Prevention Matters

CQ Health Day says the chairman of the Senate Finance Committee is complaining that "health care reform is in jeopardy" unless he can convince the Congressional Budget office to to score savings in the health proposals he’s shown them.

Sen. Max Baucus Baucus, D-MT, said at a hearing Thursday that the legislation would be a tough sell to the public if lawmakers and congressional actuaries can’t deliver on one of President Obama’s key promises — that a health care overhaul would lower spending growth.

“The slight challenge we have is getting numbers and estimates from CBO,” Baucus said. “Otherwise, health care reform is in jeopardy.”

President Obama on Monday named Eric Goosby as the new global AIDS coordinator and administrator of the President's Emergency Plan for AIDS Relief, the New York Times reports.

According to the Times, Goosby likely will be a "lightning rod" if he is confirmed by the Senate because some advocates are hoping to expand the current focus of PEPFAR prevention programs beyond abstinence and fidelity to include things like increased condom distribution and family planning programs. Although Goosby will stipulate some guidelines, other policies were written into law, the Times reports.

Goosby currently serves as CEO and chief medical officer of Pangaea Global AIDS Foundation and is a professor of clinical medicine at the University of California-San Francisco. During the Clinton administration, he served as deputy director of the White House National AIDS Policy Office and director of HHS' Office of HIV/AIDS Policy. According to White House officials, Goosby was a key player in the developing and implementing national HIV/AIDS treatment programs in China, Rwanda, South Africa and Ukraine.

Kas over at The Pump Handle eloquently zings high-profile personalities who are spreading incorrect information about the swine flu epidemic. In particular, he skewers Vice President Joe Biden and televangelist Pat Robertson for their statements about the relative unhealthiness of the air in public transportation systems.

"I would tell members of my family — and I have — I wouldn’t go anywhere in confined places now,” Biden told reporters. As examples of confined places, he mentions planes and subways. White House officials later backtracked from that statement.

Meanwhile, Robertson told "700 Club" viewers that airlines improve fuel efficiency by decreasing the indoor quality of air through its circulation systems. (YouTube clip starts at 3:15).

"Shame on you Joe. Shame on you Pat," says Kas, who identifies himself as an industrial hygienist studying public health in the DC metro area. "You know that your names and your faces are more widely-recognized than any public health official’s name or face. You know that you bear the responsibility to get it right not just because you’ve both gotten it wrong before, but because there are a lot of people out there who still like you and may be inclined to believe at face value what you’re saying."

Mexican police dealing with the swine flu epidemic there have arrested 13 individuals accused of selling surgical masks on the street. This led Health Economist blogger Jason Shafrin to examine the ethics associated with providing free surgical masks.

If the government stayed out of the picture and allowed private enterprise to address the surgical mask situation during an epidemic, "manufacturers of surgical masks would receive the same amount of money, but instead of getting paid by the government, they would be paid by firms," Shafrin says. "Firms would be the winners in that they could resale the masks at a profit. Wealthy and middle class households would be able to purchase the masks and poor families would not."

Another argument for free distribution of surgical masks is to prevent corruption, Shafrin says. "If individuals can sell surgical masks at a profit, government workers will have an incentive to give away surgical masks to their friends," he says. "Their friends can collect rents from their receipt of a large quantity of free masks."

Orange County, California, officials have reversed themselves and agreed to restore funding to Planned Parenthood for sex education. The county supervisors then adopted new policies to restrict funds for health education programs in the future.

In March, supervisors suspended a grant worth nearly $300,000 in tobacco settlement revenue earmarked for sex education because the organization performs abortions. At the urging of county lawyers, they vote April 28 to reinstate the grant, but then voted unanimously to direct the county Health Care Agency to use tobacco settlement revenue at community clinics to direct health services, rather than health education.

The CDC released results from the national Youth Risk Behavioral Study (YRBS) that suggest it may be important to target tobacco cessation counseling to young smokers, where the likelihood of success in quitting is greatest.

