Are E-cigarettes an Important Tool in the Tobacco Fight?

May 21st, 2014 by Will Humble 3 comments »

E-CigThere’s no substitute for evidence when it comes to public health decision-making.  Over the last couple of years the public health community has been asking itself whether electronic cigarettes can play an important role in getting folks to kick their tobacco habit.  We haven’t had much evidence to answer that question so far… but a study published today in the Journal Addiction suggests that e-cigarettes may be a very effective cessation tool (if used properly).

The study basically examined the success rate for quitting tobacco among people that used e-cigarettes as a smoking cessation tool and compared their success rate with people that used classic over the counter nicotine replacement therapy and people that tried to quit cold-turkey.   They found that people that used e-cigarettes to quit their tobacco habit were more likely to be successful than people that used over-the-counter nicotine replacement tools (e.g. lozenges, gum etc.) or that tried to quit cold-turkey.

In epidemiological-speak- the study found that: “The adjusted odds of non-smoking in users of e-cigarettes were 1.63 (95% confidence interval 1.17 to 2.27) times higher compared with users of NRT bought over-the-counter and 1.61 (95% confidence interval 1.19 to 2.18) times higher compared with those using no aid.”

Of course, this doesn’t close the book when it comes to whether e-cigarettes do more harm than good when you consider that some of the e-cigarette companies appear to be marketing to non-smokers and kids- but it’s probably the most important piece of evidence that we have so far when it comes to determining whether e-cigarettes are an important cessation tool if managed properly.

P.S.:  The FDA’s proposed new regulations for e-cigarettes are still out for public comment.  Here’s a link to a  previous blog post on that subject.

Study: Flu Vaccine Cuts Kids Trips to ICU

May 21st, 2014 by Will Humble No comments »

flu-vaccineInfluenza vaccine reduces a child’s risk of flu-related intensive care hospitalization by 74% according to a CDC study published in the Journal of Infectious Diseases. This is the first study that estimates vaccine effectiveness against flu admissions to pediatric intensive care units.

American Indian Healthcare Matrix (Part III)

May 20th, 2014 by Will Humble No comments »

In addition to services provided by the Indian Health Service and the 638’s administered by tribes and tribal organizations, American Indians are eligible to apply for and receive Medicare, Medicaid, and  Children’s Health Insurance Plan.  American Indians applying for Medicaid services in Arizona need to meet the same income requirements as all other applicants.  Unearned Per Capita income via Tribal Gaming Payments is counted in determining AHCCCS eligibility… which may make them ineligible to receive or continue receiving Medicaid services.  American Indians are exempt from cost sharing requirements in the AHCCCS (Medicaid) and KidsCare programs.

Native Americans are also exempt from the managed care requirement used by AHCCCS, so they have the option to receive their healthcare benefits through an AHCCCS health plan or through the American Indian Health Program, which is a fee-for-service program (rather than a capitated managed care program).   People that sign up with the American Indian Health Program have access to a comprehensive benefit package but some services may require prior authorization from AHCCCS.  Services must be medically necessary and delivered by an AHCCCS contracted provider (subject to exclusions and limitations).

Long-term care services are also available to American Indians living on or off a reservation via the Arizona Long Term Care System, Tribal Case Management Program. Even when American Indian members sign up with an AHCCCS health plan, they can always go to Indian Health Services or 638 facilities for their care.  AHCCCS provides a Tribal Relations Liaison to assist Arizona’s tribes with issues and concerns tribal members may have with enrolling in and/or accessing services.

Native Americans can also qualify for Medicare benefits.  The federal government partners with tribes to assist them with Medicare plan enrollment, plan service delivery, and billing questions under guidance from the CMS American Indian/Alaska Native Center.  Special content-specific groups have been created within the American Indian Alaska Native Center at CMS to guide beneficiaries including the CMS Tribal Affairs Group and the Tribal Technical Advisory Group.

