September 16, 2013.
UC Davis study conducted in response to recent government funding cutbacks.
Joy Melinkow, UC Davis
When public health budgets are constrained, mammography screening should begin later and occur less frequently, a cost-effectiveness analysis for California’s Every Woman Counts (EWC) program concludes.
As outlined in a paper published in Value in Health, the analysis focused on several policy questions, including the effect on EWC program costs and outcomes of starting screening at age 50 years instead of 40 and of screening every two years instead of every year. The study was conducted in response to recent government funding cutbacks.
“This was not a clinical recommendation, but rather was intended to help a public health program use its resources to the greatest effectiveness,” said lead author Joy Melnikow, director of the UC Davis Center for Healthcare Policy and Research.
EWC, administered through the California Department of Public Health Cancer Detection Section, is one of the largest of 68 Centers for Disease Control and Prevention-funded programs across the country. It reimburses providers at Medi-Cal rates (Medi-Cal is the California version of Medicaid) for screening and diagnostic services for breast and cervical cancers. It provides services to women who are not eligible for Medi-Cal, who otherwise lack coverage for breast and cervical cancer screening, and whose income is less than 200 percent of the federal poverty threshold.
The study, conducted by UC Davis and EWC researchers, was based on a sophisticated microsimulation model that projected outcomes based on existing program data. It found that starting mammography screening biennially at age 50 was strongly supported by the model results, given that program funding did not allow screening of the full population of eligible women beginning at age 40.
“Because breast cancer incidence goes up with age, using program funds to screen all eligible women over age 50 will have a greater impact on reducing breast cancer deaths,” said Melnikow. “The goal was to advise a public health program in a timeframe that could be helpful, given that cost-effectiveness analysis typically takes a long time to conduct — often too long to be of use in a quickly changing policy environment.”
September 13, 2013.
UC Davis’ Garen Wintemute to be honored by the America Public Health Association.
Garen Wintemute, UC Davis
Garen Wintmute, one of the nation’s foremost scholars addressing violence as a public-health problem, has been selected to receive the 2013 Distinguished Career Award from the Injury Control and Emergency Health Services Section of the American Public Health Association. He will receive the award at the association’s annual meeting in Boston in November.
Wintmute is a national expert on firearm violence and public policies and attitudes related to firearms. His longstanding commitment to understand the nature of firearm violence and its underlying causes has produced a uniquely rich and informative body of research on firearm violence that directly improves the health and safety of Americans and that has positioned California — and UC Davis — as national leaders in efforts to break the cycle of gun violence.
For more than 20 years, Wintemute’s work has increased awareness of gun violence as a public-health problem, fueling change in the industry and innovative legislation to prevent easy access to guns used in crime.
Wintemute is a professor of emergency medicine and holds the Susan P. Baker-Stephen P.Teret Chair in Violence Prevention. He earned his medical degree in 1977 from UC Davis School of Medicine, where he also completed his residency in family medicine. In 1981, he was medical coordinator at Nong Samet Refugee Camp in Cambodia, a remote area that had only recently been liberated from the governance of Pol Pot’s Khmer Rouge. He later returned stateside to merge his medical training with public policy, and earned a master’s degree in public health at Johns Hopkins in 1983.
As Violence Prevention Research Program director, he works to maximize the impact of current studies, advance research on multiple fronts and develop a program that will train the next generation of researchers in the field.
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September 10, 2013.
Cancer care in America needs an overhaul, national report says.
Cancer care in the United States is a system in crisis, according to a new report from the Institute of Medicine that says urgent changes are needed to boost the quality of care and improve outcomes for people diagnosed with the disease.
The report, prepared by an IOM committee chaired by UCLA’s Dr. Patricia Ganz, attributes the crisis to the growing demand for cancer care among the aging baby boom generation, rapidly rising costs, a shrinking pool of cancer care professionals and dramatic changes in cancer therapies over the last decade that sometimes make it difficult to determine which patients should receive what treatment.
“We have a lot of waste in the system, where people are given treatments that are unnecessary and costly,” said Ganz, director of cancer prevention and control research at UCLA’s Jonsson Comprehensive Cancer Center and a professor of health policy and management at UCLA’s Fielding School of Public Health. “So we’re not just talking about underuse, we’re talking about overuse as well. So the lack of coordination, the lack of the ability to evaluate the quality of care that you might receive, is what’s missing in the health care delivery system today.”
