In Doing the Best I Can, Tim Nelson, a lecturer in public policy at Harvard, and his co-author, Kathryn Edin, a professor of policy and management at the Kennedy School of Government at Harvard, take a close look at the inaccurate stereotypes about low-income fathers and how a different approach could lead to more stable, healthier families. The book also calls for reforms in the U.S. including regularly incorporating visitation into child-support orders and improving systemic approaches to fathers with employment barriers that affect their ability to pay support. According to Nelson, these efforts could result in increased income for single-mother families, social supports for dads, and improved father-child relationships.

Just before Father’s Day, NewPublicHealth spoke with Tim Nelson about the book’s findings.

NewPublicHealth: How did you come to write the book?

Tim Nelson: My co-author, Kathryn Edin, has written several books about single mothers in Camden, New Jersey and in Philadelphia, first in the mid-1990s about how single mothers make ends meet on welfare and low wage work and then in the mid-2000s, she co-wrote a book about how single moms make decisions about marriage and childrearing. Doing the Best I Can, is kind of the companion piece to the book on marriage and childrearing, which is called Promises I Can Keep. The men we interviewed are not the partners of the women in the prior book, but they do come from the same neighborhoods and have the same low income status. It’s aimed at getting the fathers’ perspectives and experiences, which are much less well known than the mothers’.

NPH: What needs correcting about the image of low-income fathers and why is it important to correct it?

Millions of cell phone customers might have heard their phones let out a high pitched alarm and spontaneously shake yesterday afternoon. The mobile siren is an indication that the severe weather is threatening the area—and roughly 62 million Americans were in the path of severe weather along the East Coast yesterday, as the region was wracked with severe thunder storms, tornados and flooding.

The mobile shake, rattle and siren is a free service from the Federal Emergency Management Agency and many nationwide cell phone carriers. You can find out if you’re covered by pressing 6-1-1 on your cell phone, which is your carrier’s customer service line. Earlier this week a NewPublichealth reporter, unaware of the service, suddenly felt his phone shake and was alerted to potential life-threatening flooding along his commuting route.

The service is actually two years old, but to get consumers to pay attention to the alerts, and the threats they’re warning about, FEMA recently partnered with the Ad Council on a new public service announcement.

The specific warnings come through as text messages with no more than 90 characters. Categories of alerts include extreme weather, AMBER alerts indicating a child has been abducted, and Presidential alerts during a national emergency.

One of the best features of the service is that it automatically tunes to weather where you are, not where you’re from. Go on vacation to the Outer Banks of North Carolina from Missouri, for example, and you will get alerts, if needed, about whether out on the barrier island. That’s important. Gary Cox, health director of Oklahoma City, which recently saw devastating tornadoes that killed and injured scores of people, said among those killed and injured were travelers to the area who hadn’t tuned into weather forecasts and didn’t know to take cover.

>>Bonus Link: Read an FAQ from FEMA on the wireless alerts.

How many children could possibly identify with a new Sesame Street character whose dad is in prison? Close to two million, according to many experts. A White House “Champions of Change” event yesterday honored twelve men and women who have spent their careers researching and improving the lives of children who have at least one parent in prison. That explains why Sesame Street released a new video and toolkit yesterday, as part of their "Little Children, Big Challenges" series, that tells the story of Alex, whose dad is in prison. Alex’s grown up and peer friends help him talk, and sing, about his feelings about his dad and how other people speak about his dad’s prison stay. The "Challenges" series includes issues many kids face such as divorce and a parent in the military, and the resources are distributed through therapist's offices, schools, jails and other key places to reach kids.

The White House program, led off by Domestic Policy Council director Cecilia Munoz and Secretary of Health and Human Services Kathleen Sebelius, included panel discussions on the needs of kids whose parents are in jail, which is a recognized “adverse childhood experience”  that can lead to poor health outcomes as children become adults. Among the problems kids of incarcerated parents can face are decreased living standards, social isolation because of the stigma they feel about having a parent in prison, and long-term or permanent separation from the incarcerated parent.

>>Watch a CBS News story on the Sesame Street program that will help support kids with incarcerated parents.

U.S. News & World Report has added a new set of rankings, “America's 50 Healthiest Counties for Kids” to its just released annual report on the Best Children’s Hospitals. The top counties have some important measures including fewer infant deaths, fewer low-birth-weight babies, fewer deaths from injuries, fewer teen births and fewer children in poverty than lower ranked counties. Most of the measures were taken from this year’s County Health Rankings, a collaboration of the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.

