Sugar-Sweetened Beverage Taxes and Public Health
Robert Wood Johnson Foundation
Chaloupka, Frank J.

Outlines research linking consumption of sodas and other sugar-sweetened drinks with obesity and type 2 diabetes. Explores the effectiveness of taxing such beverages to generate revenue, reduce consumption among at-risk groups, and promote public health.
Published: July 2009
Funder(s): Robert Wood Johnson Foundation

Medicaid and CHIP Strategies for Improving Child Health
Commonwealth Fund
Smith, Vernon K.; Jennifer N. Edwards; Esther Reagan; Dennis Roberts

Explains state programs' need for child health measures that focus on outcomes; are standardized across programs, agencies, and states; and reward performance through provider reimbursement. Points out opportunities for foundation and government support.
Published: July 2009
Funder(s): Commonwealth Fund

Expanding Performance Measurement to Include Patients' Experience of Self-Management Support
California HealthCare Foundation

Summarizes findings from a survey of chronically ill patients on the self-management support provided by medical groups. Analyzes results by condition and suggests integrating self-management support into primary care services and performance measurement.
Published: July 2009
Funder(s): California HealthCare Foundation

New Resources to Advance Quality and Safety in Nursing Care 

Two publications on safety and quality have just been released by the Robert Wood Johnson Foundation as part of their "Charting Nursing's Future" series. One report, titled "Addressing the Quality and Safety Gap--Part I: Case Studies in Transforming Hospital Nursing and Building Cultures of Safety," explores the five tenets of highly reliable organizations and includes an expert commentary by AHRQ's Kerm Henriksen, Ph.D., human factors adviser for patient safety, and highlights AHRQ’s Innovations Exchange. The report also provides five case studies of hospital systems and a state government all pursuing greater reliability with very different quality improvement approaches, together with a series of policy recommendations. The second report, titled "Addressing the Quality and Safety Gap--Part II: How Nurses are Shaping, and Being Shaped by, Health Information Technologies," provides promising models of nursing-related health information technologies in several categories: electronic health records, telenursing, and bar code medication administration (BCMA), including mention of AHRQ’s support of BCMA projects. The report also offers news about current educational efforts to bring nursing faculty online and build awareness about how to engage practicing nurses in shaping policy.

Annie E. Casey Foundation Releases 2009 KIDS COUNT Data Book
According to the twentieth-annual KIDS COUNT Data Book, key indicators of child well-being show slight improvements in six areas since 2000, but 2007 data suggest that conditions have worsened since the beginning of the recession.... More»

Disaster Relief Assistance Available
More than $2 million in federal disaster assistance has been approved for individuals and households in Missouri since President Obama issued a major disaster declaration three weeks ago. The declaration is a result of severe storms, tornadoes and flooding May 8 – 16. Individual assistance is available in the following counties: Adair, Barry, Barton, Bollinger, Cape Girardeau, Christian, Dade, Dallas, Dent, Douglas, Greene, Howell, Iron, Jasper, Jefferson, Laclede, Lawrence, Madison, Newton, Ozark, Polk, Reynolds, Ripley, St. Francois, Shannon, Texas, Washington, and Webster counties. The following documents contain additional information:
NR-08-DRC to open in Adair County (PDF)
NR-12 FEMA Community Relations teams go knocking door to door (PDF)
NR-14 More than $2 M Approved in MO Disaster Assistance (PDF)
NR11 Free Legal Services Available (PDF)

Bill Clinton Calls for More Rural Philanthropy
Speaking at the recently concluded Council on Foundations conference on rural philanthropy, Clinton argued that foundation activity in rural America has been "woefully inadequate".... More»

Covering Kids & Families Evaluation: Synthesis of 10 Case Studies: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice
Robert Wood Johnson Foundation
Wooldridge, Judith; Angela Gerolamo; Chris Trenholm

Highlights thematic findings from case studies in ten states of RWJF's 1999-2006 initiative to increase enrollment in Medicaid and State Children's Health Insurance Programs through outreach, simplified procedures, and collaboration with state agencies.
Published: June 2009
Funder(s): Robert Wood Johnson Foundation

Your Disease Risk
Welcome to Your Disease Risk, the source on prevention. Here, you can find out your risk of developing five of the most important diseases in the United States and get personalized tips for preventing them. Developed over the past ten years by world-renowned experts, Your Disease Risk collects the latest scientific evidence on disease risk factors into one easy-to-use tool.
http://www.yourdiseaserisk.wustl.edu/

Pandemic Flu Preparedness: Lessons From the Frontlines
Trust for America's Health

Outlines early lessons from the 2009 H1N1 influenza outbreak and recommendations for strengthening the U.S. core public health capacity, including vaccine stockpile and development, planning and coordination, infrastructure, and surge capacity and care.
Published: June 2009
Funder(s): Robert Wood Johnson Foundation

