we launched the transit time webpage that features hospital performance reports- providing  soon-to-be parents and the general public with information about progress towards the goal.  The site also recognizes 4 hospitals as top performers for their respective level based on the January 2014 reports- Little Colorado Medical Center, Banner Ironwood Medical Center, Flagstaff Medical Center, and St. Joseph’s Hospital and Medical Center.

Special thanks to Celia Nabor, Sondi Aponte, Isaac Lee, Gannon Wegner, Jesse Lewis, Kirsten Hushagen, Rose Halberg, and Ward Jacox for their continued commitment to the success of the project.

Improving Arizona’s Birth Outcomes

March 13th, 2014

Arizona ranks in the middle of the pack in infant mortality.  We’re doing many things right to improve the health of our babies-  but we have a way to go. Last fall we participated in a learning collaborative sponsored by the National Governors Association.  About 160 folks met to begin the process developing a statewide plan.  They included physicians, public health, nutrition, behavioral health, city planners, business leaders and many more. 

After looking at the data on the health of Arizona’s women and children and reviewing some best practices from around the state, participants broke into groups to talk about the issues and to develop strategies to address these issues. These strategies will be the foundation for the statewide plan to improve birth outcomes.  

Our next step is to form workgroups to develop action plans for the different strategies identified. You can look at the presentations from the day and learn more about our efforts by going to the Healthy Babies web page. Many people have volunteered to be a part of these workgroups and have signed commitment forms.  It’s important to know that this is not an ADHS plan but Arizona’s plan.

Weigh in on Arizona’s Maternal & Child Health Block Grant

March 12th, 2014

Our Women’s and Children’s Health team administers the AZ federal maternal Child Health Block Grant.  This grant is authorized through Title V of the Social Security Act and has been in place since 1935.  Every 5 years we look at the health and well-being of Arizona’s women and children and develop our top priorities based on identified needs. We’re getting ready for the next needs assessment which is due in 2015.  

Of course- we’ll continue to prioritize infant mortality, prematurity, children with special health care needs, injury numbers, oral health and many more.  We also want to find out from you if there are other things we should look into as well.  Take a little time to review last year’s application and let us know what you think. Please send any comments to the chief of our Office of Assessment and Evaluation Dyanne Herrera at Dyanne.herrera@azdhs.gov.