Ganz said changes across the board are needed and that all stakeholders in the cancer care community — from patients and researchers to care providers, payers and federal agencies — must work together to reevaluate their current roles and responsibilities in order to improve care, quality of life and outcomes.
In particular, the committee’s report recommends working toward a system in which patients are engaged and informed, care is accessible and affordable, and the cancer care workforce is adequately staffed, trained and coordinated and provides evidence-based care. In addition, a firm focus must be placed on quality-measurement and performance improvement, improving health-care information technology, and translating research into clinical practice.
Read the full report.
September 5, 2013.
Strong link also found between nitrogen dioxide, increased risk of death from lung cancer.
Chronic exposure to ground level ozone, a powerful greenhouse gas and a widespread air pollutant in many major cities, is linked to premature death from cardiovascular disease, finds a new study led by University of California, Berkeley, researchers.
The analysis, funded by the California Air Resources Board and published in the current issue of American Journal of Respiratory and Critical Care Medicine, also found a strong link between nitrogen dioxide, a marker for traffic pollution, and increased risk of death from lung cancer.
Numerous studies have connected air pollution to a higher risk of mortality, but until now, the extent of the impact had been uncertain.
For the new paper, researchers developed individualized air pollution exposure estimates of more than 73,000 California residents. They used a combination of home addresses, government air monitors and statistical models to obtain monthly averaged values of exposure to ozone, nitrogen dioxide and fine particulate matter pollution. Researchers tracked mortality from 1982-2000 to link the deaths to air pollution exposure.
“Ozone has already been linked to respiratory problems, but this is the first study to show that it also increases the risk of death from ischemic heart disease, which accounts for more than 7 million deaths worldwide each year,” said study lead author Michael Jerrett, professor and chair of environmental health sciences at UC Berkeley’s School of Public Health. “Our findings will likely up the total deaths due to air pollution by hundreds of thousands per year in the next World Health Organization assessment.”
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August 21, 2013.
UCSF study debunks myth that smoking can be helpful in mental health treatment.
Patients who participated in a smoking-cessation program during hospitalization for mental illness were able to quit smoking and were less likely to be hospitalized again for their psychiatric conditions, according to a new study by researchers at Stanford and UC San Francisco.
The findings counter a longstanding assumption held by many mental-health experts that smoking serves as a useful tool in treating some psychiatric patients.
Smoking among such patients has been embedded in the culture for decades, with cigarettes used as part of a reward system. Indeed, clinicians sometimes smoke alongside patients as a way of creating a rapport with them, said Judith Prochaska, Ph.D., M.P.H., associate professor of medicine at the Stanford Prevention Research Center who led the study while an associate professor at UCSF. The result is that psychiatric patients are among the country’s most prolific smokers and among those most likely to die of smoking-related ailments, Prochaska said.
Nearly half of the cigarettes sold in the United States are to people with psychiatric or addictive disorders, according to data from the U.S. Centers for Disease Control and Prevention. And the average life expectancy for people with severe mental illness is 25 years less than that of the general population, and their leading cause of death is chronic illness, mostly tobacco-related.
The study is the first to examine the impact of a stop-smoking intervention in adult psychiatric patients. It was published online Aug. 15 in the American Journal of Public Health.
Co-authors of the study are Stephen Hall, M.D., director of acute services at Langley Porter Psychiatric Institute; Kevin Delucchi, Ph.D., professor of biostatistics in psychiatry; and Sharon Hall, Ph.D., professor of psychiatry, all of UCSF.
August 7, 2013.
Faustina Solís was 90.
Faustina Solís — an educator and pioneer in public health and the second provost of UC San Diego’s Thurgood Marshall College — died on Aug. 3 in San Diego at age 90.
A UC San Diego professor emeritus, Solís was also the university’s first Latina provost. She served as provost of the university’s Thurgood Marshall College (then known as Third College) from 1981-88, and taught at the UC San Diego School of Medicine beginning in 1971. She established public health coursework for undergraduates and medical students, following many years in social work focused on healthcare for underserved populations. Solís’s contributions were honored in 1990 when Thurgood Marshall Lecture Hall on the UC San Diego campus was renamed the Faustina F. Solís Lecture Hall.
“Without bold leaders like Faustina Solís, UC San Diego would not be the world-class university it is today,” said Chancellor Pradeep K. Khosla. “She was a beloved campus leader who helped establish the foundation of excellence on which the university has been built.”
