|ACPM Headlines 11/23/15|
Policy and Practice
Research and Reports
1. HUD SECRETARY AND SURGEON GENERAL ANNOUNCE SMOKE-FREE PUBLIC HOUSING RULE
Surgeon General Vivek Murthy, MD, and Secretary of Housing and Urban Development (HUD) Julian Castro have announced a proposed rule to make the nation’s public housing properties entirely smoke-free. The proposed rule would require more than 3,100 public housing agencies (PHAs) across the country to implement smoke-free policies in their developments within 18 months of the final rule.
Under the proposed rule, PHAs must implement a policy prohibiting lit tobacco products (cigarettes, cigars or pipes) in all living units, indoor common areas, administrative offices and all outdoor areas within twenty-five feet of housing and administrative office buildings. Public comment on the proposed rule will be accepted through January 19th.
This action comes in response to a call for action from the public health community, including a letter signed by ACPM and more than 30 other organizations to the HUD secretary in the spring.
ACPM has established a new annual award, the "Distinguished Federal Preventive Medicine Medical Officer” award, and is seeking nominees from the membership. The award is intended to recognize outstanding contributions and achievements of physicians in federal service toward preventive medicine goals. All physicians practicing preventive medicine in federal agencies and in military service—including ACPM members and non-members, uniformed services or civil service positions—are eligible for the award.
Additional detail about the award, including the review criteria, can be found on the ACPM web site. The deadline for submission is December 31, so please act quickly and nominate a deserving colleague. The awardee will be announced in conjunction with Preventive Medicine 2016, February 24-27, in Washington, DC.
Your contribution to the 2015 Annual Fund, and those from your fellow members, helps ACPM be a strong and vibrant leader in the field of preventive medicine. When you make a gift, you support your professional society of more than 2,700 physicians working in research, academia, government, clinical settings, and other entities worldwide.
This year has been a one of tremendous growth and impact for ACPM, made possible through the generous support of ACPM members and your colleagues committed to the work of the ACPM. Making your gift today is a partnership in supporting our mission and enabling ACPM to continue to pursue its highest priority initiatives, programs that contribute to our shared goal of preventing disease and promoting health and wellbeing among individuals and populations.Every single gift we receive, both large and small, helps. Please join me by making your gift today by visiting 2015 Annual Fund.
If you have any questions regarding the Annual Fund or any other activities related to the fundraising program, please contact Maureen Simmons, MA, CFRE, Chief Development Officer, at email@example.com or 202-466-2044, ext. 120.
With kind regards for all you do to support preventive medicine,
Miriam Alexander, MD, MPH, FACPM
4. ACPM PROVIDES $40,000 IN SCHOLARSHIP SUPPORT FOR EMERGING HEALTH SYSTEMS LEADERS
For the second consecutive year, ACPM, in partnership with Georgetown University, is pleased to offer as an exciting member benefit scholarship support for the Executive MHSA Program at Georgetown University. This is a competency-based, multidisciplinary program that grants a Master of Science in Health Systems Administration degree.
The program of study is offered with both synchronous and asynchronous online coursework (scheduled on Tuesday and Thursday evenings) to allow participation by working professionals across the country and two weeks of in-person intensive coursework (on the Georgetown campus and with international travel opportunities) per year. The two-year program includes concentrations that focus on leadership and leading change, health care strategy, management & policy, quality and patient safety, financial and health outcomes, as well as population health (with an emphasis on the competencies required by the American Board of Preventive Medicine for board certification).
ACPM members admitted into the program will be designated as ACPM Scholars and will receive $20,000 per year in direct scholarship support applied to tuition costs. More information about the program and its admissions requirements is available at ExecutiveMHSA.georgetown.edu. Questions should be directed to ACPMscholars@acpm.org.
ACPM had a strong presence at the recent American Public Health Association Conference in Chicago, October 29–November 2. ACPM Executive Director Michael Barry participated in an APHA Science Board panel titled, "Integrating Primary Care and Public Health through Prevention: Leading Wedge Policies to Create the Healthiest Nation in a Generation.” His presentation, "Population Health in Health Care Systems: The Role of Preventive Medicine in Health Systems Transformation,” highlighted the work ACPM currently is leading on Health Systems Transformation.
Associate Executive Director Dani Pere also attended and presented during a CDC Cooperative Agreement Grantee meeting. This meeting provided the opportunity for CDC grantees to share updates on their projects, collaborate on potential work, and develop stronger relationships. ACPM Board of Regents member Wendy Braund, MD, MPH, MSEd, FACPM, also participated in both sessions.
ACPM participated in the recent AMA interim House of Delegates meeting in Atlanta, where physicians from across the country gathered to contribute to the AMA policy agenda. Although ACPM did not introduce any resolutions for consideration at this meeting, its AMA delegation was busy working with its partners in the Section Council on Preventive Medicine to build support for several resolutions, which called on the AMA to: encourage the development and dissemination of evidence-based public awareness campaigns aimed at increasing vaccination rates; address the need to eliminate barriers to health care access for incarcerated individuals; and support publicizing the importance of teaching Cardiopulmonary Resuscitation (CPR), including the use of automated external defibrillation, and advocate the widespread placement of automated external defibrillators.
