One of the objectives in our Strategic Map is Building Awareness of Public Health Value. One of the ways we can do that is to educate community groups, students and other Stakeholders about the return on investment that public health provides and how the system works. Lucky for us the CDC recently published a PowerPoint called “Public Health 101” which runs through how valuable is and how the system works. The slide deck is posted on the CDC’s Office for State, Tribal, Local, and Territorial Support Gateway in both PowerPoint and PDF format. Please keep this resource in mind as you identify opportunities to educate the public about the value of public health!
Posts Tagged ‘CDC’
How do we evaluate Arizona’s trauma system, you ask? Good question. Over the next few weeks I’ll blog about “Trauma System Evaluation 101” as well as some of the evaluation tools we use to assess Arizona’s trauma system.
The goal of any trauma system is to get the right patient to the right place in the right amount of time. Level I and II Trauma Centers have the equipment, staff and training for caring for the most severely injured patients (about 14% of all injuries). Level III Trauma Centers can care for the moderately injured patients (about 22% of all injuries) and stabilize and transfer the more seriously injured. Level IV Centers have the fewest resources and able to care for minor injuries (about 64% of all injuries) and stabilize and transfer the more seriously injured.
Remember, our goal is to get folks to the right place at the right time- which means severely injured patients arrive at a level I or II center (or are to be transferred there as quickly as possible)… and that mild or moderately injured patients aren’t over-triaged into an expensive level I or II facility. Over-triage means that patients whose injuries are not serious are never-the-less transferred to a level I or II trauma center instead of being transported to the closer level III or IV trauma center.
Why is this a problem? First off, it’s always better to keep a patient close to their home when possible. It’s easier on the patient and family for a lot of different reasons. Second, trauma care at a level I is an expensive proposition but considerably less expensive at the level III and IV trauma center. Third, if all of our trauma patients get sent to the level I trauma centers, not only will they be inundated with non-critical patients, but they won’t be able to respond when the patients that really need their help arrive.
Just like any other evaluation process, you have to look at a variety of different measures in order to perform a meaningful assessment. Looking for over-triage is one tool in the trauma system assessment tool box… but it needs to be looked at hand in hand with its partner measure – under triage. Measuring over-triage is done retrospectively. Hindsight is always more clear, particularly during a stressful situation. It’s human nature to be cautious, therefore it is awfully hard to fault the paramedic who, in an abundance of caution, decides to transport a kid to a level I trauma center, even though they do not appear seriously injured.
A few years ago, the CDC brought together experts from across the country to review the peer reviewed literature on trauma triage. The outcome of that process was the development of the Guidelines for the Field Triage on Injured Patients – a proscriptive, evidence-based tool that takes into account variation within states and regions, while providing some good directions to our EMS folks on how to make decisions in the field. Our own State Trauma Advisory Body adopted these guidelines a couple of years back. If you want to learn more about over-triage, here is a link to a good article recently by the Robert Wood Johnson Foundation on this topic. More next week.
A new report from the CDC shows some good news for older adults in Arizona. According to the report, people in Arizona have a life expectancy of more than 20 years after the age of 65, with 15 of those years healthy. This places Arizona as one of the top states in the nation for life expectancy, with a good quality of life in the later years of life. Some of the reasons for the good health outcomes for older adults in the State are better injury prevention through education and programs and lower rates of chronic disease such as heart disease and some types of cancer.
Our Healthy Aging Program has several resources for older adults in Arizona, including a Healthy Living Guide, reports on the health status of people 65 and older and links to events and agencies that provide services for older adults. The Healthy Aging Program is looking to the future to develop a framework for addressing emerging health trends with older adults, which is a fast growing segment of our population.
Some of the emerging issues are increased suicide attempts, sexually transmitted disease rates including HIV, and Dementia and Alzheimer’s disease. We’ll be looking for ways to address these health factors so Arizona will continue to be a place where we can have long, healthy lives after retirement age.
The 5 most common hospital-acquired infections cost the U.S. health care system almost $10B a year, according to a new study by Harvard researchers. The study was published online in JAMA Internal Medicine this week. According to CDC, one out of every 20 patients admitted to a hospital will pick up an infection while there. Central line-associated bloodstream infections averaged about $45,000 per case. Pneumonia infections that strike patients who are put on ventilators to help them breathe cost about $40,000 per case. The most common infections, surgical site infections, which happen in about one out of every 50 operations, cost around $21,000 each to treat.