The study showed that nearly two-thirds (60.9%) of students who ever smoked cigarettes daily tried to quit smoking cigarettes. However, among those who tried to quit, only 12.2% were successful. While the prevalence of success in quitting did not vary by sex or race/ethnicity, more students in 9th grade (22.9%) than in 10th grade (10.7%), 11th grade (8.8%) and 12th grade (10.0%) were successful at quitting.

The 2008 Public Health Service Guidelines – Treating Tobacco Use and Dependence agree that counseling has been shown to be effective in treating adolescent smokers, and recommend that adolescent smokers be provided with counseling interventions to help them quit smoking.

These findings also reinforce the need to fully implement and sustain comprehensive tobacco prevention and control programs that increase excise taxes, promote smoke-free air policies, and conduct media campaigns in conjunction with other community-based interventions, such as tobacco-use prevention programs in schools that include school policy and education components. These proven interventions are effective in reducing smoking among youth and adults.

Diane M. Canova
Managing Senior Fellow and Senior Program Officer

Former Health and Human Services Secretary Tommy Thompson says lifestyle-oriented prevention initiatives could help control future health care costs.

"Will health reform require an upfront investment? Yes. But will that investment pay off in the long term? Yes, it will," Thompson says in a column appearing in Politico.

He expresses concerns that the Congressional Budget Office's estimated price tag for a health reform bill "will not capture the future savings, because it underestimates the value of investment in health care as a means to achieving a healthier, more productive and, ultimately, more prosperous America. "

"While not all prevention and disease management programs are cost-saving, especially in the short term, reliable research indicates that if we can get Americans to lead healthier, more active lives and proactively manage their health, we can help control the cost of health care by delaying — and in some cases fully avoiding — costly chronic health problems," he adds.

Tommy G. Thompson is a partner at Akin Gump Strauss Hauer and Feld, former four-term governor of Wisconsin, former secretary of the Department of Health and Human Services and co-chairman of the Wisconsin chapter of the Partnership to Fight Chronic Disease.

Jacob Goldstein over at WSJ's Health Blog recalls the swine flu "non-pandemic in 1976" and says the experience is relevant today.

"That year, more than 200 soldiers at Fort Dix, N.J., came down with the swine flu, and one died. Wary of a 1918-style pandemic, the Ford administration rushed out a vaccine," Goldstein writes. "But the new strain of flu didn’t spread widely, and the hastily made vaccine appeared to be linked to a neurological disorder in about 500 of the 40 million people who were vaccinated.

"That’s a reminder of the tightrope public-health officials must now walk, as they try to mount an aggressive response without using the kind of undue haste that can wind up harming the people they’re trying to help."

Gary Schwitzer resurrected some public service announcements promoting swine flu shots during the outbreak in the 1970s that are worth a look.

The CDC is posting regular updates on the swine flu outbreak, as well as guidance for clinicians and public health professionals and travel advisories .

Meanwhile, the Washington Post's Howard Kurtz voices concern that coverage of swine flu has reached a "fever pitch," Gawker agrees, and provides a video montage of swine flu television coverage. And the Schweitzer Health News Blog resurrected some public service announcements promoting swine flu shots during the outbreak in the 1970s that are worth a look.

Former Kansas Gov. Kathleen Sibelius has been overwhelmingly confirmed by the Senate to serve as secretary of the U.S. Department of Health and Human Services. As recently as last week, Republicans were citing "blockbuster" information that could stop her nomination, but Tuesday's vote was 65-31 in favor of nomination. The swine flu outbreak appeared to override ideological concerns.

"We find ourselves in the midst of a global crisis," Sen. Christopher J. Dodd (D-Conn.) said during Senate debate. "What we've been missing in all of this is the head of the Health and Human Services Department."

Meanwhile, the Food and Drug Administration is without an administrator, since nominee Margaret "Peggy" Hamburg - who also happens to be one of the nation’s experts on bioterrorism and pandemics - is still awaiting Senate confirmation.