ACPM would like to thank its delegate Rob Gilchick, MD, MPH, FACPM, alternate delegate Jason Spangler, MD, MPH, FACPM and representative Wendy Braund, MD, MPH, FACPM, for their successful representation of ACPM and promotion of the preventive medicine agenda during the meeting. ACPM is always interested in hearing your ideas about policy resolutions it could champion at the AMA meetings. If you have an idea for an AMA policy resolution please contact Paul Bonta at firstname.lastname@example.org.
ACPM was a proud supporter of the inaugural National Obesity Care Week, observed November 1-7, 2015. The new initiative aimed to advance a comprehensive, compassionate, and personalized approach to treating obesity as a disease and improve care for the millions of people affected by obesity.
To further support the new initiative, ACPM President Dan Blumenthal authored the opinion article, "Caring for People With Obesity, Not Statistics," which recently was published in theMorning Consult.
8. AAP SAYS RAISE TOBACCO AGE TO 21 AND REGULATE E-CIGARETTES
The American Academy of Pediatrics (AAP) has released a policy statement recommending raising the legal age to purchase tobacco to 21 across the United States. Currently only one state—Hawaii—and about 90 cities in several other states have increased the minimum age to purchase tobacco products to 21. The statement is one of several recommendations aimed at tightening regulations on cigarettes, e-cigarettes, tobacco and nicotine products to reduce youth smoking and nicotine addiction.
In another statement AAP calls for the U.S. Food and Drug Administration to regulate e-cigarettes the same way it regulates other tobacco products. This includes age restrictions, taxes, bans on advertising to youth, and bans on flavored products that are particularly attractive to youth. The AAP also recommends smoke-free laws that already govern secondhand smoke be expanded to include e-cigarettes. AAP has included evidence in the statement to show that use of e-cigarettes among teens is associated with a higher likelihood of using regular tobacco products and lower rates of cessation.
The recently updated American Cancer Society (ACS) mammogram guidelines, which recommend annual screenings for healthy women between the ages of 45 to 54 and screenings every other year for women over 54, are causing controversy within the medical community. Many of the nation’s top cancer centers, including Memorial Sloan Kettering, MD Anderson Cancer Center, and the National Comprehensive Cancer Network, have all announced that they will not follow ACS’s new guidelines. They contend the guidelines may place too much emphasis on potential harm from false positive readings in women receiving regular mammograms.
The new cancer society guidelines are closer to those of the U.S. Preventive Services Task Force (USPSTF). The USPSTF received similar criticism back in 2009 when it recommended that most healthy women without increased breast cancer risk wait until age 50 to begin mammography, and then undergo the procedure every other year.
Some doctors argue that the new guidelines are not all that different from ACS’s prior guidelines, which called for annual mammograms for women beginning at age 40. The guidelines still support the right of women 40 to 44 to get yearly mammograms if they want them.
The Community Preventive Services Task Force has released two new sets of recommendations:
Early Childhood Education Programs: The Task Force recommends early childhood education (ECE) programs to improve long-term health and social outcomes. When these programs are provided to children from low-income and racial and ethnic minority communities, ECE programs are likely to reduce educational achievement gaps, improve the health of student populations and promote health equity. These programs are for cognitive or social development of children of ages three or four and involve a variety of components including literacy, numeracy, and motor skills. These recommendations are based on a 2014 meta-analysis of 49 center-based school programs for low-income children ages three and four.
School-based sealants: The Task Force recommends school-based sealant delivery programs to prevent dental caries. The recommendation is based on strong evidence that shows that these programs increase the number of children who receive sealants at school. These sealants also show a large reduction in tooth decay among school aged children (ages 5 to 16). The recommendation is based on four studies that looked at the effectiveness of programs that deliver sealants in school-based settings and one systematic review of the efficacy of sealants among school-based kids.
The Food and Drug Administration (FDA) has announced that it would let Swedish Match North America sell eight snus smokeless tobacco products, the first time a new tobacco product has been approved since the agency was granted such authority under the Tobacco Control Act of 2009.
FDA’s action "demonstrates that the pre-market tobacco application process is a viable pathway under which products can be marketed as long as the public health can be protected,” said Mitch Zeller, director of FDA’s Center for Tobacco Products. The FDA review found that the snus products would likely provide less toxic options if current adult smokeless tobacco users used them. However, the approval does not allow the company to market the products as less harmful than others.
