Public/Global Health

Federal regulators are seeking public input on how to improve the ethics, safety and oversight of human research. 

The Department of Health and Human Services says it is overhauling its 1991 regulations, known as the "Common Rule," to keep current with changes in how research is conducted. While research used to be conducted for the most part at a single site at a university or medical institution, now it's much more fragmented and can involve an array of disciplines and venues. 

"The adoption of the Common Rule two decades ago was a landmark event to ensure ethical practices and the safety of those individuals who participate in research," assistant secretary for Health Howard Koh said in a statement. 

"This regulatory review effort is primarily about enhancing protections for human subjects. The changes under consideration offer the promise of updating and enhancing those protections to keep pace with current challenges."

The Institute of Medicine will recommend that insurers provide free coverage for contraceptives, according to a copy of the recommendations obtained by The Hill.

The highly anticipated recommendations are slated for public release on Wednesday. The IOM report says the Health and Human Services Department should classify eight categories of women's healthcare as preventive services that are available without a co-pay. The healthcare reform law made certain preventive care available without co-pays.

The IOM said "the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling" should be covered for "all women with reproductive capacity."

It also recommends coverage for annual HIV tests for sexually active women, annual counseling on other sexually transmitted diseases and — for women older than 30 — testing for the human  papillomavirus.

Screenings for domestic violence also should be covered, the IOM said.

Every state in the U.S. has an obesity rate of at least 20 percent, the Centers for Disease Control and Prevention said Tuesday.

Obesity rates are rising significantly, according to the CDC data. In 2000, no state had an obesity rate of 30 percent or more. Nine states topped 30 percent in 2009; now there are 12 states over that threshold.

At least 25 percent of the population is obese in 36 states.

"State obesity rates are still high," CDC Director Thomas Frieden said in a statement. "Some of the leading causes of death are obesity-related — heart disease, stroke, type 2 diabetes and certain types of cancer. We must continue our efforts to reverse this epidemic."

CDC found that obesity is most problematic in the South. The 12 states where obesity tops 30 percent are Alabama, Arkansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas and West Virginia.

The Trust for America's Health recently released similar findings, and said several policies in the healthcare reform law are key to fighting obesity.

Contaminations in drinking water often are not reported to the federal government, making it harder to reduce the health risks posed by dirty water, according to a Government Accountability Office report.

Incomplete reporting undermines the Environmental Protection Agency's (EPA) efforts to track contamination and target its enforcement activities toward the water systems with the biggest problems, GAO said.

The top three Democrats on the House Energy and Commerce Committee said the report shows the danger of cutting EPA funding. They said Republicans have proposed a $134 million cut to a fund that helps states comply with EPA regulations.

“Rather than slashing funding for this critical public health resource, Congress should be moving legislation to improve the reporting and policing of drinking water violations," Rep. Henry Waxman (D-Calif.) said in a statement.

After auditing 14 states, GAO found that 26 percent of health-related violations in drinking-water systems were either not reported to the EPA or were reported inaccurately in 2009.

Contaminated drinking water causes as many as 11 million illnesses per year in the U.S., according to a study cited in the GAO report.

The American Lung Association is urging White House Chief of Staff Bill Daley to cast aside a powerful business group’s bid to scuttle the Environmental Protection Agency’s (EPA) upcoming smog standards, alleging it would lead to pollution-related deaths.

The group's Monday letter to Daley follows last week’s Business Roundtable effort to convince Daley to override EPA’s upcoming rule that toughens ozone standards that the Bush administration issued in 2008.

“To be plain, the delay being sought by the Business Roundtable and their allies means more Americans will get sick and more will die due to exposure of unhealthful levels of air pollution,” writes American Lung Association CEO Charles Connor in the Monday letter.

His letter states that “scientific evidence overwhelmingly supports a more protective ozone standard.”

