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January - June 2011

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Suggested Citation: Jung, B.C. (2011 - 2023). Betty C. Jung's 2011 Public Health Blog (January - June).
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  • June 30, 2011 - Simplifying Eating Healthy

    Graphic source:

    Eating right has gotten so much easier now with the introduction of the MyPlate icon. Basically, half of what you eat should be fruits and vegetables.

    If you want to make it even easier, I recommend "Cut out white foods" or "Do colors." Make your plate as colorful as possible. The only thing white would be the glass of milk (preferably skim or low-fat), and everything else should be non-white. This means cutting out white rice, white potatoes, white bread, etc. You can eat as much fruits and vegetables as you like as they are nutrition dense. Grains and protein should make up less than half your plate. Happy eating!

    Read the from the USDA about eating right. For more information, see Nutrition

  • June 29, 2011 - Potato Chips and Creeping Weight Gain

    Putting on weight with chips

    Graphic source:

    According to a June 23rd New England Journal of Medicine's report, based on data from the Nurses' Health Study I and II and the Health Professionals Follow-up Study:

    • Roughly half of the average 3.35 pounds a healthy, nonobese American gains over four years could be chalked up to eating more potato chips over time (1.69 lb per additional serving per day);
    • Other food strongly associated with weight gain...included:
      • Potatoes at 1.28 lb
      • Sugar-sweetened beverages at 1.00 lb
      • Unprocessed red meats at 0.95 lb
      • Processed meats at 0.93 lb
    • Four-year weight loss was most associated with intake of:
      • Yogurt at -0.82 lb
      • Nuts at -0.57 lb
      • Fruits at -0.49 lb
      • Whole grains at -0.37 lb
      • Vegetables at -0.22 lb
      • Eating more or less of any single food generally had a modest effect on weight, but together the changes in diet and exercise accounted for large differences in weight gain over time.
      • These tended to be creeping gains of only 0.8 lb on average per year, which makes it tough to perceive specific causes, "But accumulated over time, even modest increases in weight have implications for long-term adiposity-related metabolic dysfunction, diabetes, cardiovascular disease, and cancer,"
      • The foods associated with weight loss fit with the emphasis on fruit, vegetables, and grains on the U.S. Department of Agriculture's plate graphic that recently replaced the food pyramid to guide food choices,
      • Weight gain averaged 3.35 lb across the cohorts during each four-year period, representing 2.4% of body weight, and added up to an average 16.8 lb over 20 years.
      • Weight gain was linked to alcohol use (0.41 lb per drink per day), smoking cessation (new quitters gained 5.17 lb, former smokers gained 0.14 lb), and television watching (0.31 lb per hour per day).
      • Not surprisingly, physical activity was associated with 1.76 lb of weight loss over four years....
      • Citation source:Mozaffarian D, et al "Changes in diet and lifestyle and long- term weight gain in women and men" N Engl J Med 2011; 364: 2392-2404, as reported at

      For more information, see Nutrition Resources

  • June 28, 2011 - CDC: Sugar Drink Consumption among U.S. High School Students Should Be Reduced

    Teen drinking soda
    Graphic source: Google search

    According to the June 23rd CDC Healthy People, Healthy Places Newsletter , high school students are drinking too much sugary beverages.

    • Sugar drinks, also called sugar-sweetened beverages, are the largest source of added sugars in the diets of U.S. youth. Consuming sugar drinks increases calories a factor potentially contributing to obesity among youth nationwide.
    • America's youths are drinking more sugar drinks than youths of previous generations.
    • Sugar drinks are those to which sweeteners with calories have been added. High fructose corn syrup, sucrose (table sugar) and other sweeteners add calories without adding any nutrients.
    • Some common sugar drinks are:
      • Soft drinks, soda or pop
      • Fruit drinks, punches
      • Sports drinks and energy drinks
      • Sweetened tea and coffee drinks
      • Sweetened, or flavored, milk
    • To support youth in choosing healthier beverages, families, schools, and other youth-serving organizations should
      • Reduce youths access to sugar drinks to decrease consumption.
      • Make adolescents aware that water and low-fat or fat-free milk are the most healthful beverages.
      • In limited amounts, 100% fruit juice also has health benefits.
    • Citation source: Berkey CS, Rockett HRH, Field AE, Gillman MW, Colditz GA. Sugar-added beverages and adolescent weight change. Obesity Research 2004;12:778-788; CDC listserv

    And,"The BBC reports that drinking excessive amounts of cola can lead to muscle weakness and possibly even muscle paralysis...the ingredients within soda can cause blood potassium levels to plummet.

    The study finds that when the three main ingredients commonly found in soda -- glucose, fructose, and caffeine -- are consumed in large quantities, it can lead to "caffeine intoxication" and "dangerously low" blood potassium levels. Even caffeine-free cola can be dangerous...because it still contains fructose." (Graphic and Citation Source:; as reported at

    For more information, see Nutrition and Health behavior data

  • June 27, 2011 - National HIV Testing Day

    National HIV Testing Day
    Graphic source:
    May 23, 2011 was the 30th anniversary of the first case of AIDS. That is over 30 years ago! These days, we know a lot more about this viral disease and how to treat it, and those with an HIV infection can live for many years. While there is still no cure for AIDS, it is absolutely essential that those who are infected get treated early on. It is therefore essential that those who are at risk for the infection be screened regularly.

    According to the CDC, annual HIV testing is recommended for:

    • Sexually active men or women, who are not in a long term, mutually monogamous relationship;
    • Sexually active men who have sex with men (MSM), who are not in a long term, mutually monogamous relationship;
    • Citation source:

    For more information about testing, see . For additional information about AIDS/HIV, see AIDS/HIV

  • June 24, 2011 - Man Up!

    Man up!
    The CDC has great E-Cards, but this has to be my favorite one! Click on the graphic and find out what it is to Man Up!
  • June 23, 2011 - FDA's Graphic Cigarette Health Warnings

    FDA graphic cigarette warnings

    Graphic source: FDA Listserv
    Graphic cigarette health warnings are coming to all cigarette packages, as stipulated by the FDA, within 15 months. Images will be paired with one of nine warnings:
    • WARNING: Cigarettes are addictive with an image of a man smoking through a hole in his throat
    • WARNING: Tobacco smoke can harm your children with an image of a parent holding a baby as smoke drifts towards them
    • WARNING: Cigarettes cause fatal lung disease with an image of a disease-riddled lung and a healthy lung
    • WARNING: Cigarettes cause cancer with an image of an open sore and stained teeth on the lips and mouth of a smoker with mouth cancer
    • WARNING: Cigarettes cause strokes and heart disease with an image of a man who needs an oxygen mask to breathe
    • WARNING: Smoking during pregnancy can harm your baby with an illustration of a crying newborn in an incubator and hooked-up to a monitor
    • WARNING: Smoking can kill you with the image of a dead man with a surgery-scarred chest
    • WARNING: Tobacco smoke causes fatal lung disease in nonsmokers with an image of a grieving family member
    • WARNING: Quitting smoking now greatly reduces serious risks to your health with an image of a man wearing an I Quit T-shirt
    • Citation source: FDA Unveils New Cigarette Health Warnings

    For more information, see Tobacco

  • June 22, 2011 - Tobacco Use and Lung Cancer Deaths

    American Cancer Society 2010

    Graphic source: CancerFactsFigures/cancer-facts-and-figures-2010
    This American Cancer Society line graph shows that per capita cigarette consumption has decreased in recent years, along with a gradual decrease in the male lung cancer death rate. Unfortunately, the female lung cancer death is not showing a similar decline. In fact, cancer of the lung and bronchus is the leading cause of cancer deaths in women (May 12th entry). Regardless of gender, tobacco is the main reason why men and women are dying from lung cancer.

    Smoking Causes Cancer
    Graphic source:

    For more information, see Cancer, and Tobacco

  • June 21, 2011 - Happy Summer - New FDA sunscreen labeling is coming

    Now that daylight will be around longer, everyone will be spending more time in the sun. However, excessive exposure to the sun's rays increases the risk for skin cancer for those who are fair-skinned and accelerates skin wrinkling and aging for everyone.

    The FDA is issuing new rules for how sunscreen products will be labeled. Watch these FDA videos for information about how sunscreens work, and what the new rules will be.

    For more information, see FDA Sunscreen Page

  • June 20, 2011 - Cancer Deaths in Men

    American Cancer Society 2010

    Graphic source:

    Here is a line graph from American Cancer Society's "Cancer Facts & Figures 2010" showing the cancer death rates for men.

    According the 3/31 NIH news release, "Report to nation finds continued declines in many cancer rates"

    • "In men, incidence rates have declined for cancers of the lung, colon and rectum, oral cavity and pharynx, stomach, and brain (malignant only) while rates have risen for kidney, pancreas and liver cancers, as well as melanoma of the skin.
    • Citation source:

    Keep in mind that tobacco use contributes to 90% of lung cancer deaths, among other forms of cancer. It's best to never start smoking, or if you do, to quit. For more information, see Tobacco Resources and Cancer Resources

  • June 19, 2011 - Happy Father's Day!

    Encouraging Dads to quit smoking. Learn more
    Men who are fathers are very special to those around them - their parents, their children and their wives and partners. Continue to play a vital role in their lives by being there for them. Smoking cuts into the time you can spend with those you love, so if you smoke, make the effort to stop. Not only will you improve the environment, but your lungs as well. You will breathe better, reduce the chances of developing cancer and heart disease, and generally improve your quality life. It is a win-win situation.

    For more information, see Smoking Cessation

  • June 18, 2011 - Men's Health Basics

    What men die from

    Table source: reports, "The ranking is for all races and ages combined. Different races have different rankings. For example, homicide is the fourth highest cause of death for black men and HIV/AIDS is the seventh, neither of which is in the top ten for all races. For Hispanic men, homicide is sixth, followed by chronic liver disease." Source: also reports on the health concerns for men of different racial and ethnic groups:

    • African-American and Hispanic-American/Latino men are less likely than white men to see a doctor.
    • Minority men are less likely to get timely preventive care, such as flu shots and colonoscopies.
    • African-American men are 30 percent more likely to die from heart disease compared to non-Hispanic white men.
    • Even though blacks account for about 13 percent of the U.S. population, they account for about half of the people who get HIV/AIDS.
    • American Indians and Alaska Natives have especially high rates of depression, suicide, and substance abuse.
    • African-Americans who get skin cancer are more likely to die from it than whites.
    • Type 2 diabetes is more common among African-Americans, Hispanic-Americans/Latinos, and American Indians than among whites.
    • Asians and Pacific Islanders make up 4.5 percent of the U.S. population but have more than half of the chronic cases of hepatitis B.
    • The reasons for these health disparities are not directly related to race and ethnicity. Instead, low income, lack of access to care, language and cultural differences, and other barriers often make good health hard to achieve for many minority groups.
    • ...many health problems can be prevented or lessened with healthy habits like eating a healthy diet, exercising, and not smoking. Make sure to visit your doctor regularly and get the vaccines that are right for you. Also ask about screenings for conditions like high blood pressure and diabetes.
    • Citation source:

    For more information, see Men's Health Resource

  • June 17, 2011 - 9 in 10 Teens Are Not Exercising Enough

    9 in 10 teens are out of shape!
    Graphic source:

    Yesterday HealthDay reported in "High School Kids Get Too Many Sugary Drinks, Too Little Exercise: CDC" (6/17 MMWR) on what CDC researchers are finding:

    • "Not only are high school kids guzzling far too many high-calorie sodas, they're also getting very little exercise"
    • In fact, just one in 10 high school boys and girls are meeting the minimum goals for physical activity outlined by in the CDC's recently released "Healthy People 2020" report,"
    • just over 15 percent of poll participants met the aerobic objectives, while only about half met the strength-building goal. Only 12.2 percent met both guidelines.
    • ...consumption of sodas, sports drinks and other sugar-sweetened beverages is all too common.
    • ...boys downed more sugar-sweetened beverages than girls. Black teens were also more likely than their white and/or Hispanic peers to drink at least one such beverage per day.
    • Teens should be encouraged to consume greater amounts of water and low and/or fat-free milk, alongside 100 percent fruit juice,
    • ...the CDC team called on schools, communities and health-care facilities to band together to promote physical activity while providing more places to exercise."
    • "The problem is that physical activity is not required on a daily basis in most schools. And when that's the case kids are probably not exercising at all, unless they're involved in a sport."
    • "The goal [for schools] should be to create more opportunities for teens to be physically active,"... "And frankly, that might mean bringing back gym class."
    • ...parents need to try to encourage healthy habits way before kids reach their teens. "Because you have to get to them when they're between 5 and 10, before they become more influenced by what their peers are doing than what their parents say."
    • Citation source:Dorothy Teegarden, Ph.D., professor, department of nutrition science, Purdue University, West Lafayette, Ind.; Lona Sandon, R.D., assistant professor, clinical nutrition, University of Texas Southwestern Dallas; June 17, 2011, Morbidity and Mortality Weekly Report as reported by

    For more information, see Obesity, Fitness, and Nutrition

  • June 16, 2011 - No Energy Drinks for Kids and Teens

    No Energy Drinks for Kids and Teens
    Graphic source:
    The American Academy of Pediatrics (AAP) published online (May 29) and in June's issue of Pediatrics its report,"Clinical Report Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate?" AAP recommendations reported by Medscape on June 1st:
    • Pediatricians should educate patients and their parents regarding the potential health risks of energy drinks and sports drinks and explain the significant differences between these types of drinks. The terms should not be used interchangeably.
    • Energy drinks should never be consumed by children or adolescents, because the stimulants they contain pose potential health risks.
    • Children and adolescents should avoid and restrict routine consumption of carbohydrate-containing sports drinks, which can increase the risk for overweight, obesity, and dental erosion.
    • For pediatric athletes, sports drinks should be consumed in combination with water during prolonged, vigorous physical activity, when rapid replenishment of carbohydrates and/or electrolytes is needed.
    • For children and adolescents, water, not sports drinks, should be the principal source of hydration.
    • Citation source:

    Read Clinical Report Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? Report. For more information, see Nutrition Resources

  • June 15, 2011 - Global Warming Trends

    Global Warming Trends
    Graphic source:

    Oh no - more data to show global warming is definitely affecting current weather. Although many Americans had experienced probably one of the worst winters in recent memory, snowing like there's no tomorrow, followed by horrific spring flooding and EF-5 tornadoes (and, let's not forget Japan's March 11th earthquake and tsunami), trending by atmospheric experts tell a similar story about global weather patterns.

    According to NASA's "Despite Subtle Differences, Global Temperature Records in Close Agreement", "four widely referenced records [NASA's Goddard Institute for Space Studies (GISS), NOAA's National Climatic Data Center (NCDC), the Japanese Meteorological Agency and the Met Office Hadley Centre in the United Kingdom] show remarkable agreement. In 2010, global temperatures continued to rise...2010 tied with 2005 as the warmest year on record, and was part of the warmest decade on record."
    Citation source:

  • June 14, 2011 - Canadian Arctic Archipelago is Melting

    Map of the Arctic
    Enlarged Map
    Map source:
    NASA - What happening to the Canadian Arctic
    Map source:

    Map #1 depicts the Canadian Arctic Archipelago as the dark red region on the left side of the map, just above Greenland, which is colored green.

    NASA reported on June 7 that

    • "Though much attention has been focused in recent years on the melting of ice from Greenland and Antarctica, nearly half of the ice volume currently being lost to the ocean is actually coming from other mountain glaciers and ice caps. Ice loss from a group of islands in northern Canada accounts for much of that ice in both the northern and southern Canadian Arctic Archipelago has declined sharply.
    • Map #2 shows ice loss from surface melting for the northern portion of the archipelago from 2004-2006 (left) and 2007-2009 (right). Blue indicates ice gain, and red indicates ice loss.(Nature, April 2011)
    • ...the Canadian Arctic Archipelago lost an average of approximately 61 gigatons of ice per year. (A gigaton is a billion tons of ice.) The research team also found the rate of ice loss was accelerating. From 2004 to 2006, the average mass loss was roughly 31 gigatons per year; from 2007 to 2009, the loss increased to 92 gigatons per year.
    • ...from 2001 to 2004, the sum of melting from all mountain glaciers and ice caps around the world (but not the Greenland and Antarctic ice sheets) contributed an estimated 1 millimeter per year to global sea level rise. Recent estimates suggest the Greenland and Antarctic ice sheets add another 1.3 millimeters per year to sea level.
    • This means 1 percent of the land ice volume mountain glaciers and ice caps account for about half of all ice loss to the world's oceans, ...Most of the ice loss is coming from the Canadian Arctic Archipelago, Alaska, Patagonia, the Himalayas, and the smaller ice masses surrounding the main Greenland and Antarctic ice sheets."
    • Citation source:
  • June 13, 2011 - Greenland is Melting

    NASA - What happened to Greenland in 2010
    Graphic source:
    The YouTube video shows researchers trying to measure the speed of water as Greenland's glaciers are melting.

    According the NASA, there was record melting in Greenland during 2010.

    • By the end of the season, much of southern Greenland had set a new record, with melting that lasted 50 days longer than average.
    • This image shows 2010 compared to the average number of melt days per year between 1979 and 2009.
    • Melting ice in Greenland freshens the seas near the Arctic and contributes to rising sea levels around the world. It is unclear just how much melting ice from Greenland will push sea levels up, largely because the melting is occurring much more quickly than scientists predicted. Current estimates call for an increase of up to 0.6 meters by 2100.
    • Citation source:
  • June 10, 2011 - Natural Hazards Maps

    NY Times Natural Hazards
    Graphic source:
    Here is a scary map of all the areas you can encounter a natural disaster. Aside from avoiding known geographic locations for such disasters, the one thing we can do is to prepare as best as we can for the possibility, or even eventuality of natural disasters. I like CDC's social media approach to making emergency preparedness relevant to young people today, which was released May 18th. If faced with a zombie invasion, what would we do? For more information, explore this widget:

    Social Media: Preparedness 101: Zombie Apocalypse
  • June 9, 2011 - Floods and Tornadoes Plague the U.S.

    Worst U.S. floods, to date
    Graphic source:
    Tornado Alley
    Graphic source:
    In recent weeks, the midsection of the U.S. has been devastated by natural disasters. First, there were the historic floods from the Mississippi River, and then the killer tornadoes during the last week of May, with a few devastating several towns in Massachusetts on June 1st. Lives lost are in the hundreds, and property damage and loss in the millions. It will be years before survivors can regain a semblance of the their lives before these disasters.

    According to "Nearly 1,200 tornadoes have swarmed the United States this year, according to preliminary numbers from the National Oceanic and Atmospheric Administration (NOAA). Four of these storms have been rated at the highest tornado strength, an EF-5. The death toll from these tornadoes has likely topped 500, a number not seen since 1953."

    "The tornado that devastated Joplin, Mo., killing at least 125 people, is not only the deadliest single tornado to strike the United States since 1947, but the storm has now been upgraded to an EF-5, the most intensely damaging tornado on the Enhanced Fujita Scale, with winds in excess of 200 mph (322 kph). It is the fourth EF-5 tornado this year. In contrast, a single EF-5 hit the United States in 2008, one hit in 2007; before that, the last EF-5 hit in 1999." (Citation source:

    The CDC offers useful information about dealing with the aftermath of floods on their Returning Home after a Disaster: Be Healthy and Safe page.

    For additional information about what to do when faced with natural disasters, see Emergency Preparedness

  • June 8, 2011 - National Academies Press Free Downloads

    National Academy Press Free Downloads
    Graphic source:
    For all you scholarly types, this is your lucky day!

