Archive for Health

New Study Inspires Researchers to Hit the Road

New Study Inspires Researchers to Hit the Road

A new $21.4 million RURAL study will examine rural, southern U.S. communities to find out why people there have more disease, shorter lives. Traveling in a mobile examination van, researchers will examine 4,000 study participants over the course of six years in 10 rural counties across Kentucky, Alabama, Mississippi and Louisiana.

Vasan Ramachandran, who leads the Framingham Heart Study at Boston University, is about to embark on the ultimate road trip with 50 other scientists. But this is not for adventure and sightseeing. The research team is part of a new study led by Ramachandran, called the Risk Underlying Rural Areas Longitudinal (RURAL) study, which has the goal of discovering why people in rural areas of the southern United States tend to live shorter, less healthy lives compared to the rest of the country.

With $21.4 million in funding from the National Heart, Lung, and Blood Institute, Ramachandran and his team plan to use their know-how from the Framingham Heart Study—the longest-running heart disease study in the country—to ask the question, “What causes the high burden of heart disease, lung disease and stroke in the rural South?”

To find out the answer, the researchers will travel by custom van, built as a “mobile examination unit,” to examine 4,000 study participants over the course of six years in 10 counties across Kentucky, Alabama, Mississippi, and Louisiana. Throughout the entire US, heart disease is the number-one killer of both men and women, but rates are even worse in southern states. People living in these areas also have higher rates of lung, blood, and sleep disorders compared to the national average.

“We hope that what we do [in RURAL] changes the lives of common human beings who live in these communities, who are robust individuals like you and me,” says Ramachandran, a BU School of Medicine professor of medicine and epidemiology and chief of preventive medicine and epidemiology. “The burden of [health] risk is high, in part because of geospatial characteristics that we don’t fully understand.”

The most crucial aspect of the study, Ramachandran explains, is going to be listening. Partnering with 16 institutions, including universities in all four states, the researchers will work with participating communities to organize active discussions, working groups, listening groups, and community advisory boards. Their plan is to take the “science to the people and study these health issues at their doorstep,” Ramachandran says.

The mobile exam unit will be constructed after carefully consulting with community partners and participants, long before the examination process begins. Ramachandran says this will ensure that the space will be comfortable, accessible, and customized to the needs of specific areas. The van, once fully operational, will spend time in each county over the next few years. Counties in Alabama will be the group’s first stop to conduct baseline examinations.

“We do hope to build relationships within these communities to understand them better beyond the 4,000 people [who will participate] in RURAL,” Ramachandran says.

Six years might seem like a long time, but this is only the first step toward a much longer process and larger goal. Once the RURAL van completes its trip through all 10 counties, the cohort will continue working with the communities through advisory boards and participant networks. After the data is collected and analyzed, the team intends to share the results with district health officials and provide health recommendations based on their findings.

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Can We Overhaul Our ‘Broken’ Health Data System?

Can We Overhaul Our ‘Broken’ Health Data System?

COLUMBUS, Ohio – Our system for protecting health data in the United States is fundamentally broken, and we need a national effort to rethink how we safeguard this information, according to three experts in data privacy.

“Data scandals are occurring on a regular basis, with no end in sight,” said Efthimios Parasidis, a co-author of the NEJM article and a professor at the Ohio State University’s Moritz College of Law and College of Public Health. “Data privacy laws for health information don’t go far enough to protect individuals. We must rethink the ethical principles underlying collection and use of health data to help frame amendments to the law.”

Parasidis wrote the article with Elizabeth Pike, Director of Privacy Policy in the Office of the Chief Information Officer at the U.S. Department of Health and Human Services; and Deven McGraw, chief regulatory office at Citizen, a company that helps people collect, organize and share their medical records digitally. Previously, McGraw was Deputy Director for Health Information Privacy at the Office of Civil Rights in the U.S. Department for Health and Human Services, and Acting Chief Privacy Officer at the Office of the National Coordinator for Health Information Technology.

Parasidis said a process analogous to the Belmont Report would be a good blueprint to follow today. The Belmont Report is one of the leading works concerning ethics and health care research. Its primary purpose is to protect subjects and participants in clinical trials or research studies. This report consists of three principles: beneficence, justice, and respect for persons.