12. LOWER BLOOD PRESSURE TARGET CAN REDUCE CARDIOVASCULAR DEATHS
According to a landmark National Institutes of Health (NIH) Systolic Blood Pressure Intervention (SPRINT) Trial, published in the New England Journey of Medicine, treating patients 50 years and older with high blood pressure to lower their blood pressure to 120 Hg systolic (as opposed to 140 Hg systolic) reduces the risk of cardiovascular disease and can save lives. The study demonstrates that reducing the blood pressure of patients to 120 Hg systolic reduces cardiovascular events, including heart failure, stroke and heart attack, by 25%. Additionally, reducing the systolic blood pressure to 120 Hg reduced deaths due to all cardiovascular events by 27% compared to reducing the systolic blood pressure to 140 Hg.
The NIH-sponsored trial enrolled more than 9,300 participants from a diverse population, ages 50 and older, with a high risk for cardiovascular events. The study observed certain adverse events—including low blood pressure, fainting, electrolyte abnormalities and acute kidney damage—among participants randomized to the 120 Hg systolic group. However, other consequences associated with low blood pressure, including falls with injuries and slow heart rate, were not observed in the intensive 120 Hg systolic group. The trial continues to examine kidney disease, cognitive function and dementia among SPRINT participants and the result of these will be collected and analyzed over the year.
Most boys in the United States are not getting the HPV vaccine along with other scheduled inoculations, according to a study by the U.S. Centers for Disease Control and Prevention (CDC). The most-often cited reason—reported by 24% of parents whose sons between the ages of 13-17 did not get shots—was that doctors fail to recommend or explain the benefits to the parents. Parents also cited a lack of understanding about the vaccine as another reason. Nearly one in five parents felt that the vaccine was not needed, and 7% had safety concerns.
There has been some improvement in vaccination rates, however, with 42% of boys between the ages of 13-17 receiving at least one dose of HPV in 2014, up from about 33% in 2013. Similarly, 21.6% of boys received the full three-dose vaccine in 2014, up from less than 14% in 2013.
In another CDC study, HPV vaccination rates among 11- and 12-year old American girls remain too low. Only 12% of girls who were privately insured and 19% of girls who were covered by Medicaid received all three doses of the vaccine. Knowledge of barriers and attitudes of clinicians or family members contribute to low vaccination coverage.
A new Journal of the American Medical Association (JAMA) study reveals that paying patients to take their cholesterol medicine more consistently does not translate into better adherence. Neither does paying physicians. However, giving both patients and doctors financial incentives to stay on track in monitoring and controlling cholesterol levels does lead to slightly better outcomes.
15. ACLM ANNOUNCES LAUNCH OF TRUE HEALTH INITIATIVE
The American College of Lifestyle Medicine at its recent annual meeting in Nashville announced the official launch of The True Health Initiative, a growing coalition of more than 250 world-renowned health experts "committed to cutting through the noise and educating on only the time-honored, proven principles of lifestyle as medicine.” Coalition members include physicians, scientists, nutritionists and authors from nearly 30 countries, including many Fellows and leaders of ACPM.
Spring boarded by ACLMand the Turn the Tide Foundation, the Coalition has been formed to help demonstrate that, despite appearances to the contrary, there is in fact overwhelming agreement among diverse experts worldwide about the theme of healthful eating and living. A basic goal of the initiative is to convey this consensus to the public and to replace the competing claims, changing views, and fad diets that now seem to prevail with reliable, actionable understanding. Other objectives include global reforms in both medical education and practice related to lifestyle medicine; and support for efforts to foster health-promoting culture change, such as the Blue Zones Project®.
Drawing on current research and the expertise of world-recognized leaders in public, global, clinical, and social health in both developed and developing nations, this book by George Lueddeke, PhD, delivers an evidence-based examination of 21st-century challenges in global population health and well-being.
Global Population Health and Well-Being in the 21st Century: Toward New Paradigms, Policy, and Practice promotes innovative and transformative paradigms for global public health practice, curricula, workforce training, and leadership.
The publisher has placed introductory pages, Chapter 1,and open-access ancillary materials—research tools and book aims/educational objectives—online. ACPM is profiled in the book in Appendix A1 - Profiles of Leading Global, Regional, and National Health Organizations.
ACPM Member Scott Kahan, MD, MPH, has been named Chair of the Clinical Committee for The Obesity Society. Congratulations Dr. Kahan! Dr. Kahan also will be moderating and speaking at the Obesity Medicine Institute at Preventive Medicine 2016.
Atlas Research, led by its Chief Executive Officer and ACPM Board Member, Ryung Suh, MD, MPH, MBA, has been named Contractor of the Year by the Fairfax County Chamber of Commerce and Professional Services Council. Congratulations to Dr. Suh and his team!
Preventive Medicine Fellowship: The City of New York Department of Health and Mental Hygiene has announced an open position for a fellow in public health practice. The Fellowship will provide on-the-job training and mentoring to a recent public health/preventive medicine residency graduate or early-career physician in the areas of graduate and undergraduate medical education, public health practice, and residency administration to prepare the Fellow for a future leadership position. The Fellow will serve for one year beginning July, 2016 (flexible).
Board Certification or Eligibility in Public Health/Preventive Medicine is preferred. Applications will be accepted until March 15, 2016 and will be reviewed on a rolling basis until the position is filled. Please click here for more information.