    As of June 2, 2011, the National Academies Press is making its treasure trove of publications, some 4000+, plus any future reports to come, available for free downloads!

    This is a wonderful contribution to the global knowledge base of scientific knowledge. This comes at a good time, given that many people are hardpressed during these economic times to spend only on bare necessities. Well, now you can keep your mind active and thriving with what you can find here!

    Go to National Web site or just click on the graphic.

  • June 7, 2011 - U.S. Unemployment, 2007, 2010

    U.S. Unemployment 2007,

    U.S. Unemployment 2010,
    Graphic source:

    These 2 maps say it all about the current economy. Being unemployed has become a more common experience for a larger portion of the population between 2007 and 2010.

    According to the May 4th yahoo Finance article,"America's Middle Class Crisis: The Sobering Facts":

    • "There are 8.5 million people receiving unemployment insurance and over 40 million receiving food stamps.
    • At the current pace of job creation, the economy won't return to full employment until 2018.
    • Middle-income jobs are disappearing from the economy. The share of middle-income jobs in the United States has fallen from 52% in 1980 to 42% in 2010.
    • Middle-income jobs have been replaced by low-income jobs, which now make up 41% of total employment.
    • 17 million Americans with college degrees are doing jobs that require less than the skill levels associated with a bachelor's degree.
    • Over the past year, nominal wages grew only 1.7% while all consumer prices, including food and energy, increased by 2.7%.
    • Wages and salaries have fallen from 60% of personal income in 1980 to 51% in 2010.
    • The middle class is shrinking, which threatens the social composition and stability of the world's biggest economy."
    • Citation source:
  • June 6, 2011 - AHRQ and Public Health Emergency Preparedness

    Today the AHRQ listserv reports that it is changing its priorities regarding Public Health Emergency Preparedness:

    • "AHRQ Public Health Emergency Preparedness Program Announcement As of June 30, 2011, the Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) is discontinuing its Public Health Emergency Preparedness Research Program (PHEP)."
    • Since AHRQ began its work in public health emergency preparedness in 2000, the federal government has increased its efforts to prepare for and respond to public health emergencies.
    • As preparedness programs have expanded and diversified at the federal level, coordination among them has become more complex and a realignment of federal resources is needed. Activities pursued under AHRQ's program will continue to be supported by other federal agencies.
    • AHRQ is currently working with its federal partners to ensure that emergency preparedness materials developed by the agency remain publicly available to emergency planners and responders in the field....
    • AHRQ is proud of the contributions it has made to the emergency preparedness field and is confident that our federal partners will continue to provide valuable leadership and support. We appreciate the dedication of those in the emergency preparedness community who continue working to keep our nation safe and ready to respond in times of crisis."

    For more information, see Emergency Preparedness/Disaster Planning

  • June 3, 2011 - Cell Phones & Cancer

    In recent years there have been continuous reports about a possible connection between cell phone use and cancer. On May 31st, The World Health Organization thinks there is enough of a connection to warrant caution. As reported in Medscape:

    • The World Health Organization (WHO) announced today that radiation from cell phones can possibly cause cancer. According to the WHO's International Agency for Research on Cancer (IARC), radiofrequency electromagnetic fields have been classified as possibly carcinogenic to humans (group 2B) on the basis of an increased risk for glioma that some studies have associated with the use of wireless phones.
    • More specifically, the IARC Monograph Working Group discussed and evaluated literature that included several exposure categories involving radiofrequency electromagnetic fields:
      • Occupational exposures to radar and to microwaves;
      • Environmental exposures associated with transmission of signals for radio, television, and wireless telecommunication; and
      • Personal exposures associated with the use of wireless telephones.
    • "Given the potential consequences for public health of this classification and findings," ...."it is important that additional research be conducted into the long-term, heavy use of mobile phones. Pending the availability of such information, it is important to take pragmatic measures to reduce exposure such as hands-free devices or texting."
    • results have been inconsistent, although some European countries have taken precautionary measures aimed specifically at children.
    • Some of the strongest evidence supporting a link between brain tumors and cell phone use comes from a series of Swedish studies.. showed that risk increased with the number of cumulative hours of use, higher radiated power, and length of cell phone use. They also reported that younger users had a higher risk. (Int J Oncol. 2006;28:509-518; Int Arch Occup Environ Health. 2006;79:630-639; Arch Environ Health. 2004;59:132-137; Pathophysiology. 2009;16:113-122).
    • date, the industry-funded Interphone studies found no increased risk for brain tumors from cell phone use, with only 4 exceptions. The findings contradicted the Swedish studies, which were independent of industry funding."
    • Citation source: To be release online soon in The Lancet Oncology and in print in its July 1 issue.

  • June 2, 2011 - Greetings from the San Diego Zoo!

    Betty at The San Diego Zoo in San Diego, California
    Photo: Lee Jung

  • June 2, 2011 - A Lifetime of Good Health: Your Guide to Staying Healthy

Womenhealth A Lifetime of Good Health: Your Guide to Staying Healthy
    Graphic source:
    So, as I bring to a close this more than a month long series of blog entries (") "Focus on Women's Health Issues" in collaboration with's National Women's Health Week, I am hoping you have enjoyed this adventure of learning about all the public health issues facing women today. And, here is a recent quote that I found to capture it all:

    "And we as women in particular and this is such an important message starting today, you all have to be supportive of each other. You can't be jealous, and push and trip, you know? It's hard enough." (Michelle Obama [May 26, 2011]; Q&A at London's Elizabeth Garrett Anderson School) [Citation Source:

    For additional information, check the Women's Health Index for all the health topics available on the Web site pertaining to women's health.

  • May 31, 2011 - Asian Women & Breast Cancer Risk Assessment

    Breast Cancer Risk Factors

    Graphic source:

    In a May 16th NIH news release,"Breast cancer risk calculator updated for Asian-Americans," the National Cancer Institute reported:

    • Researchers have developed a more accurate method for estimating breast cancer risk for Asian and Pacific Islander American (APA) women. Most current risk estimates rely on data from non-Hispanic white women, but researchers have now come up with a statistical model that more specifically assesses risk for American women who identify themselves as Chinese, Japanese, Filipino, Hawaiian, other Pacific Islander, or other Asian.
    • "The new model is the latest step in our ongoing effort to improve NCI's Breast Cancer Risk Assessment Tool by updating it with newly obtained data for specific subgroups of the population,"
    • Each year in the general population, there are about 93.7 new cases of breast cancer per 100,000 APA women, and 127.3 new cases per 100,000 non-Hispanic white women, according to SEER data. In a 2007 SEER study, researchers found that among APA subgroups, native Hawaiian women had the highest breast cancer incidence rates (175.8 per 100,000), followed by Japanese-Americans (126.5 per 100,000). For Chinese-Americans, the largest subgroup, there are approximately 77.6 new cases per 100,000 women.
    • The new model may overestimate risk for women who have recently immigrated to the United States from certain regions of Asia where breast cancer risk is low. Further, the tool may not be appropriate for women living outside the United States.
    • To access: NCI's Breast Cancer Risk Assessment Tool (BCRAT)
    • NCI's Division of Cancer Epidemiology and Genetics
    • 2007 SEER study on incidence rates in the APA population
    • Citation source: Matsuno RK, Costantino JP, Ziegler RG, Anderson GL, Li H, Pee D, Gail MH. Projecting Individualized Absolute Invasive Breast Cancer Risk in Asian and Pacific Island American Women. J Natl Cancer Inst; May 11, 2011; as reported at

    For more information, see Breast and Other Female Cancers

  • May 30, 2011 - Women & Minority Health Minority Health
    Graphic source:

    US Household composition, by race and ethnicity
    Graphic source:

    In a May 7th report on research funded by National Institute of Neurological Disorders and Stroke and the National Center on Minority Health and Health Disparities, researchers reported that those living in a Washington, DC underserved community (catchment area of the Washington Hospital) did not know the importance of getting medical help for stroke in a timely manner:

    • The issue is important because African Americans -- the vast majority of the respondents (91.3%) -- are at greater risk of stroke than are whites and are more likely to die.
    • And the time between the onset of the stroke and arrival at hospital is a critical factor, since the success of thrombolysis depends on early treatment,
    • "With every minute that passes, more brain cells die,"
    • "we found that virtually no one knew that treatment was available and that getting to the hospital quickly means right now -- as in drop everything."
    • "89% of the survey participants said they would call 911 first, but only 12% of the patients actually did so.
    • 63% of survey participants said they would first call a friend or family member, while 75% of patients did just that.
    • Most of the patients 89% -- reported a significant delay in seeking medical attention, and almost half of those said the delay resulted from thinking the symptoms were not serious or that they would self-resolve.
    • Of the patients who suspected they were having a stroke, only half came to hospital by ambulance, and 35% of those said they had no other transportation options.
    • Only 25% said ambulance would be faster, although use of emergency medical services has several advantages, including speed, that the hospital can be alerted in advance, and that patients who arrive by ambulance are given priority and treated sooner.
    • "If you show up in your car, the hospital has to triage and figure out how serious your symptoms are, which takes more time."
    • Citation source: Hsia AW, et al "Understanding reasons for delay in seeking acute stroke care in an underserved urban population" Stroke 2011; 42: DOI:10.1161/STROKEAHA.110.604736; as reported in Medpage Today

    For more information about stroke in women, see Women's Health - Heart Disease, and Cerebrovascular Disease Information

  • May 29, 2011 - Women & Fitness

    Graphic source:

      According to's "Why fitness matters" - "

      • ".... 15 years ago type 2 diabetes was rare among adolescents, but now it accounts for almost 50 percent of new cases of diabetes in young people.
      • New research shows that exercise during the teen years (beginning at age 12) can help protect girls from breast cancer when they are older. Also, regular physical activity can help prevent colon cancer later in your life.
      • "Exercise can also improve your overall mood. A workout at the gym or a brisk 30-minute walk will make your brain produce chemicals that will make you happier and more relaxed than before you started working out.
      • Regular exercise can help you fall asleep faster and help you sleep deeper. A good night's sleep can improve your concentration and productivity in school the next day.
      • Citation source:

        For more information, see Fitness and Sleep

        Eat healthy and exercise
  • May 28, 2011 - Women & Violence

    HRSA - violence

    Graphic source:

    According to HRSA:
    • In 2008, an estimated 4.9 million nonfatal violent crimes were committed in the United States. Males were more likely than females to experience nonfatal violent crime victimization overall (21.3 versus 17.3 per 1,000 persons aged 12 and older; data not shown), however, females were more likely to report nonfatal intimate partner violence than males (4.3 versus 0.8 per 1,000 persons aged 12 and older).
    • Intimate partner violence (IPV) refers to any physical, sexual, or psychological harm by a current or former partner or spouse. IPV can take on many forms and vary in frequency and severity, ranging from threats of abuse to chronic, severe battering. IPV often is underreported, especially with regard to sexual and psychological violence.
    • In 2007, females with disabilities reported higher rates of violent crime victimization than females without disabilities. Nearly 35 per 1,000 females aged 12 and older with disabilities (age-adjusted) experienced violent crime victimization; this was nearly twice the rate of females without disabilities (18.9 per 1,000; data not shown).
    • Among female victims of violent crimes, the relationship of the victim to the offender varied by disability status. For instance, more than one-quarter of nonfatal violent crimes committed against females without disabilities were by an intimate partner, compared to 16.1 percent of crimes against females with disabilities. Females with disabilities were more likely to be victims of crimes committed by strangers than females without disabilities (33.5 versus 24.2 percent, respectively), and by non-intimate relatives, such as parents, siblings or cousins (12.5 versus 8.7 percent, respectively).
    • Citation source:

    For more information, see Women's Health - Social Issues

  • May 27, 2011 - Women & Immigration

    According to on their country of origin, recent immigrants (to the U.S.) are more likely to have health problems such as:

    • Tuberculosis
    • Hepatitis B
    • Parasite diseases
    • Rheumatic heart disease
    • Malaria
    • Leprosy
    • Post-traumatic stress disorder from rape or torture."
    • Citation source:

  • May 26, 2011 - Women & Human Traffficking

    US Map - Human Trafficking
    Graphic source:

    This map shows the unfortunate reality in today's world - the existence of human trafficking. It is an international public health issue - the sexual abuse of women and children that knows no borders.

    "One of today's biggest human rights crises is the international trafficking of women and girls (and, to a lesser extent, boys) into sex slavery. Human trafficking is the third largest criminal industry in the world, outranked only by arms and drug dealing. The United Nations estimates that trafficking in persons generates $7 to $10 billion annually for traffickers.

    Unlike some human rights abuses which are primarily regional, sex trafficking is global in nature. Victims come from virtually all developing countries and are trafficked into or through virtually all developing and developed countries. It is estimated, for example, that 50,000 people are trafficked into the United States every year, most of whom are sold into prostitution." (Citation source: P>For more information, see Women's Health - Social issues

  • May 25, 2011 - FDA Goes After Bogus STD Products

    It is unfortunate that there are unscrupulous people trying to sell fraudulent products for treating STIs that basically do not work. Here is a video produced by the FDA about these bogus products.

    Unlike men, women can be left infertile from untreated sexually-transmitted infections/diseases (STIs/STDs) that are most commonly caused by Chlamydia and Gonorrhea. Such STIs can result in pelvic inflammatory disease (PID). When PID is not treated it can damage the reproductive organs so a woman cannot bear a child.

    If you are sexually active, then you should practice safe sex to avoid contracting STIs. If you have unprotected sex and you think you may have contracted something, then see a health care provider promptly for proper treatment.

    For more information, see FDA Warns: Beware of Bogus STD Products, Sexually-Transmitted Diseases and University Health and Wellness - Immunity and Infection LI>

  • May 24, 2011 - Women & STDs/STIs

    HRSA -  chlamydia, gonorrhea

    HRSA -  HSV-1, HSV-2

    Graphic source:

    STDs - Having sex with all the partners of your partner!

    CDC - 2009 Chlamydia stats
    Graphic source:

    See Women and STDs, Sexually Transmitted Diseases/Infections

  • May 23, 2011 - Women & Alcohol

    Health effects of alcohol
    Graphic source:

    For this year's April Alcohol Awareness Month, the CDC focused on how alcohol affects women. Its site reports:

    • "In 2009, more than 1 out of every 10 women reported binge drinking during the past 30 days. On average, women who binge drink said they engaged in this risky behavior at least three times per month. Among women binge drinkers, they consume, on average, almost six drinks per drinking occasion, which exceeds the threshold for binge drinking.
    • Binge drinking is a risk factor for sexual assault, especially among young women in college settings. The risk for rape or sexual assault increases when both the perpetrator and victim have used alcohol before the attack.
    • Women who binge drink are more likely to have unprotected sex and multiple sex partners, which can increase their risk of acquiring HIV and other sexually transmitted infections (STIs).
    • Female binge drinkers are more likely to engage in unsafe sexual activities compared with women who are not binge drinkers. Binge drinking increases the risk for unintended pregnancy which may lead to a delay in recognizing pregnancy.
    • Upon drinking equal amounts, women tend to absorb more alcohol when they drink, and take longer to break it down and remove it from their bodies compared to their male counterparts. These differences are caused by differences in body composition and chemistry between men and women. Even when they drink the same amount of alcohol, women tend to have higher levels of alcohol in their blood than men, and the immediate effects of impairment occur more quickly and last longer.
    • Alcohol tends to leave the body at a slower rate in women who take birth control pills compared with those who do not. The result can be greater alcohol impairment in women who take birth control pills.
    • No amount of alcohol is safe to drink while pregnant. There is also no safe time during pregnancy to drink, and no safe kind of alcohol.
    • Women who drink alcohol while pregnant increase their risk of having a baby with fetal alcohol spectrum disorders (FASDs).
    • Women are often more vulnerable than men to the long-term effects of alcohol on their health. Over time, drinking too much alcohol can lead to cancer, liver disease and heart problems.
    • Citation source:

    For more information, see Alcohol, Alcohol and Women, and Health & Wellness - Alcohol

  • May 22, 2011 - How Chronic Diseases in Women Impact Reproductive Health

    CDC - Women and Chronic Diseases
    Prevalence of Chronic Diseases Among Women of Reproductive Age*
    CDC - Women and Chronic Diseases
    Prevalence of Chronic Disease Risk Behaviors and Risk Factors Among Women of Reproductive Age*

    Graphic source: WomensRH/PDF/ChronicDisease_FactSheet.pdf

    During the reproductive years, women need to take care of themselves as best as they can so if they should decide to have children they will be able to provide the best "internal" environment they can for the growing fetus. This is more important these days because women are waiting longer to start a family so there are more years in which chronic diseases can develop if proper care is not taken to eat, sleep and exercise well.

    The CDC has published an exellent fact sheet that provides an overview of how chronic disease, risk behaviors, and risk factors impact pregnancy and infant outcomes.

    For more information, see Life Cycle Issues, and Maternal and Child Health Resources

  • May 21, 2011 - Women & Diabetes

    Women and Diabetes - 18 and older, HRSA

    Women and Diabetes - 45 and older, HRSA

    Graphic source:

    On April 19th, Diabetes Care reported online that those with diabetes are at increased risk for cancer. Men with diabetes have a greater risk for developing colon, pancreas, rectum, urinary bladder, kidney or prostate cancer, while women with diabetes were at increased risk for developing breast cancer, leukemia or cancer of the womb. Citation source:

    JAMA researchers reported on May 4th that structured exercise is important for controlling diabetes:

    • "...the researchers found that exercising for longer periods of time was better at bringing blood sugar levels down than exercising more intensively.
    • People with type 2 diabetes should engage in regular exercise training, for more than 150 minutes per week, this would be more beneficial concerning their glucose control. However, if they cannot reach this amount of weekly exercise, lower exercise amounts are also beneficial.
    • Currently, exercise guidelines recommend that people with type 2 diabetes perform at least 150 minutes a week of moderate-intensity aerobic exercise, and resistance training, such as weight lifting, three times a week
    • Exercise improves insulin sensitivity; it makes insulin work better
    • Citation source: Beatriz Schaan, M.D., professor, Hospital de Clinicas de Porto Alegre, Brazil; Joel Zonszein, M.D., director, clinical diabetes center, Montefiore Medical Center, New York City; May 4, 2011 Journal of the American Medical Association; as reported on HealtDay

    For more information, see Diabetes and Fitness

  • May 20, 2011 - U.S. Obesity Prevalence, by Gender, Race/Ethnicity & Education

    NCHS Obesity by Gender
    Graphic source:

    During the 2007-2008 time period, comparisons of the obesity prevalence between men and women show that women were more obese than men, regardless of race/ethnicity. While there was a slightly higher percentage of obese White women when compared to White men, the percentages were much higher for Black women when compared to Black men, and Hispanic women when compared to Hispanic men.
    Obesity prevalence, by gender and education
    Graphic source:
    Unfortunately, regardless of how much education, men and women have become more obese over time. Fortunately, more education seems to be a bit more protective for women than for men, especially for those who are college educated.

    Having less education had a greater impact on whether or not women were obese. For example, for the 2005-2008 period, 42% of women with less than a high school education were obese vs. 32.1% of men with a similar education background.

    For more information, see Obesity Resources on the Internet

  • May 19, 2011 - U.S. Female Obesity Prevalence, Globally & Over Time

    WHO, Female Obesity, 2005
    Graphic source: Graphic created by BCJung, using
    According to the WHO Infobase 2005 data, the percentage of obese American women is greater than in most countries.