“The administration and the general public greatly benefit from having a confirmed Secretary and FDA Commissioner who would help provide the stability, leadership and confidence the public seeks from the nation’s top public health department at times of such public health emergencies,” said Jim Greenwood, a former GOP congressman and current CEO of BIO — the Washington lobby for the biotechnology industry.

A little boy who lives in a Mexico mountain village flanked by pig farms has been named as "patient zero" in the swine flu outbreak. Five-year-old Edgar Hernandez and his family live in La Gloria in the state of Veracruz. His mother blames the virus on a huge, U.S.-owned pig farm in their neighborhood.

Meanwhile, a child in Texas has become the first person to die from swine flu in the United States, according to Dr. Richard Besser, the acting director of the CDC. The 22-month-old boy from Mexico City had traveled with his family to Brownsville, Texas. Six of the 64 confirmed swine flu cases in the U.S. have been reported in Texas, according to the CDC.

The recession is causing American teenagers to cut back their spending on food, according to research from Piper Jaffray. Will this have a positive effect on the obesity epidemic? Maybe not, according to the study.

While teens are spending 20% less on eating out compared with fall 2007, Chipotle and McDonald's are gaining market share over casual dining restaurants.

"Key influencers have always been taste and convenience, but now value is trumping that," says Nicole Miller Regan, senior research analyst at Piper Jaffray. "They're eating more at [quick-service restaurants] than they are at casual dining. It's all about value, value menus, dollar menus and a lower average ticket."

A new study from the Netherlands suggests that helmet laws are counterproductive in terms of net health, and that the strictly health impact of a US wide helmet law would cost around $5 billion per year. The study uses an approach that balances the health benefits of increased safety against the health costs due to decreased cycling, using estimates suggested in the literature of the health benefits of cycling, accident rates and reductions in cycling.

Sen. Tom Harkin, D-Iowa, said in an interview with CQ HealthBeat that he is “well down the road” toward drafting a bill that would require private health insurers as well as Medicare and Medicaid provide better coverage and reimbursements for effective preventive health measures. That would include annual physicals, mammograms and colonoscopies.

“Prevention has to be incorporated in how we extend coverage, how we reform the payment system,” Harkin said

Among the elements of his legislation:

- An emphasis on a concept known as ‘integrative health,’ in which various practitioners collaborate in coordinated care on a patient’s physical, emotional and mental health

- tax credits for businesses that offer wellness programs such as smoking cessation or depression screening

- annual physicals and other preventive measures - whatever preventive service that gets a recommendation of an “A” or a “B” from the U.S. Preventive Services Task Force - ought to be covered without co-pays or deductibles in any basic benefits private insurance policy

As the swine flu epidemic was elevated to category 4 status, Sen. Susan Collins, R-Maine, was defending her efforts earlier this year to strike $870 million from the federal economic stimulus package passed by Congress earlier this year. That money would have gone to improve the Center for Disease Control's ability to handle a possible flu pandemic.

"I think everybody in the room is concerned about a pandemic flu," Collins told MSNBC on Feb. 5 during stimulus negotiations. "But does it belong in this bill? Should we have $870 million in this bill? No. We should not."

Collins' office notes that the senator herself has called for additional pandemic funding, but she did not believe a bill to create jobs and stimulate the economy was the proper vehicle for it. She favored seeking the funding through the regular appropriations process.

House Appropriations Chairman David Obey (D-Wisc.) disputed the notion that pandemic preparedness was unrelated to the economy. "A pandemic hitting in the midst of an economic downturn could turn a recession into something far worse," he said at the time.

The Senate Homeland Security and Governmental Affairs Committee has announced it will hold an April 29 hearing on the federal government's response to the swine flu outbreak.

Robert J. Gould, a behavioral scientist who has helped lead some of the nation’s most successful social marketing campaigns, has been named president of Partnership for Prevention. The appointment by Partnership’s board of directors was announced today by Dr. Jonathan E. Fielding, chairman of the board.

“Rob’s unique combination of behavioral science expertise, proven leadership, achievements in applying social marketing to health promotion and his passion for the mission of Partnership make him the right choice,” said Fielding, who is Director of Los Angeles County’s Department of Public Health and chairman of the US Community Preventive Services Task Force.

