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ACPM Headlines 4/23/12
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In This Issue:

Top Stories

1. IOM report calls for doubling in public health spending

2. ACPM meets with HRSA chief of public health

3. Report reveals uneven quality of care at U.S. community health centers


ACPM News

4. Perspectives in Prevention: ACA and Cancer Surveillance Informatics

5. ACPM adopts two policy resolutions: Modernization of Federal TSCA; and Breastfeeding

6. ACPM welcomes two new staff

 

Policy and Practice

7. Evidence review on chronic kidney disease released

8. Community Guide releases recommendation on depressive disorders

9. FDA releases voluntary plan to get antibiotics out of animal feed


Research and Reports

10. Study estimates calorie reductions needed to achieve obesity-prevention goals

11. Teen birth rates at all-time low

12. What is behind the continuing downward trend in health care utilization?


Announcements

13. ACLM announces annual meeting

14. Updated action plan on healthcare-associated infections

15. Members in the News: Finnel; Lednar (RIP)

 
Top Stories

1. IOM COMMITTEE CALLS FOR DOUBLING IN PUBLIC HEALTH SPENDING

The Institute of Medicine has released a report that notes the best way to slow the nation's breakneck spending on medical care is to double our nation’s investment in public health by imposing a new tax on medical care. The report, "For the Public’s Health: Investing in a Healthier Future,” calls for an increase in public health spending from $11.6 billion to $24 billion a year "as a starting point to meet the needs of public health."

"Viewing US health problems through a funding lens reveals two issues: (1) insufficient

funding for public health and (2) dysfunction in how the public health infrastructure is funded, organized and equipped to use its funding…Solving the challenges described in this report will empower public health to "bend the curve” on health risks, contributing to a decrease in the volume of people who require medical care for preventable conditions, and in a broader sense, leading to improved population health outcomes,” concludes the report.

To view a copy of the IOM report visit http://bit.ly/JeotX9.

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2. ACPM MEETS WITH HRSA CHIEF OF PUBLIC HEALTH

ACPM representatives recently met with the Health Resources and Services Administration’s (HRSA) Chief Public Health Officer Sarah Linde-Feucht, MD to discuss federal funding for preventive medicine residency training programs and the recent IOM report on integrating primary care and public health.

The ACPM team was led by president Miriam Alexander, MD, MPH, FACPM, joined by executive director Mike Barry, associate executive director for policy and government affairs Paul Bonta, and current Pfizer health policy resident Young-Rok Shin, MD. ACPM’s representatives expressed the strong and unique skill set preventive medicine physicians bring to bear across health systems and that any strategy aimed at integrating primary care and public health should recognize preventive medicine physicians as a core component. The ACPM team also stressed the need to allocate increased federal funding to preventive medicine residency training programs, particularly in light of the substantial Prevention and Public Health Fund allocations to HRSA’s public health workforce programs.

For more information, please contact Paul Bonta at pbonta@acpm.org or 202-466-2044, x110.

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3. REPORT REVEALS UNEVEN QUALITY OF CARE AT U.S. COMMUNITY HEALTH CENTERS

Hundreds of the nation's nearly 1,200 federally-funded community health centers fall short on key quality of care measures, according to federal data analyzed by Kaiser Health News and USA Today. The level of care varies widely, including by region: Centers in the South generally perform worse than those in New England, the Midwest and California. The centers' performance most often lagged national averages on helping diabetics keep their blood sugar under control and screening women for cervical cancer.

Specifically:

  • Nearly 75 percent of centers performed significantly worse—at least 10 percent below the national average for the entire U.S. population—for cervical cancer screening rates. While 75 percent of U.S. women had at least one Pap test for cervical cancer in the past three years, the average was 58 percent for women in community health centers.
  • About 73 percent performed significantly below average in helping diabetics maintain their blood sugar levels.
  • About 28 percent of centers performed significantly below average for immunizing 2-year-olds.

After doubling the number of patients served in the past decade to more than 20 million people a year, the mostly privately run, nonprofit centers are coming under increased pressure as they gear up for a major expansion under the health care law. Beginning in 2014, about 30 million Americans are expected to gain health coverage, half through Medicaid. Congress authorized $10 billion to expand the centers' capacity on the assumption many of the newly covered would seek care there.

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ACPM News

4. PERSPECTIVES IN PREVENTION: AFFORDABLE CARE ACT AND CANCER SURVEILLANCE INFORMATICS

The first two ACPM Perspectives in Prevention columns for 2012 have posted on Medscape/WebMD. The first, "Preventive Health Services Under the Affordable Care Act: Role of Delivery System Reform," by ACPM Member Anthony Shih, MD, MPH, Julia Berenson, MSc, and Melinda Abrams, MS, addresses provisions of the Affordable Care Act that could have the greatest impact on the use of preventive services. It also addresses the role of healthcare reform in increasing access to insurance coverage, reducing financial barriers to care, and improving the care delivery system. This column offers CME credit.