    According to, over one-third of U.S. adults are obese. All adults: 33.8 percent; Women: 35.5 percent; Men: 32.2 percent. (Citation source:

    CDC Female Obesity
    Between 1988 and 2008, the prevalence of female obesity in the U.S. has increased over time, regardless of race and/or ethnicity. However, the increase in percentage has been greater for Black and Hispanic women over the two decades.

    According the

    • Among women, the age-adjusted prevalence of obesity (BMI > 30) in racial and ethnic groups is higher among non-Hispanic Black and Hispanic women than among non-Hispanic White women.
    • Non-Hispanic Black Women: 49.6 percent; Hispanic Women: 43 percent; Non-Hispanic White Women: 33 percent
    • Citation source:

    For more information, see Obesity Resources on the Internet

  • May 18, 2011 - Women & Stroke

    Stoke and Women

    Enlarged Graphic
    Graphic source:

    According to the University of Medicine and Dentistry of New Jersey:
    • "Stroke is the No. 3 cause of death in the U.S., behind heart disease (with which it is closely linked) and cancer.
    • Stroke affects more than 700,000 individuals annually in the United States (approximately one person every 45 seconds). About 500,000 of these are first attacks, and 200,000 are recurrent attacks.
    • Someone in the U.S. dies every 3.3 minutes from stroke.
    • Stroke is the leading cause of disability among adults in the U.S.
    • Women account for approximately 43 percent of strokes that occur each year, but they account for 61 percent of stroke deaths.
    • Stroke risk increases with age. For each decade after age 55, the risk of stroke doubles.
    • Each year, 28 percent of people who suffer a stroke are under age 65.
    • In African-American females, the incidence is 79 per 100,000, with a death rate of 39.2 percent.
    • Stroke Survival Rates:
        10 percent of stroke victims recover almost completely.
      • 25 percent of stroke victims recover with minor impairments.
      • 40 percent of stroke victims experience moderate to severe impairments requiring special care.
      • 10 percent of stroke victims require care in a nursing home or other long-term care facility.
      • 15 percent die shortly after the stroke.
    • More than 75 percent of Americans cannot name the most common warning sign of stroke sudden numbness or weakness of the face, arm or leg, especially on one side of the body according to the American Stroke Association.
    • Fewer than half of all individuals over 50 are actually aware of what stroke is, its signs and symptoms, and the importance of seeking immediate medical attention.
    • Citation source:

    For more information, see Stroke and Women and Stroke

  • May 17, 2011 - Tobacco & Breast Cancer Risk in Women

    According to an April 3rd news release from American Association for Cancer Research, based on data from the Women's Health Initiative study and were recruited between 1993 and 1998 and followed until 2009:

    • "There's a significant link between smoking and breast cancer risk in postmenopausal women, but it depends on their body weight.
    • Breast cancer risk was higher than normal among female smokers who were not obese, but this strong association was not evident in obese female smokers
    • Non-obese smokers with a body-mass index (BMI) of less than 30 had a significantly increased risk of cancer compared to nonsmokers. Those who smoked for 10 to 29 years had a 16 percent higher risk, those who smoked for 30 to 49 years had a 25 percent increased risk, and those who smoked for 50 years or more had a 62 percent greater risk.
    • But obese women who smoked didn't appear to be at increased risk for breast cancer."
    • Citation source: As reported in HealthDay,

    The take-home message is tobacco may contribute to breast cancer, and not that obesity does not. Other studies have shown obesity increases the risk for breast cancer. Other confounding factors to consider is that people who develop cancer commonly lose a lot of weight, and many smokers use nicotine to control appetite and their weight so that smokers with a normal BMI do not necessarily mean they are healthy. For more information, see Breast and Other Cancers of Women and Cancer

  • May 13, 2011 - Lung Cancer Deaths in Women

    American Cancer Society 2010
    Graphic source: CancerFactsFigures/cancer-facts-and-figures-2010

    Cancer is the second leading cause of death in the U.S. Here is a line graph from the American Cancer Society's "Cancer Facts & Figures 2010" showing the overall trend in cancer deaths for women.

    Over time, cancer of the lung or bronchus has overtaken breast cancer so that now it is the #1 cause of cancer deaths for women (26%), followed by breast cancer deaths (15%). It should be noted that the "incidence of lung cancer is strongly correlated with cigarette smoking, with about 90% of lung cancers arising as a result of tobacco use."(Source:

    On March 31, 2011, the NIH reported that many cancer rates are declining. According to the news release:

    • "...for the first time, lung cancer death rates decreased in women, more than a decade after rates began dropping in men.
    • In women, incidence rates decreased for breast, lung, colorectal, uterine, cervical, bladder, and oral cavity cancers, but increased for kidney, pancreas, and thyroid cancers as well as for leukemia and melanomas of the skin."
    • Citation source:

    This trend in decreasing lung cancer deaths for women can continue as more women quit smoking, or never start. So, if you smoke, it is never too late to stop. For more information, see Tobacco Resources, Cancer Resources

  • May 12, 2011 - Women & Cancer

    HRSA - Women and Cancer
    Cancer of the lung and bronchus is the #1 cause of cancer in women. This can be directly attributed to smoking. This is followed by breast cancer and colon and rectum cancer, which can be caught early with screening. Women can take preventive measures by simply eating more fruits, vegetables and fiber, exercising daily for an hour, getting adequate sleep and going for regular checkups with their health provider.

    For more information, see Tobacco, Cancer, Nutrition, Fitness, and Sleep

    HRSA - Women and Cancer, by Race and Ethnicity

    Graphic source:

    Invasive cancer statistics show a slightly different story regarding women and cancer. Breast cancer has the highest rates for invasive cancer, and this is true for all women, regardless of race/ethnicity. Know your family history and work with your healthcare provider on the best strategy if you have been diagnosed with breast cancer. For all women, it is essential to get regular clinical breast examinations and mammograms, as early detection will allow for earlier treatment and better outcomes.

    For more information, see Cancer, Breast and other Female Cancers

  • May 11, 2011 - Women & Heart Disease, 2000 - 2006

    CDC, BRSS, Women and Heart Disease, 2000 - 2006, CDC, BRSS
    Graphic source:
    Here is a sobering map of mortality rates for women dying from heart disease. While heart disease is the leading cause of the death in the U.S., it is also the leading cause of death for women as well. Once again, Mississippi leads in the number of deaths from heart disease.

    According to NIH's "Lower Your Heart Risk" webpage:

    • "An astonishing 80 percent of women ages 40 to 60 have one or more risk factor for heart disease. Having one or more risk factors dramatically increases a woman's chance of developing heart disease because risk factors tend to worsen each other's effects...having just one risk factor doubles your chance of developing heart disease.
    • ..among U.S. women ages 18 and older, 17.3 percent are current smokers, 51.6 are overweight (BMI of 25 or greater), 27 percent have hypertension, 35 percent have high cholesterol, and 53 percent do not meet physical activity recommendations.
    • African American and Hispanic women, in particular, have higher rates of some risk factors for heart disease and are disproportionately affected by the disease compared to white women. More than 80 percent of midlife African American women are overweight or obese, 52 percent have hypertension, and 14 percent have been diagnosed with diabetes. Some 83 percent of midlife Hispanic women are overweight or obese, and more than 10 percent have been diagnosed with diabetes. Learn more about the risk factors of heart disease.
    • By doing just 4 things eating right, being physically active, not smoking, and keeping a healthy weight you can reduce your risk of heart disease by as much as 82 percent.
    • Citation source:

    Here is an excellent comprehensive resource about heart disease and women, what the risk factors are, how to estimate your risk, how to develop an action plan if you have been diagnosed with heart disease, etc. Click on the graphic to access the handbook.

    Healthy Heart Handbook for Women
    Graphic source:

    For more information, see Women and Heart Disease and Cardiovascular Disease

  • May 10, 2011 - Where women get health information

    CDC - January through June 2009
    Graphic source:
    Where do women get health information from? According to the Kaiser Family Foundation's Women's Health Care Chartbook, "...women are still most likely to turn to a provider when seeking information, with 44% reporting providers as their leading source....more than a quarter of women (28%) turn to {the Internet} first for health information, making it the second leading provider of information; 16% of women first turn to family and friends when they are searching for health information." (Citation source:

    According to the CDC's "Health Information Technology Use Among Men and Women Aged 18-64: Early Release of Estimates From the National Health Interview Survey, January-June 2009":

    • From January through June 2009, 51% of adults aged 18-64 had used the Internet to look up health information during the past 12 months ;
    • Among adults aged 18-64, women were more likely than men to look up health information on the Internet (58.0% versus 43.4%) and were also more likely to use online chat groups to learn about health topics (4.1% versus 2.5%).
    • Citation source:

    Since the Internet is fast becoming the go-to source for health information, credibility becomes a key consideration, especially if you are going to use the information for making health care decisions. To help you determine whether or not a Web site is a credible source, use the Web site Evaluation Grid I have developed to help you critique a Web site.

  • May 9, 2011 - National Women's Checkup Day: May 9, 2011

    The purpose of the 9th annual National Women's Checkup Day is to:
    • Encourage women to visit health care professionals to receive or schedule a checkup.
    • Promote regular checkups as vital to the early detection of heart disease, diabetes, cancer, mental health illnesses, sexually transmitted infections (STIs), and other conditions.

    Check out the ( General Screenings and Immunizations for Women Chart to see what you should be getting at your age.

    ( Women's Checkup Day: May 9, 2011 Page to make a pledge to schedule an appointment with your healthcare provider. I have! Your quality of life depends on it! And, when you take the pledge, enter the state you are from and get a certificate to show your commitment to take care of yourself!

    For more information, see Essential Screening Tests Every Woman Needs from WebMD, and Women's Health - General Resources

  • May 8, 2011 - National Women's Health Week Starts Today! (12th year)

    Happy Mother's Day!
    Graphic source:
    Happy Mother's Day to all women who believe in the power of nurturing! On this day, take a moment to reflect on how important it is to take care of ourselves so we can continue to nurture those we love! wants to raise awareness of why women should adopt the "It's Your Time" attitude. (

  • May 6, 2011 - Women and War

    Military spouses
    Graphic source:

    Today is Military Spouse Appreciation Day, and it is always celebrated on the Friday before Mother's Day. I only discovered this as I was researching topics for this month's focus on women's public health issues.

    Military Spouse (or, Milspouse) Facts:

    • Live in all 50 states. In the US there are more than 5,900 military installations of varying sizes
    • Typical military spouse is a female under the age of 35 (80% are under 35)
    • 95% of all military spouses are female
    • 37% have children average is two children
    • Military spouses often fill the role of single parent due to deployments
    • 54% of active duty spouses are employed
    • 63% of active duty enlisted spouses are employed
    • Military spouses are ethnically diverse and hail from around the world
    • Source: 2002 demographic report published by the Military Family Resource Center, as reported on

    In last year's proclamation by President Obama, he notes:

    • "As we mark Military Spouse Appreciation Day, we reaffirm our steadfast commitment to supporting and honoring the husbands, wives, and loved ones of our Nation's servicemembers.
    • At the heart of our Armed Forces, servicemembers' spouses keep our military families on track. They balance family life, military life, and their careers all while supporting other military families and giving back to their communities. Many have served in uniform themselves and, understanding the obligations involved, can provide unparalleled support. They are pillars of strength in their families, often celebrating their children's life milestones while the other parent is away.
    • Military spouses also care for our wounded warriors and honor the memory of our Nation's fallen heroes, including their own loved ones. They impact countless lives on military bases and in schools, places of worship, and neighborhoods across our Nation. Their contributions help protect our freedom by strengthening our communities and our servicemembers.
    • Citation source:

    US VA - National Center for PTSD
    Graphic source:
    The U.S. Department of Veteran Affairs host the National Center for PTSD (Post-Traumatic Stress Disorder). The Center provides a Webpage called "Issues Specific to Women." It addresses, unfortunately, the reality of women caught in the crossfire of combat (as female soldiers) and war (as civilian casualties). This site offers fact sheets about what can cause PTSD in women.
    • Rape of Women in a War Zone (Summarizes the prevalence and effects of war-related rape on women in a war zone, such as in Kosovo and Bosnia).
    • Sexual Assault against Females (Defines sexual assault, how often it occurs, and the characteristics of perpetrators. Discusses women's reactions to sexual assault and what to do if you have been sexually assaulted).
    • Traumatic Stress in Women Veterans (Discusses stressors faced by women Veterans and what can help).
    • Women, Trauma and PTSD (Learn about trauma and PTSD in women).
    • Women's Mental Health Services in the VA (Describes services offered to women Veterans, including the Women Veterans Health Care Program).
    • (Source: Post-Traumatic Stress Disorder - Issues Specific to Women)

    It's a sad fact that the consequences of war could reach so far as to affect half of the world's population that truly has no interest in the devastating effects of brutality. But it's good to know that the US Department of Veteran Affairs is cognizant of the plight of women and has offered information that is useful to those who suffer from PSTD and those who care for them. It is also good to see that military spouses (predominantly women) are recognized for the important roles they play in supporting those serving in the armed forces.

    For more information, see Mental Health Resources & Women's Health Issues. This issue is artistically captured in the 1960 film, "Two Women" for which Sophia Loren won an Oscar.

  • May 5, 2011 - What Women Die From

    HRSA - Leading causes of death for women

    Graphic source:

    Yes, heart disease is the leading cause of death for women. Heart disease is responsible for 1/4 of all deaths, followed by cancer and then stroke. The one to watch out for is type 2 diabetes. Though it may seem diabetes is responsible for "only" 3.0% of female deaths, this statistic is deceptive.

    "Diabetes is likely to be underreported as a cause of death. Studies have found that about 35 to 40 percent of decedents with diabetes had it listed anywhere on the death certificate and about 10 to 15 percent had it listed as the underlying cause of death. Overall, the risk for death among people with diabetes is about twice that of people of similar age but without diabetes."

    "In 2004, heart disease was noted on 68 percent of diabetes-related death certificates among people ages 65 years or older. In 2004, stroke was noted on 16 percent of diabetes-related death certificates among people ages 65 years or older. Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes. The risk for stroke is 2 to 4 times higher among people with diabetes."

    "Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness among adults in the United States. Diabetes is a major cause of heart disease and stroke." Citation source:

    Mayo Clinic's "Women's health: Preventing the top 7 threats" provides some basic approaches to reducing your risk of dying from the top 7 causes of death. But if you just eat healthy, exercise regularly, get adequate sleep and don't smoke, you will pretty much be on your way to a lifetime of good health.

    For more information, see Women's Health Index Page, Fitness, Nutrition

  • May 4, 2011 - Gender Differences

    PEW: Men or Women: Who's the Better Leader?
    Graphic source:
    PEW: Men or Women: Who's the Better Leader?
    Graphic source:

    Do gender differences exist? You bet. According to the 2008 PEW study, Men or Women: Who's the Better Leader? A Paradox in Public Attitudes : "...on seven of eight leadership traits measured in this survey, the public rates women either better than or equal to men," "Men prevail over women on decisiveness (their lone victory in the battery of eight traits), with 44% of respondents saying that men are more decisive and 33% saying women are."

    It is also interesting that respondents reported gender differences for common traits. "...for men, gender solidarity goes only so far. Overall, they give their gender the better ratings on just five of the 12 traits (decisiveness; hard work; ambition; not being emotional; not being manipulative) and they give themselves inferior ratings on seven (honesty; intelligence; compassion; creativity; being outgoing; being stubborn; being arrogant). By contrast, while women say they are more emotional and more manipulative than men, they give themselves higher marks than men on the 10 other traits measured."

    "Of all demographic groups, black women are distinctive in the degree to which they say women are superior to men in their evaluations of character traits. Nearly eight-in-ten (78%) black women (compared with 51% of white women and 50% of all adults) say women are more honest than men. About two-thirds (65%) of black women (compared with 37% of white women and 38% of all adults) say women are smarter than men. And about half (49%) of black women (compared with 33% of white women and 28% of all adults) say women are more hardworking than men."

    "By a ratio of nearly two-to-one, Americans say that, all things considered, men rather than women have a better life in this country. Women believe this in greater numbers than men do, and younger and middle-aged adults believe it in greater numbers than older adults do. In 1972, during the early days of the modern gender revolution, slightly more adults said women had the better life than said that about men."

    Citation source:

  • May 3, 2011 - Women and Mental Health

    SAMHSHA Women's Mental Health
    Graphic source:
    SAMHSHA Children mental health
    Graphic source:
    Since the Substance Abuse & Mental Health Services Administration (SAMHSA) has designated today as National Children's Mental Health Awareness Day, I decided to start this month's blog entries with a look at mental health, one of the basic foundations for overall wellness.

    Did you know that 1/2 of all mental illnesses start before the age of 14? It may be the result of child abuse, and maybe not, but mental health problems that are not identified and addressed early on can result in behaviors that compromise quality of life later on in life. Common mental health problems affecting women more than men include eating and anxiety disorders and major depression.

    Click on the "Women's Mental Health" graphic for the SAMHSA publication that provides a comprehensive look at the importance of mental health for women, how to identify problems and when to seek help. The second graphic is a link to the SAMHSA webpage with links to resources pertaining to children's mental health.

    For additional information and resources, see Maternal and Child Health Resources, Women's Health Issues, and Mental Health Resources

  • May 2, 2011 - Celebrating National Women's Health Week

    2011 National Women's Health Week
    Graphic source:

    2008 US population, by gender
    Graphic source: once again is celebrating National Women's Health Week, this year during May 8 - 14, 2011. I have decided to collaborate with ( with Online Event devoting May's blog entries to women's health issues. So, be prepared to be enlightened!

    My goal for this month is to highlight and raise awareness of the variety of public health issues facing women today. I will offer a Public Health perspective of how members of over 1/2 of the U.S. population are affected. Most telling is, even within the female population, differences exist.

    For example, I was surprised to find how many women, in 2008, lived below the poverty level, especially among women of color, and not necessarily those who are older. Most shocking is about 1/4 of African-American, Hispanic and Native American/Alaska Native women age 18-44 live below the poverty level!

    HRSA female poverty
    Graphic source:

    When possible I will provide online resources for additional information and support. I will do my best to make these entries not only educational but interesting as well! Please feel free to E-mail Me your thoughts and ideas for what you want to see and I will try and do my best to include them. Thank you for your interest, and I hope you learn something new about the "human condition" of being a woman!

  • May 1, 2011 - Thank you, Columbia University-Presbyterian Hospital Alumni Association!

    Betty gets Columbia University School of Nursing Distinguish Alumni Neighbors Award!
    Columbia University-Presbyterian Hospital School of Nursing Alumni Association
    Graphic source:

    I would like to offer heartfelt thanks to my alma mater's Distinguished Awards Committee of the Columbia University-Presbyterian Hospital Alumni Association for honoring me with this year's Distinguished Alumni Neighbor's Award on April 29th at the New York Athletic Club. It was a memorable day!

    Also, special thanks to the Association's President, Dr. Suzanne Hawes, who nominated me; Dr. Joan Hagen, Awards Committee Chair, for giving a wonderful introduction, and to my colleagues for writing letters of support for me: Dr. William Faraclas, Dr. Jadwiga Goclowski, Mary Nescott, Dr. Michael Perlin & Lara Reintz.

    Indeed, it was a once in a lifetime honor, and the best part was having the opportunity to acknowledge the contributions of 3 of my nursing professors to my education, who also happen to be alums and attending the meeting.