The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research produced the 1979 Belmont Report, which resulted in Congress passing laws to protect people who participated in medical research.

“Indignities in human subjects research compelled the government to create a commission to propose ethical guidelines for new laws. We are experiencing a rerun of what was happening then, with the scandals involving use of health data now rather than the use of human subjects,” Parasidis said. “We need an equivalent response.”

Currently, the Health Insurance Portability and Accountability Act (HIPAA) is the main law protecting the data of patients. But it doesn’t apply to many of the new companies and products that regularly store and handle customer health information, including social media platforms, health and wellness apps, smartphones, credit card companies and other devices and companies.

“All of this data held by digital health companies raises a lot of ethical concerns about how it is being used,” Parasidis said.

For example, some life insurers are offering contracts that have policyholders wear products that continuously monitor their health, and the information can be used to increase a customer’s premiums.

Most regulations require only that consumers be notified about how their information is used and give their consent.

“That system doesn’t work. Very few people read the notice and most people just click agree without knowing what they’re agreeing to,” he said.

So how can health data privacy be fixed?

One idea would be to establish data ethics review boards, which would review projects in which health data are collected, analyzed, shared or sold, according to the authors of the NEJM article.

Parasidis said such boards could function as safeguards required in both public and private settings, from university medical centers to private life insurance companies.

These boards could consider the benefits and risks of the proposed data use and consider policies governing data access, privacy and security. Members could include project developers, data analysts and ethicists, as well as people whose data would be collected.

“Right now, everything is about compliance. Companies and institutions check the boxes, fill out the forms and don’t really think about whether they’re doing the right thing,” Parasidis said.

“Deliberations about use of health data should take the ethical obligations to individuals and society into account. The law should mandate that this occurs.”

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First Presumptive Positive Measles Case in Alabama for 2019

First Presumptive Positive Measles Case in Alabama for 2019

The Alabama Department of Public Health received notification of a case of presumptive positive measles the morning of May 2 in an infant in St. Clair County. Currently, this is the only presumptive measles case under investigation in Alabama.

The infant was considered contagious from April 23, 2019, through May 1, 2019. ADPH is working to confirm the diagnosis and to contact those exposed. The child is not in daycare and has had no out-of-state travel. So far in 2019, ADPH has conducted 174 investigations, including 32 open investigations, but this is the first presumptive positive case.

Measles (rubeola) is a notifiable disease in Alabama. The ADPH Immunization Division investigates reports of suspected measles. ADPH urges that all persons know their measles vaccine status. If never vaccinated and born after 1956, persons are strongly encouraged to obtain an MMR (measles, mumps, rubella vaccine) from their physician, healthcare provider or pharmacy. ADPH vaccine efforts primarily focus on children under 19 years of age. Free MMR vaccine is only available for children participating in the Vaccines for Children (VFC) Program and for persons who may qualify based upon local health department fee schedules.

ADPH has a very limited supply of MMR vaccine for adults and urges those with insurance and other coverage such as Medicaid to be vaccinated at their pharmacy or provider. About 95 percent or more of unvaccinated people exposed to a single case of measles will contract the disease.

For every single case of measles disease, 12-18 additional cases can be expected. The complication rate from measles is about 20-30 percent, especially in infants, children less than 5 years of age, and persons 20 years and older. Complications can range from ear infections and pneumonia to deadly encephalitis. For every 1,000 people with measles, one to two people will die.

Signs and symptoms of measles that occur before the rash are as follows:

  • Patients develop fever, sometimes as high as 105 degrees, followed by cough, runny nose, and red eyes (conjunctivitis).
  • Anywhere from 1-7 days after these symptoms begin, the rash develops.
  • The rash starts on the face and spreads across the body.
  • Patients may also have small white spots on the inside of the mouth on the cheek which may occur from two days before and up to two days after the rash.

From the time that a person is exposed to measles, it can take seven to 21 days for signs and symptoms to occur with an average of 10-14 days. People are contagious from four days before the rash develops until four days after.

