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Thu Dec 9 03:57:02 EST 2010

Personal Health and Safety. CDC says that *=94heat-related deaths and =
illness are preventable yet annually many people succumb to extreme heat. =
Historically, from 1979 to 1999, excessive heat exposure caused 8,015 =
deaths in the United States. During this period, more people in this =
country died from extreme heat than from hurricanes, lightning, tornadoes, =
floods, and earthquakes combined. In 2001, 300 deaths were caused by =
excessive heat exposure.=94 To learn more about tips to stay, go to =

New Report from the Institute of Medicine (IOM): Preterm Birth: Causes, =
Consequences, and Prevention. The IOM says that 12.5 percent of births in =
the United States were preterm, at less than 37 weeks gestation. This high =
rate of premature births in the United States constitutes a public health =
concern that costs society at least $26 billion a year. Preterm Birth: =
Causes, Consequences, and Prevention notes troubling disparities in =
preterm birth rates among different racial and ethnic groups.  Despite =
great strides in improving the survival of infants born preterm, little is =
known about how preterm births can be prevented. The report recommends a =
multidisciplinary research agenda aimed at improving the prediction and =
prevention of preterm labor and better understanding the health and =
developmental problems to which preterm infants are more vulnerable.   In =
addition, the report recommends that guidelines be issued to further =
reduce the number of multiple births -- a significant risk factor for =
preterm birth -- resulting from infertility treatments. To view it or =
order a copy, go to

News Release from the American College of Obstetricians and Gynecologists =
"ACOG  applauded the Institute of Medicine (IOM) for addressing the =
important health, economic, and societal consequences of preterm birth in =
the US in its report, "Preterm Birth: Causes, Consequences, and Prevention.=
" ACOG is a cosponsor of this report because the impact of preterm birth =
is a major public health problem both in the US and worldwide. ACOG says =
preterm birth is, and has been, a key concern of the nation's obstetrician-=
gynecologists, who deliver the majority of babies in this country. ACOG =
commends the IOM for tackling this extremely complicated issue and for =
developing such a comprehensive analysis. In particular, ACOG strongly =
supports the IOM recommendation for an increase in federal funding for =
research into the causes and prevention of preterm birth." To view the =
entire news release, go to and look on the right hand column.

March of Dimes Also Urges Federal Legislation for IOM Prematurity Report!  =
The March of Dimes also called for passage of proposed federal legislation =
to address the nation=92s skyrocketing rate of premature birth.  The =
severe health consequences and extraordinary medical costs associated with =
prematurity are documented in a new report, =93Preterm Birth Causes, =
Consequences, and Prevention,=94 released today by the Institute of =
Medicine (IOM). The March of Dimes also pledged to strengthen its national =
Prematurity Campaign launched in 2003 by:                   =20
*	Increasing its efforts to raise public awareness that prematurity =
is a common, costly, and serious problem.=20
*	 Increasing its own research investment into finding and preventing=
 the underlying causes of preterm birth.  =20
*	Expanding its health professional and consumer education programs =
that help identify and reduce the risks of preterm birth.=20
*	 Increasing the size of its Neonatal Intensive Care Unit (NICU) =
Family Support Program that provides information and comfort to parents of =
premature babies.=20
To learn more, go to

New Rural Website Launched. Annie E Casey Foundation has developed rural =
family economic success (RuFES) work, which  focuses on helping rural =
families increase their income, stabilize their finances, acquire assets =
and build wealth. A new website area highlights rural strategies, reports, =
data and other resources.  To view it, got to
es/ruralfes/ =20

The American Public Health Association (APHA) recently announced its =
support of the Campaign for Children=92s Health Care, an effort to =
increase awareness of the 9 million uninsured children and millions more =
that are underinsured in the United States and to make coverage for all =
children a national priority. Launched in July 2006, the Campaign for =
Children=92s Health Care will coordinate public education efforts across =
the country to demonstrate the importance of health insurance for children =
and families and to show why national action is needed to expand coverage =
for children. Other Campaign sponsors include AIDS Alliance for Children, =
Youth and Families, Alliance for Children and Families, American Academy =
of Pediatrics, American Association on Mental Retardation, American =
Federation of State, County, and Municipal Employees, American Federation =
of Teachers, American Occupational Therapy Association, Association of =
Women=92s Health, Obstetric and Neonatal Nurses, Catholic Health Associatio=
n of The United States,  Children's Defense Fund, Child Welfare League of =
America, Coalition on Human Needs, Consumers Union Docs for Tots, Families =
USA,  Jewish Council for Public Affairs, National Association of Children's=
 Behavioral Health, National Association of Mental Health Planning and =
Advisory Councils, National Head Start Association, National Immigration =
Law Center, National Indian Health Board, National Partnership for Women =
and Families, NETWORK: A National Catholic Social Justice Lobby, Parents =
Action for Children, Presbyterian Church (USA), Society for Adolescent =
Medicine, and Summit Health Institute for Research and Education, Inc. To =
learn more about this new initiative, go to http://www.childrenshealthcampa=