  • April 29, 2011 - Cost of Chronic Diseases

    McKinsey Quarterly: German Statutory Health Insurance (public payor) data

    Graphic source: McKinsey Quarterly Chart Focus Newsletter March 2011 German Statutory Health Insurance (public payor)

    If you live long enough you will have the opportunity to experience what most older people experience, chronic diseases. This graphic plots what German Statutory Health Insurance (public payor) [~US's Medicare] pays for in terms of chronic diseases. (Source: McKinsey Quarterly Chart Focus Newsletter March 2011)

    While the majority of costs for patients is greater for those with chronic diseases, I just find it interesting that for chronic diseases: cardiovascular disease, diabetes, cancer and pulmonary diseases make up only 37% of the total, with "other" chronic conditions making up 35% and non-chronic diseases affecting those with chronic conditions - 27%. So, what exactly are these "other" chronic conditions?

    For more information, see Chronic Diseases

  • April 28, 2011 - Why It's So Hard to Quit Smoking

    Pack Mentality

    Enlarged Graphic
    Graphic source:

    While tobacco is the most preventable cause of death, people continue to smoke and chew tobacco. This graphic illustrates the hazards of nicotine addiction from smoking and how difficult it is for those who use tobacco, to quit. Chewing is just as lethal.

    Still, if you smoke (or chew tobacco), it is best to quit, and if don't, don't start.

    For more information, see Tobacco and Health And Wellness Resources - Tobacco

  • April 27, 2011 - Healthy Living Cuts Death Rate in Half for Nonsmokers

    An April 19th American Cancer Society news release on findings from the Cancer Prevention Study reports:
    • A healthy lifestyle nearly halves nonsmokers' risk of death from cancer, cardiovascular disease and other causes,
    • ...the risk of cardiovascular-related death was 58 percent lower for women and 48 percent lower for men, and the risk of cancer death was 24 percent lower in women and 30 percent lower in men.
    • The findings were similar for both never and former smokers.
    • Citation source: American Cancer Society, news release, April 14, 2011, online study at Cancer Biomarkers, Epidemiology, and Prevention, as reported in HealthDay

    Let's advocates for children to exercise an hour a day as a strategy to addressing the childhood obesity epidemic. Great idea!

    For more information, see Fitness and Nutrition

  • April 26, 2011 - BMI Graph

    NIH BMI Chart

    Graphic source:

    If you know your height and weight, then you can use this simple graph to see where your BMI is. I remembered learning about graphing data when I was in junior high school, so even if you don't have a high school diploma you should be able to use this to see if you are within the normal weight range, or if you need to lose some pounds. If you do, then this is a good time to start since it's getting nice outside and there is no excuse....

    If you like calculators and want to learn more about obesity, see Obesity

    Eat healthy and exercise Even cats exercise!
  • April 25, 2011 - Infographics Depicts Dead Weight

    December NEJM report on obesity and mortality
    Graphic source:
    Here is an interesting Infographics visualization of how increasing BMI increases the risk for death. Will this make people think twice about portion control? It should.

    Carrying excess weight is like dragging around excess baggage, and you know how that feels in an airline terminal!

    The normal BMI range is 18.5 to 25.

    For more information, see Obesity Information

  • April 22, 2011 - Obesity Prevalence, 2010

    BMI >30 WHO
    BMI >30 WHO
    Map source:
    In this last blog entry using the WHO Global Infobase, I decided to look at the global prevalence of obesity.

    While the data are more current (2010) by gender (maps below), I had to look on another page to get a global picture of obesity.

    This map includes the most recent data for "BMI % Obese >=30." Unfortunately, the US leads in global obesity, along with the Middle East.

    When looking at obesity by gender, high male obesity prevalence is found for all countries in the Western Hemisphere, Australia, Egypt, Saudi Arabia. High female obesity prevalence is found for all countries in the Western Hemisphere, Egypt, South Africa and Mongolia! (Gender graphics generated by BCJung at:

    From a preventive standpoint, addressing obesity will definitely impact the mortality rates for diabetes, heart disease and stroke.

    Male Obesity, 2010 WHO

    Female Obesity,  2010 WHO

  • April 21, 2011 - A Visual Guide to High Blood Pressure

    Salt amounts
    Graphic source:

    High blood pressure (hypertension) puts people at risk for cardiovascular disease and strokes. It is considered a modifiable risk factor, which means you can do something about it. An easy first step is to cut out salt from your diet. Current recommendation: "less than 1,500 mg for all African Americans and those with hypertension, diabetes, and chronic kidney disease (including children), as well as persons older than 50; everyone else is advised to consume under 2,300 mg of sodium a day." (Citation source:

    You can easily achieve this by cutting out sodas, fast food, junk food, canned and frozen foods. Check the labels, you will be surprised at how much sodium is found in what we eat.

    According to a 2007 MMWR report,

    "Approximately 98.1% of adults with self-reported HBP reported taking at least one action to lower or control their blood pressure, and a majority of respondents reported taking each of the five actions: 70.9% changed their eating habits, 79.5% decreased use of salt or did not use salt, 79.2% reduced consumption of alcohol or did not drink alcohol, 68.6% exercised, and 73.4% took antihypertensive medication.

    Women were more likely than men to report changing eating habits and reducing consumption of alcohol or not drinking alcohol. Reducing use of salt or not using salt and taking antihypertensive medicine increased with age. A higher proportion of non-Hispanic blacks (90.0%) compared with other racial/ethnic groups reported reducing use of salt or not using salt." (

    To learn more about high blood pressure, click on the graphic for WebMD's "A Visual Guide to High Blood Pressure," which is an excellent slideshow of the main points you need to know.

    Also see, High blood pressure, High blood pressure statistics & Salt

  • April 20, 2011 - Stroke Mortality, 2004

    Stroke, 2004 WHO

    Graphic generated by BCJung at:

    Using the WHO Global Infobase I decided to continue looking at mortality statistics, this time for stroke (cerebrovascular disease). Stroke is the 3rd leading cause of death in the U.S., and causes major disabilities for those who survive it.

    If you look at global mortality rates, stroke is more of a major player than ischemic heart disease! Practically all of Asia have high stroke mortality rates, as well as several African countries.

    When looking at stroke mortality, by gender, Chinese men have higher stroke mortality than Chinese women, as well as women of several African countries. Who would have ever thought that stroke would be such a great health issue for women than it is for men?

    According to the American Heart Association, the following stroke risk factors can be changed, treated or controlled: High blood pressure; Cigarette smoking; Carotid or other artery disease; Atrial fibrillation; Other heart disease (coronary heart disease or heart failure; Dilated cardiomyopathy (an enlarged heart), heart valve disease and some types of congenital heart defects)); Sickle cell disease (also called sickle cell anemia); High blood cholesterol; Poor diet; Physical inactivity and obesity. (Citation source:

    For more information, see Cerebrovascular Disease

    Male Stroke Mortality, 2004 WHO Female Stroke Mortality, 2004 WHO
  • April 19, 2011 - Beer and Stomach (Gastric) Cancer

    Stomach Cancer
    Graphic source:

    Beer consumption averaging 2-3 drinks/day is now associated with stomach (gastric) cancer, and almost nine-fold for beer drinkers who also had a key genetic variant.
    European Prospective Investigation into Cancer and Nutrition (EPIC) researchers report:

    • "Relatively uncommon in the U.S., gastric cancer is the second leading cause of cancer death worldwide...environmental factors play a prominent role in the risk,
    • Heavy alcohol consumption, irrespective of the type of drink, boosted gastric cancer risk by 65% compared with very light consumption.
    • as the principal culprit, associated with a 75% greater risk of gastric cancer in people who averaged 30 g of alcohol daily from beer (two to three per day),...
    • The presence of a mutation in the alcohol dehydrogenase gene cluster (ADH1) greatly exacerbated the cancer threat. The combination of the variant and regular high intake of beer resulted in a relative risk for gastric cancer risk more than 700% higher, as compared with light consumption and absence of the mutation.
    • Beer contains certain compounds not found in wine or spirits, notably nitrosamines,.... The difference offers a plausible explanation for the lack of risk specifically attributable to other forms of alcohol.
    • Infection with Helicobacter pylori is one of the best-known environmental contributors to gastric cancer risk. However, suspicion also has fallen on diet, smoking, and alcohol consumption, among other potential factors.
    • Biologic explanations for the findings:
      • Accumulation of potentially toxic acetaldehyde in the stomach
      • Excessive generation of nitrosamines (found in beer), known to be carcinogenic in animals
      • Excess bacteria in the stomach resulting from atrophic gastritis (which can lead to accumulation of acetaldehyde and nitrosamines)
      • Excess in the combination of acetaldehyde and nitrosamines
    • Source: American Association for Cancer Research - Duell EJ, et al "Polymorphisms in the alcohol dehydrogenase (ADH1) gene cluster, alcohol consumption, and interactions in relation to gastric cancer risk in the EPIC cohort" AACR 2011; Abstract 3748; as reported

    For more information, see Cancer, Nutrition, and Alcohol

  • April 18, 2011 - Facebook Depression

    Facebook depression
    Graphic source:

    For more information, see Adolescent Health, and Health Issue - Kids & Bullying, Mental Health & Depression

    In the recent Pediatrics report,"Clinical Report - The Impact of Social Media on Children, Adolescents, and Families Pediatrics" that was posted online last month, researchers explore the pros and cons of social media.
    • "Using social media Web sites is among the most common activity of today's children and adolescents. Any Web site that allows social interaction is considered a social media site, including social networking sites such as Facebook, MySpace, and Twitter; gaming sites and virtual worlds such as Club Penguin, Second Life, and the Sims; video sites such as YouTube; and blogs.
    • Such sites offer today's youth a portal for entertainment and communication and have grown exponentially in recent years. For this reason, it is important that parents become aware of the nature of social media sites, given that not all of them are healthy environments for children and adolescents.
    • Pediatricians ...encourage healthy use and urge parents to monitor for potential problems with cyberbullying, Facebook depression, sexting, and exposure to inappropriate content."
    • Source: Pediatrics 2011;127:800-804;

    "Facebook depression" is "With in-your-face friends' tallies, status updates and photos of happy-looking people having great times, Facebook pages can make some kids feel even worse if they think they don't measure up. It can be more painful than sitting alone in a crowded school cafeteria or other real-life encounters that can make kids feel down, ....because Facebook provides a skewed view of what's really going on. Online, there's no way to see facial expressions or read body language that provide context." (Source:

  • April 15, 2011 - NSAIDS and Cardiovascular Risks

    NSAIDS and cardiovascular risk
    Graphic source:

    NSAIDS (nonsteroidal anti-inflammatory drugs) are very popular drugs used for the relief of pain. However, you should be aware that taking this class of drugs can put you at risk for a cardiovascular event.

    Earlier this year, the British Medical Journal reported on a meta-analysis that looked at credible evidence and were shocked at the increased risk they found for myocardial infarctions (heart attacks), strokes and cardiovascular deaths.

    This table (from Medscape's "All Nonsteroidal Anti-Inflammatory Drugs Have Cardiovascular Risks") summarizes the rate ratios for 7 NSAIDs. Probably, the most popular is Ibuprofen (aka Motrin, Advil), which you can get over the counter.

    Think of a value of 1 as no risk, so that anything above 1 means an increased risk. Thus, in the case of Ibuprofen, there is over 3x the risk for stroke. And, I should note that rofecoxib (Vioxx) is associated with the highest risk for myocardial infarction (with a rate ratio of 2.12), and this drug was taken off the market in 2004 due to concerns over cardiotoxicity.

    If you are taking any of these NSAIDs, you should probably talk to your health care provider about the cardiovascular risks involved and maybe think of other ways to control the pain than with this class of drugs. (Citation source: BMJ. 2011;342:c7086; as reported

    For more information, see Cardiovascular Disease, and Stroke

  • April 14, 2011 - AHRQ's Care Coordination Atlas

    AHRQ's Care Coordination Atlas

    Graphic source:

    The AHRQ has recently released "Care Coordination Measures Atlas" which is to provide guidance on how to measure the extent to which care coordination activities are being implemented.

    Here is the "Care Coordination Ring" they came up with to depict all the parties involved with coordinating the care for a patient. Though this looks well thought out, one would have think there has got to be a better way. Why are so many people involved? Are all these people absolutely necessary to provide services to the patient? Of course, good communication is key, but we really have to find a way to simplify this!

    For a link to this document and other resources, see Health Care Quality Issues

  • April 13, 2011 -'s New Media Web site (8/23/2013 - This site no longer exists)

    HHS New Media Web site is the excellent social media Web site of the U.S. Department of Health and Human Services. It is truly amazing how the agency has found inexpensive ways to reach the public it serves, in timely ways, through social media venues. This will definitely help the nation in achieving the goals and objectives of the new Healthy People 2020!

    Extremely easy to navigate, you will be able to find a wealth of resources you can use in your Public Health work, especially in the area of health education and health promotion. Not only does it provide links to health and related information that you can add to your Web presence, but, technical-oriented documents such as "Social Media 101" to best practices in a particular media venue.

    Just click on the title or graphic of this blog entry to get to the site. You can also find links to specific pages on my Health Education/Health Promotion Resources on the Internet (Resources - Multimedia & Social Media), Public Health Practices (Communication Skills) and Web Resources on the Internet (Social Networks)

  • April 12, 2011 - Excellent Analytic Methods Resource

    Analytic Methods in Maternal and Child Health

    Graphic source:

    Need to brush up on your analytical skills? This online publication should do the trick. While it is entitled "Analytic Methods in Maternal and Child Health," it pretty much covers the basics you need to know to be a good public health analyst. Topics covered include:
    • Module 1: Descriptive Epidemiology and Statistical Estimation
    • Module 2: Measures of Association and Hypothesis Testing
    • Module 3: Analytic Epidemiology and Multivariable Methods
    • Module 4: Methods for Summarizing Data
    • Module 5: Methods for Analyzing Trend Data
    • Module 6: Creating Target Population Estimates Using National Survey Data
    • Module 7: Using Census Data in MCH
    • Summary of Commonly Used Formulae

    Click on the graphic to get there. Links also available at: Research Resources on the Internet, (Research Methods) Epidemiology Sites, (Textbooks Online) Graphing, (General Resources) and Statistical Procedures (Foundations)

  • April 11, 2011 - Drug Resistance Map

    Here we are, in the 21st century, and we thought that at least we have conquered infectious diseases, if not the growing number of chronic diseases. Wrong!

    Infectious diseases are experiencing a resurgence with the growth of antibiotic-resistant superbugs, such as methicillin-resistant Staphylococcus aureus (MRSA), NDM-1, etc. Even as I am writing this, Southern California is dealing with carbapenem-resistant Klebsiella pneumoniae, or CRKP (Source:

    The over-usage of antibiotics has killed off the weaker bacterial strains, leaving us with antibiotic-resistant superbugs, which are fatal to those who are most susceptible. Many are found in health care facilities, and the victims are those most vulnerable, such as the very young, very old and those who are immunocompromised.

    Click on the graphic to get to the CDDEP. You can also find a link to site, along with information about drug resistance at Infectious Disease

    Drug Resistance Map

    The Center for Disease Dynamics, Economics & Policy (CDDEP) offers on its Web site the "Extending the Cure's ResistanceMap" which consists of a carousel of U.S. maps for 2000-2009. Annual maps highlight the prevalence of each known superbug over time. "The numbers used to make the maps are stratified by isolate source into inpatient and outpatient samples, where inpatient includes ICU and nursing home admissions." (Graphic and Citation Source:

  • April 8, 2011 - In Case the Federal Government Shuts Down...

    Then all links to government Web sites (.gov) may not be functional. I hope that they will all be back online when budget issues are resolved. All links I have to federal government sites provide the best information possible for the public health topics I track so they are critical to advancing knowledge in those areas. I have always appreciated that those agencies that address public health issues have tried over the years to make their information as accessible as possible for anyone who wants to learn more and be informed.

  • April 8, 2011 - CETP Inhibition 101

    CETP inhibitors
    Graphic source:

    Up until now the treatment for high cholesterol has been to lower low density lipoproteins (LDLs). This is basically what the statin class of drugs mainly do. Those who are being treating for coronary heart disease must take statins to control LDLs. However, the more important lipoprotein when considering cardiovascular risk is high density lipoprotein (HDL), which basically scrubs the vascular system of any LDL buildup. Having a high HDL level is cardioprotective.

    Current pharmaceutical approaches is to raise HDL. Some drugs can raise HDL (e.g., Fibrates raise HDL about 5% to 10%, and the average in most trials is about 6%; Nicotinic acid HDL probably more than fibrates, 15% to 25% ) Citation source: HDL: The Next Frontier in Reducing Atherosclerosis and Cardiovascular Risk; 734620_transcript ), but there are problems with tolerance and side effects. The most effective way to raise HDL levels is through aerobic exercise, whick involves working the large muscles in our body. So, running, jogging, brisk walking, swimming and biking will do the trick.

    Recent research has found that "5 infusions of an HDL-like particle actually led to ...coronary atheroma regression." Citation source: Emerging HDL Therapies: What Is on the Horizon to Further Reduce Cardiovascular Risk?; . So, current drug strategies to raise HDL is based on blocking CETP inhibition.

    They have found "...cholesteryl ester transfer proteins move cholesteryl esters from HDL to the atherogenic LDL. That means that HDL decreases and the LDL increases. The CETP inhibitors act to make lipoproteins more atherogenic. By blocking this, you could increase the HDL and decrease the atherogenic LDL. That's the principle of CETP inhibition." (Citation source: Novel CETP Inhibitors in Clinical Development;

    However, I should mention that this approach was used in the development of Torcetrapib in the mid-2000s, but the ILLUMINATE study ( reported: ...patients who received torcetrapib and atorvastatin had an increased risk of death and cardiac events compared to patients who only took atorvastatin. (Citation source: a/torcetrapib1.htm)

    So, for now, stick to aerobic exercise to raise your HDL levels.

    For more information, see Fitness and Cardiovascular Disese

  • April 7, 2011 - WebMD's "Cholesterol 101 Slideshow: What Your Levels Mean"

    WebMD - cholesterol particles graphic

    Graphic source:

    While I am talking about cholesterol, here is a simple way to get up to speed about cholesterol. Cholesterol 101 Slideshow: What Your Levels Mean is a visually appealing tour of everything you need to know about cholesterol.

    A basic understanding of cholesterol is necessary to appreciate the importance of this substance to our physical well-being and why too much of this can be detrimental to our heart. Check out the slideshow and learn something that will improve your quality of life!

    For more information about cholesterol, see Cardiovascular Disease

  • April 6, 2011 - Low HDL and Obesity in Middle-school Children

    The April 3rd Medpage Today article,"ACC: CVD Risk Seen in Middle School Students" reports:

    • "...children as young as 11 showed worrisome signs of future cardiovascular danger -- with 16% of them found to have low HDL cholesterol levels (40 mg/dL)
    • Low HDL cholesterol (≤40 mg/dL) was associated strongly with a higher BMI (P=0.001 for trend). In the group of children with low HDL levels, 60.3% were overweight, compared with 28.8% in the group with high levels.
    • ...low HDL cholesterol levels were also associated with a higher body mass index, worse lipid profiles, and higher blood pressures.
    • Both low HDL cholesterol levels and worse heart rate recovery were associated with increased prevalence of traditional cardiovascular risk factors, such as increased body mass index, poorer lipid profiles, and decreased physical activity levels,...
    • About half of the children with low HDL had at least two additional components of the metabolic syndrome -- which includes high LDL and triglycerides, elevated blood pressure, and abdominal obesity.
    • According to practice guidelines from the American Academy of Pediatrics, certain children should be screened for dyslipidemia -- including those with a family history of either significant hyperlipidemia or premature heart disease, and overweight children regardless of family history or other cardiovascular risk factors.
    • ...the National Heart, Lung and Blood Institute recommends lipid screening in children as early as age 2 if they have a parental history of high cholesterol (total cholesterol >240 mg/dl) or a family history of early heart disease.
    • In children with low HDL cholesterol in particular, lifestyle modifications should be tried, because studies show -- at least in adults -- that exercise can raise HDL cholesterol levels."
    • Citation source: Flynn S, et al "Decreased high-density lipoprotein cholesterol in a cohort of 6th-grade children: association with cardiovascular risk factors and lifestyle behaviors" ACC 2011; Abstract 1097-429; as reported in:

    For more information, see Obesity and encourage children to get active!!!

