Tag: public health

Conference Highlights Rapid Growth of Health Impact Assessments in the United States

Apr 22, 2012

By Aaron Wernham

According to a recent poll in Washington State, 71 percent of voters supported a bill that would require the state to consider impacts on people’s health when planning new transportation projects. This poll speaks to the growing recognition that illnesses like asthma, obesity, and diabetes, as well as injuries are shaped by the conditions in the places where we live and work. To address this, we need to factor health into decisions in fields like transportation, energy, housing, and agriculture.

The level of interest in the inaugural National Health Impact Assessment (HIA) Meeting held April 3 and 4 in Washington, D.C., highlights that this approach has become a centerpiece of community, state, and national efforts to improve Americans’ wellness. An HIA is a type of study that allows decision makers to factor health into projects like planning roads, passing agriculture policy, and siting schools. I have been using HIAs for over eight years, and until recently, I knew most of the people in the field. In organizing the National HIA Meeting, I worried that we might not find 200 people to attend. Instead, we had to close registration six weeks early: more than 430 leaders in public health, urban planning, housing, transportation, agriculture, and environmental regulation participated, and many more were on the waiting list.

The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, sponsored the two-day meeting, along with The California Endowment, the Centers for Disease Control and Prevention, and the National Network of Public Health Institutes.

Keynote speaker Jonathan Fielding, the director of the Los Angeles County Department of Public Health who also chairs the U.S. Community Preventive Services Task Force, gave an overview of the fast-growing approach. “The first HIAs were done roughly 12 years ago in the United States,” he said. “There has been huge progress in this field.”

At the Health Impact Project, we are tracking this growth. Today, nearly 200 HIAs have been completed or are ongoing. In 2007, there were only 27 such studies on the books.

Is mHealth Just Another Gimmick?

Mar 19, 2012• 2

By Sanjay Bansu, MD

The use of cell phones by community health workers and other medical practitioners in low-income countries has been promoted as a potential revolution for health systems development. This “mHealth” revolution has been seen as an opportunity to develop diagnostic, treatment and surveillance networks wirelessly, to build mobile apps allowing remote nurses and doctors to provide higher-quality care to rural patients even in places without a hospital or well-functioning health clinic. Several foundations are now offering grants to build and distribute phone applications that will offer everything from prescription drug advice to epidemic surveillance tools. But is mHealth really going to improve health outcomes? Or is it just another technological bomb thrown at poverty and poor infrastructure?

The theory

Globally, about 3.1 billion people used mobile phones in 2007; that’s nearly half the planet. The greatest growth during the last decade has occurred in Asia, the Middle East, and Africa. In many of these continents, mobile phone subscribers outnumber fixed-line telephone subscribers, particularly as countries leap-frog over the traditional development step of planting land-lines and rely instead on building wireless communication towers and Internet-based businesses.

Is Nanotechnology the New GMO?

Dec 21, 2011

By Marion Nestle

Food Navigator reports that UK experts are demanding public debate and regulation of nanomaterials in foods. Without that, they warn, nanotechnology risks “facing the same fate as genetically modified (GM) foods in consumer perceptions.”

Nanotechnology is about manipulating materials on the scale of atoms or molecules, measured in nanometers (nm), one billionth, or 10⁻⁹, of a meter.

Many companies are already using nanomaterials in agriculture, food processing, food packaging, and supplements. This is not something the public has heard much about. Food companies often don’t know whether or not they are using these materials.

Nanotechnology science is new, and the industry is unregulated.

The FDA’s nanotechnology web page links to a quite thorough 2007 report from a task force, but the agency’s only guidance to date tells companies how they can find out whether they are using nanomaterials.Continue reading…

Is the Foreclosure Crisis Making People Sick?

Sep 19, 2011• 4

By Sanjay Basu, MD

The housing crisis that precipitated our ongoing recession began with the foreclosure of 15% of US mortgages. There remains substantial disagreement, however, about whether and how public health departments should specifically address health problems experienced by the people who lost their homes in this crisis. While poor housing quality and homelessness have been statistically correlated to illness for many years, some argue that the correlation merely represents the influence of other factors that are common among people with housing insecurity: indebtedness and inability to pay for medical services, unemployment and associated insurance loss, food insecurity, mental illness, substance abuse, or family instability resulting in poor healthcare seeking or inadequate medical adherence.

