Jan Dyer

Americans who live in rural areas are more likely than their urban counterparts are to die of the 5 leading causes of death, according to a CDC study of data from the National Vital Statistics System.

In 2014, 25,000 rural residents died of heart disease, 19,000 of cancer, 12,000 of unintentional injuries, 11,000 of chronic lower respiratory disease, and 4,000 of stroke. The study also found that unintentional injury deaths were about 50% higher in rural areas than in urban areas, partly due to a greater risk of death in vehicle crashes and of opioid overdoses. The problem is compounded by the fact that the distance between health care facilities and trauma centers can make rapid access to specialized health care difficult.

The study researchers say several factors could influence the rural-urban gap. For instance, many of the deaths are associated with sociodemographic differences. Rural residents tend to be older, poorer, and sicker with limited physical activity due to chronic conditions. But that “striking gap” in health can be closed, says CDC Director Tom Frieden, MD, MPH, by better understanding and addressing the health threats that put rural Americans at risk.

CDC suggests, for instance, that health care providers in rural areas:

• Screen patients for high blood pressure and make control a quality improvement goal;
• Increase cancer prevention and early detection—for example, by participating in state-level comprehensive control coalitions, which focus on prevention, education, screening, access, support, and overall good health;
• Encourage physical activity and healthy eating to reduce obesity;
• Encourage patients to stop smoking;
• Promote vehicle safety (rural residents are less likely to use seatbelts); and
• Engage in safe prescribing of opioids for pain, and use nonpharmacologic therapies

The report and a companion commentary are part of a new rural health series in CDC’s Morbidity and Mortality Weekly Report. The Health Resources and Services Administration, which houses the Federal Office of Rural Health Policy, will collaborate with the CDC on the series and help promote the findings and recommendations to rural communities.

Americans who live in rural areas are more likely than their urban counterparts are to die of the 5 leading causes of death, according to a CDC study of data from the National Vital Statistics System.

In 2014, 25,000 rural residents died of heart disease, 19,000 of cancer, 12,000 of unintentional injuries, 11,000 of chronic lower respiratory disease, and 4,000 of stroke. The study also found that unintentional injury deaths were about 50% higher in rural areas than in urban areas, partly due to a greater risk of death in vehicle crashes and of opioid overdoses. The problem is compounded by the fact that the distance between health care facilities and trauma centers can make rapid access to specialized health care difficult.

The study researchers say several factors could influence the rural-urban gap. For instance, many of the deaths are associated with sociodemographic differences. Rural residents tend to be older, poorer, and sicker with limited physical activity due to chronic conditions. But that “striking gap” in health can be closed, says CDC Director Tom Frieden, MD, MPH, by better understanding and addressing the health threats that put rural Americans at risk.

CDC suggests, for instance, that health care providers in rural areas:

• Screen patients for high blood pressure and make control a quality improvement goal;
• Increase cancer prevention and early detection—for example, by participating in state-level comprehensive control coalitions, which focus on prevention, education, screening, access, support, and overall good health;
• Encourage physical activity and healthy eating to reduce obesity;
• Encourage patients to stop smoking;
• Promote vehicle safety (rural residents are less likely to use seatbelts); and
• Engage in safe prescribing of opioids for pain, and use nonpharmacologic therapies

The report and a companion commentary are part of a new rural health series in CDC’s Morbidity and Mortality Weekly Report. The Health Resources and Services Administration, which houses the Federal Office of Rural Health Policy, will collaborate with the CDC on the series and help promote the findings and recommendations to rural communities.

Americans who live in rural areas are more likely than their urban counterparts are to die of the 5 leading causes of death, according to a CDC study of data from the National Vital Statistics System.

In 2014, 25,000 rural residents died of heart disease, 19,000 of cancer, 12,000 of unintentional injuries, 11,000 of chronic lower respiratory disease, and 4,000 of stroke. The study also found that unintentional injury deaths were about 50% higher in rural areas than in urban areas, partly due to a greater risk of death in vehicle crashes and of opioid overdoses. The problem is compounded by the fact that the distance between health care facilities and trauma centers can make rapid access to specialized health care difficult.

The study researchers say several factors could influence the rural-urban gap. For instance, many of the deaths are associated with sociodemographic differences. Rural residents tend to be older, poorer, and sicker with limited physical activity due to chronic conditions. But that “striking gap” in health can be closed, says CDC Director Tom Frieden, MD, MPH, by better understanding and addressing the health threats that put rural Americans at risk.

CDC suggests, for instance, that health care providers in rural areas:

• Screen patients for high blood pressure and make control a quality improvement goal;
• Increase cancer prevention and early detection—for example, by participating in state-level comprehensive control coalitions, which focus on prevention, education, screening, access, support, and overall good health;
• Encourage physical activity and healthy eating to reduce obesity;
• Encourage patients to stop smoking;
• Promote vehicle safety (rural residents are less likely to use seatbelts); and
• Engage in safe prescribing of opioids for pain, and use nonpharmacologic therapies

The report and a companion commentary are part of a new rural health series in CDC’s Morbidity and Mortality Weekly Report. The Health Resources and Services Administration, which houses the Federal Office of Rural Health Policy, will collaborate with the CDC on the series and help promote the findings and recommendations to rural communities.

Normally, negotiations to use drugs in preclinical studies and clinical trials can take as long as 18 months. But the National Cancer Institute’s (NCI) new drug formulary will allow investigators at NCI-designated cancer centers quicker access to approved and investigational agents, helping make more effective treatments available sooner.