For additional information, go to http://alabamapublichealth.gov/immunization/index.html

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SURVEY: Prior Authorization Obstacles Unnecessarily Delay Patient Access to Cancer Treatments

SURVEY: Prior Authorization Obstacles Unnecessarily Delay Patient Access to Cancer Treatments

ARLINGTON, Va., April 25, 2019 — Restrictive prior authorization practices cause unnecessary delays and interference in care decisions for cancer patients, according to a new survey of nearly 700 radiation oncologists — physicians who treat cancer patients using radiation– released today by the American Society for Radiation Oncology (ASTRO).

Nearly all radiation oncologists (93%) said that their patients are delayed from life-saving treatments, and a third (31%) said the average delay lasts longer than five days – a full week of standard radiation treatments. These delays cause added stress and anxiety to patients already concerned about their health, and they are cause for alarm given research linking each week of delay in starting cancer therapy with a 1.2% to 3.2% increased risk of death.

In addition to prevalent treatment delays, the ASTRO physician survey illuminates other ways prior authorization negatively impacts patient outcomes and takes physicians away from caring for their patients:

Added Patient Stress

  • More than 7 in 10 radiation oncologists (73%) said their patients regularly express concern to them about the delay caused by prior authorization.
  • More than 3 in 10 radiation oncologists (32%) have been forced to use a different therapy for a substantial number of their patients (>10%) due to prior authorizations delays.

Unnecessary Delay Tactics

  • Nearly two-thirds of radiation oncologists (62%) said most denials they receive from prior authorization review are overturned on appeal.
  • Radiation oncology benefit management companies (ROBMs) required 85% of radiation oncologists to generate multiple treatment plans, which require physicians and medical physicists to spend several hours developing alternatives to their recommended course of treatment.
  • More than 4 in 10 respondents (44%) said their peer-reviews typically are not conducted by a licensed radiation oncologist.

Wasting Physician Time

  • Nearly one in five radiation oncologists (17%) said they lose more than 10% of time that they could be caring for their patients focused instead on dealing with prior authorization issues. An additional 39% spend 5-10% of their average workday on prior authorization.
  • More than 4 in 10 radiation oncologists (44%) needed prior authorization for at least half of their treatment recommendations. An additional third (37%) needed it for at least a quarter of their cases.
  • Many radiation oncologists (63%) had to hire additional staff in the last year to manage the prior authorization process.

Disproportionate Impact on Patients at Community-Based Clinics

  • Patients treated at community-based, private practices experience longer delays than those seen at academic centers. For example, average treatment delays lasting longer than a week were reported by 34% of private practitioners vs. 28% of academic physicians (p=0.005).
  • Radiation oncologists in private practice are almost twice as likely to spend more than 10% of their day focused on prior authorization, compared to physicians at academic centers (23% vs. 13%, p=0.003)

“This survey makes clear that restrictive prior authorization practices can cause unnecessary, stressful and potentially life-threatening delays for cancer patients,” said Paul Harari, MD, FASTRO, Chair of the ASTRO Board of Directors and professor and Chairman of human oncology at the University of Wisconsin-Madison. “While the system may have been designed as a path to streamline and strengthen health care, it is in fact frequently harmful to patients receiving radiation therapy. In its current form, prior authorization causes immense anxiety and wastes precious time for cancer patients.”

“Radiation oncology and cancer patients have been particularly hard hit by prior authorization’s unnecessary burden and interference in care decisions,” said Vivek Kavadi, MD, Vice Chair of ASTRO’s Payer Relations Subcommittee and a radiation oncologist at Texas Oncology. “Radiation oncologists increasingly are restricted from exercising our clinical judgment in what is in the best interest of the patient, yet we are held accountable for the outcomes of treatments where decisions have been taken out of our hands.”

In the 2018 annual ASTRO member survey, radiation oncologists named prior authorization as the greatest challenge facing the field. The burden was especially prominent among private practitioners in community-based settings, where the majority of cancer patients receive care.

The findings from ASTRO’s new physician survey align with recent reports from the American Medical Association (AMA), American Cancer Society Cancer Action Network (ACS CAN) and others, demonstrating the pervasiveness of prior authorization obstacles throughout the American health care system.