The second, "Cancer Surveillance Informatics: Where Health Statistics, Information Systems, and Clinical Decision-Making Intersect,” was written by ACPM Member Manijeh Berenji, MD, MPH and May Darwish-Yassine, PhD. This column provides clinicians and healthcare professionals with a better understanding of the burgeoning field of comprehensive population-based cancer surveillance informatics and its potential patient-centered clinical applications. It reviews the history of cancer surveillance in the United States, describes the current systems, and evaluates the utility of informatics. This column will soon be available for CME.

The columns can both be accessed through ACPM’s website at http://www.acpm.org/?PerspectivesPrevent.

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5. ACPM ADOPTS TWO RESOLUTIONS: MODERNIZATION OF FEDERAL TSCA AND BREASTFEEDING

The ACPM Board of Regents has adopted two ACPM policy resolutions. The first, Modernization of the Federal Toxic Substances Control Act (TSCA) of 1976, was developed by the ACPM Environmental Health Committee and will be submitted to the AMA House of Delegates. The resolution calls on the AMA to support modernizing the TSCA to require chemical manufacturers to provide adequate safety information on all chemicals and gives federal regulatory agencies the authority to regulate hazardous chemicals; support the public disclosure of chemical use, exposure and hazard data in forms that are appropriate for use by medical practitioners, workers, and the public; and work with the Federation of medicine to promote a reformed TSCA that is harmonized with REACH.

The second, Protection, Promotion and Support for Breastfeeding: Essential Preventive Medicine Practices, was introduced by the ACPM Breastfeeding Interest Group. It resolves that ACPM will endorse and share with ACPM membership the January 2011 Surgeon General’s Call to Action to Support Breastfeeding (http://bit.ly/IDO8tm) and call on ACPM members to support its recommendations, with attention to the Ten Steps to Successful Breastfeeding in maternity facilities and the limitation of formula marketing. It also resolves that ACPM will explore opportunities to renew ACPM membership in the United States Breastfeeding Committee.

Both resolutions can be found at http://www.acpm.org/?Policy_Issues.

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6. ACPM ANNOUNCES NEW STAFF ADDITIONS

ACPM is pleased to announce the hiring of two new staff members—Camille Sanders and Maureen Simmons. Ms. Sanders, ACPM’s new Membership Manager, is a polished professional coming from the American Association of Pharmaceutical Scientists. She brings a wealth of association management experience in membership and marketing, along with a passion for customer service and for cultivating and growing a membership. She will be starting on May 1, and you can reach her after that date at csanders@acpm.org.

Ms. Simmons, ACPM’s new Chief Development Officer, brings over 15 years of experience in fundraising and development, including five years with the American Society of Radiologic Technologists Education and Research Foundation. She holds a masters degree in philanthropy and development and is a certified fundraising executive. Maureen brings high energy and passion to the position, and will help ACPM in expanding its strategic alliances and corporate partnerships, growing revenues, and developing a business plan to assure long-term financial stability for the College. She is already off and running, and can be reached at msimmons@acpm.org.

Welcome Camille and Maureen!

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Policy and Practice

7. EVIDENCE REVIEW ON CHRONIC KIDNEY DISEASE PUBLISHED

The Annals of Internal Medicine has published a review of the evidence on screening for, monitoring, and treatment of chronic kidney disease stages 1 to 3. This review is based on a report that was posted for public comment from March 22 to April 6, 2011, through a partnership with the Agency for Healthcare Research and Quality’s Effective Health Care Program. The evidence review will inform the U.S. Preventive Services Task Force’s forthcoming draft recommendation statement on screening for chronic kidney disease. The evidence review is available at http://bit.ly/JrVA9X.

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8. COMMUNITY GUIDE TASK FORCE ISSUES RECOMMENDATION ON DEPRESSIVE DISORDERS

The Task Force on Community Preventive Services (Task Force) has issued a recommendation on collaborative care to improve the management of depressive disorders. Based on strong evidence of effectiveness in improving depression symptoms, adherence to treatment, response to treatment, and remission and recovery from depression, the Task Force recommends collaborative care for the management of depressive disorders. The Task Force also finds that collaborative care models provide good economic value based on the weight of evidence from studies that assessed both costs and benefits.

To read the full Task Force recommendation visit http://bit.ly/HWqdtQ.

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9. FDA TAKES STEP TOWARD PHASE OUT OF ANTIBIOTICS IN FARM ANIMALS

The Food and Drug Administration (FDA) recently published draft guidance aimed at the drug and livestock industry to voluntarily phase out the routine use of medically important antibiotics from farm animal feed. The action comes on the heels of a U.S. District Court ruling in New York that ordered the FDA to take action to stop use of penicillin and tetracyclines in livestock feed because they threaten human health.

ACPM, as an active member of the national Keep Antibiotics Working coalition, has been a strong proponent of new measures to thwart the use of antibiotics in farm animals.

To read the draft guidance visit http://bit.ly/Isn1AZ.