The NCI Formulary, a public-private partnership between NCI and pharmaceutical and biotechnology companies, is one of NCI’s efforts in support of the Cancer Moonshot (ex-Vice President Biden’s call for greater collaboration and faster development of new therapies). The formulary enables NCI to act as an intermediary between investigators at cancer centers and participating pharmaceutical companies, streamlining arrangements for access to and use of drugs.

The formulary launched with 15 targeted agents from 6 pharmaceutical companies: Bristol-Myers Squibb, Eli Lilly and Company, Genentech, Kyowa Hakko Kirin, Loxo Oncology, and Xcovery Holding Company LLC.

Normally, negotiations to use drugs in preclinical studies and clinical trials can take as long as 18 months. But the National Cancer Institute’s (NCI) new drug formulary will allow investigators at NCI-designated cancer centers quicker access to approved and investigational agents, helping make more effective treatments available sooner.

The NCI Formulary, a public-private partnership between NCI and pharmaceutical and biotechnology companies, is one of NCI’s efforts in support of the Cancer Moonshot (ex-Vice President Biden’s call for greater collaboration and faster development of new therapies). The formulary enables NCI to act as an intermediary between investigators at cancer centers and participating pharmaceutical companies, streamlining arrangements for access to and use of drugs.

The formulary launched with 15 targeted agents from 6 pharmaceutical companies: Bristol-Myers Squibb, Eli Lilly and Company, Genentech, Kyowa Hakko Kirin, Loxo Oncology, and Xcovery Holding Company LLC.

Normally, negotiations to use drugs in preclinical studies and clinical trials can take as long as 18 months. But the National Cancer Institute’s (NCI) new drug formulary will allow investigators at NCI-designated cancer centers quicker access to approved and investigational agents, helping make more effective treatments available sooner.

The NCI Formulary, a public-private partnership between NCI and pharmaceutical and biotechnology companies, is one of NCI’s efforts in support of the Cancer Moonshot (ex-Vice President Biden’s call for greater collaboration and faster development of new therapies). The formulary enables NCI to act as an intermediary between investigators at cancer centers and participating pharmaceutical companies, streamlining arrangements for access to and use of drugs.

The formulary launched with 15 targeted agents from 6 pharmaceutical companies: Bristol-Myers Squibb, Eli Lilly and Company, Genentech, Kyowa Hakko Kirin, Loxo Oncology, and Xcovery Holding Company LLC.

Diabetes-related kidney failure has declined dramatically among Native Americans—54% between 1996 and 2013— largely thanks to team- and population-based approaches begun by the IHS in the mid-1980s.

In addition to lowering the prevalence of kidney failure, those approaches led to other improvements:

•   Use of medicines to protect kidneys increased from 42% to 74% in 5 years
•      Average blood pressure in people with hypertension is well controlled (133/76 mm Hg in 2015)
•     Blood sugar control improved by 10% between 1996 and 2014
•     Kidney testing in adults aged ≥ 65 years increased  > 10% compared with the Medicare diabetes population

The CDC and IHS advise team-based care should include patient education; community outreach; care coordination; tracking of health outcomes; and access to health care providers, nutritionists, diabetes educators, pharmacists, community health workers, and behavioral health clinicians. For instance, care managers use clinical data to identify people who need to be linked to health care and call patients if they miss appointments. The care model also includes integrating kidney disease prevention and education into routine diabetes care.

Diabetes-related kidney failure has declined dramatically among Native Americans—54% between 1996 and 2013— largely thanks to team- and population-based approaches begun by the IHS in the mid-1980s.

In addition to lowering the prevalence of kidney failure, those approaches led to other improvements:

•   Use of medicines to protect kidneys increased from 42% to 74% in 5 years
•      Average blood pressure in people with hypertension is well controlled (133/76 mm Hg in 2015)
•     Blood sugar control improved by 10% between 1996 and 2014
•     Kidney testing in adults aged ≥ 65 years increased  > 10% compared with the Medicare diabetes population

The CDC and IHS advise team-based care should include patient education; community outreach; care coordination; tracking of health outcomes; and access to health care providers, nutritionists, diabetes educators, pharmacists, community health workers, and behavioral health clinicians. For instance, care managers use clinical data to identify people who need to be linked to health care and call patients if they miss appointments. The care model also includes integrating kidney disease prevention and education into routine diabetes care.

Diabetes-related kidney failure has declined dramatically among Native Americans—54% between 1996 and 2013— largely thanks to team- and population-based approaches begun by the IHS in the mid-1980s.

In addition to lowering the prevalence of kidney failure, those approaches led to other improvements:

•   Use of medicines to protect kidneys increased from 42% to 74% in 5 years
•      Average blood pressure in people with hypertension is well controlled (133/76 mm Hg in 2015)
•     Blood sugar control improved by 10% between 1996 and 2014
•     Kidney testing in adults aged ≥ 65 years increased  > 10% compared with the Medicare diabetes population

The CDC and IHS advise team-based care should include patient education; community outreach; care coordination; tracking of health outcomes; and access to health care providers, nutritionists, diabetes educators, pharmacists, community health workers, and behavioral health clinicians. For instance, care managers use clinical data to identify people who need to be linked to health care and call patients if they miss appointments. The care model also includes integrating kidney disease prevention and education into routine diabetes care.

Nearly half of a group of homeless and formerly homeless veterans reported experiencing food insecurity, according to VA researchers. More than one-quarter of those said they’d averaged only 1 meal a day.