MERS-CoV (Middle East Respiratory Syndrome coronavirus) is back in the news again this week. Two weeks ago, I mentioned The Lancet study that identified the potential link between dromedary camels and MERS. Last week, a new animal has been found with a potential link to MERS… the bat.
An article in Emerging Infectious Diseases describes a study conducted by the Ministry of Health of Saudi Arabia (where 70% of the cases have been found), Columbia University, and EcoHealth Alliance looking at bats as a reservoir for MERS-CoV. The researchers collected samples from bats around the homes and workplaces of people who have had MERS so they could test them for diseases.
The researchers found a wide range of coronaviruses among the bats tested, but only found MERS in one bat. We know that bats are reservoirs for all kinds of diseases like rabies and SARS, so it’s not a stretch to think they could also be carriers of MERS. In all likelihood- future studies will probably find other animals carrying MERS given how far across the Middle East we are seeing MERS cases. Updated information about MERS is available through the CDC. As of August 23rd, 103 cases had been identified (none in the US), almost 50% of which were fatal.
September is Childhood Obesity Awareness Month and is a great time for us to take stock of where we are in the “Winnable Battle” of combatting obesity. Last month, we got some good news from the Centers for Disease Control and Prevention (CDC) that obesity rates in children and adults are leveling off after decades of going up.
Now we’ve learned that we are also making progress in school policies to promote healthy eating and physical activity. CDC just released the 2012 School Health Policies and Practices Study which shows the amazing changes that have occurred in schools to help students be healthy and ready-to-learn. For example, the number of school districts that prohibit offering junk food in vending machines has increased from just 4.1% in 2000 to nearly half in 2012 (43.3%).
Even with these encouraging signs, there is still work to do. The childhood obesity epidemic puts nearly one third of America’s children at risk for Type 2 diabetes, high blood pressure, and heart disease – conditions usually associated with adulthood. Even greater disparities exist among young Hispanics and children of color. There are opportunities every day to change these trends and the results can last a lifetime. All children deserve a healthy start in life and it’s our responsibility to make that possible. Let’s use Childhood Obesity Month to renew our resolve and use this opportunity to build awareness and take action where we live, learn, work, play, and receive care throughout Arizona.
The Departments of Economic Security and Health Services are working together to raise awareness of childhood obesity . I invite you to view a similar blog piece by my agency counterpart, Director Clarence Carter.
There’s a new CDC Sortable Stats web application that went live a couple of weeks ago that provides an interactive tool to analyze behavioral risk factors and health indicators compiled from various published CDC and federal sources. You can search by state for things like death rates (e.g. infant mortality, heart disease, motor vehicle death rates, etc.); health burden (e.g. obesity, Hepatitis B & C, diabetes, teen birth rate, etc.); risk factors (e.g. smoking, physical activity, seat belt use, etc.); and preventive services (colorectal cancer screening, flu vaccine, and child vaccination coverage).
A good place to start are the individual fact sheets for individual states or territories. Here’s a link to the Arizona report.
Last year, a new SARS-like virus called Middle East Respiratory Syndrome coronavirus (MERS-CoV) broke out in Saudi Arabia. Since then, 94 cases of the very lethal disease have been reported by the World Health Organization (50% of the cases have been fatal). All the cases have been on the Arabian Peninsula. The virus causes severe respiratory symptoms like fever, cough, and shortness of breath. The virus has spread person-to-person among family members and close contacts… but there hasn’t been any sustained transmission.
Our Arizona State Public Health Laboratory passed all the requirements to test for the new virus under an Emergency Use Authorization from the FDA this week. We received the CDC-developed assay test kit last week from the Laboratory Response Network… so now we’re able to test any suspect patient samples in Arizona.
Interestingly, a study published in The Lancet this week found that the virus is common among dromedary (one hump) camels on the Arabian Peninsula. CDC, WHO, and other public health organizations are looking into all severe acute respiratory cases, especially those with recent travel to the region to find any new cases and learn more about how it might be spreading.
Hopefully we won’t see any cases here in Arizona, but if any patients are suspected of having MERS-CoV because of their symptoms and travel history, our State Lab will now be able to verify or rule out the diagnosis quickly so epidemiologists at the state and county can prevent additional cases. If you’re interested in learning more about MERS-CoV, here’s some up to date information.