Thurgood Marshall College is one of six colleges at UC San Diego, each led by a provost. The campus’s college system is designed to provide students with many of the advantages of a small liberal arts college plus the resources of a large research university.
During her years as provost of Marshall College, Solís promoted mentoring programs and aimed to engage new students—particularly from minority backgrounds. She was once quoted about her experiences with her students: “They weren’t left to fly by themselves. Freshman and transfer students can feel very lost in a large university. They need support and assistance in every way possible, whether financial, social or counseling.”
August 5, 2013.
UCSF study first to examine health impact of casino smoking ban.
Stanton Glantz, UCSF
Commercial casinos throughout the country are often exempt from smoke-free workplace laws. Now a new study led by UC San Francisco has found that when smoking is banned in casinos, it results in considerably fewer emergency calls for ambulances.
The study is the first to examine the health impact of smoking bans in casinos.
The authors conclude that if smoke-free laws were to apply to casinos as well as other businesses, it would prevent many medical emergencies and reduce public health costs.
“Our study suggests that exempting casinos from smoke-free laws means that more people will suffer medical emergencies as a result,” said lead author Stanton A. Glantz, Ph.D., UCSF professor of medicine and director of the Center for Tobacco Control Research and Education at UCSF.
“The research shows strong evidence of a significant drop in ambulance calls due to less secondhand smoke exposure,” Glantz said. “Inhaling secondhand smoke increases the likelihood of dangers with blood clots and makes it more difficult for arteries to expand properly – changes that can trigger heart attacks. Legislative and tribal exemptions for casinos, which are all too common, are potentially putting employees and customers at risk of secondhand smoke exposure.”
For decades, Glantz and his colleagues at UCSF have been pioneers in tobacco research, disclosing how the tobacco industry manipulated its products and led the public into cigarette addiction.
The latest research was published today (Aug. 5) in the American Heart Association journal Circulation.
August 5, 2013.
UCSF joins community partners in leading transition to “Collective Impact” model.
Mayor Ed Lee announces the SFHIP
San Francisco is ranked 23rd in health outcomes among California’s 57 counties.
In an effort to improve health and health equity in the city, Mayor Ed Lee has announced the expansion and alignment of three successful community health collaboratives into one body, now known as the San Francisco Health Improvement Partnership (SFHIP).
SFHIP builds off the existing program administered by the Community Engagement and Health Policy program at UC San Francisco’s Clinical and Translational Science Institute (CTSI) and facilitated in collaboration with community partners and the San Francisco Department of Public Health (SFDPH). The newly formed entity brings in two other existing collaboratives:
- Building a Healthier San Francisco (BHSF) and Community Benefit Partnership (CBP) programs, efforts spearheaded by San Francisco’s non-profit hospitals and SFDPH in conjunction with wide-ranging community partners; and
- SFDPH through the Public Health Accreditation Board and its community health improvement process.
Recognizing the original SFHIP program as a prototype of successful community engagement and collective impact principles, leaders of this new citywide effort adopted the name.
“SFHIP brings together three successful efforts into one, unified vision with a shared purpose,” said Abbie Yant, R.N., M.A., vice president of Mission, Advocacy and Community Health at Saint Francis Memorial Hospital and member of SFHIP’s steering committee.
August 2, 2013.
UC Berkeley/LBNL study finds risks well above the acceptable level.
In the first study to evaluate the health risks of exposure to secondhand smoke for patrons of restaurants and bars, researchers have found that the risks are well above the acceptable level. The study assessed the risk for lung cancer and heart disease deaths among both patrons and servers and also for asthma initiation — the first study to do so — among servers.
Lawrence Berkeley National Laboratory scientists Lara Gundel and Michael Apte contributed to the study, which was led by Ruiling Liu and Katharine Hammond from UC Berkeley’s School of Public Health. The results were published in the journal Tobacco Control in a paper titled, “Assessment of risk for asthma initiation and cancer and heart disease deaths among patrons and servers due to secondhand smoke exposure in restaurants and bars.”
Taking exposure data from 65 restaurants and bars in Minnesota over an eight-month period in 2007, the researchers found that the lifetime excess risk of lung cancer death was 18 in a million for patrons visiting only nonsmoking sections and 80 in a million for patrons in the smoking section. For servers, the lifetime excess risk was 802 in a million for lung cancer death.