“I look forward to helping Partnership maintain the momentum it has gained in making science-based prevention a priority as policymakers grapple with re-shaping our country’s approach to health and health care,” said Gould. “Americans don’t just want better health care. They want and deserve health policies and programs that help them stay healthy.”

Gould brings to partnership more than 30 years of experience in health promotion, including more than 20 years with global communications firm Porter Novelli.

As leader of Porter Novelli’s Health and Social Marketing practice, he worked on anti-tobacco accounts that included the award-winning ‘truth’ campaign with the Florida Department of Health and the follow-on national ‘truth’ campaign with the American Legacy Foundation. He also worked with public and private non-profit organizations that included the American Cancer Society, the National Cancer Institute, the National Institute on Drug Abuse, the National Heart Lung and Blood Institute, Centers for Disease Control and Prevention and the American Heart Association. In the early ‘90s, Gould was the lead researcher in the development of the now iconic Food Guide Pyramid for the United States Department of Agriculture.

From 2001 to 2007, he was a partner at Porter Novelli and managing director of its Washington office – the second-largest operation within the firm.

In 1978, he received a PhD in social psychology at the University of Maryland, where he subsequently developed and taught a four-course marketing specialty track for its Masters of General Administration Degree program. He also taught in the Executive Masters program and administered its masters thesis program. Gould graduated Phi Beta Kappa from Bucknell University in 1973.

The Christian Science Monitor recently examined how some advocates and others who work with injection drug users worldwide are welcoming a shift in U.S. policy toward IDUs and harm reduction. Gerry Stimson, executive director of the International Harm Reduction Association, said that the U.S. "has been a big block on harm reduction at the international political level," but that is "beginning to change, and it's changed quite suddenly." According to the Monitor, some advocates are calling on the U.S. to support programs aimed at IDUs in developing countries.

An Ohio program to train beauticians about cancer screening was named Partnership for Prevention's Best Prevention Idea of the Week, while a recent vote by the Nevada Senate to soften a statewide smoking ban was named the Worst Prevention Idea of the week.

The Best/Worst Idea awards are a regular feature of Prevention Matters, the blog of Partnership for Prevention. Each week, Partnership for Prevention's staff will choose the designees based on nominations of items in the previous week's news submitted by members, staff and the public at large. To submit a nomination or for more information, contact Damon Thompson at dthompson@prevent.org .


BEST

Beauticians learning cancer prevention

The Cleveland Clinic is training local beauticians about cancer screenings and research information. The program is targeted to African-American women. Salon employees were educated on how to give encouragement and guidance for clients who need mammograms and breast health information


WORST

Nevada Senators Vote to Ease the State’s Ban on Smoking

The Nevada Senate voted 16 to 5 on Friday to advance a measure that would soften a statewide smoking ban, putting the state on track to become the first in the nation to ease restrictions it had imposed on cigarette use in public spaces. The Nevada Clean Indoor Air Act, which took effect in 2007, bans smoking in any indoor space where minors may be present and where food is served. The new bill, which now moves to the Assembly for consideration, would allow taverns that offer food to permit smoking if they bar people under 21 from entry.

The Centers for Disease Control and Prevention recently reported that screening rates for Chlamydia are disturbingly low, even as it has become the nation’s most common reportable sexually transmittable disease. Partnership for Prevention has organized the National Chlamydia Coalition to help increase routine screening for Chlamydia infections. We discuss these concerns with Dr. Yolanda Wimberly, a nationally recognized pediatrician and the medical director for the Center for Excellence in Sexual Health at Morehouse School of Medicine in Atlanta.

From Science Insider:

"Ordinary folk can now try to be masters of their own health, as private companies offer online DNA tests and full-body CT or MRI scans. But these services, which often offer health information without a doctor’s guidance, have stirred up much controversy in the medical community, with claims that the results the companies provide can be inaccurate or misleading to the average layperson. In response to this issue, the U.K.’s Nuffield Council on Bioethics launched a consultation today on the ethical, legal, social, and economic issues behind these commerical health services."