Researchers screened 270 new patients who enrolled in 1 of 6 VA primary care clinics. Screening began with a single question: “In the past month, were there times when the food for you just did not last, and there was no money to buy more?” Patients who answered yes were then asked where they got their food, how many meals per day they ate, whether they prepared their meals, whether they received food stamps, whether they had diabetes, and whether they had symptoms of hypoglycemia.

Of the respondents, 63% were living in their own apartment, and 26% were in a transitional housing program where they were responsible for some of their meals. Of the patients who reported food insecurity, 87% prepared their meals, with half relying on food they bought, 23% on food from soup kitchens and food pantries, 15% from shelters, 19% from family and friends. About half (47%) were receiving food stamps.

One-fifth of the patients had diabetes or prediabetes, and 44% reported hypoglycemia symptoms when without food. The researchers point out that the consequences of food insecurity are “significant and potentially life threatening.” They cite another study that found risk for hospital admissions for hypoglycemia rose 27% in the last week of the month among low-income populations, typically when food stamps and supplies at food pantries ran low or were exhausted.

The study revealed that asking about only food insecurity was not enough, the researchers say. “The additional context provided by the follow-up questions and the breadth of different responses underscored that the needs of these patients extend beyond those available from 1 health care provider or 1 health care discipline.”

Both patients and health care providers endorsed the screening program. One staff member, for instance, called the program a good rapport builder. No team found the questions burdensome, the researchers say. In fact,4  teams said the follow-up questions highlighted the complexity of issues underlying food insecurity and the need for a well-integrated, multidisciplinary approach to the problem.

Nearly half of a group of homeless and formerly homeless veterans reported experiencing food insecurity, according to VA researchers. More than one-quarter of those said they’d averaged only 1 meal a day.

Researchers screened 270 new patients who enrolled in 1 of 6 VA primary care clinics. Screening began with a single question: “In the past month, were there times when the food for you just did not last, and there was no money to buy more?” Patients who answered yes were then asked where they got their food, how many meals per day they ate, whether they prepared their meals, whether they received food stamps, whether they had diabetes, and whether they had symptoms of hypoglycemia.

Of the respondents, 63% were living in their own apartment, and 26% were in a transitional housing program where they were responsible for some of their meals. Of the patients who reported food insecurity, 87% prepared their meals, with half relying on food they bought, 23% on food from soup kitchens and food pantries, 15% from shelters, 19% from family and friends. About half (47%) were receiving food stamps.

One-fifth of the patients had diabetes or prediabetes, and 44% reported hypoglycemia symptoms when without food. The researchers point out that the consequences of food insecurity are “significant and potentially life threatening.” They cite another study that found risk for hospital admissions for hypoglycemia rose 27% in the last week of the month among low-income populations, typically when food stamps and supplies at food pantries ran low or were exhausted.

The study revealed that asking about only food insecurity was not enough, the researchers say. “The additional context provided by the follow-up questions and the breadth of different responses underscored that the needs of these patients extend beyond those available from 1 health care provider or 1 health care discipline.”

Both patients and health care providers endorsed the screening program. One staff member, for instance, called the program a good rapport builder. No team found the questions burdensome, the researchers say. In fact,4  teams said the follow-up questions highlighted the complexity of issues underlying food insecurity and the need for a well-integrated, multidisciplinary approach to the problem.

Nearly half of a group of homeless and formerly homeless veterans reported experiencing food insecurity, according to VA researchers. More than one-quarter of those said they’d averaged only 1 meal a day.

Researchers screened 270 new patients who enrolled in 1 of 6 VA primary care clinics. Screening began with a single question: “In the past month, were there times when the food for you just did not last, and there was no money to buy more?” Patients who answered yes were then asked where they got their food, how many meals per day they ate, whether they prepared their meals, whether they received food stamps, whether they had diabetes, and whether they had symptoms of hypoglycemia.

Of the respondents, 63% were living in their own apartment, and 26% were in a transitional housing program where they were responsible for some of their meals. Of the patients who reported food insecurity, 87% prepared their meals, with half relying on food they bought, 23% on food from soup kitchens and food pantries, 15% from shelters, 19% from family and friends. About half (47%) were receiving food stamps.

One-fifth of the patients had diabetes or prediabetes, and 44% reported hypoglycemia symptoms when without food. The researchers point out that the consequences of food insecurity are “significant and potentially life threatening.” They cite another study that found risk for hospital admissions for hypoglycemia rose 27% in the last week of the month among low-income populations, typically when food stamps and supplies at food pantries ran low or were exhausted.

The study revealed that asking about only food insecurity was not enough, the researchers say. “The additional context provided by the follow-up questions and the breadth of different responses underscored that the needs of these patients extend beyond those available from 1 health care provider or 1 health care discipline.”

Both patients and health care providers endorsed the screening program. One staff member, for instance, called the program a good rapport builder. No team found the questions burdensome, the researchers say. In fact,4  teams said the follow-up questions highlighted the complexity of issues underlying food insecurity and the need for a well-integrated, multidisciplinary approach to the problem.

The number of older Americans is growing, but the number of those with hearing loss is declining, according to data from the National Health and Nutrition Examination Survey. Researchers compared 2 time periods (1999-2004 and 2011-2012) and found overall annual prevalence of hearing loss dropped from 16% to 14% in 1999-2004, to 28 million adults, then dropped further to 27.7 million in 2011-2012.

