Chronic
New High Blood Pressure Guidelines: Back on Track With Lower Treatment Goals, but Implementation Challenges Abound
The recently released 2017 High Blood Pressure Guidelines depart from past guidelines in both their approach and recommendations. Developed by multiple health organizations, including the American College of Preventive Medicine, the guidelines continue to define normal blood pressure as <120/80 mmHg, but now define hypertension as ≥130/80 mmHg (previously ≥140/90 mmHg). This change categorizes 101 million Americans (46% of adults) as hypertensive (compared to 32% previously). The guidelines rely heavily on findings from the Systolic Blood Pressure Intervention Trial (SPRINT).Prevention Research Center Collaborations With State Departments of Health: Washington State
State health departments and Prevention Research Centers (PRCs) have complementary mandates and expertise important to improving population health. State health departments manage and administer numerous programs with broad population reach. PRCs bridge dissemination and implementation research and public health practice to improve health programming and outcomes. This paper describes the 15-year partnership between the Washington State Department of Health and the PRC at the University of Washington.Impact of the Cancer Prevention and Control Research Network: Accelerating the Translation of Research Into Practice
The Cancer Prevention and Control Research Network (CPCRN) is a thematic network dedicated to accelerating the adoption of evidence-based cancer prevention and control practices in communities by advancing dissemination and implementation science. Funded by the Centers for Disease Control and Prevention and National Cancer Institute, CPCRN has operated at two levels: Each participating network center conducts research projects with primarily local partners as well as multicenter collaborative research projects with state and national partners.The Challenge in Improving the Diets of Supplemental Nutrition Assistance Program Recipients: A Historical Commentary
This paper provides a historical background for the current nutrition issues faced by the Supplemental Nutrition Assistance Program (SNAP). The Food Stamp Program evolved into SNAP during a period when U.S. diets, particularly those of the poor, became less healthful. During the 1960s, the U.S. (Kennedy–Johnson era) addressed malnutrition first with a pilot project focused on retail sales and cash food stamps, which showed that low-income consumers purchased relatively healthy foods for a fairly high-quality diet.The Social Determinants of Chronic Disease
This review article addresses the concept of the social determinants of health (SDH), selected theories, and its application in studies of chronic disease. Once ignored or regarded only as distant or secondary influences on health and disease, social determinants have been increasingly acknowledged as fundamental causes of health afflictions. For the purposes of this discussion, SDH refers to SDH variables directly relevant to chronic diseases and, in some circumstances, obesity, in the research agenda of the Mid-South Transdisciplinary Collaborative Center for Health Disparities Research.The Economics of Breast Cancer in Younger Women in the U.S.: The Present and Future
In the past four decades, substantial progress has been made in breast cancer survival in part because of advances in early detection and treatment following diagnosis.1,2 Further, recent studies3,4 have reported that the observed improvement in breast cancer mortality and survival between the 1970s and 2000s is also the result of changes in the distribution of tumor characteristics, which include the identification of the human epidermal growth factor receptor 2 and the development of the targeted agent such as trastuzumab that extends survival in both the adjuvant and metastatic settings for a range of 15%–25% of patients with human epidermal growth factor receptor 2–positive tumors.The Essential Role of Public Health in Preventing Disease, Prolonging Life, and Promoting Health of Cancer Survivors
Public health’s longstanding mission has been to “prevent disease, prolong life, and promote health” through organized efforts across societies, organizations, communities, and individuals.1 The public health community has worked to achieve this mission of combating both infectious and chronic disease through research and surveillance, public health programs, health communication activities, and policy and system changes. Cancer survivorship serves as an example of the dynamic work of the public health community in addressing this issue.Advancing Health Equity in Cancer Survivorship: Opportunities for Public Health
The number of cancer survivors who are members of underserved groups is growing, with members of racial and ethnic minorities predicted to increase significantly by 2030.1 The Healthy People 2020 objectives advocate reduced death rates for several cancers, increasing the proportion of survivors living more than 5 years, and improving the quality of life of survivors.2 Considerable challenges exist to achieving these goals equitably for all survivors and their families.Public Health’s Future Role in Cancer Survivorship
Despite modest reductions in the incidence rates for many cancers in recent years,1 the absolute number of people who will be diagnosed with cancer and the number of cancer survivors are expected to increase substantially over the next few decades in the U.S., due to changing demographics, an aging population, and improvements in survival.2–4 Advances in treating childhood cancer have led to an increase in the number of adolescents and young adults who are cancer survivors, and the late effects of treatment can be substantial in this age group.The Role of Clinical Decision Support Systems in Preventing Cardiovascular Disease
Based on evidence from the Njie et al.1 systematic review, the Community Preventive Services Task Force recommends clinical decision support systems (CDSS) due to sufficient evidence of effectiveness to improve cardiovascular disease (CVD) risk factor screening and practices for CVD-related preventive care services, clinical tests, and treatments; however, evidence was lacking for effectiveness to improve CVD risk factor outcomes from several studies with inconsistent conclusions.2 These findings are particularly important in the current national atmosphere that encourages clinicians to use electronic health records (EHRs) and the health information technology (IT) capacity within those systems, including clinical decision supports, to meaningfully improve the quality of delivered care, reduce costs, and improve population health management practices.Reducing Cervical Cancer Incidence Using Evidence-Based Programs in Community Settings
Considering the tremendous public health challenges in the U.S., including obesity, cardiovascular disease, substance abuse, diabetes, and a host of issues related to unintentional injuries, at least one disease remains quite mutable: cervical cancer. By taking advantage of the ability to intervene in the slow progression of cervical dysplasia to invasive cancer, screening programs have been successful in lowering age-adjusted incidence and mortality rates of cervical cancer.1 The advent of effective vaccines against human papillomavirus (HPV) magnifies the potential to dramatically reduce endemic levels of cervical cancer incidence and mortality.Making Health Information Technology Sing for People with Chronic Conditions
A dramatic increase in the public's use of digital technologies theoretically should provide new audiences for those who develop, test, fund, and implement applications to help people with chronic conditions care for themselves more effectively. However, to date, such technologies—for example, telemedicine, virtual visits, home health monitors, social networks, digital pill bottles, patient/clinician communities—have attracted scant interest from the public and yielded few if any sustainable improvements in health and functioning.