American Medical Association President Nancy H. Nielsen makes a strong case for including prevention and wellness in government-funded comparative effectiveness research (CER).

"We do not have CER findings in the area of wellness, prevention, nutrition and obesity, yet there is a wide range of available interventions," Nielsen says in National Journal's Health Care Blog. "Clarity from CER findings as to which intervention is the most effective will help physicians provide patients with the treatment most likely to have the best outcome."

Only two states passed comprehensive smokefree laws in 2008, while only three states and the District of Columbia raised their tobacco taxes, according to a new report from the American Lung Association.

Stephen J. Nolan, American Lung Association National Board Chairsaid the results indicated that "the significant momentum previously achieved with the passage of smokefree workplace laws stalled during 2008."

To date, 24 states and the District have passed comprehensive smokefree laws as part of the American Lung Association's Smokefree Air challenge.

The U.S. Preventive Services Task Force reaffirmed its 2003 recommendation that clinicians ask all adults about their tobacco use and provide cessation interventions for those who use tobacco products. The Task Force also recommended that all pregnant women who use tobacco be provided pregnancy-tailored counseling. These reaffirmations, which were published in the April 21 issue of Annals of Internal Medicine, are based on information found in the 2008 Update of the Public Health Service Clinical Practice Guidelines.

The US Preventive Services Task Force is the leading independent panel of experts in prevention and primary care. Copies of the recommendations are available at http://ahrq.gov/clinic/uspstf/uspstbac2.htm.

Diane M. Canova
Managing Senior Fellow

Reimbursing doctors to engage patients in obesity prevention is a better approach to tackling the epidemic than United Airline's recent decision to charge higher fares to obese passengers, a leading cardiologist said in today's Huffington Post.

"...changing our health-care system and weaning ourselves off of fast food are clearly going to take some time," says Dr. Arthur Agatston, author of The South Beach Diet. "In the meantime, we need to support, not discriminate against, the obese in this country and we need to urge our government to provide the incentives to stop this health crisis in its tracks."

"Until incentives for prevention can be built into our health-care system, until doctors can afford the time they'd like to spend with patients, the problem of obesity and so many other chronic diseases will continue to persist in this country," he says.

Agatston says the nation's insurance system "currently pays more for doctors to perform procedures than to listen to and educate patients.

"Today primary-care doctors often find themselves having trouble meeting overhead and so they try to see more people in less time, leaving the patients feeling rushed and neglected. Doctors have little time to practice preventive medicine--to teach obese patients, for example, about the value of a proper diet and exercise program or to get to the root cause of a person's weight problem. This simply can't be done in a typical 10-minute doctor visit."

The state of Georgia’s new web portal to actively help residents improve their heart health was named Partnership for Prevention’s Best Prevention Idea of the Week, while recent cuts in the number of health reporters in the U.S. was named the Worst Prevention Idea of the week.

The Best/Worst Idea awards are a regular feature of Prevention Matters, the blog of Partnership for Prevention. Each week, Partnership for Prevention's staff will choose the designees based on nominations of items in the previous week’s news submitted by members, staff and the public at large. To submit a nomination or for more information, contact Damon Thompson at dthompson@prevent.org .


BEST

Georgia Portal to Engage Public in Heart Health


The Georgia Department of Human Resources’ Division of Public Health is engaging a web portal to promote heart health and wellness among residents and to help them identify risk factors for chronic conditions, including heart disease, diabetes and obesity. The program, which is being funded with a grant from the Centers for Disease Control and Prevention (CDC), is known as MyHealthVillage. Participants can log onto MyHealthVillage.com for a comprehensive health risk assessment, which can be completed online; an online consultation with trained health professionals on how to understand health assessment results; and online access to the American Heart Association’s “Search Your Heart” curriculum.