Age was the greatest predictor of hearing loss; people in the oldest age group surveyed (aged 60 to 69) had the most loss. Although not included in the study, people aged ≥ 70 years have the highest prevalence of hearing loss of any age group, the authors say. Men of all ages were twice as likely as women to have hearing loss. Non-Hispanic white adults were more likely to have hearing loss than were adults in other ethnic groups. Non-Hispanic black adults had the lowest risk.

The researchers don’t know why hearing loss is becoming less prevalent but suggest reasons include fewer manufacturing jobs, increased use of hearing protectors, less smoking, and better medical care to manage risk factors associated with hearing loss. They did find that lower education level and heavy use of firearms were associated with hearing loss.

“Our findings show a promising trend of better hearing among adults that spans more than half a century,” says Howard Hoffman, MA, first author on the paper and director of the National Institute on Deafness and Other Communication Disorders Epidemiology and Statistics Program. “The decline in hearing loss rates among adults aged < 70 years suggests that age-related hearing loss may be delayed until later in life. This is good news because for those who do develop hearing loss, they will have experienced more quality years of life with better hearing than earlier generations."

The number of older Americans is growing, but the number of those with hearing loss is declining, according to data from the National Health and Nutrition Examination Survey. Researchers compared 2 time periods (1999-2004 and 2011-2012) and found overall annual prevalence of hearing loss dropped from 16% to 14% in 1999-2004, to 28 million adults, then dropped further to 27.7 million in 2011-2012.

Age was the greatest predictor of hearing loss; people in the oldest age group surveyed (aged 60 to 69) had the most loss. Although not included in the study, people aged ≥ 70 years have the highest prevalence of hearing loss of any age group, the authors say. Men of all ages were twice as likely as women to have hearing loss. Non-Hispanic white adults were more likely to have hearing loss than were adults in other ethnic groups. Non-Hispanic black adults had the lowest risk.

The researchers don’t know why hearing loss is becoming less prevalent but suggest reasons include fewer manufacturing jobs, increased use of hearing protectors, less smoking, and better medical care to manage risk factors associated with hearing loss. They did find that lower education level and heavy use of firearms were associated with hearing loss.

“Our findings show a promising trend of better hearing among adults that spans more than half a century,” says Howard Hoffman, MA, first author on the paper and director of the National Institute on Deafness and Other Communication Disorders Epidemiology and Statistics Program. “The decline in hearing loss rates among adults aged < 70 years suggests that age-related hearing loss may be delayed until later in life. This is good news because for those who do develop hearing loss, they will have experienced more quality years of life with better hearing than earlier generations."

The number of older Americans is growing, but the number of those with hearing loss is declining, according to data from the National Health and Nutrition Examination Survey. Researchers compared 2 time periods (1999-2004 and 2011-2012) and found overall annual prevalence of hearing loss dropped from 16% to 14% in 1999-2004, to 28 million adults, then dropped further to 27.7 million in 2011-2012.

Age was the greatest predictor of hearing loss; people in the oldest age group surveyed (aged 60 to 69) had the most loss. Although not included in the study, people aged ≥ 70 years have the highest prevalence of hearing loss of any age group, the authors say. Men of all ages were twice as likely as women to have hearing loss. Non-Hispanic white adults were more likely to have hearing loss than were adults in other ethnic groups. Non-Hispanic black adults had the lowest risk.

The researchers don’t know why hearing loss is becoming less prevalent but suggest reasons include fewer manufacturing jobs, increased use of hearing protectors, less smoking, and better medical care to manage risk factors associated with hearing loss. They did find that lower education level and heavy use of firearms were associated with hearing loss.

“Our findings show a promising trend of better hearing among adults that spans more than half a century,” says Howard Hoffman, MA, first author on the paper and director of the National Institute on Deafness and Other Communication Disorders Epidemiology and Statistics Program. “The decline in hearing loss rates among adults aged < 70 years suggests that age-related hearing loss may be delayed until later in life. This is good news because for those who do develop hearing loss, they will have experienced more quality years of life with better hearing than earlier generations."

Veterans are 40% more likely than nonveterans to experience severe pain, according to the 2010-2014 National Health Interview Survey. Epidemiologists from the National Center for Complementary and Integrative Health analyzed data on 6,647 veterans and 61,049 nonveterans who were asked about the persistence and intensity of self-reported pain during the previous 3 months.

Veterans were more likely to report having pain (65.5% vs 56.4%) and more likely to describe severe pain—that is, pain that occurred “most days” or “every day” and bothered the respondent “a lot” (9.1% vs 6.3%). Younger veterans in particular were more than 2 times as likely to report severe pain (7.8% vs 3.2%), even when researchers controlled for underlying demographic characteristics. Veterans aged 18 to 39 years and 50 to 59 years were more likely than nonveterans of the same ages to have any pain, but veterans aged ≥ 70 years were less likely to have severe pain than were similarly aged nonveterans.

Back pain and joint pain topped the list for veterans compared with jaw pain and migraines for nonveterans.

The majority of veteran participants were men (92.5%), whereas the majority of nonveteran participants were women (56.5%). The survey data did not identify any specific aspects of military service, including branch of the armed forces, years of service, or whether the veteran served in a combat role.

The survey also didn’t collect information on pain treatment, so it isn’t clear whether differences in treatment would explain the differences in pain experiences. Nor did the survey reveal whether younger veterans with severe pain were in pain despite treatment or because they weren’t getting any treatment.