According to U.S. News, “America’s 50 Healthiest Counties for Kids,” represents the first national, county-level assessment of how health and environmental factors affect the well-being of children younger than 18 and shows that even the highest-ranking counties grapple with challenges such as large numbers of children in poverty and high teen birth rates.

>>Read the full U.S. News & World Report article.

Last week, a lunch briefing hosted by Women’s Policy, Inc., a national nonprofit that focuses on women’s issues, brought together a packed house of policymakers, public health leaders, academics, and legislative staff in key Congressional offices to discuss how data can inform action around women's and population health.

The briefing focused on the County Health Rankings & Roadmaps, a collaboration between the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute that measures the health of every county in the United States and provides tools to help create solutions that make it easier for people to be healthy in their own communities. Measuring health outcomes like length and quality of life along with health factors like education, income, and obesity rates, the Rankings provide an annual snapshot of where counties are doing well and where they can improve.

In turn, the Roadmaps to Health program helps counties partner with other local leaders to use that data to improve the health of residents. One of the featured speakers at the briefing was Claude-Alix Jacob, Chief Public Health Officer of Cambridge, Mass., one of six inaugural winners of RWJF’s Roadmaps to Health Prize.

Jacob pointed out the value of having data to work with determining where to put resources in order to improve community health. Women’s health data points of in Cambridge include:

• Girls reported slightly higher rates of smoking and binge drinking than boys
• Girls reported rates three times higher than boys of verbal abuse.
• Girls reported being three times more likely to hurt themselves than boys
• 87 percent of eligible women have had Pap smears, and 85.5 have had mammograms
• One-third of single mothers live in poverty

One key program that Jacob pointed to that Cambridge has begun is Baby University, a free 16-week innovate program designed for parents with children from birth to age 3. The goal is to increase parents’ knowledge  about child-rearing topics, strengthen parent-child relationships and connect parents to community resources. “While the first few cycles have largely included only moms,” said Jacob, “ the two most recent cycles have included more dads.”

The program includes childcare and transportation costs for enrolled parents, as well as home visits by professional staff. Parents who complete the program become part of an alumni association that continues the relationship between the parents and the program staff. So far, the program has had 140 graduates.

>>Read more about the briefing from the County Health Rankings blog.

>>Bonus Link: Among the resources for improving community health discussed at the Women Policy Inc. briefing was the “Town Hall Meeting in a Box” to help facilitate community conversations. The toolkit includes invitation samples, venue ideas and presentation documents. See more County Health Rankings & Roadmaps resources here.

Last week, efforts to add a ten year old with cystic fibrosis to the list of adult patients waiting to get donated lungs, increasing her chances of a transplant, made big news. NewPublicHealth had planned to write about the urgent need for citizens to step up and sign on to become organ donors and help whittle down the long lists of patients desperately waiting for hearts, lungs, kidneys and other organs. But our colleagues at the The Public’s Health, a well-worth-reading public health blog hosted by the Philadelphia Inquirer, beat us to it. We urge you to read the post by Michael Yudell, one of the blog’s writers as well as an associate professor at the Drexel University School of Public Health.

Writes Yudell:

"…The demand for organs in the United States far outpaces the supply. There are currently 75,650 active candidates (meaning they are medically suitable for a transplant) waiting for organs in the United States. But 18 people die every day, on average, waiting for an organ transplant."

A new American Public Health Association (APHA) Press book, “Veteran Suicide: A Public Health Imperative,” addresses the critical and growing issue of suicide among military veterans. The book is a collaboration between the APHA and the Department of Veterans Affairs. Both organizations previously partnered on a supplement to the American Journal of Public Health on suicide risks among veterans.

Topics addressed by the book include

• suicide prevention,
• substance abuse, and
  
• suicide surveillance.

The new book includes very recent research on suicide among veterans. "The research represented by the collection of manuscripts included in this volume is an important step towards addressing the national problem of suicide and a reminder that even one death by suicide is too many," said Janet Kemp, RN, PhD, Department of Veterans Affairs National Mental Health Program Director for Suicide Prevention.

“Veteran Suicide: A Public Health Imperative” is available for purchase online.