WORST

Americans Can't Shake Salt Habits

Most Americans consume more than double the amount of their daily recommended level of sodium. A new study by the Centers for Disease Control and Prevention shows that more than 2 out of 3 adults are in population groups that should consume no more than 1,500 milligrams (mg) per day of sodium. During 2005-2006 the estimated average intake of sodium for persons in the United States age 2 years and older was 3,436 mg per day. A diet high in sodium increases the risk of having higher blood pressure, a major cause for heart disease and stroke. These diseases are the first and third leading causes of death in the United States.

Sugar-sweetened beverages (e.g., regular soda, sports drinks, fruit punches/drinks) are a major source of calories for most Americans, particularly teenagers. On any given day, 80% of teenagers and 63% of adults consume such beverages, adding about 300 unnecessary calories to their daily caloric intake. 300 calories may not sound like much, but burning off those calories would require a 30-minute jog. Coupling high consumption of sugar-sweetened beverages with low rates of physical activity and it is no wonder Americans are becoming obese.

People who drink sugary beverages are at greater risk for obesity and diabetes. It seems intuitive that reducing consumption of such drinks should lead to weight loss. However, there hadn’t been conclusive data to support that idea. An article in the April 1 issue of the American Journal of Clinical Nutrition has provided that crucial evidence. This randomized multi-center study showed that study participants that reduced their consumption of sugar-sweetened beverages lost weight over the short- and long-term. Participants did not lose weight when they changed consumption of other types of beverages. Even more interesting was that participants lost more weight by reducing liquid calories than by reducing calories obtained from food.

Interventions to help Americans cut back on sugary drinks are greatly needed. Soft drink taxes are becoming popular to both increase state revenue and potentially curb consumption. Although it is well-known that higher tobacco taxes lead people to consume less tobacco, there isn’t much published data yet on whether soft drink taxes significantly reduce consumption of sugar-sweetened beverages. Despite this lack of data, soft drink taxes could generate huge amounts of money for obesity-prevention programs if that revenue was directed to a special fund instead of into the general treasury. Complementary interventions include policies removing sugary drinks from vending machines in schools and workplaces, and behavioral interventions to promote healthy eating.

- Alyson Hazen Kristensen, MPH

Senior Fellow and Program Officer

Pharmaceutical company Johnson & Johnson has decided to drop plans to start a separate wellness and disease-prevention unit, the company's chief financial officer told the Wall Street Journal in an interview.

"America's Health Rankings" has been named a finalist for the Public Relations Society of America's Silver Anvil and Award of Excellence.

The annual report, which each year gives comparative rankings to all 50 states and the District of Columbia, is a joint project of Partnership for Prevention, United Health Foundation and the American Public Health Association, with the assistance of Fleischman-Hilliard public relations firm. It receives significant media attention each year when it is released, and helps call attention not only to the nation's health status but also to the ways health risk factors in each state.

The Silver Anvil awards are iconic of the best practices of the public relations industry. The winners will be announced June 4 at a celebration event in New York City. For more information on America's Health Rankings, read more here.

The U.S. Chamber of Commerce -- which has been participating in daily meetings with members of the Obama administration, Congress and the Treasury Department -- has "found a surprising number of places to agree" with Obama's agenda, including issues such as health care, Politico reports.

Chamber President and CEO Thomas Donohue in an interview with Politico said that there have been "five or six or seven things that everybody can agree to" on health care -- including "wellness, children's diabetes and obesity, (information technology)" -- but that there "are a lot of things (there are) going to be big debates about, and that's reimbursement rates and who's paying and all that."

He said the Chamber hopes to "figure out a way to stay at the table to advance the discussion and to find ways to drive these people to some common agreement, without going over the line." However, Donohue added, "Are we going to stop the world and turn off everything else and do health care? I don't think so."

The state of Ohio’s new obesity prevention strategy was named Partnership for Prevention’s Best Prevention Idea of the Week, while recent cuts in the number of health reporters in the U.S. was named the Worst Prevention Idea of the week.

