|ACPM Headlines 4/10/14|
In this Issue
Policy and Practice
Research and Reports
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.
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
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.
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.”
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.”
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.
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).
see the Progress Update
for more information.
9. UPDATES FROM CLINICAL AND COMMUNITY PREVENTIVE SERVICES TASK FORCES
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 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.
10. GALLUP-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:
11. HOW HEALTHY IS YOUR COUNTY? 2014 COUNTY HEALTH RANKINGS RELEASED
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
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
13. DESPITE 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
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.
15. HEALTH 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.
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.
16. FORGOTTEN 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.
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.
17. MEMBERS IN THE NEWS: SOKOL, STIEGMANN