ADHS Publishes Arizona-Specific “Evidence Toolkit” for Decision-Making

May 19th, 2014 by Will Humble No comments »

rulesRegsThe core of our decision-making as an agency relies on evidence.  Evidence can be scientific like surveillance or research or it can be administrative or financial (like return on investment).  Whichever way you slice it- the key is to get good reliable information so that our public health system can make effective decisions as we execute our mission.

One of the tools that the statewide public health system relies upon is called the Arizona Behavioral Risk Factor Survey.  We conduct the survey every year in AZ and examine the self-reported habits of thousands of people from across the state. The report contains key data on lifestyle risk factors contributing to the leading causes of death and chronic diseases- and measures the public health system’s progress on smoking, overweight, high blood pressure, exercise, flu/pneumonia vaccination, cholesterol, seat belt use, fruit/vegetable consumption and other risk factors.

We published our 2012 Report this week- providing key data that can be used to monitor and plan health promotion and help AZ’s public health system to better target our intervention strategies for chronic disease prevention in Arizona. Strategic wins in the new report include reductions in smoking, alcohol abuse, and obesity rates.  Check it out and forward this year’s link to your Stakeholders.

MERS-CoV x 2

May 16th, 2014 by Will Humble 1 comment »

MERSA couple of weeks ago a healthcare worker who recently returned from Saudi Arabia was the first confirmed case of Middle East Respiratory Syndrome (MERS) in the U.S.  This week the CDC and the Florida health department   confirmed a 2nd US case.   A person with MERS traveled Saudi Arabia – London – Boston – Atlanta – Orlando.  Twenty states are participating in the contact tracing of the more than 500 travelers on the flights.  Maricopa County is following up with a patient that was on one of the flights.

We had an unrelated suspect case this week that turned out to be negative.  The person had a travel history to Saudi Arabia and was exposed to sick people.  The person had MERS-compatible signs, symptoms, and incubation period- so alert healthcare providers collected specimens for us to test at our State Lab. We received specimens on Monday night and tested them on Tuesday- and by mid-afternoon Tuesday we knew that the samples were negative.  If it had been positive, we would have sent it to the CDC for confirmation.

MERS (an RNA Coronavirus) isn’t very contagious.  It has been known to spread person to person- but there hasn’t been any documented sustained transmission.  So far, there are over 500 cases worldwide- with a case fatality rate of about 25%.  The virus causes severe respiratory symptoms like fever, cough, and shortness of breath.  Improved infection control in healthcare settings appears to be a critical point to better control this new disease.

Stroke Awareness Month

May 15th, 2014 by Will Humble 3 comments »

TStrokes can cause long-term health problems and death.  The good news is that strokes can be prevented by understanding the risk factors (which are similar to heart disease) like high blood pressure, diabetes, high cholesterol, obesity, and tobacco.  To find out more about your risk for a stroke, you can talk with your physician and participate in Stroke Check this May, which is American Stroke Month.

Stroke Check is The American Stroke Association’s Arizona-founded program to encourage physicians, hospitals, and community service groups to utilize stroke risk assessment tools to perform free stroke screenings and increase awareness of stroke. The Stroke Check Program is free and you can find a screening program.

Quick pre-hospital and hospital interventions are critical once a stroke happens.  Remembering the acronym F.A.S.T can teach you the signs of stroke. F.A.S.T. stands for Face Drooping where one side of the face droops or it is numb; Arm Weakness where one arm is weak or numb; Speech Difficulty, when speech is slurred, the person is unable to speak or hard to understand; and finally Time to call 9-1-1. If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital straight-away.

For more resources you can visit our Heart Disease and Stroke Prevention Program.

The Top 5 Killers

May 14th, 2014 by Will Humble 1 comment »

top-5-killersThe Top 5 things that kill people in the US are: heart disease, cancer, lung disease such as emphysema and chronic bronchitis, stroke and injuries.  In fact- these 5 conditions cause 63% of all deaths in the US — which is nearly 18,000 people each year in AZ (about 50 people/day in AZ).