MEDICAID Alert from Families USA:=20
In February 2006, the Deficit Reduction Act (DRA) was signed into law. =
Families USA says that the DRA fundamentally alters many aspects of the =
Medicaid program.Some of these changes are mandatory provisions that =
states must enact and that will make it more difficult for people to =
either qualify for or enroll in Medicaid. Other changes are optional =
provisions that allow states to make unprecedented changes to the Medicaid =
program through state plan amendments.

Families USA has published new issue briefs this July, which are designed =
to inform advocates about the specifics of these changes and to highlight =
key implementation issues and strategies to mitigate the harm these =
provisions could cause to people on Medicaid.=20

One such Brief is titled Citizenship Update: Administration Creates =
Additional Barriers to Medicaid Enrollment. Families USA says that=20
one of the provisions of the new DRA requires that states obtain proof of =
citizenship from all new Medicaid applicants, and from current enrollees =
who renew their eligibility, beginning on July 1, 2006.1 On June 9, =
2006-just three short weeks before the provision was scheduled to =
begin-the Centers for Medicare and Medicaid Services (CMS) sent guidelines =
to states about how to implement the new citizenship documentation =
requirement. These guidelines make the provision even more stringent than =
the law requires, and they leave many unanswered questions for both states =
and Medicaid enrollees.
The new citizenship documentation requirement is a drastic shift in policy =
that will directly affect the more than 51 million U.S. citizens currently =
enrolled in Medicaid. .It could also cause substantial delays in enrollment=
 for future applicants or discourage enrollment altogether. To read this =
and other briefs about the DRA, go to

The Center for Budget and Policy Priorities (CBPP) also reports that up to =
1.6 Million Citizen Children and 600,000 Citizen Adults Could Be Affected =
By The DRA. CBPP also says that the policy changes announced by CMS reduce =
but do not eliminate the problems that the new requirement will create for =
Medicaid beneficiaries and applicants.  CBPP says that between 1.2 and 2.3 =
million U.S.-born citizens, including about 600,000 to 1.6 million =
children and 500,000 to 600,000 adults, may have serious problems getting =
or retaining their Medicaid coverage because they lack a birth certificate =
or passport and their citizenship cannot be ascertained through a =
cross-match with vital records data (or is not so ascertained because =
their state is not conducting cross-matching).  Many may eventually secure =
their documents but may experience serious delays in receiving Medicaid =
coverage because of the additional time, effort, and expense imposed; the =
regulations do not permit states to provide applicants with Medicaid =
coverage for needed health care services while they attempt to obtain the =
needed documents.   =20
CBPP says that those most likely to encounter problems under the revised =
policies are low-income children and parents who are citizens and =
otherwise eligible for Medicaid, but who lack a birth certificate or =
passport. =20
For example, a U.S.-born pregnant woman and her child who become homeless =
due to flooding and are currently residing in a different state than their =
state of birth may be unable to get Medicaid coverage because they lost =
their documents, or they could face substantial delays in getting coverage =
as they struggle to obtain citizenship and identity documents.  A =
U.S.-born child placed in foster care due to child abuse may be barred =
from Medicaid coverage because the child welfare agency cannot locate her =
birth certificate. To learn more about the effects of the DRA, go to =

Conference: Moving Toward Real Solutions: Advances to Address Low Health =
Literacy, Fifth Annual National Health Communication Conference: November =
29, 2006 Co-Sponsored by the Institute of Medicine, National Academy of =
Sciences, 2100 C Street NW, Washington, DC. This conference provides a =
unique opportunity for attendees from various sectors to learn about the =
growing problem of low health literacy and hear about innovative solutions =
that can be implemented in various locales and settings.
The complete list of all topics and speakers can be found at http://foundat= For more information, email =
the ACP Foundation here or call (877) 208-4189

Large Recall! The U.S. Consumer Product Safety Commission, in cooperation =
with Small World Toys, of Culver City, Calif. announced a voluntary recall =
of 92, 300 vehicles in the IQ Baby Pillow Soft Activity Blocks, IQ Baby =
Travelin' Train Blocks, IQ Baby Vroom Vroom vehicles and Discovery Channel =
Vroom Vroom vehicles. The plastic wheels on the toys can detach, posing a =
choking hazard to young children. To learn more or to view the toys, go =
to =20

