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ACPM Headlines 4/10/14
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In this Issue

Top Stories

1.  ACPM sponsors congressional briefing on Rx drug overdose

2.  ACPM signs letter to FDA urging tobacco product standards

3.  ACPM hosts advocacy day for NVDRS funding

 

ACPM News

4.  Video produced by PM resident touts PM specialty

5.  ACPM urges advancement of All-Hazards Preparedness Act programs

6.  ACPM requests FY15 funding to support FDA food safety programs

7.  ACPM welcomes new Corporate Roundtable member

 

Policy and Practice

8.  HHS reports progress on disease prevention and health promotion

9.  Updates from clinical and community preventive services task force

10. Gallup-Healthways release Well-Being Index, 2013

11. How healthy is your county?  2014 county health rankings released

 

Research and Reports

12. Smoking stays stubbornly high among the poor

13. Despite progress, hospital-acquired infections inflict ~722,000 people

14. IOM:Applying a health lens to decision making in non-health sectors

15. Why walk-in health care is a fast-growing profit center for retail chains

16. Article cautions about limits of HIV treatment as prevention (TasP) models

 

Announcements

17. Membersin the news: Sokol, Stiegmann

 

Top Stories

 

1 ACPM SPONSORS CONGRESSIONAL BRIEFING ON PRESCRIPTION DRUG OVERDOSE

 

ACPM joined with the Association of State and Territorial Health Officials (ASTHO), Safe States Alliance, and Trust for America’s Health (TFAH) on a congressional briefing to engage policymakers in discussions aimed at combating the growing prescription drug overdose epidemic.  Congressman Hal Rogers (R-KY), chair of the House Appropriations Committee, provided welcoming remarks and was joined by Illeana Arias, PhD, principal director for the Centers for Disease Control and Prevention (CDC), Van Ingram, executive director for the Kentucky Office of Drug Control Policy, Mary Bono, former Congresswoman and prior co-chair of the Congressional Caucus on Prescription Drug Abuse, Terry Cline, PhD, president of ASTHO and commissioner of the Oklahoma State Department of Health, and Richard Hamburg, deputy director at TFAH.

 

While several speakers touted recent action by states, such as implementation of prescription drug monitoring programs and restrictions on prescribing practices to address the prescription drug overdose epidemic, former Congresswoman Mary Bono urged policymakers to utilize federal policy levers, including the power of oversight committees, to encourage action by federal agencies. 

 

2.  ACPM SIGNS LETTER TO FDA ON TOBACCO PRODUCT STANDARDS

 

ACPM recently co-signed an open letter to Mitchell Zeller, Director of the Food and Drug Administration (FDA) Center for Tobacco Products, demonstrating support for FDA to use its regulatory powers to mandate changes to the design and composition of tobacco products that would reduce the risk of fatal disease among users.

 

The Health Consequences of Smoking—50 Years of Progress, a report recently issued by the U.S. Surgeon General, finds that smokers today are at a much higher risk for developing lung cancer and chronic obstructive pulmonary disease (COPD) as a result of product changes in cigarettes made by tobacco companies over the last 50 years. Specific changes that may be responsible include increased carcinogenic nitrosamines in cigarettes and incorporation of ventilation holes in filters that enable deeper inhalation of smoke into the lungs.

 

3.  ACPM HOSTS ADVOCACY DAY FOR FEDERAL FUNDING

 

As the administrative home for the National Violence Prevention Network, ACPM hosted an annual advocacy day with state injury prevention officials to build support for the president’s FY15 budget proposal to expand the National Violent Death Reporting System (NVDRS) to all 50 U.S. states and territories.  The National Violence Prevention Network was instrumental in advocating for nationwide expansion of NVDRS in the president’s FY15 budget request.

 

NVDRS is a state-based surveillance program funded by the Centers for Disease Control and Prevention (CDC) that identifies the who, what, when, where and how of violent deaths, leading to a more complete picture of the circumstances that lead to such deaths.  Preventive medicine physicians in state government roles and other public health officials use this information to inform and target state violent death prevention programs.

 

Advocacy day attendees represented some of the 18 states that currently have CDC funding to operate an NVDRS program.  Additional funding was included in the FY14 budget to expand the program from 18 to roughly 30 states.