 “These findings suggest that more attention should be paid to helping veterans manage the impact of severe pain and related disability on daily activities,” the lead researcher said.

Veterans are 40% more likely than nonveterans to experience severe pain, according to the 2010-2014 National Health Interview Survey. Epidemiologists from the National Center for Complementary and Integrative Health analyzed data on 6,647 veterans and 61,049 nonveterans who were asked about the persistence and intensity of self-reported pain during the previous 3 months.

Veterans were more likely to report having pain (65.5% vs 56.4%) and more likely to describe severe pain—that is, pain that occurred “most days” or “every day” and bothered the respondent “a lot” (9.1% vs 6.3%). Younger veterans in particular were more than 2 times as likely to report severe pain (7.8% vs 3.2%), even when researchers controlled for underlying demographic characteristics. Veterans aged 18 to 39 years and 50 to 59 years were more likely than nonveterans of the same ages to have any pain, but veterans aged ≥ 70 years were less likely to have severe pain than were similarly aged nonveterans.

Back pain and joint pain topped the list for veterans compared with jaw pain and migraines for nonveterans.

The majority of veteran participants were men (92.5%), whereas the majority of nonveteran participants were women (56.5%). The survey data did not identify any specific aspects of military service, including branch of the armed forces, years of service, or whether the veteran served in a combat role.

The survey also didn’t collect information on pain treatment, so it isn’t clear whether differences in treatment would explain the differences in pain experiences. Nor did the survey reveal whether younger veterans with severe pain were in pain despite treatment or because they weren’t getting any treatment.

 “These findings suggest that more attention should be paid to helping veterans manage the impact of severe pain and related disability on daily activities,” the lead researcher said.

Veterans are 40% more likely than nonveterans to experience severe pain, according to the 2010-2014 National Health Interview Survey. Epidemiologists from the National Center for Complementary and Integrative Health analyzed data on 6,647 veterans and 61,049 nonveterans who were asked about the persistence and intensity of self-reported pain during the previous 3 months.

Veterans were more likely to report having pain (65.5% vs 56.4%) and more likely to describe severe pain—that is, pain that occurred “most days” or “every day” and bothered the respondent “a lot” (9.1% vs 6.3%). Younger veterans in particular were more than 2 times as likely to report severe pain (7.8% vs 3.2%), even when researchers controlled for underlying demographic characteristics. Veterans aged 18 to 39 years and 50 to 59 years were more likely than nonveterans of the same ages to have any pain, but veterans aged ≥ 70 years were less likely to have severe pain than were similarly aged nonveterans.

Back pain and joint pain topped the list for veterans compared with jaw pain and migraines for nonveterans.

The majority of veteran participants were men (92.5%), whereas the majority of nonveteran participants were women (56.5%). The survey data did not identify any specific aspects of military service, including branch of the armed forces, years of service, or whether the veteran served in a combat role.

The survey also didn’t collect information on pain treatment, so it isn’t clear whether differences in treatment would explain the differences in pain experiences. Nor did the survey reveal whether younger veterans with severe pain were in pain despite treatment or because they weren’t getting any treatment.

 “These findings suggest that more attention should be paid to helping veterans manage the impact of severe pain and related disability on daily activities,” the lead researcher said.

“There is no safe level of smoking”—that’s the conclusion of National Cancer Institute researchers, based on data from 290,215 adults in the 2004-2005 NIH-AARP Diet and Health Study. “[S]moking even a small number of cigarettes per day has substantial negative health effects,” said Maki Inoue-Choi, PhD, lead author.

The participants responded to a questionnaire that assessed lifetime smoking intensity. Those who smoked between 1 and 10 cigarettes a day had an 87% higher risk of earlier death. But even people who smoked an average of < 1 cigarette per day over their lifetime still had a 64% higher risk of earlier death, compared with never-smokers.

The researchers also looked at specific causes of death. Not surprisingly, they found a “particularly strong” association for lung cancer mortality. But again, even people who consistently averaged < 1 cigarette per day over their lifetime had 9 times the risk of dying from lung cancer than never-smokers. Among those who smoked between 1 and 10 cigarettes a day, the risk of dying from lung cancer was nearly 12 times higher.

People who smoked between 1 and 10 cigarettes a day also had > 6 times the risk of dying from respiratory disease and about 1 and a half times the risk of dying of cardiovascular disease, compared with never-smokers.

The younger people were when they quit smoking, the lower their risk of early death.

“There is no safe level of smoking”—that’s the conclusion of National Cancer Institute researchers, based on data from 290,215 adults in the 2004-2005 NIH-AARP Diet and Health Study. “[S]moking even a small number of cigarettes per day has substantial negative health effects,” said Maki Inoue-Choi, PhD, lead author.

The participants responded to a questionnaire that assessed lifetime smoking intensity. Those who smoked between 1 and 10 cigarettes a day had an 87% higher risk of earlier death. But even people who smoked an average of < 1 cigarette per day over their lifetime still had a 64% higher risk of earlier death, compared with never-smokers.

The researchers also looked at specific causes of death. Not surprisingly, they found a “particularly strong” association for lung cancer mortality. But again, even people who consistently averaged < 1 cigarette per day over their lifetime had 9 times the risk of dying from lung cancer than never-smokers. Among those who smoked between 1 and 10 cigarettes a day, the risk of dying from lung cancer was nearly 12 times higher.

People who smoked between 1 and 10 cigarettes a day also had > 6 times the risk of dying from respiratory disease and about 1 and a half times the risk of dying of cardiovascular disease, compared with never-smokers.