  • April 5, 2011 - HDL's Critical Role in Heart Disease and Cancer

    Cholesterol HDL
    Graphic source:

    High Density Lipoprotein (HDL) is considered the good component of cholesterol. Having a low level of HDL puts a person at risk for heart disease. Presently, the best way to raise HDL in our bodies is through aerobic exercise. It basically keeps the arteries clean of bad cholesterol (low density lipoprotein [LDL]) by transporting it back to the liver so it can be eliminated from the body.

    However, a 4/1 research report of mice studies from MD Anderson and University of North Texas indicates that HDL may also play a role in control the spread of cancer cells. This is really promising research that may lead to the possibilty of a cancer cure, and possibly shoring up people's HDL levels to fight heart disease.

    Findings from the study include:

    • "good cholesterol" can... act as a special delivery vehicle of destruction for cancer.
    • Previous studies have shown that cancer cells attract and scavenge HDL by producing high levels of its receptor, SR-B1. As cancer cells take in HDL, they grow and proliferate. The only other site in the body that makes SR-B1 receptor is the liver. This selectivity for cancer cells protects normal, healthy cells from side effects.
    • The team developed a synthetic version of HDL, called rHDL, because it's more stable than the natural version.
    • rHDL has not shown to cause immunologic responses, helping to minimize potential side effects, exhibits longer time in circulation...because SR-B1 is found only in the liver, an rHDL vehicle will help block and treat metastasis to that organ.
    • The siRNA/rHDL formulation alone reduced the size and number of tumors by 60 to 80 percent. Combinations with chemotherapy caused reductions above 90 percent."
    • Citation source:
  • April 4, 2011 - It's National Public Health Week!

    Public Health gets taken for granted when it is doing its job. While it is "public" in scope, most of what happens for the good of the public goes on behind the scenes. It is only when things break down do we realize just how important Public Health is to our daily lives.

    Enjoy the American Public Health Association's video that summarizes what falls under the purview of Public Health.

    To learn more about Public Health practice, check my Public Health Practice Page and the rest of this Web site, which is predominately devoted to Public Health.

  • April 1, 2011

    Just launched, promises to provide more accessible data to the public. The government Web site organizes data into communities, of which is one.

    The purpose of is to increase public access to high value, machine readable datasets generated by the Executive Branch of the Federal Government.

    A primary goal of is to improve access to Federal data and expand creative use of those data beyond the walls of government by encouraging innovative ideas (e.g., web applications). strives to make government more transparent and is committed to creating an unprecedented level of openness in Government. The openness derived from will strengthen our Nation's democracy and promote efficiency and effectiveness in Government.
    Citation source:

    You can find links to the main and sites by clicking on the graphics of this blog entry, and on the U.S. Federal Government Statistics Sites, Public Health Data Search Engines, and Healthy People 2020

  • March 31, 2011 - New Data Source: World Life Expectancy

    World Life Expectancy
    Graphic source:
    Here is a super data site that I accidentally came across while looking for some data. Covers a variety of data that would be of interest to any epidemiologist at heart, globally and for the USA, down to state-level. Primary sources of data they use to compile their statistics come from the WHO, World Bank, UNESCO, CIA and individual country databases for global health and causes of death, and the CDC, NIH and individual state and county databases for verification and supplementation for USA data. Developed and maintained by by LeDuc Media, it is worth exploring.

    For a link to this site and other data sources, see Public Health Data Sites

  • March 30, 2011 - CDC's Birth Defects Statistics

    After learning about how exposure to tobacco either from smoking or from others can result in birth defects (3/8/2011 blog entry), I decided to look into birth defects some more. Interestingly enough, the CDC just recently posted birth defects statistics.

    Did you know that cleft palates/lips are the most common form of birth defects? Preliminary studies indicate "a combination of genes and other factors, such as exposures in the environment, maternal diet, and medication use" with an increased risk for those who smoke and/or have diabetes. (Source:

    Birth Defects
    Graphic source:

    But, this graphic was the most interesting to me. Many times when we think of infant deaths, we most likely associate that with SIDS, which is not as common as deaths from birth defects, followed by deaths from low weight and prematurity. Though some defects may be the result of genetic aberrations, many are preventable.

    The following guidance comes from the CDC for preventing birth defects:
    1. Take 400 micrograms (mcg) of folic acid every day.
    2. Don't drink alcohol.
    3. Don't smoke.
    4. Don't use street drugs.
    5. Talk to a health care provider about taking any medications.
    6. Prevent infections.
    7. Talk to your doctor about vaccinations (shots).
    8. Keep diabetes under control.
    9. Reach and maintain a healthy weight.
    10. See a health care professional regularly.

    Source citation:

    Check out the CDC's Birth Defects Pages . For more information, see Maternal Child Health Resources

  • March 29, 2011 - NIH's "Helping Your Overweight Child"

    Get active with your kids!
    Graphic source:
    Kids get fat for various reasons, from eating poorly to not getting enough exercise. Parents and caregivers need to take an active role in helping their kids, especially if they are overweight, to develop healthy habits.

    Participating together in leisure activities that are physically active is one strategy that's not only good for the kids, but for the parents as well. It nurtures the familial relationship and creates emotional bonds kids need to face the stress in their lives (yes, they have that, too!) Make sure they get enough sleep will also help them to handle stress, which includes dealing with peer pressure.

    Check out NIH's Helping Your Overweight Child Webpage for tons of helpful hints.

  • March 28, 2011 - Fat is bad for you, regardless of where you carry it

    Get rid of that fat!
    Graphic source:
    Though much have been made about the dangers of visceral fat, a University of Cambridge's 3/11 report in Lancet contends that fat is bad for you, period.
    • "...being obese boosts the likelihood of a heart attack or stroke regardless of where the excess fat is stored in the body.
    • doesn't matter where your fat is located. If you're overweight you're at risk, full stop."
    • The study concluded that being obese certainly raises the overall risk for heart disease, but that those who carry much of their excess fat in the stomach region do not appear to face a particularly higher risk, compared with those whose fat deposits are distributed differently.
    • They also found that tracking a person's blood pressure and cholesterol levels, as well as monitoring their history of diabetes, appeared to be best way to assess heart disease risk. When such indicators were readily available, they noted, adding in BMI and waist measurement information did not improve risk diagnosis.
    • Excess weight, they said, remains a key culprit in the onset of medical conditions that boost the risk for cardiovascular illness.
    • ...the factors that proved most useful in assessing heart risks -- such as high blood pressure and cholesterol -- are themselves the product of the "adverse effects of overweight."
    • Citation source: Emanuele Di Angelantonio, M.D., Ph.D., lecturer, medical screening, University of Cambridge, England; March 11, 2011, The Lancet, online; as reported
    • For more information, see Obesity

  • March 25, 2011 - Putting on weight when you should be sleeping

    CDC - sleep-deficit issues
    Graphic source:
    According to a March 23rd American Heart Association news release, " sleep-deprived adults ate almost 300 calories more a day on average than those who got enough sleep.... Women...ate an average of 329 more calories a day if they weren't well-rested, while men ate 263 more calories on average." (

    Hmmm. Let's do a little arithmetic. If a woman were to do this for one year (365 days) x 329 calories (per day), that would come to a whopping excess average intake of 120,085 calories, OR, 34.51 pounds (3,500 calories = 1 pound). For a man, it would be 95,995 excess calories, or 27.43 pounds!!!

    Here is a graphic from the CDC's Insufficient Sleep Is a Public Health Epidemic page which shows all the other problems one can have with insufficient sleep. "The National Sleep Foundation suggests that school-age children (5-10 years) need 10-11 hours of sleep daily, teens (10-17 years) need 8.5-9.5 hours, and adults need 7-9 hours According to data from the National Health Interview Survey, nearly 30% of adults reported an average of ≤6 hours of sleep per day in 2005-2007.3 In 2009, only 31% of high school students reported getting at least 8 hours of sleep on an average school night." (Source:

    So-o-o, it would be more sensible to go to sleep than stay up. For more information, see Sleep

  • March 24, 2011 - Radiation Dose Chart

    Radiation Dose Chart

    Enlarged Graphic
    Graphic source:

    For more information, see Radiation

  • March 23, 2011 - Tohoku Earthquake Shaking Intensity

    Tohoku Earthquake Shaking Intensity
    Tohoku Palette
    Here is a new rendering of earthquake intensity from NASA's Earth Observatory for the 3/11 Japan earthquake:
    • On March 11, 2011, the largest earthquake in Japan's modern history struck off the northeast coast, about 130 kilometers (81 miles) east of the mainland region of Tohoku. Initially categorized as magnitude 8.9, the quake was later revised upward to magnitude 9.0 by the Japanese Meteorological Agency (JMA) and the U.S. Geological Survey (USGS). The event shook buildings and damaged infrastructure hundreds of kilometers away. Closer to the main shock, coastal regions were devastated by the quake and the resulting tsunami.
    • This map shows the ground motion and shaking intensity from the earthquake at dozens of locations across Japan. Each circle represents an estimate of shaking as recorded by the USGS, in conjunction with regional seismic networks. Shades of pale yellow represent the lowest intensity and deep red represents high intensity. The ground shaking data is overlaid on a map of population density provided by Oak Ridge National Laboratory.
    • A shaking intensity of VI is considered strong and can produce “light damage, while a IX on the scale is described as violent and likely to produce heavy damage.
    • Note the number of VIIs and VIIIs near Tokyo, well away from the epicenter; the lack of a severe human toll in that metropolitan area is surely a testament to the quality of the nation's earthquake preparedness.
    • In the week after the main quake, Japan endured 262 aftershocks of at least magnitude 5, according to JMA. Forty-nine of them were magnitude 6 or greater, and three were magnitude 7 or higher. (For comparison, the Christchurch earthquake of February 2011 was a magnitude 6.3.) The aftershocks have been almost entirely offshore, in a zone stretching about 500 kilometers (300 miles) from Iwate to Ibaraki prefectures.
    • Graphic & Citation source:
  • March 22, 2011 - Promoting preventive services for adults age 65 and older, especially among minorities.

    CDC -Promoting Preventive Services for Adults 65 and older
    Graphic source:

    According to a recent report from the US DHHS, "Enhancing Use of Clinical Preventive Services Among Older Adults: Closing the Gap":

    • "Critical gaps exist between older Americans who receive potentially lifesaving preventive services and those who do not...
    • Clinical prevention services examined...include vaccinations that protect against influenza and pneumococcal disease (e.g., bloodstream infections, meningitis, and pneumonia), screenings for the early detection of breast cancer, colorectal cancer, diabetes, lipid disorders, and osteoporosis, and smoking cessation counseling.
    • About 10,000 Americans turn 65 every day; by 2030, about 1 in 5 Americans will be 65 older.
    • "We know prevention is critical to healthy living and independence,"
    • ...49 percent of Asian/Pacific Islanders and 47 percent of Hispanics reported not being screened for colorectal cancer, in comparison to 34 percent of whites. More than 50 percent of Hispanics, 47 percent of blacks and Asian/Pacific Islanders, and 36 percent of whites report never receiving a pneumococcal vaccination."
    • Citation source:
    It should be noted only starting this year that changes to Medicare coverage for those 65 and older have changed from a one-time Medicare entry-only comprehensive physical to expanded clinical preventive services coverage.

    It is good that the US DHHS has taken this approach to raise awareness that preventive clincial services are critical for quality of life among those who are at the age of vulnerability. People who are 65 or older can benefit from early detection of diseases and conditions that can compound and exacerbate already existing chronic conditions.

    Now the only thing left is to ensure health care providers are adequately compensated to continue to provide care to those who are on Medicare!

    Click on graphic for the report. For more information, see Senior Health

  • March 21, 2011 - NIH's Diabetes Research Strategic Plan

    NIH's Diabetes Research Strategic Plan
    Graphic source: ReportsAndStrategicPlanning/DiabetesPlan/planposting.htm
    On 3/18, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) announced the release of its Diabetes Research Strategic Plan, which will be available in print on 4/1. The plan...focuses on 10 areas of diabetes research with the most promise. The goal is to accelerate discovery on several fronts, including:
    • -- the relationship between obesity and type 2 diabetes, and how both conditions may be affected by genetics and environment
    • -- the autoimmune mechanisms at work in type 1 diabetes
    • -- the biology of beta cells, which release insulin in the pancreas
    • -- development of artificial pancreas technologies to improve management of blood sugar levels
    • -- prevention of complications of diabetes that affect the heart, eyes, kidneys, nervous system and other organs
    • -- reduction of the impact of diabetes on groups disproportionately affected by the disease, including the elderly and racial and ethnic minorities.

    Diabetes eventually damages nearly every organ system in the body. People with diabetes are at increased risk for blindness, kidney failure, and lower limb amputation. Overall, the risk for death among people with diabetes is about twice that of people of similar age without diabetes. In addition, it is a very expensive disease to manage. Total costs of diabetes, including medical care, disability, and premature death, reached an estimated $174 billion in 2007 in the United States. (Source:

    Click on graphic for the report. For more information, see Diabetes Resources on the Internet

  • March 18, 2011 - The Relationship Between Obesity and Diabetes

    Gallup - Diabetes and Obesity

    Graphic source:

    Here's an interesting extrapolation that predicts how lower obesity levels could mean fewer people with diabetes. Analysis of Gallup-Healthways Well-Being Index data report:
    • "The diabetes rate in the US, which is related to obesity, also remains up from 2008, with 11.3% of American adults reporting in 2010 that they have ever been diagnosed with the disease, similar to 11% in 2009, but up more than 6% from 10.6% 2008.
    • ...the relationship between obesity levels and diabetes diagnoses, revealing that there is an average diabetes rate of 9.9% in the 10 states with the lowest obesity levels, which is almost 28% lower than the average rate of 13.7% in the 11 states with the highest obesity levels.
    • These data reveal that if the 11 states with the highest obesity levels had the same average obesity rate as the 10 states with the lowest obesity levels, approximately 3.3 million fewer American adults would be obese and there could be as many as 1.6 million fewer diagnosed with diabetes in those 10 states alone.
    • If the remaining 40 states had the same average diabetes rate as the 10 states with the lowest obesity levels, approximately 4.6 million fewer American adults would have diabetes.
    • Source:

    For more information see Obesity, and Diabetes

  • March 17, 2011 - Shifting the Earth's Axis with an Earthquake

    NASA: Japan Earthquake Shifting the Earth's Axis

    Graphic source:

    Because of the magnitude of the Japan earthquake, geological changes have occurred:
    • The quake caused a rift 15 miles below the sea floor that stretched 186 miles long and 93 miles wide,
    • The areas closest to the epicenter of the quake jumped a full 13 feet closer to the United States,
    • The 9.0 magnitude quake (the fourth-largest recorded since 1900) was caused when the Pacific tectonic plate dove under the North American plate, which shifted Eastern Japan towards North America by about 13 feet
    • The quake also shifted the earth's axis by 6.5 inches, shortened the day by 1.6 microseconds, and sank Japan downward by about two feet. As Japan's eastern coastline sunk, the tsunami's waves rolled in.
    • Why did the quake shorten the day? The earth's mass shifted towards the center, spurring the planet to spin a bit faster. Last year's massive 8.8 magnitude earthquake in Chile also shortened the day, but by an even smaller fraction of a second. The 2004 Sumatra quake knocked a whopping 6.8 micro-seconds off the day.
    • Citation source:

    I tried to do a little more research online about the earth shifting axis but ended up with numerous sites about what's going to happen in 2012 and others with apocalyptic doomsday warnings. I'll report more when I find good scientific evidence worth passing along.

  • March 16, 2011 - Most Dramatic Footage of the Japan Earthquake/Tsunami

  • Crying, boo hoo

  • March 15, 2011 - FDA Takes on Fraudulent Dietary Supplements

    FDA Fraud Supplements

    Today the FDA released its "Beware of Fraudulent 'Dietary Supplements'" fact sheet to raise awareness of tainted products.
    • The Food and Drug Administration (FDA) has found nearly 300 fraudulent products promoted mainly for weight loss, sexual enhancement, and bodybuilding that contain hidden or deceptively labeled ingredients, such as the active ingredients in FDA-approved drugs or their analogs (closely-related drugs) other compounds, such as novel synthetic steroids, that do not qualify as dietary ingredients
    • These products are masquerading as dietary supplements they may look like dietary supplements but they are not legal dietary supplements, says Michael Levy, director of FDA's Division of New Drugs and Labeling Compliance. Some of these products contain hidden prescription ingredients at levels much higher than those found in an approved drug product and are dangerous.
    • Source citation:

    I am so glad that the FDA is taking an aggressive approach to warning the general public about fraudulent dietary supplements. It's a start. I would like to see the FDA regulate anything that is called a dietary supplement so the public can be assured that they are getting what they are paying for. Additionally, they have released a widget that will provide a continuous feed of the latest news regarding tainted products. The widget can be found on Home Page, the Nutrition Page, and right here!

  • March 14, 2011 - Mercalli -> Richter -> Moment Magnitude Scales

    Moment Magnitude Scale

    Graphic source:

    Japan's 8.9 earthquake/tsunami catastrophe is totally devastating. Earthquakes are measured in magnitude and energy released. Many people will probably remember the Richter Scale, but it has been superceded when the Moment Magnitude Scale was introduced in 1979. Both have its strengths and weaknesses, but generally speaking, the Richter Scale is more accurate for measuring smaller earthquakes (<3.5), and the Moment Magnitude Scale for larger earthquakes (7 or greater).

    This graphic compares the magnitudes of large earthquakes and other energy-releasing phenomena. They will probably update this with the historic Japan earthquake (between San Francisco and Alaskan earthquakes).

    For more information, see Earthquakes

  • March 11, 2011 - Japan's 8.9 Earthquake

    Crying, boo hoo

    NOAA tsunami travel times for Japan's 8.9 earthquake of 3/11/2011
    Graphic source:
    NOAA energy plot of Japan's 8.9 earthquake of 3/11/2011
    Graphic source:

    Sometimes we forget the force of Nature until something catastrophic happens. It's good that globallly, emergency preparedness has become a priority to protect the Public's health. Having tools, like NOAA's Tsunami Travel Times and Energy Plot, help to prepare for sometimes inevitable natural disasters, and save lives in the process.

    For more information, see Emergency Preparedness/Disaster Planning and Earthquakes

  • March 10, 2011 - US Physical Inactivity Estimates by County, 2008

    US physical inactivity, 2008, CDC US physical inactivity, 2008, CDC US physical inactivity, 2008, line chart, CDC
    Graphic source:
    Recently released CDC 2008 county estimates of physical inactivity look very bleak, especially for southeastern states that already have a high prevalence of obesity, heart disease and diabetes. Physical inactivity in these areas will continue to perpetuate the hold of chronic diseases on those who live in these areas.