>>Bonus Link: This week the Huffington Post published an article by Kimberly Williams, Director of the Center for Policy, Advocacy, and Education of the Mental Health Association of New York City, pointing out that the connectedness members of the military feel with each other often disappears when they return to their communities, which may be a factor in the rising suicide rates among veterans.

New funding by the National Institutes of Health (NIH) is aimed at improving treatment for bacterial infections, treating alcohol dependence and determining effective drugs for long-term diabetes treatment.

• Antibiotic Resistance: Duke University has been awarded $2 million by the NIH for a clinical research network focused on antibacterial resistance. Funding could rise to close to $70 million by 2019. According to the NIH, bacterial infections resistant to antibiotic drugs were first reported more than 60 years ago and since then have become more common in both health care and community settings. In some cases, no effective antibiotics exist. The funding will be used to conduct clinical trials on new drugs, optimizing use of existing ones; testing diagnostics and conducting research on best practices for infection control.
• Alcohol Dependence: A new study funded by the NIH and published in the Journal of Addiction Medicine finds that the smoking-cessation drug varenicline (brand name Chantix), significantly reduced alcohol consumption and craving among people who are alcohol-dependent. “Current medications for alcohol dependence are effective for some, but not all, patients. New medications are needed to provide effective therapy to a broader spectrum of alcohol dependent individuals,” said says Kenneth R. Warren, PhD, acting director of the National Institute on Alcohol Abuse and Alcoholism, part of NIH. Participants who took varenicline, compared with those taking a placebo, decreased their heavy drinking days per week by nearly 22 percent.  
• Diabetes: The NIH is currently recruiting volunteers for a study to compare the long-term benefits and risks of four widely used diabetes drugs in combination with metformin, the most common first-line medication for treating type 2 diabetes. The study is important because if doctors find that metformin is not effective enough to help manage type 2 diabetes, they often add another drug to lower blood glucose levels. However, there have been no long-term studies on which of the add-on drugs are most effective and have fewest side effects. The study will compare drug effects on glucose levels, adverse effects, diabetes complications and quality of life over an average of nearly five years and will enroll about 5,000 patients at 37 study sites.

While the U.S. Departments of Health and Human Services, Labor and the Treasury jointly released rules about workplace wellness programs under the Affordable Care Act (ACA) last week, the financial and health improvement value of the programs has not yet been proven, according to several panelists at a briefing late last week co-sponsored by the Alliance for Health Reform and the Robert Wood Johnson Foundation.

How effectively these programs work is especially important now: beginning in 2014, employers will be allowed to charge their workers up to 30 percent more for health insurance premiums if they don't meet certain health goals. Currently, nearly half of large companies offer wellness programs, which can range from smoking cessation programs to penalties for employees who don’t meet employer-defined health targets in such areas such as cholesterol, blood pressure, and Body Mass Index.

To what lengths will hospitals go to make sure their employees are washing their hands? The answer for North Shore University Hospital on Long Island, N.Y., is thousands of miles to India where far-flung employees check their monitors, trained on the hospital floors, to find workers who skip the sinks on their way to the hospital’s intensive care units. According to a recent article in the New York Times, that is just one of many ways hospitals are working to increase hand washing and stop the spread of germs that can kill hospitalized patients. Other methods include free pizza and coffee incentives for frequent hand-washers and embedded chips on hospital employees that emit an alarm when a doctor bypasses a sink outside a patient room.  

A March report from the Centers for Disease Control and Prevention (CDC) easily explains the increasing emphasis on hospital hand washing. According to the report, a family of bacteria called Carbapenem-Resistant Enterobacteriaceae, which includes e.coli, have become increasingly resistant to last-resort antibiotics during the past decade, and more hospitalized patients are developing incurable infections. CDC researchers found that during the first half of 2012, 4 percent of hospitals and 18 percent of long-term care facilities treated a patient with this type of infection. 

Some hospitals have incentive ideas that employers and families can adopt including buttons that say, “Ask me if I’ve washed my hands?”

>>Read the article.

>>Bonus Links:

• Read about a new CDC study that found that using germ-killing soap and ointment on all ICU patients can reduce blood stream infections by up to 44 percent.
• Read tips from the CDC on how to wash hands thoroughly including a song to hum timed precisely to the time it takes to wash hands thoroughly.