 

ACPM News

 

4 ACPM WEB SITE FEATURES RESIDENT-PRODUCED PREVENTIVE MEDICINE VIDEO

 

The home page of the ACPM web site now features a video that captures the diversity of the field of preventive medicine, the emphasis on working upstream, and the creativity of the field to change what might be perceived as the traditional roles of the practice of medicine. The video was produced as a capstone project by ACPM Resident member and incoming Resident Physician Section Vice President of Communications Shelly Choo, MD. Dr. Choo currently is a first-year preventive medicine resident at the Johns Hopkins Bloomberg School of Public Health.

 

Dr. Choo created this project specifically for medical students for easy sharing through social media, and to inspire the next generation of preventive medicine physicians to continue to expand the field and future of medicine.

 

The video features interviews with ACPM members Stephen Haering, MD, MPH, FACPM, Phil Blanc, MD, MPH, Shelly Bhowmik, MD, Mary Carol Jennings, MD, MPH, and Clarence Lam, MD, MPH. Dr. Choo founded Coshi Productions, "a videography company that works to craft meaningful stories of love and public health."

 

5 ACPM URGES ADVANCEMENT OF ALL-HAZARDS PREPAREDNESS ACT PROGRAMS

 

ACPM joined with its partners in medicine and public health on a sign-on letter to congressional appropriators to urge “support of funding for programs critical to the nation’s preparedness against threats, whether naturally occurring like pandemic influenza or deliberate, such as a chemical, biological, radiological, and nuclear (CBRN) event.”

 

The letter notes that ACPM and its partners “support robust funding for medical countermeasures (MCM) development and procurement through the Biomedical Advanced Research and Development Authority (BARDA) and the Project BioShield Special Reserve Fund (SRF)…Cutbacks to the public health workforce over the last five years have contributed to the loss of over 22% of 50,600 jobs, or 22% of the state and local health department workforce. National security is a shared local, state, and federal responsibility that is not currently at an appropriate stage of readiness.”

 

6.  ACPM REQUESTS FY15 FUNDING TO SUPPORT FDA FOOD SAFETY PROGRAMS

 

ACPM joined a sign-on letter to congressional appropriators to draw “attention to the critical need for enhanced funding to fully implement the regulatory and oversight activities conducted by the U.S. Food and Drug Administration (FDA) in support of a safer, more reliable food supply.”

 

The letter states, “In 2011, Congress wisely enacted the Food Safety Modernization Act (FSMA), to strengthen and modernize the regulatory, administrative and information technology systems that oversee and protect our food supply.  FSMA fundamentally changed the FDA’s approach to addressing food safety, allowing the agency to focus on preventing food safety problems before they make people sick, rather than reacting to illness after they occur, and expanding oversight in high-risk areas like overseas processing facilities and U.S. ports.”

 

The Centers for Disease Control and Prevention (CDC) estimates that contaminated food causes 48 million foodborne illnesses, 128,000 hospitalizations, and as many as 3,000 deaths nationwide every year with a total health system cost of roughly $70 billion each year. 

 

7 ACPM WELCOMES NEW CORPORATE ROUNDTABLE MEMBER

 

ACPM welcomes Metagenics as its latest addition to the Corporate Roundtable.  Metagenics was founded in 1983 on the concept of how nutrition and better lifestyle choice might help people realize their best possible health. Today, based on the experience Metagenics has garnered over time and with its expertise in plant-based therapies, Metagenics is in the forefront of making lifestyle medicine more effective with the support of targeted clinical nutrition. Metagenics’ research-based medical foods, nutriceuticals and educational programs for the practitioner (such as FirstLine Therapy®) are aimed at helping each patient identify, manage and improve their unique and evolving health needs over the course of their lifetime.

 

Metagenics joins the Corporate Roundtable at the Silver level.  For more information on the ACPM Corporate Roundtable, contact Maureen Simmons, MA, CFRE, ACPM Chief Development Officer. 