    For more information, see Physical Inactivity Statistics, Obesity Resources, Diabetes, Cardiovascular Disease, and Chronic Disease Information

  • March 9, 2011 - Leafy Greens, Diabetes and Cardiovascular Disease

    Eat your greens to reduce diabetes
    Graphic source:
    According to a recent British Medical Journal, people are not eating enough vegetables. "Researchers found that eating an extra 1.5 servings (about 4 extra ounces) of green leafy vegetables was associated with a 14% reduction in diabetes risk. Beneficial green, leafy vegetables include cabbage, Brussels sprouts, broccoli, and spinach." (Citation source: 1.Carter P, Gray LJ, Troughton J, et al. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010;341:c4229, as reported by

    "Leafy vegetables are ideal for weight management as they are typically low in calories. They are useful in reducing the risk of cancer and heart disease since they are low in fat, high in dietary fiber, and rich in folic acid, vitamin C, potassium and magnesium, as well as containing a host of phytochemicals, such as lutein, beta-cryptoxanthin, zeaxanthin, and beta-carotene. One study showed that an increment of one daily serving of green leafy vegetables, lowered the risk of cardiovascular disease by 11 percent." Citation source:

    For more information, see Diabetes Resources on the Internet, and Nutrition Resources on the Internet

  • March 8, 2011 - Tobacco and Birth Defects

    Environmental Tobacco Exposure
    Graphic source:

    Two recent research reports now link exposure to maternal smoking and environmental tobacco smoke to the development of birth defects in the developing fetus, both from Pediatrics

    "Maternal cigarette smoking during the first trimester was linked with the following heart defects:

    • Atrial septal defects, type 2
    • Right ventricular outflow tract obstruction defects, specifically pulmonary valve stenosis
    • Truncus arteriosus
    • L-transposition of the great arteries"
    • Source citation: Alverson CJ, Strickland MJ, Gilboa SM, Correa A. Maternal Smoking and Congenital Heart Defects in the Baltimore-Washington Infant Study. Pediatrics. 2011 [Epub ahead of print]; as posted on
    • "Nonsmoking women who breathe secondhand tobacco smoke during pregnancy increase their risk of stillbirth, major birth defects, and other harms to their babies,
    • ...a 23% increased risk of stillbirth with tobacco smoke exposure during pregnancy (odds ratio 1.23, 95% confidence interval 1.09 to 1.38)
    • ...pregnant women exposed to second hand smoke were also 13% more likely give birth to a child with congenital malformations (OR 1.13, 95% CI 1.01 to 1.26)
    • "...elevated point estimates for some risks,included:
      • Conotruncal heart defects (OR 1.30, 95% CI 0.85 to 2.10)
      • Clubfoot and other similar deformities of the feet (OR 1.80, 95% CI 0.97 to 3.30)
      • Cryptorchidism (OR 1.55, 95% CI 0.95 to 2.54)
      • Neural tube defects (OR 1.20, 95% CI 0.83 to 1.73)
      • Anencephaly (OR 2.10, 95% CI 0.90 to 4.90)
      • Spina bifida (OR 1.90, 95% CI 0.70 to 9.40)
      • Orofacial clefts (OR 1.09, 95% CI 0.93 to 1.27)
      • Craniosynostosis (OR 1.30, 95% CI 0.89 to 1.90)"
    • Source Citation: Leonardi-Bee J, et al "Secondhand smoke and adverse fetal outcomes in nonsmoking pregnant women: A meta-analysis" Pediatrics 2011; DOI: 10.1542/peds.2010-3041; reported at

    For more information, see Tobacco and Health and Wellness Resources: Smoking

  • March 7, 2011 - Exercise and Hypertension

    AHRQ - 2008 Hypertension stats - Effects of Exercise

    Graphic source:

    In the just released STATISTICAL BRIEF #315: Hypertension in America: Estimates for the U.S. Civilian Noninstitutionalized Population, Age 18 and Older, 2008 is this super chart that shows the benefits of exercising 3x a week!

    The percentage of exercisers reporting hypertension is lower than every group except for those who are normal weight and underweight. I say this is pretty good evidence that exercise helps to keep the blood pressure down. Of course, there have been numerous studies that show exercise reduces blood pressure. If you are interested, see the Google Scholar Search Results for Exercise and Blood Pressure

    For more information, see Hypertension Statistics , Hypertension and Fitness

    Source Citation: Hypertension in America: Estimates for the U.S. Civilian Noninstitutionalized Population, Age 18 and Older, 2008

  • March 3, 2011 - Ischemic Heart Disease Mortality, 2004

    Ischemic Heart Disease, 2004 WHO

    Graphic generated by BCJung at:

    Using the WHO Global Infobase I decided to continue looking at mortality statistics, this time for ischemic heart disease. Heart disease is the leading cause of death in the U.S.

    And, if you look at global mortality rates, ischemic heart disease is a major player. Whoa!! Who would have known that the mortality rates are so high for those living in Russia?

    When looking at ischemic heart disease mortality, by gender (maps below), isn't it shocking that Indian and middle eastern women have such high mortality rates for ischemic heart disease, and that Brazilian women have higher rates than Brazilian men?

    Male Ischemic Heart Disease Mortality, 2004 WHO Female Ischemic Heart Disease Mortality, 2004 WHO
  • March 2, 2011 - World Diabetes Mortality, 2004

    Diabetes Mortality, 2004 WHO

    Graphic generated by BCJung at:

    The WHO Global Infobase is a real cool interactive online tool that you can use to generate epidemiologic statistical tables and maps dealing with a variety of health indicators. To try it out I decided to find out what the world's diabetes mortality is.

    And, this is what came up. I was really surprised to see that Africans are dying from diabetes more than anywhere else. However, a more accurate picture of diabetes mortality must account for gender differences.

    Looking at 2004 diabetes mortality, by gender (maps below), we see that it is the women who were dying from diabetes more than men in most African and Asian countries, while men were dying from diabetes more than women in the middle east, India and South America. Finally, it's high for both sexes in Mexico.

    Male Diabetes Mortality, 2004 WHO Female Diabetes Mortality, 2004 WHO
  • March 1, 2011 - U.S. Cancer Incidence and Deaths, by Gender and Race & Ethnicity

    CDC 2007 cancer rates, by gender

    CDC 2007 cancer rates, by race

    According to a 2/24 CDC posting, health disparities in cancer incidence and deaths continue to exist.
    • " expectancy and overall health have improved for most Americans in recent years, but not all Americans have benefited equally.
    • Health disparities are differences in the incidence, prevalence, and mortality of a disease and the related adverse health conditions that exist among specific population groups. Disparities affect many populations, including racial and ethnic minorities, residents of rural areas, women, children and adolescents, the elderly, and people with disabilities.
    • Incidence. Among U.S. men in 2007 ..., black men were diagnosed with cancer most often, at a rate of 598.5 per 100,000. White men had the second highest incidence rate at 533.1 per 100,000, followed by Hispanic* men at 400.5, Asian/Pacific Islander men at 318.7, and American Indian/Alaska Native men at 290.0.
    • Among U.S. women in 2007, white women were diagnosed with cancer most often at a rate of 412.5 per 100,000, followed by black women at 387.7, Hispanic* women at 318.3, Asian/Pacific Islander women at 276.2, and American Indian/Alaska Native women at 252.6.2
    • Deaths. Among U.S. men in 2007, black men died from cancer at a rate of 284.2 per 100,000, followed by white men at 215.2, Hispanic* men at 142.3, American Indian/Alaska Native men at 141.2, and Asian/Pacific Islander men at 131.4.
    • Among women, black women had the highest death rate at 175.2 per 100,000, followed by white women at 150.6, American Indian/Alaska Native women at 103.1, Hispanic* women at 99.0, and Asian/Pacific Islander women at 90.9.
    • Source: Rates for New Cancer Cases and Deaths by Race/Ethnicity and Sex
    • Graphic source:

    For more information, see Cancer Resources on the Internet
    Graphic source:

  • February 28, 2011 - Health, United States 2010 - Now the bad news: Childhood Obesity Continues to Rise

    Health, United States 2010
    Graphic source:
    And, to be fair I decided to highlight what I consider to be bad news from Health, United States 2010.

    Unfortunately, this graph is pretty much self-explanatory - kids have been getting fatter, at least since 1994. If these trends continue we will be looking at the early onset of many of the chronic diseases in the coming decades that are now plaguing the older generations.

    Most likely, these children will probably die much earlier than they should and that the years they live with chronic diseases will compromise their quality of life. If you think health care costs are high now, just expect such costs to exacerbate, unless, of course, we start doing something about this growing problem now. Healthy management of stress, good diet and adequate exercise are are a start to reversing these awful trends.

    For more information, see Obesity Resources, Nutrition Resources, and Fitness Resources

  • February 25, 2011 - Health, United States 2010 - Promising trends: Women Serum Cholesterol Levels

    Health, United States 2010
    Graphic source:

    Today I decided to highlight what I consider to be promising news from Health, United States 2010. High serum cholesterol is a major modifiable risk factor for heart disease and stroke.

    (Not shown) Table 66: "Selected health conditions and risk factors: United States, selected years 1988-1994 through 2007-2008" reports the age-adjusted prevalence of High serum total cholesterol for 2007-2008 to be at 14.2%, down from 20.8 for the 1988-1994 time period. Table 68: "Cholesterol among persons 20 years of age and over, by selected characteristics: United States, selected years 1988-1994 through 2005-2008" reports the female prevalence for 2005-2008 to be 27.5%, up from 24% for the 1988-1994 period.

    Thus, this graphic showing the percentages of cholesterol levels of 240 mg/dL and higher (which is really high, considering that normal is less than 200 mg/dL) for age-specific prevalence by gender highlights the disparities between men and women. Women in older age groups have much higher prevalences than for men, and it begs the question,"Why is this so?" Are men more aggressively treated for high cholesterol and women are not?

    Nevertheless, it does show that because of the much higher prevalences of high cholesterol levels among older women they are much more likely than men to develop heart disease and stroke if these women don't get their cholesterol under control. The good news is that at least there is a downward trend for women over 45 and older between 1988 and 2008.

    For more information, see Women and Heart Disease and Cholesterol and Heart Disease

  • February 24, 2011 - Health, United States 2010

    Health, United States 2010
    Graphic source:
    Health, United States 2010 is the best resource for U.S. Health Statistics published by the CDC/National Center for Health Statistics. Issued annually it provides a wealth of data. Extremely Internet-friendly, there are links throughout the document to related tables and graphics as well updates as they become available.

    Check it out at: Health, United States, 2010

    For more data, see Public Health Data Index

  • February 23, 2011 - Triglycerides and the Risk for Stroke

    Composition of lipoproteins
    Graphic source:

    According to the American Heart Association:

    • "Triglycerides in plasma are derived from fats eaten in foods or made in the body from other energy sources like carbohydrates. Calories ingested in a meal and not used immediately by tissues are converted to triglycerides and transported to fat cells to be stored. Hormones regulate the release of triglycerides from fat tissue so they meet the body's needs for energy between meals.
    • The National Cholesterol Education Program guidelines for (fasting plasma) triglycerides are:
      • Normal: Less than 150 mg/dL
      • Borderline-high: 150 to 199 mg/dL
      • High: 200 to 499 mg/dL
      • Very high: 500 mg/dL or higher
    • Citation source:

    On February 21st, the Annals of Neurology released a report that high triglyceride levels increase the risk for stroke:

    • Men and women with high triglyceride levels are at an increased risk of ischemic stroke, which typically occurs when blood flow to the brain is blocked by a build-up of fatty deposits within blood vessels,
    • ...this stroke risk seems to be more pronounced for triglyceride fats than it is for cholesterol,...suggest that triglyceride levels should be incorporated into stroke-prevention guidelines.
    • High triglyceride levels may indicate the presence of fat particles similar to "bad" low-density lipoprotein (LDL) cholesterol, which can also contribute to the build-up of plaque in arterial walls.
    • "Triglycerides...are a marker of high levels of atherogenic lipoprotein remnants [very low density lipoproteins and intermediate density lipoproteins]."
    • For both men and women, higher non-fasting triglyceride levels were linked with an increased risk of stroke, even after adjusting for age, gender, smoking, alcohol use, lipid-lowering therapy, hormone therapy (in women) and other factors.
    • Women with triglyceride levels of 443 mg/dL had nearly quadruple the risk of suffering a stroke, compared to women whose levels were less than 89 mg/dL. Those with levels between 89 and 177 mg/dL had a 20 percent increased risk.
    • Increased cholesterol was not linked to an increased risk of stroke in women, though it was in men whose cholesterol was 348 mg/dL or higher.
    • "Patients should attempt to reach this goal through lifestyle changes [weight loss, reduction of intake of saturated fatty acids, cholesterol, and alcohol, more exercise, and cessation of smoking],"
    • Citation source: Marianne Benn, M.D., Ph.D., consultant, department of clinical biochemistry, Herlev Hospital, Copenhagen University Hospital, Denmark; Tara Narula, M.D., cardiologist, Lenox Hill Hospital, New York City; Feb. 21, 2011, Annals of Neurology; as reported in HealthDay

    For more information, see Cardiovascular Disease Information

  • February 22, 2011 - CDC's Winnable Battles

    According to Trust for America's Health (, its "Ten Top Priorities for Prevention for a National Prevention Strategy" include:
    • Promoting Disease Prevention
    • Combating the Obesity Epidemic
    • Preventing Tobacco Use and Exposure
    • Preventing and Controlling Infectious Diseases
    • Preparing for Potential Health Emergencies and Bioterrorism Attacks
    • Recognizing the Relationship Between Health and U.S. Economic Competitiveness
    • Safeguarding the Nation's Food Supply
    • Planning for Changing Health Care Needs of Seniors
    • Improving the Health of Low-Income and Minority Communities
    • Reducing Environmental Threats
    • Citation source:
    However, the CDC recently unveiled its new strategy for addressing what it considers to be those Public Health issues that are winnable.

    CDC's Winnable Battles
    Graphic adapted from ppt at
    "CDC has coined the term Winnable Battles to describe public health priorities with large-scale impact on health and with known, effective strategies to intervene. The charge under Winnable Battles is to identify optimal strategies and to rally resources and partnerships to accelerate a measurable impact on health....based on the magnitude of the health problems and CDC′s ability to make significant progress in improving outcomes."(Citation source:

    So, here is an example of what Public Health has to deal with - competing priorities. Though there is some overlap between these two lists, differences will always emerge and priorities will surely change over time. The challenge is to address all these priorities, despite dwindling funds, with strategies that have proven to work, which is what the CDC is trying to do. This is why it is so important for public health practitioners to evaluate their work and share with others what works and doesn't work to avoid waste of time and resources. I suppose healthyamerican's list is more of a "wish list," but what a great wish list it is!

    For more information, see Public Health Practice

  • February 21, 2011 - CDC's 2011 National Diabetes Fact Sheet

    National Diabetes Fact sheet

    Graphic source:

    CDC just released its "2011 National Diabetes Fact Sheet" which provides a wealth of information and statistics about one of the fastest growing chronic diseases plaguing us today, type 2 diabetes. Packed with the latest statistics and disease information, major points include:
    • Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness among adults in the United States.
    • Diabetes is a major cause of heart disease and stroke.
    • Diabetes is the seventh leading cause of death in the United States.
    • During 2002-2005, 15,600 youth were newly diagnosed with type 1 diabetes annually, and 3,600 youth were newly diagnosed.
    • Type 2 diabetes was extremely rare among youth aged <10 years. While still infrequent, rates were greater among youth aged 10-19 years than in younger children, with higher rates among U.S. minority populations than in non-Hispanic whites.
    • ... people with prediabetes who lose weight and increase their physical activity can prevent or delay type 2 diabetes and in some cases return their blood glucose levels to normal.
    • Immediately after pregnancy, 5% to 10% of women with gestational diabetes are found to have diabetes, usually type 2.
    • Women who have had gestational diabetes have a 35% to 60% chance of developing diabetes in the next 10-20 years.
    • Overall, the risk for death among people with diabetes is about twice that of people of similar age but without diabetes.
    • Citation source: Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.

    For more information, see Diabetes Resources on the Internet

  • February 18, 2011 - How Infographics Sees Chronic Diseases and the Internet

    Infographics - Chronic Diseases
    Graphic source:
  • February 17, 2011 - Chronic Diseases 2008 - 2010

    Gallup - Chronic Diseases 2008 - 2010

    Gallup - Chronic Diseases 2008 - 2010
    Graphic source:

    According to the 2010 Gallup-Healthways Well-Being Index survey, not much progress has been made with the chronic diseases that are plaguing Americans today. Survey results show:
    • "US adults were as likely in 2010 as they were in 2009 to say they have ever been diagnosed with high blood pressure, high cholesterol, depression, asthma, diabetes, cancer, and heart attack, revealing that the country as a whole has made no progress in decreasing these costly chronic conditions,
    • ...about three in 10 American adults continue to report having been diagnosed with high blood pressure or high cholesterol in their lifetimes, making these two illnesses the most widespread diseases measured.
    • Income, health habits such as exercise and healthy eating, age, and genetic predisposition all relate to whether individuals have chronic conditions.
    • ...low-income Americans, regardless of age, have worse emotional and physical health, health habits, and access to healthcare than do those with higher incomes.
    • Seniors (58.7%) and black Americans (38.7%) are the groups most likely to report high blood pressure.
    • Americans 45 years of age and older are among the most likely to report high cholesterol.
    • One in four low-income Americans reports having been diagnosed with depression, which is more than any other group.
    • Asthma is most prevalent among low-income Americans (14.6%), women (13.7%), young adults (13.4%), and blacks (13.2%).
    • The percentage of seniors who have diabetes (22.7%) is double the national average (11.3%). Blacks are the second most likely group to report diabetes (15.5%).
    • Nearly two in 10 seniors have been diagnosed with cancer.
    • Seniors (12.2%) and low-income Americans (6.2%) are the most likely to have had a heart attack.
    • Three groups stand out as being in the best health: Asian Americans, high-income Americans, and young adults.
    • More than six in 10 American adults (62.9%) were either overweight (36.3%) or obese (26.6%) in 2010, on par with 2009, but still slightly more than the 62.2% in 2008.
    • Citation source:

    For more information, see Chronic Diseases

  • February 16, 2011 - OK, guys, you've got to lose that weight!

    Fat man
    Graphic source:

    Obesity has been the controversial risk factor for chronic diseases, but not anymore. Two recent research reports point to the deleterious effects of carrying around too much weight.