Extrapolating to the entire country, the researchers estimate that the lifetime excess risk for the general nonsmoking population due to exposure to secondhand smoke in restaurants and bars would result in 214 additional lung cancer deaths and 3,001 additional heart disease deaths per year.
“One in a million is significant,” said Gundel. “You can’t control people smoking, but to support tobacco-free policies we need to know how to protect people.”
August 1, 2013.
Irva Hertz-Picciotto honored for achievements in environmental epidemiology.
Irva Hertz-Picciotto, UC Davis
Environmental epidemiologist Irva Hertz-Picciotto, UC Davis professor of public health sciences, has been appointed to the Neurological, Aging and Musculoskeletal Epidemiology (NAME) Study Section of the Center for Scientific Review of the National Institutes of Health (NIH). The appointment is effective immediately and ends in June 2017.
Hertz-Picciotto was selected for the honor because of her “demonstrated competence and achievements in her scientific discipline as evidenced by the quality of research accomplishments, publications in scientific journals, and other significant scientific activities, achievements and honors,” said Center for Scientific Review Director Richard Nakamura.
Professor Hertz-Picciotto is section chief of the Division of Environmental and Occupational Health in the Department of Public Health Sciences in the UC Davis School of Medicine. As a member of the NAME Study Section, she will review grant proposals submitted to any of the NIH institutes, primarily those that address health concerns related to child neurotoxins, mechanisms governing abnormal development and neurodegenerative diseases, as well as disorders of aging, such as osteoporosis.
“It’s an honor to serve the NIH, which is the primary funder of biomedical research in the United States and the premier national research funding institution worldwide,” Hertz-Picciotto said of the appointment.
July 23, 2013.
UC Davis stem cell study uncovers the brain-protective powers of astrocytes.
(From left) Chen Chen, Wenbin Deng and Peng Jiang led a study of the therapeutic potential of stem-cell-derived astrocytes in treating ischemic brain disorders.
One of regenerative medicine’s greatest goals is to develop new treatments for stroke. So far, stem cell research for the disease has focused on developing therapeutic neurons — the primary movers of electrical impulses in the brain — to repair tissue damaged when oxygen to the brain is limited by a blood clot or break in a vessel. New UC Davis research, however, shows that other cells may be better suited for the task.
Published today (July 23) in the journal Nature Communications, the large, collaborative study found that astrocytes — neural cells that transport key nutrients and form the blood-brain barrier — can protect brain tissue and reduce disability due to stroke and other ischemic brain disorders.
“Astrocytes are often considered just ‘housekeeping’ cells because of their supportive roles to neurons, but they’re actually much more sophisticated,” said Wenbin Deng, associate professor of biochemistry and molecular medicine at UC Davis and senior author of the study. “They are critical to several brain functions and are believed to protect neurons from injury and death. They are not excitable cells like neurons and are easier to harness. We wanted to explore their potential in treating neurological disorders, beginning with stroke.”
Deng added that the therapeutic potential of astrocytes has not been investigated in this context, since making them at the purity levels necessary for stem cell therapies is challenging. In addition, the specific types of astrocytes linked with protecting and repairing brain injuries were not well understood.
July 18, 2013.
UCLA-led study shows that many countries have it, but not the U.S.
Jody Heymann, UCLA
Uruguay has it. So does Latvia, and Senegal. In fact, more than half of the world’s countries have some degree of a guaranteed, specific right to public health and medical care for their citizens written into their national constitutions.
The United States is one of 86 countries whose constitutions do not guarantee their citizens any kind of health protection. That’s the finding of a new study from the UCLA Fielding School of Public Health that examined the level and scope of constitutional protection of specific rights to public health and medical care, as well as the broad right to health.
The study examined the constitutions of all United Nations member states and found the results to be mixed, despite the fact that all U.N. members have universally recognized the right to health, which is written into the original foundational document establishing the international body in 1948.The researchers reviewed the constitutions of all the member states as amended to two points in time: August 2007 and June 2011.
The report appears in the July issue of the journal Global Public Health.
The study also calls for regular and long-term monitoring of all countries’ protection of health rights, whether or not such rights are written into specific country’s constitutions.
That’s because a constitutional definition of what health protection actually is varies widely between nations. Further, how such protections have been implemented varies widely, said the study’s first author, Dr. Jody Heymann, dean of the Fielding School of Public Health.
“With respect to specific rights to health, the status of the world’s constitutions can be described as either half empty or half full,” Heymann said.