 

Policy and Practice

 

8.  HHS ANNOUNCES PROGRESS IN DISEASE PREVENTION AND HEALTH PROMOTION

 

The U.S. Department of Health and Human Services (HHS) has released Healthy People 2020 Leading Health Indicators: Progress Update, highlighting the nation’s progress toward meeting the goals of the 26 Leading Health Indicators outlined in Healthy People 2020. As of March 2014, 14 indicators (including environmental quality and injury and violence prevention) are either improving or have met or exceeded their Healthy People targets.  An additional 8 indicators show little to no detectable change (such as in nutrition and obesity and access to health services), and 4 are either getting worse or only have baseline data available (such as in mental health indicators).

 

Please see the Progress Update Executive Summary for more information.

 

9 UPDATES FROM CLINICAL AND COMMUNITY PREVENTIVE SERVICES TASK FORCES

 

USPSTF

 

The United States Preventive Services Task Force (USPSTF) has posted a draft recommendation statement on low-dose aspirin for the prevention of morbidity and mortality from preeclampsia. The task force recommends (B recommendation) low-dose aspirin (81 mg/day) preventive medication after 12 weeks’ gestation in women who are at high risk for preeclampsia.

 

In addition, the final evidence summary for this topic is posted on the USPSTF web site and published in the online edition of Annals of Internal Medicine.  Comments can be submitted through May 5, 2014.

 

Community Guide

The Community Guide team has announced an update to the Community Preventive Services Task Force recommendation on Cardiovascular Disease Prevention: Clinical Decision-Support Systems regarding economic evidence. The task force recommends clinical decision-support systems (CDSS) for prevention of cardiovascular disease (CVD) based on sufficient evidence of effectiveness in improving screening for CVD risk factors and practices for CVD-related preventive care services, clinical tests, and treatments.

 

10GALLUP-HEALTHWAYS RELEASE WELL-BEING INDEX, 2013

 

Gallup and Healthways have released their 6th annual Gallup-Healthways Well-Being Index, “State of American Well Being, 2013,” which provides an in-depth, real-time view of Americans’ perceptions of their well-being. The information is designed to give employers, health plans, health systems, governments, and communities unmatched insight into the state of their populations.

 

Six domains of well-being comprise the national Well-Being Index, including life evaluation, emotional health, work environment, physical health, healthy behaviors, and basic access.  In this year’s report, Gallup and Healthways found that over the six years of their well-being measurement Americans’ life evaluations have improved, emotional health and healthy behaviors have remained stable, and basic access, physical health, and work environment have declined. The three most prominent trends that have impacted the national score since 2008, are:

 

  • Annual decreases in the rate of those with health insurance
  • Rising rates of obesity
  • Declining work environment scores

The full report is downloadable at www.well-beingindex.com. Additionally, individual state-level reports are now available when you click to download the full report.

 

 

11. HOW HEALTHY IS YOUR COUNTY? 2014 COUNTY HEALTH RANKINGS RELEASED

 

The Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute have released the 5th edition of the County Health Rankings & Roadmaps report.  Updated annually, this interactive map measures vital health factors, including social determinants of health, in nearly every county in the United States.  Providing a snapshot of the influences on health, program data can be used as a starting point for community health changes with guidance and tools to promote action. 

 

Research and Reports

 

12. SMOKING STAYS STUBBORNLY HIGH AMONG THE POOR

 

The Institute for Health Metrics and Evaluation has released a new analysis of federal smoking data that reveals a strong disparity between the poor and the affluent. The study evaluated federal survey data from 1996 to 2012 to produce smoking rates by county, finding that wealthy counties have seen the largest and quickest decline in smoking rates, while the poorest counties have seen their rates hold steady.  For example, in the wealthier counties surrounding Washington DC, only 1 in 10 people smoke. But in the more economically depressed counties of eastern Kentucky, nearly 4 in 10 smoke.  This dramatic gap in smoking rates is responsible for increasing the inequality of health outcomes across the country.

 

13DESPITE PROGRESS, HOSPITAL INFECTIONS INFLICT THREE-QUARTERS OF A MILLION PEOPLE EACH YEAR

 

New data released by the Centers for Disease Control and Prevention show that progress has been made to eliminate common hospital infections but more improvement is needed to reduce infection rates.  The data reveal that approximately one in 25 hospital patients obtain at least one hospital acquired infection during the course of their care, which leads to about 722,000 avoidable infections in a year.