The younger people were when they quit smoking, the lower their risk of early death.

“There is no safe level of smoking”—that’s the conclusion of National Cancer Institute researchers, based on data from 290,215 adults in the 2004-2005 NIH-AARP Diet and Health Study. “[S]moking even a small number of cigarettes per day has substantial negative health effects,” said Maki Inoue-Choi, PhD, lead author.

The participants responded to a questionnaire that assessed lifetime smoking intensity. Those who smoked between 1 and 10 cigarettes a day had an 87% higher risk of earlier death. But even people who smoked an average of < 1 cigarette per day over their lifetime still had a 64% higher risk of earlier death, compared with never-smokers.

The researchers also looked at specific causes of death. Not surprisingly, they found a “particularly strong” association for lung cancer mortality. But again, even people who consistently averaged < 1 cigarette per day over their lifetime had 9 times the risk of dying from lung cancer than never-smokers. Among those who smoked between 1 and 10 cigarettes a day, the risk of dying from lung cancer was nearly 12 times higher.

People who smoked between 1 and 10 cigarettes a day also had > 6 times the risk of dying from respiratory disease and about 1 and a half times the risk of dying of cardiovascular disease, compared with never-smokers.

The younger people were when they quit smoking, the lower their risk of early death.

A single cough can propel as many as 3,000 droplets into the air at a velocity of 6 to 28 m/s. The droplets travel in what classic fluid mechanics calls a “2-stage jet”: the starting jet (when the cough starts) and interrupted jet (when the cough stops). After the original cough ends, a “leading vortex” carries particles forward, but as the momentum slows, particles fall out of the jet according to researchers from the University of Hong Kong and Shenzhen Institute of Research and Innovation, both in China, who studied cough trajectories and the implications for disease transmission in buildings.

Once the penetration velocity drops below 0.01 m/s, environmental factors, such as ventilation and human body temperature, begin to influence the flow. Beyond 1 to 2 m, the exhaled air stream dissolves into the room airflow, and the pathogen-containing droplets or droplet nuclei are dispersed according to the global airflow in the room.

When a cough doesn’t last long, the researchers say, the velocity of fine particles decays significantly after the jet is interrupted. However, even short coughs have consequences: Pathogen-containing droplets as large as ≥ 5 µm in diameter can be directly deposited on the nasal or oral mucosa of a nearby “new host.”

But coughs differ in many ways, including how far and wide they send the droplets. The researchers conducted experiments to help determine spread by discharging dyed or particle-filled water into a water tank.  They examined 3 different temporal exit velocity profiles: pulsation, sinusoidal, and real-cough.

The “most striking phenomenon,” the researchers say, is that the particle clouds of all 3 sizes of particles (small [8-14 µm], medium [57-68 µm], large [96-114 µm]) penetrated almost the same distance at different time steps. In other words, large particles can travel as far as fine particles.

The cough flow’s maximum penetration distance was 53.4 to 69.7 opening diameter. That is, for a mouth opening to a diameter of 2 cm, the large particles could penetrate 1 to 1.4 m in a “real cough case,” they note. Cough duration was important in determining the spread range of particles. Their maximum travel distance was “much enhanced” in a long starting jet, especially for small particles.

Source:
Wei J, Li Y. PLoS One. 2017;12(1): e0169235.
doi:  10.1371/journal.pone.0169235.

A single cough can propel as many as 3,000 droplets into the air at a velocity of 6 to 28 m/s. The droplets travel in what classic fluid mechanics calls a “2-stage jet”: the starting jet (when the cough starts) and interrupted jet (when the cough stops). After the original cough ends, a “leading vortex” carries particles forward, but as the momentum slows, particles fall out of the jet according to researchers from the University of Hong Kong and Shenzhen Institute of Research and Innovation, both in China, who studied cough trajectories and the implications for disease transmission in buildings.

Once the penetration velocity drops below 0.01 m/s, environmental factors, such as ventilation and human body temperature, begin to influence the flow. Beyond 1 to 2 m, the exhaled air stream dissolves into the room airflow, and the pathogen-containing droplets or droplet nuclei are dispersed according to the global airflow in the room.

When a cough doesn’t last long, the researchers say, the velocity of fine particles decays significantly after the jet is interrupted. However, even short coughs have consequences: Pathogen-containing droplets as large as ≥ 5 µm in diameter can be directly deposited on the nasal or oral mucosa of a nearby “new host.”

But coughs differ in many ways, including how far and wide they send the droplets. The researchers conducted experiments to help determine spread by discharging dyed or particle-filled water into a water tank.  They examined 3 different temporal exit velocity profiles: pulsation, sinusoidal, and real-cough.

The “most striking phenomenon,” the researchers say, is that the particle clouds of all 3 sizes of particles (small [8-14 µm], medium [57-68 µm], large [96-114 µm]) penetrated almost the same distance at different time steps. In other words, large particles can travel as far as fine particles.

The cough flow’s maximum penetration distance was 53.4 to 69.7 opening diameter. That is, for a mouth opening to a diameter of 2 cm, the large particles could penetrate 1 to 1.4 m in a “real cough case,” they note. Cough duration was important in determining the spread range of particles. Their maximum travel distance was “much enhanced” in a long starting jet, especially for small particles.

Source:
Wei J, Li Y. PLoS One. 2017;12(1): e0169235.
doi:  10.1371/journal.pone.0169235.