    February 14th online Heart journal:

    • "Obese men face a dramatically higher risk of dying from a heart attack, regardless of whether or not they have other known risk factors for cardiovascular disease,...
    • ...chronic inflammation that typically accompanies significant weight gain might be the driving force behind the increased risk.
    • "Obese, middle-aged men have a 60 percent increased risk of dying from a heart attack than non-obese middle-aged men, even after we cancel out any of the effects of cholesterol, blood pressure and other cardiovascular risk factors,...This means [that] obesity itself may be causing fatal heart attacks through a factor that we have not yet identified."
    • .........the risk of death among obese men -- those with a body mass index (BMI) between 30 and 39.9 -- was still 75 percent higher than it was for non-obese men."
    • Citation source: Jennifer Logue, clinical lecturer, metabolic medicine, British Heart Foundation, Cardiovascular Research Centre, University of Glasgow, Scotland; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Murray A. Mittleman, M.D., Dr.P.H., director, Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston; Feb. 14, 2011, Heart, online, as reported on HealthDay
    February 15th Annals of Internal Medicine:
    • "Obesity and osteoarthritis of the knee are robbing millions of older Americans of an average of 3.5 years of life in which they might otherwise be feeling healthy and free of chronic pain,...
    • Some 40 percent of older Americans are either obese and/or have osteoarthritis of the knee, an often painful and potentially disabling condition that can be exacerbated by carrying around extra weight.
    • Rolling back obesity even slightly (say, a reduction of 3.74 pounds in a person about 5 feet, 7 inches tall) would also avert 178,000 cases of coronary heart disease and 890,000 cases of diabetes,
    • ... black and Hispanic women were the hardest hit by obesity and knee osteoarthritis, with some 55 percent of black women and 50 percent of Hispanic women being either obese and/or suffering from knee osteoarthritis, compared to 38 percent of white women.
    • Citation Source: Elena Losina, Ph.D., associate professor, orthopedic surgery, Harvard Medical School, Boston, Mass.; Evan McDevitt, orthopedic surgeon, Bay Area Orthopaedics & Sports Medicine, Arnold, Md., Feb. 15, 2011 Annals of Internal Medicine, as reported in HealthDay

    For more information, see Obesity Resources on the Internet

  • February 15, 2011 - Diabetes: Prevalence and Disease Management

    Diabetes Prevalence, 2007

    Diabetes Prevalence 2007, CDC
    Map source:

    (You can move the legend box by dragging it on the title bar)

    Map source:

    Diabetes is a growing problem in the U.S. as well as for the rest of world. Here are two maps that tell the story better than I can.

    The top map from the CDC shows the prevalence of diabetes for 2007. The bluer the color, the higher the prevalence. As you can see, the prevalence is very high for the Southeastern U.S. For many of those states, the prevalence is over 10%!

    The bottom map is an interactive one (go ahead, scroll over with your mouse and see what happens) from the Dartmouth Altas site. This map shows the percentage of Medicare recipients receiving appropriate management of their diabetes, the browner the color, the better the care.

    As you can see, the diabetes management better for those living outside of the areas where the prevalence of diabetes is the highest. So, if you live in the upper half of the U.S. (Northwest, mideast and northeast) and have diabetes you are probably getting good care for managing the disease.

    Of course, I must add my caveats: the prevalence data are for adults 20 and over, and the evaluation of diabetes management was only for those on Medicare, using claims data. It could be that those under 65 who have diabetes can be getting good care but we don't know that from the Dartmouth map. Claims data are used for their convenience, but any biostatistician will tell you that such data have their weaknesses. As for looking at the incidence of diabetes: "In 2008, 68% of the adult incident cases (i.e, cases diagnosed within past year) of diabetes were diagnosed between the age of 40 and 64 years. About 15% were diagnosed before the age of 40 and about 17% were diagnosed at age 65 or older."(Source:

    Nevertheless, these 2 maps do give us a birdseye view of the scope of diabetes and how well the health care system is doing in controlling the problem (at least for those 65 and older). For more information, see Diabetes Resources

  • February 14, 2011 - Training Children to Eat Right

    Junk food

    Graphic source: news/fullstory_108191.html

    MedlinePlus recently reported in "Kids Fed Unhealthy Foods Learn to Prefer Them" that
    • Most preschool children develop a taste for salt, sugar and fat at home, and quickly learn which types of brand-name fast foods and sodas meet these preferences,
    • food and soda brand knowledge is linked to the development of a preference for sugar, fat and salt in food,"
    • Parents need to carefully consider the types of foods they give to young children at home and in restaurants,
    • "Repeated exposure builds taste preferences."
    • Citation source:University of Oregon, news release, Jan. 24, 2011, as reported in HealthDay;

    See Childhood Obesity

  • February 11, 2011 - Can't Blame Childhood Obesity on Genetics

    CDC graphic - kid on computer with soda and burger
    As if just saying "It's genetics" will absolve everyone of the responsibility to take care of our bodies, the University of Michigan Cardiovascular Center recently reported:
    • "Poor eating and activity habits, not genetics, are the underlying causes for most cases of adolescent obesity
    • "For the extremely overweight child, genetic screening may be a consideration,....For the rest, increasing physical activity, reducing recreational screen time and improving the nutritional value of school lunches offers great promise to begin a reversal of current childhood obesity trends."
    • in 1980, just 6.5 percent of U.S. children aged 6 to 11 years were considered obese, but that percentage rose to nearly 20 percent by 2008.
    • Obese children were much less likely than non-obese kids to participate in regular exercise and/or physical education classes, and less likely to be a part of a sports team.
    • Among obese children, 58 percent reported watching two hours of TV in the past day. That compared with 41 percent of non-obese kids.
    • Citation source: University of Michigan Cardiovascular Center, news release, Jan. 31, 2011; American Heart Journal; as reported in HealthDay

    For more information, see Obesity Resources

  • February 10, 2011 - Make the Call, Don't Miss A Beat: Women & Heart Attacks

    Women and Heart Attacks

    Graphic source:'s "Make the Call, Don't Miss a Beat; Heart Attack Information for Women" is a great page that provides information about an overlooked health issue among women - heart attacks. The common perception has been that only men get heart attacks. This is not true, women get heart attacks as well, but they ignore the symptoms and end up dying needlessly.

    Coronary heart disease is the number one cause of death for women followed by stroke. Breast cancer, which is what women fear most, is the number 6th cause of death (

    Here are the symptoms to watch out for:

    • Unusually heavy pressure on the chest, like there's a ton of weight on you
      Most heart attacks involve chest pain or discomfort in the center or left side of the chest. It usually lasts for more than a few minutes or goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. It may even feel like heartburn or indigestion.`
    • Sharp upper body pain in the neck, back, and jaw
      This symptom can include pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of stomach (not below the belly button). Pain in the back, neck, or jaw is a more common heart attack symptom for women than it is for men.
    • Severe shortness of breath
      This symptom can come on suddenly. It may occur while you are at rest or with minimal physical activity. You may struggle to breathe or try taking deep breaths. Shortness of breath may start before or at the same time as chest pain or discomfort, and can even be your only symptom.
    • Cold sweats, and you know it's not menopause
      Unexplained or excessive sweating, or breaking out into a "cold sweat," can be a sign of heart attack.
    • Unusual or unexplained fatigue (tiredness)
      Sudden and unusual tiredness or lack of energy is one of the most common symptoms of heart attack in women, and one of the easiest to ignore. It can come on suddenly or be present for days. More than half of women having a heart attack experience muscle tiredness or weakness that is not related to exercise.
    • Unfamiliar dizziness or light-headedness
      Unlike in the movies, most heart attacks do not make you pass out right away. Instead, you may suddenly feel dizzy or light-headed.
    • Unexplained nausea (feeling sick to the stomach) or vomiting
      Women are twice as likely as men to experience nausea, vomiting, or indigestion during their heart attack. These feelings are often written off as having a less serious cause. Remember, nausea and vomiting may be signs that something is seriously wrong, especially if you have other symptoms.
    • If you have any one of these symptoms and it lasts for more than five minutes, call 9-1-1 for emergency medical care. Even if your symptoms go away in less than five minutes, call your doctor right away—it could be a sign that a heart attack is coming soon. Don't waste time trying home remedies or waiting for the feelings to pass on their own. Remember, quick treatment can save your life.
    • Citation source:

    For the link to this site and more info, see Women's Health - Heart Disease and Cardiovascular Index

  • February 9, 2011 - Get off the SoFAS - The New Dietary Guidelines for Americans 2010

    2010 Dietary Guidelines

    Graphic source:

    The new U.S. dietary guidelines looks a lot more user-friendly than those in the past.
    • "Every five years, the USDA and HHS update the dietary guidelines that form the basis of U.S. nutritional policy. The new 2010 guidelines, more than ever before, focus on scientific evidence as distilled from last summer's advice from an expert advisory panel.
    • Eat more seafood -- at least 8 ounces a week
    • Eat more fruits and vegetables
    • Substitute healthy oils for solid fats (such as margarine)
    • Lower your sodium intake
    • Avoid fast foods
    • Exercise more
    • Read food labels
    • Substitute whole grains for refined grains
    • Eat more beans and peas
    • Get plenty of fiber, potassium, and vitamin D
    • Eat/drink more nonfat or low-fat dairy products
    • Replace high-fat meats with lean meats
    • For some Americans, drink less alcohol
    • Get off your SoFAS (Solid Fats and Added Sugars)
    • Citation source:

    You can find a link to the "Dietary Guidelines for Americans 2010" at Nutrition Resources on the Internet

  • February 8, 2011 - Show World's Take on Cancer Deaths

    Map source:

    Here is a new way of mapping cancer deaths from Show World, a new mapping site. Click on the circular arrow and see what happens!

    Using WHO data from 2004, it visualizes cancer deaths by resizing countries according the number of cancer deaths for each country. Asian countries appear much larger because of the number of deaths from cancer in those countries.

    The site offers a variety of maps covering different topics that are of interest to public health professionals and health policy makers as well. You can even suggest maps that you would like to see.

    You can find a link to this site and other mapping resources at Health Maps & Public Health Software Resources

  • February 7, 2011 - Exercise Outdoors!

    Exercise Outdoors!

    Graphic source:

    According to a February 4th article in "Environmental Science and Technology", exercising in the natural environment benefits mental and physical well-being and is associated with greater feelings of revitalisation, increased energy and positive engagement, together with decreases in tension, confusion, anger and depression.

    Citation source:

    For more info, see Fitness

  • February 4, 2011 - Healthy Lifestyle to Fight Cancer

    Healthy Lifestyle Every Month

    Graphic source:

    I love how this graphic, from the US Department of Defense, emphasizes the importance of a healthy lifestyle. However, we all should adopt a healthy lifestyle all year round!

    According to the just released "Healthier Lifestyles May Prevent 340,000 U.S. Cancers a Year: Study" report:

    • "About 340,000 cancer cases in the United States could be prevented each year if more Americans ate a healthy diet, got regular exercise and limited their alcohol intake, according to the World Cancer Research Fund (WCRF).
    • These types of lifestyle changes could lead to significant reductions in particularly common cancers such as breast (38 percent fewer cases per year), stomach (47 percent fewer) and colon (45 percent fewer).
    • "In order to improve their health and prevent several diseases, adults should do at least 150 minutes of moderate physical activity throughout the week. This can be achieved by simply walking 30 minutes five times per week or by cycling to work daily,"
    • Other healthy lifestyle habits that reduce the risk of cancer include quitting smoking, avoiding secondhand smoke, avoiding excessive sun exposure, and preventing cancer-causing infections,
    • Cancer is the leading cause of death worldwide. Each year, 12.7 million people are diagnosed with cancer and 7.6 million die from the disease. But 30 percent to 40 percent of cancers can be prevented and one-third can be cured through early diagnosis and treatment,..."
    • Citation source: World Cancer Research Fund, news release, Feb. 3, 2011, as reported on HealthDay.

    For more info, see Cancer Resources on the Internet

  • February 3, 2011 - Using the Ngram Viewer to Trend Childhood Obesity and Gestational Diabetes References

    Google Ngram Viewer: Childhood Obesity and Gestational Diabetes 1900 - 2000

    Gestational Diabetes and Childhood Obesity 1900-2000. Analyzed by Betty C. Jung

    Google Ngram Viewer: Childhood Obesity and Gestational Diabetes 1950 - 2000

    Gestational Diabetes and Childhood Obesity 1950-2000. Analyzed by Betty C. Jung

    Graphics created by Betty C. Jung from interactive graphs at:

    The Google Ngram Viewer is so easy to use that I decided to try and answer some burning questions I had about gestational diabetes and childhood obesity.

    While childhood obesity references showed a steady increase between years of 1965 - 2000, the references to gestational diabetes have increased dramatically during the same time period.

    Are we really writing (talking) about childhood obesity and gestational diabetes more than we did over 50 years ago? Apparently so. Hopefully all this "talking" will lead to action in addressing the growing prevalence of childhood obesity and preventing type 2 diabetes by helping women with gestational diabetes adopt healthy lifestyles.

  • February 2, 2011 - Using the Ngram Viewer to Trend Obesity, Diabetes and Cardiovascular Disease References

    Google Ngram Viewer: Obesity, Diabetes and Cardiovascular Disease References 1500 - 2000

    Obesity, Diabetes and Cardiovascular Disease 1500-2000 Analyzed by Betty C. Jung

    Google Ngram Viewer: Obesity, Diabetes and Cardiovascular Disease References 1900 - 2000

    Obesity, Diabetes and Cardiovascular Disease 1900-2000 Analyzed By Betty C. Jung

    Graphics created by Betty C. Jung from interactive graphs at:

    Google is constantly raising the bar with the online tools it develops for conducting research. One of the more recent tools is its Ngram Viewer. Atlantic Wire reports:

    "This week, a new Google search tool made its debut: the Books Ngram Viewer, which draws on a database of nearly 5.2 million books published in six languages between 1500 and 2008. You can use the Ngram Viewer to search for words and phrases, and track the frequency with which they appear over a given amount of the ability to browse cultural trends throughout history, as recorded in books." Bloggers are marveling over their sudden ability to comb centuries of the written word. Source:

    So, what I did was apply it to hot Public Health issues of today: Obesity, Diabetes, and Cardiovascular Disease. Are writers talking more about these problems than they did, say hundred years ago? Well, apparently so. Collapsing the time period from 1500 - 2000 to 1900 - 2000 is helpful in looking at the 3 topics of interest. Seems like diabetes is being written about with greater frequency since 1900 and may reflect the growing prevalence of diabetes.

  • January 31, 2011 - Roadmap for Chronic Disease Prevention

    NACCHO's Roadmap for Chronic Disease Prevention
    Graphic source:
    The National Association of County and City Health Officials ( recently released "Roadmap for Chronic Disease Prevention" to provide guidance to local health departments (LHDs) about building the capacity needed to implement population-based strategies to prevent chronic disease.

    In its introduction, "Chronic disease is the most pressing healthcare challenge of the twenty-first century. In 2009, nearly half of all Americans (145 million people) were living with a chronic illness, defined as a physical or mental health condition involving ongoing activities and responses by patients, informal caregivers, and the health system for a year or more. A number of chronic conditions, such as heart disease, cancer, diabetes, and arthritis, are the leading causes of disability. About 25 percent of people with chronic disease have some type of limitation in activities of daily living or instrumental activities of daily living. Chronic conditions currently account for seven out of 10 deaths in the United States. Because of population aging, even if chronic disease rates remain constant, the nation can expect an ever increasing number of deaths, persons with disabilities, and higher healthcare costs. Estimated at $1.5 trillion, chronic diseases account for 75 percent of all direct healthcare costs." (Source: Roadmap for Chronic Disease Prevention (NACCHO) p. 4)

    It's a free download from its site but you must register if you are not a member already. For more info, see Chronic Disease Resources and Public Health Practice

  • January 28, 2011 - Do you know someone like this?

    Healthday. A tragedy waiting to happen
    Graphic source:

    Do you know someone who looks like this man - a tragedy waiting to happen? It is probably a very common picture of Americans today, too sedentary, eating junk food, in front of some screen.

    In a recent Journal of Clinical Oncology article, researchers studied prostate cancer survivors and reported:
    • "Prostate cancer survivors can literally walk themselves to a lower risk of dying of the disease -- with some men achieving an almost 50% lower mortality risk,
    • those who walked at a normal to brisk pace for at least 90 minutes a week had a 46% lower mortality hazard -- and three or more hours of vigorous physical activity each week lowered the hazard to 49%."
    • Citation source: Kenfield SA et al. "Physical activity and survival after prostate cancer diagnosis in the Health Professionals Follow-Up Study" J Clin Oncol 2011; DOI: 10.1200/JCO.2010.31.5226; reported in

    For more information, see Obesity Resources

  • January 27, 2011 - Women at High Risk for Diabetes

    Diagnosed Overweight
    Women at high risk for diabetes who were told by a doctor or other health professional that they were obese, by race/ethnicity, education, and family income, 2003-2006

    AHRQ Women, obesity and diabetes
    Graphic source:

    According to AHRQ's recently released report,"Women at High Risk for Diabetes, Access and Quality of Health Care, 2003-2006":
    • "Almost half of the people with diabetes in this country are women, and projections indicate that women will account for most cases between 2010 and 2050.
    • Women are more likely than men to develop chronic diseases, such as diabetes, and to suffer disproportionately from disability compared to men.
    • It is important to target women at high risk for diabetes for intervention to reduce their risk of diabetes.
    • Evidence shows that people with prediabetes who lose 5 to 7% of their body weight and increase their physical activity can prevent or delay diabetes.
    • Women at high risk for diabetes with a high school education or less were significantly less likely than women at high risk for diabetes with a higher level of education to report having been told that they were overweight.
    • Women at high risk for diabetes who lived in poor, near-poor, or middle-income families were significantly less likely than women at high risk for diabetes who lived in high-income families to report having been told that they were overweight.
    • Citation source: Women at High Risk for Diabetes: Access and Quality of Health Care, 2003-2006. AHRQ Publication No. 11-0002, January 2011. Rockville, MD: Agency for Healthcare Research and Quality and Centers for Disease Control and Prevention.

    This is an excellent report about the status of factors that impact women's health, stratified by diabetes risk. For a link to this report and more info, see Diabetes Resources on the Net

  • January 26, 2011 - Rising prevalence of gestational diabetes hospitalizations

    HCUP Diabetes Pregnancies 2008

    Adapted Graphic from:

    The STATISTICAL BRIEF #102 (December 2010),"Hospitalizations Related to Diabetes in Pregnancy, 2008" reports "...the rate of hospital stays for gestational diabetes grew 75 percent (from 361 to 631 stays per 100,000 deliveries) and hospitalizations for pre-existing diabetes complicating pregnancy grew 72 percent (from 58 to 100 stays per 100,000 deliveries). In the one year interval from 2007 to 2008, the number of stays for all deliveries remained relatively stable and there was a slight, but not statistically significant, decline in stays for gestational diabetes and pre-existing diabetes complicating pregnancy." Citation source: Wier, L.M. (Thomson Reuters), Witt, E. (Thomson Reuters), Burgess, J. (Thomson Reuters), and Elixhauser A. (AHRQ). Hospitalizations Related to Diabetes in Pregnancy, 2008. HCUP Statistical Brief #102. December 2010. Agency for Healthcare Research and Quality, Rockville, MD.

    I view gestational diabetes as the "preventable moment" in diabetes prevention. Addressing the cause of gestational diabetes in these women can stem the rising prevalence of type 2 diabetes not only with these women, but in their offspring as well. For more information, see Diabetes Resources on the Net and my Gestational Diabetes Mellitus Surveillance in Connecticut Issue Brief

  • January 24, 2011 - Obesity-related Spending

    The real cost of obesity

    Graphics source:

    The McKinsey Quarterly's "The real cost of obesity" reports:
    • "An obesity pandemic has put pressure on health care systems throughout the world. The United Kingdom, for instance, spent more than 4 billion on obesity-related medical costs in 2007, and that could rise to 9.7 billion by 2050. The United States currently spends about $160 billion twice what it did a decade ago and that amount could double again by 2018.
    • Obesity indirectly costs the United States at least $450 billion annually almost three times the direct medical cost. The situation is comparable in other countries as well."
    • Citation source:

    I found these statistics interesting because the scope is so broad, from what it costs individuals to payors and employers. When "incremental food expenses" contributes so much to the cost of obesity, just by eating less can be beneficial not only to one's health, but to one's pocketbook as well.