New Initiative from CDC=92s Center for Injury Prevention and Control: =
=93Choosing Respect=94: Developing Healthy Relationships to Prevent Dating =
Abuse Choose Respect is a nationwide effort to prevent dating abuse before =
it starts. It encourages adolescents to form healthy relationships with =
others - before they even start to date.  CDC says that dating abuse can =
be prevented. Adolescence has been characterized as a "window of opportunit=
y=94 - a time for adolescents to prepare for future relationships by =
learning healthy relationship skills such as negation, compromise, and =
conflict resolution. That=92s why adults need to talk to adolescents now =
about the importance of choosing respect and developing healthy relationshi=
ps. CDC reports some key factors such as: =20
*	Acceptance of dating abuse among friends is one of the strongest =
links to future involvement in dating abuse.
*	Adolescents often believe that unhealthy relationships are the =
norm. Many relationships seen on TV, in the movies, and in magazines are =
unrealistic or unhealthy examples of relationships.=20
*	Qualities like respect, good communication and honesty are =
absolute requirements for a healthy relationship. Adolescents that do not =
have this part down before they begin to date may have trouble forming =
healthy, nonviolent relationships with others=20
For more about this worthwhile initiative, go to

Silverman JG et al. Intimate partner violence victimization prior to and =
during pregnancy among women residing in 26 U.S. states: Associations with =
maternal and neonatal health American Journal of Obstetrics and Gynecology =
Volume 195, Issue 1 , July 2006, Pages 140-148=20
The authors set out to conduct a population-based assessment of association=
s of intimate partner violence in the year prior to and during pregnancy =
with maternal and neonatal morbidity. They analyzed data from women giving =
birth in 26 U.S. states and participating in the 2000 to 2003 Pregnancy =
Risk Assessment Monitoring System (n =3D 118,579).
Compared with those not reporting intimate partner violence,  the authors =
found that women reporting intimate partner violence in the year prior to =
pregnancy were at increased risk for
v	high blood pressure or edema=20
v	vaginal bleeding=20
v	severe nausea, vomiting or dehydration=20
v	kidney infection or urinary tract infection=20
v	hospital visits related to such morbidity and=20
v	delivery preterm of a low-birth weight infant and an infant =
requiring intensive care unit care.=20
Women reporting intimate partner violence during but not prior to =
pregnancy experienced higher rates of a subset of these concerns.=20
The authors conclude that women experiencing intimate partner violence =
both prior to and during pregnancy are at risk for multiple poor maternal =
and infant health outcomes, suggesting prenatal risks to children from =
mothers' abusive partners.=20

Surkan PJ et al. The Role of Social Networks and Support in Postpartum =
Women's Depression: A Multiethnic Urban Sample Maternal and Child Health =
Journal Maternal and Child Health Journal Volume 10, Number 4, July 2006, =
Pages: 375 - 383

The authors set out to examine the relationship of social support, and of =
social networks, to symptoms of depression in a multiethnic sample of =
women having recently given birth. They randomly sampled women at =
community health centers in a Northeastern city were from groups stratified=
 by race/ethnicity (African American, Hispanic, and White) and postpartum =
interval. Mother's score on the Center for Epidemiologic Studies of =
Depression Scale (CES-D) was the dependent variable. Main independent =
variables included the Medical Outcomes Study (MOS) Social Support Survey =
and a social network item.=20

They evaluated interactions between race and social support, race and =
social networks, and social support and social networks. The authors found =
v	The multivariate models with MOS Social Support scale indicated =
that each 10-point increase in the MOS Social Support Survey was related =
to a 2.1-unit lower score on the Depression Scale.=20
v	Analysis of the social network variable showed that having two or =
more friends or family members available was associated with a 13.6-point =
lower mean score on the Depression Scale compared to women reporting none =
or only one available person.=20

The authors conclude that both low or absent social support and social =
networks were statistically significant and independently related to =
depressive symptomatology.

Hingson RW et al. Age at Drinking Onset and Alcohol Dependence: Age at =
Onset, Duration, and Severity. Arch Pediatr Adolesc Med. 2006;160:739-746
The authors set out to examine whether starting to drink at an early age =
is associated with developing alcohol dependence at a younger age and =
chronic relapsing dependence, controlling for respondent demographics, =
smoking and illicit drug use, childhood antisocial behavior and depression,=
 and family alcoholism history They surveyed a total of 43 093 adults in =
Relative to respondents who began drinking at 21 years or older, The =
authors found that those who began drinking before age 14 years were more =
likely to experience:
v	alcohol dependence ever and within 10 years of first drinking=20
v	past-year dependence and multiple dependence episodes.=20
The authors conclude that there is a need to screen and counsel adolescents=
 about alcohol use and to implement policies and programs that delay =
alcohol consumption.=20

The National Fetal and Infant Mortality Review Program is a partnership =
between ACOG and federal MCHB.

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