ASTRO recently signed onto a letter with the AMA and other medical societies calling for CMS to require Medicare Advantage plans to align their prior authorization requirements with a Consensus Statement on Improving the Prior Authorization Process authored jointly by leading provider and payer organizations.

Survey Methodology

An online survey was sent by email to all 3,882 U.S. based, practicing radiation oncologists in ASTRO’s member database, and 620 physicians completed the survey online. Invitations were sent in December 2018, with one email reminder in January 2019, and the survey closed in February 2019. ASTRO staff also administered paper surveys at the ASTRO Annual Meeting in October 2018 and collected 53 responses. Findings reflect the combined total of 673 radiation oncologist responses. For more information about respondent demographics, view the executive summary.

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ABOUT ASTRO

The American Society for Radiation Oncology (ASTRO) is the world’s largest radiation oncology society, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. The Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes three medical journals,International Journal of Radiation Oncology • Biology • PhysicsPractical Radiation Oncology andAdvances in Radiation Oncology; developed and maintains an extensive patient website, RT Answers; and created the nonprofit foundation Radiation Oncology Institute. To learn more about ASTRO, visit our website, sign up to receive our news and follow us on our blogFacebookTwitterand LinkedIn.

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National Health Survey Underway in Marengo County

National Health Survey Underway in Marengo County

The National Health and Nutrition Examination Survey (NHANES), the most comprehensive survey of the health and nutritional status of the U.S. population, is underway in Marengo County through April 20. This is an “invitation-only opportunity” in which randomly selected participants will receive a free and comprehensive health and nutrition evaluation. Respondents will be compensated for their time, travel and other expenses of up to $125.

“We encourage every eligible resident who has been selected for the survey to agree to participate,” said Alabama Department of Public Health’s Southwestern District Administrator Chad Kent. “All information collected is confidential, as required by law. If you are chosen, you will have been contacted by letter.”

A team of health professionals, nutritionists and health technicians ask respondents to first participate in a health interview in the respondent’s home followed by a health exam in the NHANES mobile examination center. Professionals will have a photo ID badge from the Centers for Disease Control and Prevention. While no medical care is provided directly, a report on physical findings is given to each participant along with an explanation from survey medical staff. All information collected in the survey is kept confidential and privacy is protected.

“NHANES serves as the nation’s ‘health check-up,’ by going into communities to collect health information throughout the country. The survey provides a wealth of important data about many of the major health and nutritional issues affecting the country,” according to the National Center for Health Statistics (NCHS) Director Jennifer H. Madans.

All counties in the United States have a chance to be selected for the NHANES, and Marengo County was one of the 15 counties chosen to be part of this initiative. NHANES provides important data on public health problems from a national perspective. Each year, 5,000 residents across the nation have the chance to participate in the latest NHANES, conducted by the NCHS, part of the Centers for Disease Control and Prevention.

“For the most part, people are very receptive,” George Dixon, study manager, said. “We may ask for some demographic information to determine if any people in the household are selected. We assist participants with transportation and even babysitting if needed.”

NHANES has had a prominent role in improving the health of all people living in the U.S. for the past 55 years. Public health officials, legislators and physicians use the information gathered by NHANES to develop sound health policies, direct and design health programs and services, and expand the health knowledge for the nation. NHANES findings provide critical health-related information on a number of issues such as obesity, diabetes and cardiovascular disease. In addition, NHANES data are used to produce national references and are used to create standardized growth charts for pediatricians across the country.

The comprehensive data collected by NHANES impact the everyday lives of the population of all ages, on everything from air quality to the vaccinations given by doctors, to the low fat and “light” foods now routinely offered in grocery stores.

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How Can Physicians Effectively Address Burnout?

How Can Physicians Effectively Address Burnout?

How many of your colleagues are complaining that they are doing more work and getting less for it? How many of them are experiencing ever-increasing levels of frustration brought on by outside influences: governmental regulation, insurance regulation, increased concern about medical malpractice, increasingly negative attitude by society towards physicians, and weakened physician-patient relationships?