    For more information, see Obesity Resources on the Internet

  • January 21, 2011 - CDC Childhood Obesity Statistical Trends

    CDC Childhood Obesity Statistics 1963-2008
    #1 . Prevalence of obesity among children and adolescents, by age group --- United States, 1963--2008

    CDC Childhood Statistics 2007-2008
    #2 Prevalence of obesity among children and adolescents, by sex, age group, and race/ethnicity --- United States, 2007--2008

    Graphics source:

    Being released today is CDC Grand Rounds: Childhood Obesity in the United States " which provides a great overview of childhood obesity.

    • In the United States, childhood obesity affects approximately 12.5 million children and teens (17% of that population).
    • Changes in obesity prevalence from the 1960s show a rapid increase in the 1980s and 1990s, when obesity prevalence among children and teens tripled, from nearly 5% to approximately 15% (#1).
    • ...among the heaviest boys,...the heaviest getting even heavier.
    • ...substantial racial/ethnic disparities exist, with Hispanic boys and non-Hispanic black girls disproportionately affected by obesity (#2)
    • ...older children and teens are more likely to be obese compared with preschoolers.
    • ...obesity in children can lead to psychosocial problems and to cardiovascular risk factors such as hypertension, high cholesterol, and abnormal glucose tolerance or diabetes.
    • ...70% of obese children had at least one additional cardiovascular risk factor, and 30% had two or more
    • ... estimated that 15% of new diabetes cases among children and adolescents are type 2 diabetes. In the 1980s, type 2 diabetes in teens was virtually unheard of.
    • The prevalence of obesity among U.S. adults (34%) is twice that observed in children and translates into nearly 73 million adult men and women.
    • On average, U.S. adults weigh 24 pounds more than they did in 1960, and they are at increased risk for health conditions such as diabetes, cardiovascular disease, and certain cancers.
    • Although obesity prevalence has remained mostly flat in the past 10 years, the costs associated with obesity have increased substantially during the same period... estimated that approximately 9% of all medical costs in 2008 were obesity-related and amounted to $147 billion, compared with $78.5 billion 10 years before.
    • Source citation:

    For more information, see Obesity Resources on the Internet

  • January 20, 2011 - Health Disparities and the Gini Index

    MMWR 1/2011 Gini Index

    Suggested text: "The figure is a line graph that presents the average number of healthy days in three income levels (i.e., low, medium, and high) and the measure of inequality based on the Gini Index during 2007. At each level of income, higher inequality is associated with lower average number of healthy days." (Graphic & Citation source: )

    The new Healthy People 2020's 4 overarching goals include:

    • Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
    • Achieve health equity, eliminate disparities, and improve the health of all groups.
    • Create social and physical environments that promote good health for all.
    • Promote quality of life, healthy development, and healthy behaviors across all life stages.
    • Citation source:

    For more information, see Healthy People 2020

    Health disparities continue to be a focus of Healthy People 2020, as it was for Healthy People 2010, but clearer definitions have been provided in the newly released MMWR report, Rationale for Regular Reporting on Health Disparities and Inequalities --- United States [1/14/2010]

    • Health disparities are differences in health outcomes and their determinants between segments of the population, as defined by social, demographic, environmental, and geographic attributes.
    • Health inequalities, which is sometimes used interchangeably with the term health disparities, is more often used in the scientific and economic literature to refer to summary measures of population health associated with individual- or group-specific attributes (e.g., income, education, or race/ethnicity)
    • Health inequities are a subset of health inequalities that are modifiable, associated with social disadvantage, and considered ethically unfair
    • Health disparities, inequalities, and inequities are important indicators of community health and provide information for decision making and intervention implementation to reduce preventable morbidity and disparities as it is defined in U.S. federal laws (10,11) and commonly used in the U.S. public health literature to refer to gaps in health between segments of the population.
    • The Gini index, the most commonly used measure of income inequality, measures the extent to which the income distribution among a population deviates from theoretical income distribution in which each proportion of the population earns the same proportion of total income. The index varies from 0 to 1, with higher values indicating greater inequality (i.e., 0 indicates complete equality, and 1 indicates perfect inequality). The Gini index has been adapted to measure health inequality across populations by providing estimates that capture the distribution of health, or health risk, among the entire population or within specific groups.
    • Citation source:

    Basically, in order to improve the health of the entire population, those subpopulations that have been identified as having higher morbidity and mortality need to be targeted for evidence-based interventions to improve their health outcomes so that the health of the entire population can be improved. Sociodemographic factors that impact subpopulations may be beyond the purview of Public Health and require broader environmental and policy changes to address those factors that have been found to impact health outcomes.

    For more information, see Social Determinants of Health and Health Disparities

  • January 19, 2011 - Google Site Search Engine Updated

    Custom Search
    The site search engine powered by Google Custom Search has been updated on all the Webpages of this site. I originally did this a few weeks ago but the code had to be reconfigured so that the initial search will look through this Web site first (BCJung Site Search Engine), and after the results appear you can choose to search the entire Internet (Web Search).
  • January 19, 2011 - Fruits and Veggies and Ischemic Heart Disease

    Eat your veggies!

    Graphic source:

    Recent observational studies reported in the European Heart Journal found increased fruit and vegetable intake can reduce ischemic heart disease, the leading cause of heart attacks.

    • "People who want to significantly reduce their risk of dying from ischemic heart disease may do well to greatly increase their daily intake of fruits and vegetables,"
    • ...those who consumed eight or more portions of fruit and vegetables each day had a reduction of 22% in their risk of fatal ischemic heart disease compared with those who ate fewer than three portions,
    • In addition, increasing daily fruit and vegetable intake by just one portion (80 gm or 2.82 oz) led to a 4% decrease in risk of death from ischemic heart disease.
    • ...significant reduction was seen only for women -- whose risk of dying of ischemic heart disease fell by 15% with higher fruit and vegetable intake.
    • ...consuming antioxidant supplements is not the same as increasing the consumption of fruits and vegetables because there are many other components in fruits and vegetables that may confer a cardioprotective effect,
    • "A possible mechanism is the impact of fruit and vegetables to lower inflammation, a known mechanism contributing to cardiovascular disease,"
    • Citation sources: Crowe F, et al "Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study" Eur Heart J 2011; DOI: 10.1093/eurheartj/ehq465; Marmot M "Fruit and vegetable intake reduces risk of fatal coronary heart disease" Eur Heart J 2011; DOI: 10.1093/eurheartj/ehq506; as reported in

    For more information see Cardiovascular Disease, and Nutrition

  • January 18, 2011 - Wikipedia Demographics

    Wikipedia Demographics

    Graphic source:

    The author of The Chronicle Review's Wikipedia Comes of Age (1/7/2011) notes that Wikipedia has survived a decade online, and these days that would give it credibility. I think not.

    In the spirit of sharing I posted, "Though Wikipedia may be used to start a search for information, I do not allow my students to use Wikipedia as a reference for their research papers. Currently, there is no way for someone to verify the accuracy of the content in a Wikipedia article, nor is there a way to contact the author(s) of such articles. Students should learn what scholarly research is, and they do this by conducting research and evaluating the sources they use. Wikipedia is not an appropriate source for academic research."

    This has always been my position regarding the credibility of Wikipedia entries. This also goes for anonymous postings of any kind. If you have something to say, then own up to it! Additionally, another poster shared the demographics of self-reported Wikipedia contributors. These demographics speak for themselves.

  • January 17, 2011 - Medical Guidelines

    The purpose of medical guidelines is to improve quality of care. If care is provided according to what has been found to work (evidence-based research), then the best of care can be delivered. Measurable outcomes can be developed and quantified, thus, allowing for evaluation and continuous quality improvement. Well, that is the theory behind the use of medical guidelines.

    However, a recent article in Archives of Internal Medicine reported:

    • "More than half of the recommendations in practice guidelines issued by a leading infectious disease organization are based on opinions from experts rather than higher-level evidence from clinical trials,
    • Over 50% of the more than 4,200 recommendations in guidelines issued by the Infectious Diseases Society of America were based on level III evidence -- the lowest possible category,
    • In general, only 14% of all recommendations were linked to top-tier evidence, whereas more than half (55%) were supported only by expert opinion.
    • Citation source: Archives of Internal Medicine Source reference: Lee DH, Vielemeyer O "Analysis of overall level of evidence behind Infectious Diseases Society of America practice guidelines" Arch Intern Med 2011; 171(1): 18-22. as reported in GeneralInfectiousDisease/24283

    For more information, see Research Resources on the Internet, Health Care Quality Standards and Health Care Quality Issues

  • January 14, 2011 - CDC Health Disparities and Inequalities Report United States, 2011

    The MMWR Supplement/Vol. 60, CDC Health Disparities and Inequalities Report United States, 2011 being released today is a super start to providing quantitative data to measure progress in the areas that Healthy People 2020 will seek to address during this decade. Actually, I find this approach of integrating what the CDC is already doing (compiling epidemiological data) and reframing it as baseline data for issues to be addressed by Healthy People 2020 to be a wise step.

    If the CDC does this annually, it would be more timelier than the mid-course reviews conducted in earlier Healthy People reports. Timelier data reports will allow for more effective monitoring and evaluation of existing programs that will save money in the long run by eliminating ineffective strategies sooner rather than later. After all, Public Health funding is more limited now than ever, given the lagging economy.

    The report covers a broad scope of Public Health Issues, and it is provided in more than one format (online, PDF). Probably the most useful one is the Online Table of Contents Webpage that links to the 23 different areas that the CDC is providing updates on:

    • Rationale for Regular Reporting on Health Disparities and Inequalities --- United States
    • Education and Income --- United States, 2005 and 2009
    • Inadequate and Unhealthy Housing, 2007 and 2009
    • Unhealthy Air Quality --- United States, 2006--2009
    • Health Insurance Coverage --- United States, 2004 and 2008
    • Influenza Vaccination Coverage --- United States, 2000--2010
    • Colorectal Cancer Screening --- United States, 2002, 2004, 2006, and 2008
    • Infant Deaths --- United States, 2000--2007
    • Motor Vehicle--Related Deaths --- United States, 2003--2007
    • Suicides --- United States, 1999--2007
    • Drug-Induced Deaths --- United States, 2003--2007
    • Coronary Heart Disease and Stroke Deaths --- United States, 2006
    • Homicides --- United States, 1999--2007
    • Obesity --- United States, 1988--2008
    • Preterm Births --- United States, 2007
    • Potentially Preventable Hospitalizations --- United States, 2004--2007
    • Current Asthma Prevalence --- United States, 2006--2008
    • HIV Infection --- United States, 2005 and 2008
    • Diabetes --- United States, 2004 and 2008
    • Prevalence of Hypertension and Controlled Hypertension --- United States, 2005--2008
    • Binge Drinking --- United States, 2009
    • Adolescent Pregnancy and Childbirth --- United States, 1991--2008
    • Cigarette Smoking --- United States, 1965--2008

    You can find links to this report on my Healthy People 2020, and links to specific reports on my Public Health Sites Pages, Cardiovascular Disease, Diabetes , Health Care Quality Issues, Obesity, Public Health Data Pages

  • January 14, 2011 - Health Education Specialists

    Health education and health promotion are two of the most popular strategies for addressing public health issues.

    Here is a YouTube video produced by SOPHE that I think really captures what public health professionals do as health education specialists.

    Becoming a certified health education specialist (CHES) by taking an exam given by the National Commission for Health Education Credentialing (NCHEC) serves to recognize those who possess a core set of competencies to do it right.

    For more information, see Health Education Resources on the Net

  • January 13, 2011 - Get up and move!

    Exercise intensity

    Graphic source:

    According to a recent Scottish study:
    • "Sitting around too much is associated with a worsening of several cardiometabolic risk factors,
    • ...longer sedentary time was negatively associated with waist circumference, HDL cholesterol, C-reactive protein, fasting triglycerides, insulin, and measures of insulin resistance (P<0.05 for all),
    • In contrast, periodically standing up and moving about for as little as a minute was associated with beneficial changes in waist circumference and C-reactive protein (P<0.05 for both),..
    • ...less sitting time would be unlikely to do harm, and would, at the very least, contribute to increase overall levels of energy expenditure."
    • .. breaks in sedentary time were associated with beneficial changes in waist circumference and C-reactive protein levels, with particularly strong relationships with waist circumference.
    • "inflammation may be an adjunct pathway (along with reduced muscular contractions) through which prolonged sedentary time may impact on cardiovascular disease risk,"
    • Citation source: Healy G, et al "Sedentary time and cardio-metabolic biomarkers in U.S. adults: NHANES 2003-06" Eur Heart J 2011; DOI: 10.1093/eurheartj/ehq451; as reported in:

    So, if you sit a lot, just get up every 30 minutes or so and move around.
    Try to work in some intensity into your physical activities. This graphic shows how mets is used to measure intensity. For more info, see Fitness and Obesity

  • January 12, 2011 - Northeast U.S. 10:30 AM

    1/12/2011 NASA Photo

    This is the 3rd snowstorm in as many weeks. Total?
  • January 11, 2011 - Healthy People 2020

    I have just finished creating a Webpage for Healthy People 2020 (HP2020)!!! I am hoping that this page will be as useful as the Healthy People 2010 page was, with close to 19,000 hits since 1999! I decided to do this because the federal government officially launched HP 2020 last month to usher in the new decade that started in 2010, plus, almost all the links on my Healthy People 2010 are broken. This provided an opportunity for a fresh start!

    Healthy People is the living Public Health planning document for the country. It is meant to be a living document so it will stay relevant despite changing times. The Internet has made it much easier to keep it current than would printed publications allow for. However, I am sure the task is quite arduous since Healthy People is trying to quantify the progress being made over the course of years, and the compilation and analysis of data from numerous sources make for tasks that would take years in and of themselves to complete.

    Historically, the process started in 1990 with the publication of Healthy People: the Surgeon General's Report on Health Promotion and Disease Prevention, a document with quantitative goals to reduce preventable death and injury by 1990. Healthy People 2000 gave way to Healthy People 2010, and now Healthy People 2020.

    On this page I have tried to capture whatever was available since Healthy People started, and it has been quite a challenge. Documents and data sources pertaining to Healthy People are scattered across the Internet, but the bulk seems to be archived by the CDC and the U.S. Department of Health and Human Services. Since it is a planning document, I thought it would be useful to link to documents that captured the development and planning processes, as well as current documents and data sources. So, there are now over 50 links and I will try my best to keep this page current as more material becomes available as the nation tries to achieve the goals and objectives set forth by HP 2020.

  • January 11, 2011 - 3,705 texts per month

    Nielson Company - Texting

    Graphic source:

    Though trying to communicate with teens can be an arduous task, especially if you are not a fellow teen, apparently they have no trouble communicating with each other.

    According to the latest Nielsen Company study, "US mobile phone owners age 13-17 send and receive an average of 3,705 texts per month." This is like passing written notes in class, except only on a more manic pace. Perhaps, health educators working with teens should find ways to make the most of this in their outreach activities.

    Graphic source:

  • January 10, 2011 - Epi Info for Windows 7

    Epi Info
    Graphic source:
    "" is the listserv of Andy Dean and the original collaborators who developed Epi Info while they were working for the CDC. Andy, along with others, have retired but continue to be in the forefront of ensuring that the program remains relevant for those working in Public Health. The most recent version suitable for Windows 7 has just been released. Listserv postings are available at: Epi Info Friends

    Epi Info continues to be the most popular free statistical software package used by public health professionals around the world. The program is in the public domain and can be downloaded from the CDC, along with tutorials to teach you how to use it. You can find links to the various Epi Info Web sites at Public Health Statistical & Mapping Software Sites

  • January 7, 2011 - NASA's Global Aerosol Map

    NASA - Global Aerosol Map
    Graphic source:

    Here is an interesting NASA graphic that shows the August 2010 distribution of aerosols which are "tiny solid and liquid particles...found in the air everywhere on the planet, at any time of year.... and fluctuate naturally with the seasons and natural events, as well as with human activities. Dust storms, volcanic eruptions, wildfires, and salt spray from the winds over the ocean are the most common and abundant producers of aerosols. Humans generate them, too, through the burning of fossil fuels, manufacturing processes, and fires for cooking, heating, and agricultural clearing.

    Yellow areas are predominantly coarse particles, like dust and sea salt, while red areas are mainly fine aerosols from smoke or pollution. Gray indicates areas with no data. The brighter or more intense the color, the higher the concentration of aerosols.

    Of all the particles that fill our lungs on any given day, the most dangerous are the small ones. Aerosol particles smaller than 2.5 micrometers pose the greatest risk to human health because they are small enough to be breathed deep into the lungs and, in some cases, enter the blood stream. These fine particles, about 30 times smaller than the width of a human hair, are also a major cause of poor visibility."

    Citation source:

    For more info, see Environmental Health

  • January 5, 2011 - Internet As a Source of News

    PEW News Sources PEW News Sources

    According to the Pew Research Center for the People and the Press study, "The internet is slowly closing in on television as Americans main source of national and international news. TV remains the most widely used source for national and international news, 66% of Americans say it is their main source of news...more people continue to cite the internet than newspapers as their main source of news,..College graduates are about as likely to get most of their national and international news from the internet (51%) as television (54%)...those with household incomes of $75,000 or more are about as likely to get most of their news on the internet (54%) as from television (57%)."

    Citation & Graphics source:

  • January 4, 2011 - CDC Media Toolkit

    CDC Media Toolkit
    Graphic source:

    Social media is all the rage these days. Whether this is the richest form of communication for emotional intimacy is debatable, but it is nevertheless replacing the types of communication we have been most familiar with before Web 2.0 came along. And, we might as well make the most of it.

    Most beneficial for public health practitioners is the universality of its reach - anyone who has access to the Internet can be your audience. Though this would suggest caveats, many of the Public Health messages we would like to convey are mostly health-related and suitable (or, should be) for the general population. And, most social media tools are free (for now) because these venues have been commercialized, so beware, privacy issues are legitimate concerns.

    The CDC has recently released a wonderful resource, "The Health Communicator's Social Media Handbook," which will bring you up to speed on Facebook, Twitter, podcasts, YouTube, RSS feeds, widgets, eCards, blogs, etc. So, if these terms are unfamiliar to you, then you will find this manual extremely helpful.

    Not only is it a how-to document that advocates best practice methods, it also offers the social media resources that have been developed by government agencies and nonprofit entities that you can use for free! For the truly ingenious and creative program planner, the art of cobbling is worth cultivating. Such talent is a godsend for cash-strapped and staff-challenged public health programs that rely on soft funding. Just because funding has been cut back does not mean the need has been met, nor that the program was ineffective. In many cases, the need is still there, but we just have to find more efficient ways to get the job done. Social media tools are an ideal way to compensate for the economic realities we all face today. We can still successfully get the message out, but it has to be visual and concise.

    You can find a link to this resource by clicking on the graphic and on my Public Health Practice Page

  • January 3, 2011 - The Baseline to Work From

    PEW 2010 People & The Press survey results
    Graphic source: on-pessimistic-note-15476/pew-research-perception-of-progress-dec10gif/
    According to new data from the Pew Research Center for the People & The Press, "US adult consumers are ending 2010 with a pessimistic viewpoint about the economy, jobs and other major issues. Almost three-quarters (72%) of consumers are dissatisfied with national conditions, virtually nine in 10 (89%) rate national economic conditions as only fair or poor, and majorities or pluralities think the country is losing ground on nine of 12 major issues."

    Citation source:

    Let's think of this as the baseline and think optimistically - things can only get better....

  • January 2, 2011 - See the World! Compliments of

  • January 1, 2011 - Happy 2011!

    Happy 2011!


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    Published on the Web: July 21, 2011
    Updated: 12/11/2021 R318
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