 

The CDC details the scope of national and state level infection estimates in two reports –Multistate Point-Prevalence Survey of Health Care-Associated Infections, published in the New England Journal of Medicine, and the other, National and State Healthcare-associated Infection Progress Report.

 

 

14. IOM: APPLYING A HEALTH LENS TO DECISION MAKING IN NON-HEALTH SECTORS

 

The Institute of Medicine (IOM) Roundtable on Population Health Improvement has issued a workshop summary on “Applying a Health Lens to Decision Making in Non-Health Sectors.” Recognizing that decision-making and policy development in transportation, housing, and education can have significant impacts on health, the IOM Roundtable convened a workshop to foster cross-sectoral dialogue. This report summarizes presentations and discussions held during the September 2013 workshop; including how social policies shape health, successful interagency collaborations, issues and strategies for working across sectors to improve health, and Roundtable member observations on the main themes from the workshop and perspective for moving forward.

 

15HEALTH REFORM DRIVING MORE PEOPLE TO RETAIL WALK-IN CHAINS

 

An article published in the Washington Post found that retail health walk–in care clinics are becoming the fastest growing profit center for many retail chains and represent a trend that focuses on augmenting the traditional doctor’s office visit. While several factors are driving the demand for more health care in retail stores, the most prominent is the Affordable Care Act and the new access it provides to millions of consumers to obtain health coverage.  As more people gain coverage, there is a growing deficit in primary care doctors to treat them—a shortfall expected to reach 45,000 by 2020, according to the Association of American Medical Colleges.

 

Walk-in clinics are staffed mainly by Nurse Practitioners and Physician Assistants and focus on treating frequent, non-life-threatening illness along with preventive care. There are currently 1,600 walk-in care clinics nationwide, although CVS, one of the largest national providers of walk-in clinics, estimates it will expand its Minute Clinics from the current 800 to 1,500 by 2017.

 

16FORGOTTEN NEGATIVES: THE LIMITS OF TREATMENT AS PREVENTION

 

A recent article by the Treatment Action Group (TAG)—an independent AIDS research and policy think tank fighting for better treatment, a vaccine, and a cure for AIDS—highlights the impact of the Centers for Disease Control and Prevention’s (CDC) High-Impact Prevention strategy, designed to target limited prevention dollars to evidence-based and cost-effective interventions in order to maximize results.  As the primary funder of HIV prevention efforts in the United States, CDC redesigned and rebranded its approach in 2011 recognizing that funding of U.S. HIV prevention programming is unlikely to see necessary increases anytime soon.  The strategy was also meant to reallocate funding to the regions and key populations that are most in need of HIV prevention services.

 

The article notes how strategies including treatment as prevention (TasP) are essential in any national effort to finally rein in new infection rates in the most affected communities. However, the article also underscores the limitations of CDC’s approach, particularly not including an ambitious plan for those at risk for the virus.  TAG describes CDC’s lack of focus on HIV-negative individuals as “a tactical misstep that leaves people who are most at risk for acquiring HIV with few effective options.”  One strategy being developed and explored by TAG is the creation of an HIV prevention continuum, similar to the HIV care continuum model that has already essentially defined key outcomes required for disease management and TasP.

 

Announcements

 

17MEMBERS IN THE NEWS: SOKOL, STIEGMANN


Michael Sokol, MD, MS, FACPM
was recently appointed as the Chief Wellness Officer for Sanofi, a leading global health care and pharmaceutical company.  In this role, Dr. Sokol is responsible for designing, implementing, and measuring a fully integrated health and wellness strategy for the employee population and their families.  The goal is to create a culture of health by promoting a healthy work environment and providing employees with the tools and resources they need to manage their health along the entire health care continuum. Dr. Sokol held prior physician executive positions over the past 20 years at Merck, GlaxoSmithKline, and Medco Health Solutions.


Congratulations to Regan A. Stiegmann, MS-4, ACPM-MSS President, who was selected to receive a 2014 Excellence in Public Health Award from the U.S. Public Health Service Physician Professional Advisory Committee.  The USPHS Excellence in Public Health Award is offered to medical students who are actively involved and engaged within the fields of Preventive Medicine and Public Health.  This award is extended to students based on the level of leadership they demonstrate, the impact of the student’s work, and the student’s commitment to a career in public health/preventive medicine.      

 

 

 



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