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Research and Reports

10. STUDY ESTIMATES CALORIE REDUCTIONS NEEDED TO ACHIEVE OBESITY-PREVENTION GOALS

According to a study published in AJPM, researchers predict that without changes to eating and activity, more than one in five young people could be obese by 2020. The study reports that in order to achieve goals set by the federal government for reducing obesity rates by 2020, children in the U.S. would need to eliminate an average of 64 excess calories per day. Without this decrease, the authors predict that the average U.S. youth would be nearly four pounds heavier than a child or teen of the same age was in 2007-2008, and more than 20 percent of young people would be obese, up from 16.9 percent today. To read the full article in AJPM, visit http://bit.ly/HXI2ES.

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11. TEEN BIRTH RATES REACH ALL-TIME LOW

Birth rates for U.S. teenagers reached an all-time low in 2010, according to data published this month from CDC’s National Center for Health Statistics. The U.S. teen birth rate declined 9 percent from 2009 to 2010, reaching a historic low at 34.3 births per 1,000 women aged 15–19. The rate dropped 44 percent from 1991 through 2010. Among other key findings:

  • Teen birth rates by age and race and Hispanic origin were lower in 2010 than ever reported in the United States.
  • Fewer babies were born to teenagers in 2010 than in any year since 1946. If the teen birth rates observed in 1991 had not declined through 2010 as they did, there would have been an estimated 3.4 million additional births to teens during 1992–2010.
  • Teen birth rates fell in all but three states during 2007–2010. Teen birth rates by state vary significantly, reflecting in part differences in the population composition of states by race and Hispanic origin.

Although teen childbearing has been generally on a long-term decline in the U.S. since the late 1950s, the U.S. teen birth rate remains one of the highest among other industrialized countries. To view recent trends and variations in teen childbearing, visit the NCHS Data Brief at ow.ly/ad4MC.

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12. EXPERT PONDERS CONTINUED DOWNWARD TREND IN HEALTH CARE UTILIZATION

Drew Altman, Ph.D., president and CEO of the Kaiser Family Foundation, recently posted a blog, "The Falloff in Utilization: There's Something Happening Here, What it is Ain't Exactly Clear,” where he examines the recent downward trend in health care utilization. Dr. Altman writes, "For as long as I have been in the field, we have seen cycles in health care costs. Per capita health spending would rise, then moderate, then rise gain… But (today) utilization continues downward even after the recession technically ended in June of 2009 and the economy started to slowly recover.”

Dr. Altman attributes the continued decline in utilization to the growth we have seen in cost-sharing and high deductible plans, which can lead consumers to purchase fewer health care services.

To read Dr. Altman’s article visit http://t.co/1XUIDT7p.

Member comments on and discussion of this article are encouraged. Click here and use your ACPM member log-in name and password to engage in discussion with your peers about this article. 

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Announcements

13. LIFESTYLE MEDICINE 2012: TREATING THE CAUSE

American College of Lifestyle Medicine and ACPM present Lifestyle Medicine 2012: "Treating the Cause," a clinical conference and practice management workshop, September 30 - October 3, 2012 at the Inverness Hotel and Conference Center in Englewood, CO. Register in April and receive up to $300 in early-bird savings. For more information, visit http://www.lifestylemedicine.org/LM2012.

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14. HHS RELEASES FOR PUBLIC COMMENT UPDATED PLAN TO ELIMINATE HEALTHCARE-ASSOCIATED INFECTIONS

The Department of Health and Human Services (HHS) has posted online an updated National Action Plan to eliminate healthcare-associated infections (HAIs) for public comment. The update confirms progress in the effort to make healthcare safer and less costly by reducing preventable complications of care, including HAIs.Visit http://ow.ly/aq7RD for more information and to submit comments.

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15. MEMBERS IN THE NEWS: LEDNAR AND FINNEL

  • ACPM is saddened to share the news of the passing of ACPM Fellow Wayne Lednar, MD, PhD, MPH, FACPM, who died suddenly at his home on April 6, 2012. Dr. Lednar completed a pediatric internship at Madigan Army Medical Center in Tacoma, WA, before completing a residency in preventive medicine at the Walter Reed Army Institute of Research in Washington, D.C.; became Director of Walter Reed's preventive medicine residency program and subsequently held the same position at Madigan Army Medical Center; was recruited by Kodak in 1988 to be its head epidemiologist and then served as its Corporate Medical Director until 2007, when he took the position as Vice President and Global Medical Director at DuPont in Wilmington, DE until the present day. He retired as a Colonel in the U.S. Army Reserves. Following his retirement from the U.S. Army, despite holding leadership positions in industry as well as a number of academic positions, Dr. Lednar exhibited tireless devotion to both the Armed Forces Epidemiological Board and the Defense Health Board as a member of the AFEB and a co-vice president of the DHB. He served on multiple critical AFEB and DHB subcommittees and work groups. As noted by his colleagues on the DHB, "With his passing the Nation has lost a treasure, and the Board a friend.” 

    Memorial donations may be directed to the Wounded Warrior Project, or to Third Presbyterian Church. To share a memory or photo of Dr. Lednar, visit www.anthonychapels.com.
  • Congratulations to ACPM Member Val Finnel, MD, MPH, who has been selected as the new preventive medicine program director at the U.S. Air Force School of Aerospace Medicine. He currently is the Chief of Medical Staff at the LA Air Force Base.

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