Most individuals considering medical school know up front that a medical career inherently makes certain demands – they will be called upon to place their personal lives on hold financially as they study and train in the field of medicine. Competition is expected, as is delayed gratification, personal sacrifice, limited sleep, lack of free time, and intense pressure to be up on the latest medical knowledge. Upon completion of their residency or fellowships, they may be able to reclaim certain aspects – they will begin drawing a paycheck, they will have more control over their daily routine, some will even “man their own ship” in private practice – but not all of them.

Unfortunately, the characteristics that a make a good clinician may also lead the physician further and faster down the road to burnout. The field of medicine and often the physicians themselves set very stringent standards to be followed. These standards can be identified in the form of self-imposed limitations.

Physicians must…

  • Work until the work gets done
  • Not permit downtime, as downtime is time wasted
  • Handle everything that comes their way without complaint or assistance
  • Be highly conscientious
  • Try to be all things to all people – patients, staff, family, colleagues, etc.

On top of all that, the medical environment brings other components. Physicians are faced with repetitive tasks on a daily basis. While the diagnosis may change, the seeing of patients often becomes routine as physicians move from one room to the next. Physicians are often faced with problems that lack solutions, accompanied by demanding and chronically ill patients. Life and death issues are faced on a daily basis. In short, there is no time to emotionally recharge.

After several years of holding themselves to such high standards, a number of physicians are being forced to reevaluate their career, their life’s decisions. Many feel increasingly dissatisfied with their daily lives, and struggle to find a coping mechanism.

Symptoms of Burnout

There are many symptoms of burnout, some emotional, others physiological. Just as he or she would query a patient about the symptoms of an illness, the physician must stop and query himself or herself to identify common burnout symptoms. Examples of these include:

  • Negative perceptions of self
  • Negative practice habits
  • Lack of empathy with patients
  • Unhealthy lifestyle
  • Dissatisfaction with career
  • Sleep disturbances

Identification of the symptoms, and eventually the cause, is critical for two reasons. First, it is the only way the physician can work to overcome burnout and its significant effects. Second, failure to address burnout can foster an environment where the “it-just-doesn’t-matter“ attitude turns into a malpractice claim.

Preventing Burnout

Given the above situations and environments, is it possible to cope with burnout? Research indicates physicians who take charge of their lives and strive to ensure balance, are far more successful than most.

Prevention and/or mitigation can be divided into several areas.

Physical:

  • You should acknowledge that you, too, can get sick, and you should take normal steps to prevent it.
  • Have an annual physical to identify health concerns promptly.
  • If you can’t get motivated alone, hire a personal trainer so someone is expecting to see you at the gym.
  • Ensure you get enough rest.
  • Maintain a healthy diet.

Environmental:

  • Maintain control of your schedule.
  • Schedule non-patient appointments when they are convenient for you, and assign a time limit.
  • Evaluate your other commitments; be willing to say no when asked to serve on just one more committee or handle one more obligation.
  • Set priorities. Identify your daily tasks and divide them into one of four categories: urgent and important; urgent but not important; important but not urgent; and neither important nor urgent. Try to take a realistic approach and avoid lumping everything into “urgent and important.”
  • Meet with your staff on a regular basis. This helps prevent their burnout, and subsequently yours if you are not having to deal with staffing issues on top of everything else.
  • Chart throughout the day. Several sources agree charting at the end of the day allows a dreaded task to cut into personal time.

Emotional:

  • Volunteer
  • Find a hobby or leisure activity that does not pertain to medicine to give yourself an outlet.
  • You should get involved in your church or a community project that is important to you.
  • Spend time with friends or colleagues where you can be yourself.
  • Modify your perspective. Instead of saying, “There is no way I can get all this done today,” say “I will do only that which I can get to today.”
  • Learn to handle conflict. Resolving conflict instead of just living with it will improve your emotional outlook in a number of areas.

Financial:

  • Avoid overextending yourself financially. Stress over finances makes most individuals feel they have given up control of their lives – they must now work to meet their financial demands, and not just to achieve career goals or personal satisfaction.
  • Indebtedness may prevent someone from implementing other key steps to preventing burnout.