We finally got some better news from the childhood obesity public health front this week. Tuesday’s CDC Morbidity and Mortality Weekly Report found that childhood obesity rates are stabilizing or decreasing slightly across the country. In fact, 19 states had a significant downward trend in obesity prevalence among low-income preschoolers. There was no change in Arizona- but that’s better than going up. The study looked at kids between 2 and 4 years old that participate in WIC, Early and Periodic Screening, Diagnosis and Treatment program, and the Maternal and Child Health programs between 2008–2011 and found a downward trend in obesity- for the first time that I can remember in my career.
Where do we go from here? Basically, we need to continue to press ahead and implement evidence-based best practices – as turning the tide on childhood obesity will be a long term effort. Here are a few AZ specific examples:
- We’ll continue to work with many county health departments on the implementation of the Health in Arizona Policy Initiative. This initiative focuses on school health, worksite wellness, healthy community design, procurement of healthy foods (like having healthy alternatives in vending machines), preventive clinical care, and inclusion of children with special health care needs.
- The CDC recently awarded us a new public health prevention grant. Like the Health in Arizona Policy Initiative, the goal is to make healthy living easier by supporting healthy environments in workplaces, schools, early childhood education/child care, and in the community. Arizona was one of 32 states to be awarded enhanced funding; in total, ADHS will receive $2M per year for five years. Activities are expected to begin rolling out by October.
- State and local partners can continue to help communities to conduct needs assessments, Health Impact Assessments, action plans, and initiatives aimed at increasing healthy eating and active living by using tools like the Arizona Health in Policy and Practice Resources and the Urban Land Institute’s Community Plan, both of which help local officials to focus on a holistic approach to land use planning, zoning, transportation, economic development, real estate development and finance.
- We’ll continue to support School Health Advisory Councils which help schools to identify and incorporate best practices for obesity prevention including standards that promote healthy eating and physical activity, like focusing on serving fruits and vegetables, limiting sugary beverages, and providing more opportunities for physical activity, and reducing screen time- like our nationally-recognized Empower program does.
- Our public health system will continue to assist local businesses, communities, and local elected by educating them about the importance of and tools to provide opportunities for physical activity, healthy food availability, and improving access to safe, free drinking water in public places. Maryvale on the Move is a good example of this kind of approach.
- We can also continue to help community groups improve access to local play spaces & increase opportunities for physical activity by helping decision-makers to provide easier access to safe recreational facilities by passing laws like ARS 33-1551 which addresses liability concerns of schools when opening outdoor facilities to the public outside of the school day- making it easier for schools to open playgrounds to the public so children have more places to play and be physically active.
Increasing the percentage of women that choose to breastfeed is a critical evidence-based practice for addressing the childhood obesity epidemic. Here in Arizona, we have a lot to celebrate during World Breastfeeding Week- because of our collective work to increase breastfeeding is paying off. Arizona’s percentage of babies who begin breastfeeding has jumped to 83% according to CDCs just released Breastfeeding Report Card… and the percentage of babies exclusively breastfed until three months old has also climbed 10% in the last 5 years.
This accomplishment demonstrates the power of working together to address the CDC – Winnable Battles including promoting nutrition and physical activity to reduce obesity. Here are just some of the places we work together to support breastfeeding families:
- Hospitals through Baby Steps for Breastfeeding Success;
- Early childcare and education programs through Empower;
- Arizona WIC Program through breastfeeding peer counseling, increasing the number of Lactation Consultants, and moving to participant-centered services for client counseling;
- Home visiting programs for families through Strong Families AZ;
- Community education with an online Baby Steps course- a self-assessment for childcare providers, and professional training;
- Arizona’s early childhood home visitors support new mothers’ desire to breastfeed during home visits;
- StrongFamiliesAz- Arizona’s alliance of early childhood home visitors, provides technical assistance and education to home visitors so they can be supportive of new mothers; and
- Arizona’s Breastfeeding Hot Line 1-800-833-4642 provides 24/7 support for breastfeeding moms.
Congratulations to the Phoenix Indian Medical Center for achieving designation as a Baby-Friendly Hospital. They’re the first AZ hospital to achieve this prestigious certification- which shows their leadership in promoting breastfeeding to reduce childhood obesity.