Robert Wood Johnson Foundation, Institute of Medicine Launch 'Future of Nursing' Initiative
As part of the initiative, a committee of experts led by former U.S. Secretary of Health and Human Services Donna Shalala will work to review innovative models of nursing care and education while putting together a report on the future of nursing.... (click on article title for more information)

Help Wanted: A Policy Maker's Guide to New Dental Providers
Pew Center on the States
Based on a literature review and interviews, details for policy makers a new dental care model in which dental therapists, community dental health coordinators, and advanced dental hygiene practitioners help provide care to underserved populations.
Published: May 2009
Funder(s): W.K. Kellogg Foundation

Health Reform: The Cost of Failure
Robert Wood Johnson Foundation
Holahan, John; A. Bowen Garrett; Irene Headen; Aaron Lucas

Estimates the intermediate and long-term implications of not enacting healthcare reform. Simulates the effects on employer-sponsored insurance, private non-group coverage, and Medicaid and State Children's Health Insurance Programs under three scenarios.
Published: May 2009
Funder(s): Robert Wood Johnson Foundation

Quality of Child Health: Expanding the Scope and Flexibility of Measurement Approaches
Commonwealth Fund
Scholle, Sarah H.; Natalie E. P. Davis; Sarah L. Sampsel; Edward L. Schor

Proposes a measurement framework to make data collection on the quality of children's health care more efficient and comprehensive. Considerations include focusing on measures with the greatest potential impact and adding new content or methods.
Published: May 2009
Funder(s): Commonwealth Fund

Diabetes Care Quality Improvement
A Resource Guide for State Action
The Agency for Healthcare Research and Quality (AHRQ) has developed Diabetes Care Quality Improvement: A Resource Guide for State Action and its companion workbook, Diabetes Care Quality Improvement: A Workbook for State Action. This Resource Guide was designed in partnership with the Council of State Governments to help States assess the quality of diabetes care and create quality improvement strategies.

This report was prepared for AHRQ by The Medstat Group, Inc. and The Council of State Governments under Contract No. 290-00-0004.

Diabetes Care Quality Improvement

A Workbook for State Action

This workbook is the companion of Diabetes Care Quality Improvement: A Resource Guide for State Action. The Agency for Healthcare Research and Quality (AHRQ) developed both resources to help States assess the quality of diabetes care and create quality improvement strategies.

Hospitals Will Fight Legislation Requiring Charity Care Standards
The American Hospital Association is preparing to launch a lobbying campaign aimed at preventing Congress from including more stringent hospital charity care requirements in healthcare reform legislation.... More»

Federal Expenditures on Infants and Toddlers in 2007
Urban Institute

Estimates how much the federal government spends on children under age three, on which programs and purposes, and in what form. Compares findings with research on the most effective investments, including Early Head Start and childcare assistance.
Published: April 2009
Funder(s): Buffett Early Childhood Fund, Irving Harris Foundation

Without Federal Reform, Number of Uninsured Could Expand Sharply Over Next Decade, Report Finds
The report from the Robert Wood Johnson Foundation found that if substantive healthcare reform is not enacted, the number of uninsured Americans could reach 65.7 million by 2019, with middle-income families hit hardest.... More»

Balance: 2008 Mid-Year Report: A Report on State Action to Promote Nutrition, Increase Physical Activity and Prevent Obesity
Robert Wood Johnson Foundation

Reviews state legislative efforts in January-June 2008 to prevent obesity by increasing access to nutritious foods and opportunities for safe physical activity for children and communities and by tightening restrictions on the food and beverage industry.
Published: March 2009
Funder(s): Robert Wood Johnson Foundation

Department of Health and Human Services Flu-related Prevention Materials - Click for more information

Reaching America's Health Potential: A State-by-State Look at Adult Health
Robert Wood Johnson Foundation

Compares the self-reported health of adults by race/ethnicity, education, and income level, nationally, within states, and as measured against a national benchmark, with state snapshots. Highlights links between educational attainment and health status.
Published: May 2009
Funder(s): Robert Wood Johnson Foundation

Beyond Health Care: New Directions to a Healthier America
Robert Wood Johnson Foundation

Outlines recommendations for governments, schools, healthcare providers, philanthropies, and others to collaborate on implementing feasible, evidence-based interventions that create healthier communities and address the needs of those most at risk.
Published: April 2009
Funder(s): Robert Wood Johnson Foundation

Community Health Centers in an Era of Health System Reform and Economic Downturn: Prospects and Challenges
Kaiser Commission for Medicaid and the Uninsured
Rosenbaum, Sara; Brad Finnegan; Peter Shin

Reviews 2008 legislation reauthorizing community health centers and the factors affecting their role as providers for the uninsured, publicly insured, and underinsured. Outlines health centers' patient mix, quality of care, revenues, and challenges.
Published: March 2009

New Report on Using Health IT Technologies for Managing Chronic Illnesses
AHRQ’s National Resource Center for Health Information Technology has released a new report on Innovations in Using Health IT for Chronic Disease Management. The report provides an overview of challenges faced by AHRQ health IT grantees when implementing or evaluating health IT systems to support care processes for the chronically ill. The approaches used by the various projects include: clinical-decision support systems, health information exchange and disease registries, telehealth, and hospital information systems. Select to access the report.