A single cough can propel as many as 3,000 droplets into the air at a velocity of 6 to 28 m/s. The droplets travel in what classic fluid mechanics calls a “2-stage jet”: the starting jet (when the cough starts) and interrupted jet (when the cough stops). After the original cough ends, a “leading vortex” carries particles forward, but as the momentum slows, particles fall out of the jet according to researchers from the University of Hong Kong and Shenzhen Institute of Research and Innovation, both in China, who studied cough trajectories and the implications for disease transmission in buildings.

Once the penetration velocity drops below 0.01 m/s, environmental factors, such as ventilation and human body temperature, begin to influence the flow. Beyond 1 to 2 m, the exhaled air stream dissolves into the room airflow, and the pathogen-containing droplets or droplet nuclei are dispersed according to the global airflow in the room.

When a cough doesn’t last long, the researchers say, the velocity of fine particles decays significantly after the jet is interrupted. However, even short coughs have consequences: Pathogen-containing droplets as large as ≥ 5 µm in diameter can be directly deposited on the nasal or oral mucosa of a nearby “new host.”

But coughs differ in many ways, including how far and wide they send the droplets. The researchers conducted experiments to help determine spread by discharging dyed or particle-filled water into a water tank.  They examined 3 different temporal exit velocity profiles: pulsation, sinusoidal, and real-cough.

The “most striking phenomenon,” the researchers say, is that the particle clouds of all 3 sizes of particles (small [8-14 µm], medium [57-68 µm], large [96-114 µm]) penetrated almost the same distance at different time steps. In other words, large particles can travel as far as fine particles.

The cough flow’s maximum penetration distance was 53.4 to 69.7 opening diameter. That is, for a mouth opening to a diameter of 2 cm, the large particles could penetrate 1 to 1.4 m in a “real cough case,” they note. Cough duration was important in determining the spread range of particles. Their maximum travel distance was “much enhanced” in a long starting jet, especially for small particles.

Source:
Wei J, Li Y. PLoS One. 2017;12(1): e0169235.
doi:  10.1371/journal.pone.0169235.

Before he assumed his position as U.S. Surgeon General, Vivek Murthy, MD, says, he stopped by to say good-bye to his colleagues. The nurses had 1 parting request: If you can only do 1 thing as Surgeon General, please do something about the addiction crisis in America.

Thus, for the first time, a U.S. Surgeon General has dedicated a report to substance misuse and related disorders, calling these issues one of America’s most pressing public health concerns. “I am issuing a new call to action,” he says in the foreword, “to end the public health crisis of addiction.” Nearly 21 million Americans suffer from substance use disorders—more than the number of people who have all cancers combined.

Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health offers an in-depth look at the science of substance use disorders and addiction, with chapters on neurobiology, prevention, treatment, recovery, health systems integration, and recommendations for the future.

One of the findings is that substance use disorder treatment in the U.S. remains “largely separate” from the rest of health care and serves only a fraction of those in need of treatment. An estimated 1 in 7 people in the U.S. develops a substance use disorder at some point in their lives, yet only 1 in 10 receives treatment. Many factors contribute to this treatment gap, including the stigma associated with drug and alcohol addiction.

There has been progress: The Obama administration has invested in research, development, and evaluation of programs to prevent and treat substance misuse and substance use disorders, as well as support recovery, the report says.

“It’s time to change how we view addiction,” said Dr. Murthy. “Not as a moral failing, but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America.”

Before he assumed his position as U.S. Surgeon General, Vivek Murthy, MD, says, he stopped by to say good-bye to his colleagues. The nurses had 1 parting request: If you can only do 1 thing as Surgeon General, please do something about the addiction crisis in America.

Thus, for the first time, a U.S. Surgeon General has dedicated a report to substance misuse and related disorders, calling these issues one of America’s most pressing public health concerns. “I am issuing a new call to action,” he says in the foreword, “to end the public health crisis of addiction.” Nearly 21 million Americans suffer from substance use disorders—more than the number of people who have all cancers combined.

Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health offers an in-depth look at the science of substance use disorders and addiction, with chapters on neurobiology, prevention, treatment, recovery, health systems integration, and recommendations for the future.

One of the findings is that substance use disorder treatment in the U.S. remains “largely separate” from the rest of health care and serves only a fraction of those in need of treatment. An estimated 1 in 7 people in the U.S. develops a substance use disorder at some point in their lives, yet only 1 in 10 receives treatment. Many factors contribute to this treatment gap, including the stigma associated with drug and alcohol addiction.

There has been progress: The Obama administration has invested in research, development, and evaluation of programs to prevent and treat substance misuse and substance use disorders, as well as support recovery, the report says.

“It’s time to change how we view addiction,” said Dr. Murthy. “Not as a moral failing, but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America.”

Before he assumed his position as U.S. Surgeon General, Vivek Murthy, MD, says, he stopped by to say good-bye to his colleagues. The nurses had 1 parting request: If you can only do 1 thing as Surgeon General, please do something about the addiction crisis in America.

Thus, for the first time, a U.S. Surgeon General has dedicated a report to substance misuse and related disorders, calling these issues one of America’s most pressing public health concerns. “I am issuing a new call to action,” he says in the foreword, “to end the public health crisis of addiction.” Nearly 21 million Americans suffer from substance use disorders—more than the number of people who have all cancers combined.

Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health offers an in-depth look at the science of substance use disorders and addiction, with chapters on neurobiology, prevention, treatment, recovery, health systems integration, and recommendations for the future.