This week the CDC released its first report on potentially preventable deaths from those causes in each one of the 50 states. The data suggest we could prevent at least a third of those deaths.  We already know how to do it — now we need to act on what we know. Whether it’s by investing resources, using proven strategies or coordinating with health care systems, we have within our communities the strengths to help people live long and healthy lives. Even identifying and focusing on just one issue that can be addressed in each community will make a difference.

Tobacco use is a major factor in four out of the five leading causes of death: heart disease, cancer, lung disease and stroke. It causes about a third of heart disease and cancer, and most emphysema. Getting the last 17% of Arizonans who still smoke to quit will make a huge difference in the length and quality of their lives.

We continue to make strides to get Arizonans to Kick the Habit.  Last year the adult smoking rate dropped 2 more percentage points…  going from 19% 2011 to 17% today.  Even more dramatic is the youth rate, which fell from 17% to 14%. We’ve had a 30% drop in our AZ youth smoking rate over the last 4 years meaning that there are 110,000 fewer kids smokers today than four years ago.

We developed a new strategic plan to improve the effectiveness of our smoking cessation resources via the Arizona Smokers’ Helpline.  A simple cost-effective campaign was created in 2010 that utilized ADHS staff as extras in their “Call Center” campaign, and it  has been very successful. The ASHLine also launched Project Quit…  which is our initiative designed to showcase the quit process.

Physical Activities for Adults with Disabilities

May 13th, 2014 by Will Humble No comments »

A new report released this week from the CDC shows nearly half of adults with disabilities who are able to do aerobic physical activity don’t get any…  putting them at a greater risk for chronic diseases. The report showed that adults with disabilities are three times more likely to have heart disease, stroke, diabetes or cancer than adults without disabilities.

We know that people who participate in some kind of regular physical activity will reduce the risk of obesity, diabetes and heart diseases. For folks who have a disability, there are additional benefits like increased heart and lung function; better performance in daily living activities; greater independence; decreased chances of developing chronic diseases; and improved mental health.

One really good (and well organized) community option is Special Olympics Arizona.  Special Olympics provides opportunities to participate in dozens of sports and activities all year long.  It’s also a great way to participate (either as an athlete or a volunteer) in the community.  Special Olympics Arizona has offices in Flagstaff, Tucson, Yuma, and Phoenix.  You can find more info about local programs on their website.

Federal Funds for Arizona Public Health

May 13th, 2014 by Will Humble 1 comment »

web az-state-health-assessment-coverWe use a lot of CDC grants  in Arizona to promote public health.  I’ve talked about what we do with the Maternal and Child Health, as well as the Behavioral Health, grants in previous blogs.  There’s another grant that lets us focus on issues that are specifically tailored to Arizona.  The Preventive Health block grant helps fund our skin cancer prevention, rape prevention and our prescription drug abuse prevention programs, along with other initiatives including Public Health Accreditation.  Every year we take time to evaluate how we’re spending the money and determine whether there are new public health priorities.

This Thursday is evaluation time – and we invite you to come hear about the programs that we fund with this block grant and give us your thoughts.  We use input from you and public health partners, along with the information we compiled in the State Health Assessment to plan ahead for the spending.  If you’re interested in coming, the meeting will be from 3:45 to 4:45 at ADHS, 150 N. 18th Avenue.

National Nurses Week & the Harlem Shake

May 12th, 2014 by Will Humble 1 comment »

White outAnybody that has worked in the healthcare industry knows who’s the backbone of care: Nurses.  Last week we celebrated nurses with National Nurses Week. We have many nurses throughout the Department in various divisions. Each nurse provides a distinct service to the Department.

The majority of our nurses work at the AZ State Hospital providing direct care to the patients and residents. The Hospital celebrated Nurses week with a variety of activities and events including “White out Wednesday” where the nurses dressed all in white with their nurses caps.  They made a great Harlem Shake video this week that they’re still editing.  We hope to get it to the Intranet sometime next week.