Is it hopeless? No. Is it easy? No. But today’s environment is highly stressful, and unfortunately, it is not likely to change for the good any time soon. This means physicians must either learn to cope with the forces battering at them on a daily basis or continue to feel ever increasing despair and frustration from their chosen career.

Article contributed by Sae Evans and Maddox Casey, Members, Warren Averett Healthcare Consulting Group. Warren Averett is an official Gold Partner with the Medical Association.

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‘Through With Chew Week’ Highlights Dangers of Smokeless Tobacco Use

‘Through With Chew Week’ Highlights Dangers of Smokeless Tobacco Use

Smokeless tobacco may not be getting as much press as e-cigarettes and vaping, but it is as addictive and has many harmful side effects. The Medical Association is joining with the Alabama Department of Public Health to encourage smokeless tobacco users to quit the spit during “Through With Chew Week,” Feb. 18-22.

The education campaign to decrease smokeless tobacco use and increase awareness of the negative health effects of using these products is an annual event begun in 1989 by the American Academy of Otolaryngology-Head and Neck Surgery.

In Alabama, 6.3 percent of adults surveyed were current smokeless tobacco users, according to the 2017 Behavioral Risk Factor Surveillance Survey. More than 9 percent of Alabama teens overall cited smokeless tobacco use in the past 30 days, according to the 2016 Alabama Youth Tobacco Survey, with 20.4 percent of high school students saying they had tried smokeless tobacco. Middle school students’ use of smokeless tobacco decreased from 6.7 percent in 2014 to 4.0 percent in 2016.

“Smokeless does not mean harmless,” said Julie Hare, Alabama Tobacco Quitline director. “Smokeless tobacco use can cause oral, esophageal and pancreatic cancers, and lead to tooth loss and gum recession,” she said. At least 28 cancer-causing chemicals have been found in smokeless tobacco, according to the Centers for Disease Control and Prevention.

Young people who use smokeless tobacco can become addicted to the nicotine it contains, making them more likely to also become cigarette smokers, Hare said.

Those who want to be “Through With Chew” can call the Quitline (1-800-Quit-Now) for help in quitting. Quitline coaching services are available seven days a week from 6 a.m. to midnight. Services are offered online at www.quitnowalabama.com.

The Quitline provides free, individualized coaching to help any type of smoker and smokeless tobacco user, including e-cigarettes and vape, to quit. In addition, the Quitline offers up to eight weeks of free nicotine patches to those medically eligible enrolled in the coaching program.

For free help to be “Through With Chew,” call the Quitline at 1-800-784-8669 or visit www.quitnowalabama.com.

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The Flu is Here! What Can You Do?

The Flu is Here! What Can You Do?

Take time to get a flu vaccine.

  • CDC recommends a yearly flu vaccine as the first and most important step in protecting against influenza and its potentially serious complications.
  • Flu vaccination can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations.
  • Flu vaccination also has been shown to significantly reduce a child’s risk of dying from influenza. There are data to suggest that even if someone gets sick after vaccination, their illness may be milder.
  • Everyone 6 months of age and older should get a flu vaccine every year before flu activity begins in their community. CDC recommends getting vaccinated by the end of October.
  • For the 2018-2019 flu season, CDC and its Advisory Committee on Immunization Practices (ACIP) recommend annual influenza vaccination for everyone 6 months and older with any licensed, age-appropriate flu vaccine (inactivated, recombinant or nasal spray flu vaccines) with no preference expressed for anyone vaccine over another.
  • Vaccination of high-risk persons is especially important to decrease their risk of severe flu illness. People at high risk of serious flu complications include young children, pregnant women, people with chronic health conditions like asthma, diabetes or heart and lung disease and people 65 years and older.
  • Vaccination also is important for health care workers, and other people who live with or care for high-risk people to keep from spreading flu to them.
  • Infants younger than 6 months are at high risk of serious flu illness, but are too young to be vaccinated. Studies have shown that flu vaccination of the mother during pregnancy can protect the baby after birth from flu infection for several months. People who live with or care for infants should be vaccinated.

Take everyday preventive actions to stop the spread of germs.

