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Diabetes Self-Management Education and Training Among Privately Insured Persons with Newly Diagnosed Diabetes — United States, 2011–2012

January 25, 2015 Comments off

Diabetes Self-Management Education and Training Among Privately Insured Persons with Newly Diagnosed Diabetes — United States, 2011–2012
Source: Morbidity and Mortality Weekly Report (CDC)

Diabetes is a complex chronic disease that requires active involvement of patients in its management (1). Diabetes self-management education and training (DSMT), “the ongoing process of facilitating the knowledge, skill, and ability necessary for prediabetes and diabetes self-care,” is an important component of integrated diabetes care (2). It is an intervention in which patients learn about diabetes and how to implement the self-management that is imperative to control the disease. The curriculum of DSMT often includes the diabetes disease process and treatment options; healthy lifestyle; blood glucose monitoring; preventing, detecting and treating diabetes complications; and developing personalized strategies for decision making (2). The American Diabetes Association recommends providing DSMT to those with newly diagnosed diabetes (1), because data suggest that when diabetes is first diagnosed is the time when patients are most receptive to such engagement (3). However, little is known about the proportion of persons with newly diagnosed diabetes participating in DSMT. CDC analyzed data from the Marketscan Commercial Claims and Encounters database (Truven Health Analytics) for the period 2009–2012 to estimate the claim-based proportion of privately insured adults (aged 18–64 years) with newly diagnosed diabetes who participated in DSMT during the first year after diagnosis. During 2011–2012, an estimated 6.8% of privately insured, newly diagnosed adults participated in DSMT during the first year after diagnosis of diabetes. These data suggest that there is a large gap between the recommended guideline and current practice, and that there is both an opportunity and a need to enhance rates of DSMT participation among persons newly diagnosed with diabetes.

Vital Signs: HIV Diagnosis, Care, and Treatment Among Persons Living with HIV — United States, 2011

January 22, 2015 Comments off

Vital Signs: HIV Diagnosis, Care, and Treatment Among Persons Living with HIV — United States, 2011
Source: Morbidity and Mortality Weekly Report (CDC)

Background:
Infection with human immunodeficiency virus (HIV), if untreated, leads to acquired immunodeficiency syndrome (AIDS) and premature death. However, a continuum of services including HIV testing, HIV medical care, and antiretroviral therapy (ART) can lead to viral suppression, improved health and survival of persons infected with HIV, and prevention of HIV transmission.

Methods:
CDC used data from the National HIV Surveillance System and the Medical Monitoring Project to estimate the percentages of persons living with HIV infection, diagnosed with HIV infection, linked to HIV medical care, engaged in HIV medical care, prescribed ART, and virally suppressed in the United States during 2011.

Results:
In 2011, an estimated 1.2 million persons were living with HIV infection in the United States; an estimated 86% were diagnosed with HIV, 40% were engaged in HIV medical care, 37% were prescribed ART, and 30% achieved viral suppression. The prevalence of viral suppression was significantly lower among persons aged 18–24 years (13%), 25–34 years (23%), and 35–44 years (27%) compared with those aged ≥65 years (37%).

Conclusions:
A comprehensive continuum of services is needed to ensure that all persons living with HIV infection receive the HIV care and treatment needed to achieve viral suppression. Improvements are needed across the HIV care continuum to protect the health of persons living with HIV, reduce HIV transmission, and reach prevention and care goals.

Implications for public health practice:
State and local health departments, community-based organizations, and health care providers play essential roles in improving outcomes on the HIV care continuum that increase survival among persons living with HIV and prevent new HIV infections. The greatest opportunities for increasing the percentage of persons with a suppressed viral load are reducing undiagnosed HIV infections and increasing the percentage of persons living with HIV who are engaged in care.

Ending Child Hunger in the United States

January 16, 2015 Comments off

Ending Child Hunger in the United States (PDF)
Source: Bread for the World Institute

In 2013, 15.8 million U.S. children were at risk of hunger. For children, even brief periods of hunger carry consequences that may last a lifetime. Many children suffer from nutritional deficiencies, sometimes referred to as “hidden hunger” since they can cause serious health problems in children who don’t “look hungry.” Nutrition affects mental health and academic achievement as well as physical health. But the damage caused by food insecurity is unnecessary and preventable. Federal nutrition programs help millions of children eat well; these programs must be maintained and strengthened to provide more eligible children with healthier food. When Congress reauthorizes child nutrition programs in 2015, the emphasis must be on enabling programs to serve all eligible children well—from WIC for infants, to meals at daycare for preschoolers, to school lunch, breakfast, and summer food for elementary and secondary students. The United States simply cannot afford the consequences of allowing children to go without the nutritious food they need. Strong child nutrition programs must be a top national priority.