The Best/Worst Idea awards are a regular feature of Prevention Matters, the blog of Partnership for Prevention. Each week, Partnership for Prevention's staff will choose the designees based on nominations of items in the previous week’s news submitted by members, staff and the public at large. To submit a nomination or for more information, contact Damon Thompson at dthompson@prevent.org .


BEST IDEA

Ohio health plan focuses on obesity prevention

The Ohio Department of Health released a statewide obesity prevention plan that places a priority on promoting more access to healthy food and exercise. It also says state officials should focus efforts on preventing more Ohioans from becoming obese, rather than promoting weight-loss among those already seriously overweight.

WORST IDEA

News Organizations Cutting Back on Health Coverage

At a time when public discussion is sorely needed on health reform issues, a new report examining the state of health care journalism showed that many reporters feel they’re sailing into a headwind at their organizations. Forty percent of respondents said the number of health reporters has gone down since they started at their news organization. More than 9 in 10 health journalists said bottom-line pressures in media organizations were hurting the quality of news coverage of health issues. Nearly 40 percent said it was either very likely or somewhat likely that their position will be eliminated in the next three years.

Hang in there; we value your work.

Tobacco is still the leading cause of preventable death in the U.S. today, but we may have some real opportunities to make substantial progress in changing that. Increases in federal and state tobacco taxes combined with mass education campaigns are sending a record number of people to telephone quitlines seeking advice on how to stop smoking. We’ll be discussing these factors with Paul Billings, Vice President for National Policy and Advocacy at the American Lung Association.

Anyone familiar with Partnership for Prevention’s work and activities knows that “real health reform starts with prevention.” Implicit within this assertion is the conviction that the issue is health reform, not just health care reform. Partnership has always promoted this idea-it is the central premise of our Principles for Prevention-Centered Health Reform and all of our health reform recommendations.

Robert Wood Johnson Foundation’s Commission to Build a Healthier America further developed this theme with the release April 2 of its 10 recommendations for improving the nation’s health. By concentrating on evidence-based interventions and programs that are outside the health care system, the Commission emphasizes the need to have a broader view of health to generate a healthier nation.

Three aspects of the recommendations are particularly worth noting:

• The Commission addresses the main causes of poor health. Half of the recommendations deal directly with the three primary actual causes of death in the United States-smoking, poor diet, and physical inactivity;
• The Commission focuses on working as “upstream” as possible in the age continuum. Determinants of health and health behavior habits start early in life, therefore any policy or program implementation must begin with our children; and
• The Commission recognizes the role that non-health factors play in the health of the country. Policies related to transportation, housing, infrastructure, agriculture, and the environment all have a “health impact,” and developing healthy communities requires measuring that impact.

Finally, these recommendations are consistent with Partnership’s emphasis on the significance that community prevention plays in health reform, and we look forward to collaborating with the Commission and other partners to advance interventions that will have a greater impact on health than increased access to medical care, improved health insurance coverage, less medical errors, or health IT. As we say in our principles, “The nation will get a much greater return on investment by focusing on health improvements in communities, schools, and worksites rather than focusing solely on what occurs in traditional healthcare settings, such as doctors’ offices and hospitals.”

Read more on Partnership’s health reform efforts at www.prevent.org/healthreform. The Commission to Build a Healthier America’s recommendations can be found on its website at http://www.commissiononhealth.org/.

- Jason Spangler, MD, MPH

The week of April 5 - April 12 marks the observance of the first-ever "National Workplace Wellness Week." This podcast features Congressman Charles Boustany Jr of Louisiana, one of the original sponsors of legislation passed by Congress last fall to create this week as a way to help "recognize the importance of workplace wellness as a strategy to maximize employee's health and well-being." Boustany, who is also a physician, talks about the significance of this observance, the importance of workplace wellness in general, and his appreciation for the value of prevention. To listen to the podcast, click on the media player below.

Octo-Mom placed the challenges posed by infertility treatments squarely in the public eye, but in this and other discussions of infertility and its treatment, I never remember anyone mentioning that some infertility can actually be prevented.