  • Try to avoid close contact with sick people.
  • While sick, limit contact with others as much as possible to keep from infecting them.
  • If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone for 24 hours without the use of a fever-reducing medicine.)
  • Cover your nose and mouth with a tissue when you cough or sneeze. After using a tissue, throw it in the trash and wash your hands.
  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Avoid touching your eyes, nose and mouth. Germs spread this way.
  • Clean and disinfect surfaces and objects that may be contaminated with germs like flu.

Take flu antiviral drugs if your doctor prescribes them.

  • If you get sick with flu, antiviral drugs can be used to treat your illness.
  • Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over-the-counter.
  • Antiviral drugs can make illness milder and shorten the time you are sick. They may also prevent serious flu complications.
  • CDC recommends prompt antiviral treatment of people who are severely ill and people who are at high risk of serious flu complications who develop flu symptoms.
  • For people with high-risk factors, treatment with an antiviral drug can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay.
  • Studies show that flu antiviral drugs work best for treatment when they are started within 48 hours of getting sick, but starting them later can still be helpful, especially if the sick person has a high-risk health condition or is very sick from flu. Follow your doctor’s instructions for taking this drug.
  • Flu-like symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people, especially children, may have vomiting and diarrhea. People may also be infected with flu and have respiratory symptoms without a fever.

Check out this helpful video from the Centers for Disease Control and Prevention

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Alabama’s Infant Mortality Rate Lowest Ever in 2017

Alabama’s Infant Mortality Rate Lowest Ever in 2017

The Alabama Department of Public Health announced the infant mortality rate of 7.4 deaths per 1,000 live births in 2017 is the lowest in Alabama history and is an improvement over the 2016 rate of 9.1. A total of 435 infants born in Alabama died before reaching 1 year of age in 2017; 537 infants died in 2016.

While there is a longstanding disparity between birth outcomes for black and white infants, the infant mortality rate for black infants declined to an all-time low in 2017, and the infant mortality rate for white infants was the second lowest. The rate of 11.2 for black infants was an improvement over the 15.1 rate in 2016, and the rate of 5.5 for white infants was a drop over the 6.5 rate for whites in 2016.

Alabama enjoyed many positive indicators. Teen births and smoking during pregnancy are risk factors that contribute to infant mortality, and both are continuing to decline. The percentage of births to teens (7.3) and the percentage of births to mothers who smoked (9.6) are the lowest ever recorded in Alabama, with the largest decrease among teen mothers. There was also a decline in the number of infants born weighing less than 1,000 grams and infant deaths to those small infants.

While there was a significant decline in infant mortality, the percent of low weight births and births at less than 37 weeks gestation remained the same. Statisticians look at average infant mortality rates for three-year periods. Between the years 2015 through 2017, the combined rate of 8.3 was tied with the years 2009 through 2011 as the two lowest three-year rates of infant mortality in Alabama.

“Due to the sharp decline in the infant mortality rate for 2017, the Alabama Center for Health Statistics worked diligently to ensure all infant deaths were reported,” Center Director Nicole Rushing said. “A decrease in the number of infant deaths reported was seen at almost all hospitals.”

State Health Officer Dr. Scott Harris said, “We are encouraged with the progress in improved pregnancy outcomes we are seeing, but many challenges remain such as addressing persistent racial disparities, the opioid epidemic and ensuring access to health care.”

Gov. Kay Ivey said, “We must continue our efforts to reduce the number of families who experience the profound sadness of infant deaths. Alabama has developed an infant mortality reduction plan that includes a pilot project to reduce infant mortality by 20 percent in five years.”

Components of the pilot project being conducted in Macon, Montgomery and Russell counties include home visitation, preconception and interconception health care, screening for substance use, domestic violence and depression, safe sleep education, and breastfeeding promotion.

The top three leading causes of infant deaths in 2017 that accounted for 43.4 percent of infant deaths were as follows:

  • Congenital malformations, deformations and chromosomal abnormalities
  • Disorders related to short gestation and low birth weight
  • Sudden infant death syndrome

These top causes of infant deaths parallel those for the U.S. as a whole in 2016.

Graphs and detailed charts are available at the Alabama Department of Public Health website at http://www.alabamapublichealth.gov/healthstats/assets/IM_17.pdf

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