The Emerging Crisis: Noncommunicable Diseases

January 15, 2015 Comments off

The Emerging Crisis: Noncommunicable Diseases
Source: Council on Foreign Relations

The gravest health threats facing low- and middle-income countries are not the plagues, parasites, and blights that dominate the news cycle and international relief efforts. They are the everyday diseases the international community understands and could address, but fails to take action against.

Once thought to be challenges for affluent countries alone, cardiovascular diseases, cancer, diabetes, and other noncommunicable diseases (NCDs) have emerged as the leading cause of death and disability in developing countries. In 2013, these diseases killed eight million people before their sixtieth birthdays in these countries. The chronic nature of NCDs means patients are sick and suffer longer and require more medical care. The resulting economic costs are high and escalating. Unless urgent action is taken, this emerging crisis will worsen in low- and middle-income countries and become harder to address.

Hunger and Poverty among Hispanics — Fact Sheet

January 15, 2015 Comments off

Hunger and Poverty among Hispanics — Fact Sheet (PDF)
Source: Bread for the World Institute

As millions of Americans begin to climb out of the deep hole the recession created, the federal government has to focus on further reducing unemployment as well as income inequality. Communities of color tend to suffer disproportionately from unemployment and low wages, thus experiencing higher levels of poverty and hunger. Hispanics are the largest ethnic minority group in the United States, both in native-born and foreign-born populations. However, Hispanics, as with the general population, are starting to see reductions of hunger and poverty due to a decrease in unemployment.

Spanish version also available.

Decision Aids for Cancer Screening and Treatment

January 13, 2015 Comments off

Decision Aids for Cancer Screening and Treatment
Source: Agency for Healthcare Research and Quality

Decision Aids for Cancer Screening and Treatment, a new research review from AHRQ’s Effective Health Care Program, examined the effectiveness of decision aids used by people facing treatment or screening decisions for early cancer. Considerable diversity in both format and available evidence among the aids were found.

The review is useful for creators of patient decision aids and those considering whether to use decision aids. It found strong evidence that cancer-related decision aids increase knowledge about available treatments and next steps without negatively impacting decisionmaking ability or causing additional anxiety. The review also found evidence that decision aids can help users make informed decisions and choices that best agree with their values and provide accurate understanding about the risks of treatment.

Approximately 1 Million Unemployed Childless Adults Will Lose SNAP Benefits in 2016 as State Waivers Expire

January 12, 2015 Comments off

Approximately 1 Million Unemployed Childless Adults Will Lose SNAP Benefits in 2016 as State Waivers Expire
Source: Center on Budget and Policy Priorities

Roughly 1 million of the nation’s poorest people will be cut off SNAP (formerly known as the Food Stamp Program) over the course of 2016, due to the return in many areas of a three-month limit on SNAP benefits for unemployed adults aged 18-50 who aren’t disabled or raising minor children. These individuals will lose their food assistance benefits after three months regardless of how hard they are looking for work.

One of the harshest pieces of the 1996 welfare law, this provision limits such individuals to three months of SNAP benefits in any 36-month period when they aren’t employed or in a work or training program for at least 20 hours a week. Even SNAP recipients whose state operates few or no employment programs for them and fails to offer them a spot in a work or training program — which is the case in most states — have their benefits cut off after three months irrespective of whether they are searching diligently for a job. Because this provision denies basic food assistance to people who want to work and will accept any job or work program slot offered, it is effectively a severe time limit rather than a work requirement, as such requirements are commonly understood. Work requirements in public assistance programs typically require people to look for work and accept any job or employment program slot that is offered but do not cut off people who are willing to work and looking for a job simply because they can’t find one.

The loss of this food assistance, which averages approximately $150 to $200 per person per month for this group, will likely cause serious hardship among many. Agriculture Department (USDA) data show that the individuals subject to the three-month limit have average monthly income of approximately 19 percent of the poverty line, and they typically qualify for no other income support.

The indigent individuals at risk are diverse. About 40 percent are women. Close to one-third are over age 40. Among those who report their race, about half are white, a third are African American, and a tenth are Hispanic. Half have only a high school diploma or GED. They live in all areas of the country, and among those for whom data on metropolitan status are available, about 40 percent live in urban areas, 40 percent in suburban areas, and 20 percent in rural areas.

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