It turns out that various infections, with chlamydia being the most common especially in young women, can progress to pelvic inflammatory disease which, untreated, can result in infertility and other serious reproductive tract problems. In pregnant women, chlamydia infections may be passed to the newborn. Surprised? I was.

And more alarming, by the time they reach 25, 1 in 2 young people will contract an STD and most will not know it. Chlamydia and other infections can be detected by a simple, non-invasive urine test and treated with an antibiotic. Yet this year, the rates of chlamydia infection continued to climb to record highs according to the CDC.

So why aren’t all sexually active young women routinely receiving this evidence-based preventive medical care? Public awareness is low and some young women incorrectly assume that they are tested for STDs whenever they receive a Pap test. Healthcare providers face barriers from lack of reimbursement for screening tests (as opposed to testing a patient with symptoms), to misperceptions that “my patients” aren’t the type to get this infection, to concerns about being able to confidentially treat a young person whose medical coverage is in a parent’s name.

Partnership for Prevention, working closely with CDC, has convened key groups interested in improving screening rates into the National Chlamydia Coalition and has developed a guide for healthcare providers to make screening a routine part of medical care. Read more at www.prevent.org/NCC.

The U.K.’s plan to offer all residents over 40 a free health screening was named Partnership for Prevention’s Best Prevention Idea of the Week, while the U.S. Border Patrol’s plan to widely spray a chemical herbicide near the city of Nuevo Laredo’s water supply was named the Worst Prevention Idea of the week.

The Best/Worst Idea awards are a regular feature of Prevention Matters, the blog of Partnership for Prevention. Each week, Partnership for Prevention's staff will choose the designees based on nominations of items in the previous week’s news submitted by members, staff and the public at large. To submit a nomination or for more information, contact Damon Thompson at dthompson@prevent.org .


BEST IDEA

UK to Launch Ambitious Health Screening Program

The UK is pressing ahead with plans to give all people in England over the age of 40 a free health screening as part of a new, heavier focus on disease prevention to better the health of the nation, tackle health inequalities, and help the National Health Service cope with the increasing demands of an aging population. The idea behind the health check – plans for which were first touted back in 2006 and then confirmed last year - is that patients at risk of developing serious illnesses such as heart disease and diabetes will be picked up on the radar much earlier, allowing for quicker lifestyle or drug-based interventions to either ward off or better treat potentially life-threatening conditions.

Under the plans, from next month everyone in England will be invited to undergo a free health check in order to identify those at risk of developing serious and expensive to manage/treat illnesses such as coronary heart disease, stroke, diabetes and kidney disease, as well as better inform people of these conditions, in a move which the government claims will help to save 650 lives and prevent 1,600 heart attacks every year.

The health check will be centered on questions regarding patients’ general health, lifestyles, family medical history, height and weight measurements, cholesterol and where necessary blood glucose tests, and will be followed up with a personal assessment of disease risk and recommendations on how to best reduce it, at an annual cost of around £330 million.


WORST IDEA

Border Patrol to Spray Chemical Herbicide near City Water Supply

The U.S. Border Patrol intends to employ a chemical herbicide in order to eradicate stands of the Carrizo cane, an invasive plant that grows as tall as 30 feet and provides convenient cover for undocumented border crossers and smugglers. The variety of Carrizo cane that is common in the Laredo-Del Rio borderlands is from the region of Valencia, Spain.

Concerned about risks to public health from possible herbicide spray drift, runoff and leaching, officials from the city government of neighboring Nuevo Laredo are steadfastly opposed to aerial spraying. “I’ve always been respectful of the law and sovereignty,” said Nuevo Laredo Mayor Ramon Garza Barrios. “But herbicides that affect health in both countries can’t be sprayed.”

The zone targeted for spraying is across the Rio Grande from Nuevo Laredo’s Hidalgo neighborhood and only hundreds of yards from the Mexican city’s public water intake system. Carlos Montiel Saeb, general manager for Nuevo Laredo’s water utility, said the Border Patrol advised his office to turn off water pumps a few hours prior to spraying. “If there is no problem, why are they asking us to do this?” Montiel questioned.