As a result, it’s not obvious whether having health departments improve housing availability or quality will necessarily improve health conditions among the groups who face foreclosure. If better housing is really directly linked to better health outcomes, then health departments should expect a return on their investment in housing programs for this group. But if the statistical finding is merely secondary to other factors like indebtedness, then the money might be better spent elsewhere, for example in debt repayment programs, or in preventing the type of predatory banking practices that lead to the foreclosures. In this post, we try to answer the question: is the foreclosure crisis making people sick? And if so, what interventions have been shown to work, if any?

Personal Liberties Versus Public Harm

Jul 18, 2011• 2

By PAUL LEVY

David Ropeik, about whose excellent work on risk perception I have written before, recently offered some additional perspectives on the issue of vaccinations — making us think about the cost of personal liberties to public harm. He wrote this Op-Ed, entitled, “Public health: Not vaccinated? Not acceptable,” in theLos Angeles Times. The subheading is: “What should we do about people who decline vaccination for themselves or their children and put the public at risk by fueling the resurgence of nearly eradicated diseases?”

Here are some excerpts:

What does society do when one person’s behavior puts the greater community at risk? We make them stop. We pass laws, or impose economic rules or find some other way to discourage individual behaviors that threaten the greater common good. You don’t get to drive drunk. You don’t get to smoke in public places. You don’t even get to leave your house if you catch some particularly infectious disease.

Continue reading…

Health Insurance Doesn’t Necessarily Mean Better Health

Mar 8, 2011• 50

By JIM MARKS, MD MPH

A new study in the influential policy journal Health Affairs gives added credence to the idea that much of what drives health falls outside of the realm of medical care. In fact, this must-read study points out what so many of us know: that simply providing someone a health insurance card is not enough to make them healthy.

What better place to test this theory than in Canada – our northern neighbor with a publicly financed universal health care system. Researchers looked at nearly 15,000 Canadians in the nation’s health system who were free of heart disease and tracked them for at least a decade. Not surprisingly, people disadvantaged by little education and low income, used the health care system more than those with higher incomes. But more importantly, this increased use of services had no discernable effect on improving their health or cutting their death rates – the ultimate bottom line – when compared with others with higher education, higher income and LESS usage of health care.

Almost all of the debate about health care here has been about how many Americans will be covered, for what care, and at what cost. The results of this Canadian study are clear. It may be helpful to have insurance to get care, but the United States cannot expect that giving people medical care will diminish differences in health outcomes or the likelihood of an early death among disadvantaged people. The authors explicitly warn against relying on universal coverage to eliminate inequalities in health.Continue reading…

Is Geography Your Health Destiny?

Feb 24, 2010• 8

By RISA LAVIZZO-MOUREY, MD Risa

Dr. Lavizzo-Mourney is the President and CEO of the Robert Wood Johnson Foundation. Before joining Robert Wood Johnson she taught at the University of Pennsylvania, where she was the Sylvan Eisman Professor of medicine and health care systems and director of Penn’s Institute on Aging. In Washington, D.C., she was deputy administrator of what is now the Agency for Health Care Research and Quality.

Thanks to a new set of reports, we now know that where you live matters to your health. People who call Prince George’s County Maryland home are twice as likely to die prematurely from disease as their neighbors just across the line in Montgomery County. The data cut both ways. People who live in the healthiest counties, such as Montgomery or Howard County Maryland have a two-to-three times better chance of living longer than people who live in less healthy counties such as Prince Georges or Baltimore.

These important new facts aren’t just for the Washington area, because the same disparities are happening across the country. This story unfolds in 50 state reports – The County Health Rankings (www.countyhealthrankings.org) – that the Robert Wood Johnson Foundation just released with the University of Wisconsin Population Health Institute.