The conservative Traditional Values Coalition is demanding a moratorium on grants awarded by the National Institutes of Health (NIH), claiming that it has identified more than half a billion dollars in grants for "questionable research" of dubious value to taxpayers.

The coalition has also launched a petition against the NIH and is pressing President Obama to select a special prosecutor or other independent investigator to conduct a full review of the agency's budget. The NIH is crafting a response to what it calls the coalition's "inaccuracies," a spokeswoman said.

"While the White House and some in Congress raise the specter of cutting Social Security and Medicare, it is outrageous that the NIH continues to funnel huge amounts of taxpayer dollars for bizarre and politically correct 'research' to people who have made a career out of playing the federal grant game," coalition President Andrea Lafferty said in a statement.

The government on Thursday awarded $95 million in grants to help 278 school-based health centers across the country expand and provide more healthcare services to students, their families and their communities.

The healthcare reform law set aside $200 million for the grants for 2010 through 2013. House Republicans voted to defund the provision to cut down on government spending. 

Federal officials say Thursday's grant recipients serve about 790,000 patients and will be able to increase their capacity by more than 50 percent — serving another 440,000 patients — thanks to the awards. School-based programs, the government says, "improve the overall health and wellness of all children through health screenings, health promotion and disease prevention activities and enable children with acute or chronic illnesses to attend school."

Advocates praised the news.

"More than 350 applicants from around the nation applied for this much-needed federal funding, which will allow (school-based health centers) to switch over to electronic medical records, purchase dental equipment to provide oral health services, help build new clinics or expand or improve existing space, and more," Linda Juszczak, executive director of the National Assembly on School-Based Health Care, said in a statement. "These projects benefit whole communities by creating construction and renovation jobs. We hope members of Congress who question the value of the program will tour the (school-based health centers) in their communities to see the importance of these grants for children and their families."

The Centers for Disease Control and Prevention on Wednesday released a guide of infection prevention recommendations for outpatient services. 

The guide comes as more and more patients have been getting their care in outpatient clinics, physician offices and community-based settings rather than inpatient hospitals over the past few decades. Such settings "have traditionally lacked infrastructure and resources to support infection prevention and surveillance activities," the CDC says.

The recommendations were crafted in collaboration with the Healthcare Infection Control Practices Advisory Committee, an advisory body of 14 infection control experts. According to the CDC, the guide seeks to provide basic infection prevention recommendations for outpatient (ambulatory care) settings; reaffirm standard precautions as the foundation for preventing transmission of infectious agents during patient care in all healthcare settings; and provide links to full guidelines and source documents for more detailed background and recommendations.

Obesity rates in the U.S. are skyrocketing alongside growth in obesity-related illnesses like diabetes, according to a report released Thursday.

The study recommends restoring funding to government anti-obesity programs and drawing from the healthcare reform law's prevention fund, which Republicans have proposed cutting.

Roughly two-thirds of adults, and one-third of children, are overweight or obese, according to the study from the Trust for America's Health and the Robert Wood Johnson Foundation. It found that obesity is growing especially fast in certain parts of the country, particularly the South.

Pushing for more research funding remains a top priority of the American Heart Association despite the tough fiscal climate, its new president tells The Hill.

Dr. Gordon Tomaselli, the chief of cardiology at Johns Hopkins School of Medicine, said he plans to push for a robust internal research program at AHA while advocating for more funding at the National Institutes of Health. Tomaselli took over Friday; his term lasts one year.

"I know this is a difficult and uphill task given the current fiscal environment," he said. "But we need to change the tenor of the discussion, from one of expenditure to one of investment. If we look at what's happened in medicine over the past three or four decades, much of it can be traced back to the NIH and fundamental discoveries at the NIH that were so early that you could never envision any corporation investing the kind of money to get to those discoveries."

The NIH took a $321 million haircut in the 2011 budget, and advocates fear even deeper cuts as lawmakers weigh an $18 billion cut to the departments of Health and Human Services, Labor and Education for 2012.