One of the findings is that substance use disorder treatment in the U.S. remains “largely separate” from the rest of health care and serves only a fraction of those in need of treatment. An estimated 1 in 7 people in the U.S. develops a substance use disorder at some point in their lives, yet only 1 in 10 receives treatment. Many factors contribute to this treatment gap, including the stigma associated with drug and alcohol addiction.

There has been progress: The Obama administration has invested in research, development, and evaluation of programs to prevent and treat substance misuse and substance use disorders, as well as support recovery, the report says.

“It’s time to change how we view addiction,” said Dr. Murthy. “Not as a moral failing, but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America.”

Cases of the most commonly reported STDs reached an “unprecedented” high in the US in 2015, with > 1.5 million chlamydia cases, nearly 400,000 gonorrhea cases, and nearly 24,000 cases of primary and secondary syphilis.

According to the CDC’s annual Sexually Transmitted Disease Surveillance Report, between 2014 and 2015, the number of syphilis cases rose by 19%, followed by gonorrhea (12.8%) and chlamydia (5.9%). Young people aged 15 to 24 accounted for nearly two thirds of chlamydia diagnoses and half of gonorrhea diagnoses. Men who have sex with men accounted for most new gonorrhea and syphilis cases. The report also notes that antibiotic-resistant gonorrhea may be higher in this group.

Syphilis diagnoses in women jumped by > 27% in 1 year, which presents  a serious risk for infants. For example, reported congenital syphilis (transmitted from a pregnant woman to the baby) rose by 6%.

But all 3 of those STDs are not only treatable, they’re curable with antibiotics. Widespread access to screening and treatment would reduce the spread. Undiagnosed and untreated, these diseases pose severe and often irreversible health consequences, including infertility, chronic pain, and a greater risk of acquiring HIV. The CDC also estimates a ”substantial economic burden” of nearly $16 billion a year.

In recent years, > 50% of state and local STD programs have had their budgets cut, the report notes, and  > 20 health department STD clinics closed their doors in 1 year alone. “STD prevention resources across the nation are stretched thin,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

The CDC says an effective national response to the epidemic requires engagement from many players. One suggestion: making screening a standard part of medical care, especially for pregnant women, and integrating STD prevention and treatment into prenatal care and other routine visits.

Cases of the most commonly reported STDs reached an “unprecedented” high in the US in 2015, with > 1.5 million chlamydia cases, nearly 400,000 gonorrhea cases, and nearly 24,000 cases of primary and secondary syphilis.

According to the CDC’s annual Sexually Transmitted Disease Surveillance Report, between 2014 and 2015, the number of syphilis cases rose by 19%, followed by gonorrhea (12.8%) and chlamydia (5.9%). Young people aged 15 to 24 accounted for nearly two thirds of chlamydia diagnoses and half of gonorrhea diagnoses. Men who have sex with men accounted for most new gonorrhea and syphilis cases. The report also notes that antibiotic-resistant gonorrhea may be higher in this group.

Syphilis diagnoses in women jumped by > 27% in 1 year, which presents  a serious risk for infants. For example, reported congenital syphilis (transmitted from a pregnant woman to the baby) rose by 6%.

But all 3 of those STDs are not only treatable, they’re curable with antibiotics. Widespread access to screening and treatment would reduce the spread. Undiagnosed and untreated, these diseases pose severe and often irreversible health consequences, including infertility, chronic pain, and a greater risk of acquiring HIV. The CDC also estimates a ”substantial economic burden” of nearly $16 billion a year.

In recent years, > 50% of state and local STD programs have had their budgets cut, the report notes, and  > 20 health department STD clinics closed their doors in 1 year alone. “STD prevention resources across the nation are stretched thin,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

The CDC says an effective national response to the epidemic requires engagement from many players. One suggestion: making screening a standard part of medical care, especially for pregnant women, and integrating STD prevention and treatment into prenatal care and other routine visits.

Cases of the most commonly reported STDs reached an “unprecedented” high in the US in 2015, with > 1.5 million chlamydia cases, nearly 400,000 gonorrhea cases, and nearly 24,000 cases of primary and secondary syphilis.

According to the CDC’s annual Sexually Transmitted Disease Surveillance Report, between 2014 and 2015, the number of syphilis cases rose by 19%, followed by gonorrhea (12.8%) and chlamydia (5.9%). Young people aged 15 to 24 accounted for nearly two thirds of chlamydia diagnoses and half of gonorrhea diagnoses. Men who have sex with men accounted for most new gonorrhea and syphilis cases. The report also notes that antibiotic-resistant gonorrhea may be higher in this group.

Syphilis diagnoses in women jumped by > 27% in 1 year, which presents  a serious risk for infants. For example, reported congenital syphilis (transmitted from a pregnant woman to the baby) rose by 6%.

But all 3 of those STDs are not only treatable, they’re curable with antibiotics. Widespread access to screening and treatment would reduce the spread. Undiagnosed and untreated, these diseases pose severe and often irreversible health consequences, including infertility, chronic pain, and a greater risk of acquiring HIV. The CDC also estimates a ”substantial economic burden” of nearly $16 billion a year.

In recent years, > 50% of state and local STD programs have had their budgets cut, the report notes, and  > 20 health department STD clinics closed their doors in 1 year alone. “STD prevention resources across the nation are stretched thin,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

The CDC says an effective national response to the epidemic requires engagement from many players. One suggestion: making screening a standard part of medical care, especially for pregnant women, and integrating STD prevention and treatment into prenatal care and other routine visits.