Patient Safety Organizations Fast Facts Now Available
Patient Safety Organizations (PSOs) are designed to improve patient safety and quality by encouraging health care providers to voluntarily submit adverse event and other clinical information for analysis. Such information is intended to help health care providers understand the underlying causes of patient harm so that risk to patients can be reduced. Clinicians, patient safety experts, risk managers, and health care leaders now have access to a list of more than 30 Fast Facts to help them better understand PSOs and the crucial role that PSOs have in fostering a culture of patient safety and quality. The Fast Facts are now available online. This information addresses key questions, including:

Who can seek listing as a PSO?
How does an entity apply to become a PSO?
Do PSOs receive Federal funding?
What are the benefits to health care providers who work with a PSO?

The Fast Facts also help explain the Patient Safety and Quality Improvement Final Rule (Patient Safety Rule), which became effective on January 19, 2009. The Patient Safety Rule establishes a framework by which hospitals, physicians, and other health care providers may voluntarily provide information to PSOs, on a privileged and confidential basis, for the aggregation and analysis of data regarding the quality and safety of patient care. AHRQ has listed 57 entities as PSOs as of April 15 that represent 25 States and the District of Columbia. Contact information for listed PSOs can be viewed through geographic and alphabetical directories on AHRQ’s PSO Web site.

Teen Births: Examining the Recent Increase
Child Trends
Moore, Kristin Anderson

Explores whether a rise in teen births in 2005-06 reflect an anomaly or a long-term reversal in the declining trend. Analyzes 1991-2006 data and potential factors, including shifts in teens' sexual behavior and demographic, social, and economic changes.
Published: March 2009
Funder(s): National Campaign to Prevent Teen and Unplanned Pregnancy, William and Flora Hewlett Foundation

Repeat C-Sections Climb by More Than 40 Percent in 10 Years

The percentage of pregnant women undergoing a repeat Cesarean section (C-section) delivery jumped from 65 percent to 90 percent between 1997 and 2006, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ). C-sections are performed for medical reasons and they can be elective. Medical reasons include a previous C-section, malposition of the baby in the uterus, the mother having active genital herpes, the baby's head being too large to pass through the mother's pelvis, or problems with the umbilical cord.

AHRQ also found that:

Nearly one-third of the 4.3 million childbirths in 2006 were delivered via C-section, compared with one-fifth in 1997.

C-sections are more costly than vaginal deliveries, $4,500 versus $2,600 in deliveries without complications, and $6,100 versus $3,500 in deliveries with complications.

Therefore, although C-sections account for 31 percent of all deliveries, they account for 45 percent of all costs associated with delivery.

C-sections account for 34 percent of all deliveries by women who are privately insured but only 25 percent of deliveries by women who are uninsured.

This AHRQ News and Numbers is based on data in Hospitalizations Related to Childbirth, 2006. The report uses statistics from the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured. For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.

Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused Disease in Adults and Pregnant Women

This recommendation reaffirms the Task Force's 2003 recommendation on Counseling to Prevent Tobacco Use and Tobacco-Caused Disease, with respect to counseling of adults and pregnant women. in 2003, the Task Force found the evidence insufficient to recommend for or against counseling of children and adolescents. An updated recommendation on this topic is being prepared. Go to http://www.ahrq.gov/clinic/uspstf/uspstbac.htm to view the 2003 recommendation.

THE MISSOURI CHILDHOOD LEAD POISONING PREVENTION PROGRAM’S FISCAL YEAR 2008 ANNUAL REPORT IS NOW AVAILABLE
The Missouri Childhood Lead Poisoning Prevention Program’s Fiscal Year 2008 Annual Report is available at http://www.dhss.mo.gov/ChildhoodLead/Reports.html.  The Childhood Lead Poisoning Prevention Program (CLPPP) is proud to announce that the number of Missouri’s children, less than six years old, who have been tested for lead exposure has increased from 50,362 in 2000 to 90,149 in 2008.  Of the number of children tested, the percentage found to have elevated blood lead levels has declined from 11.1 percent in 2000 to 1.3 percent in 2008.  This decrease mirrors a nationwide decrease in children’s blood lead levels.  In 2008, of the 90,149 children in Missouri who received a blood lead test, 1,175 (1.3 percent) had a blood lead level of 10 μg/dL or greater.  For more information on the CLPPP, contact the staff at 573-751-6102 or 866-628-9891.

2009 LEAD TESTING AREA MAPS
Each year, the DHSS Childhood Lead Poisoning Prevention Program (CLPPP) reevaluates the state for areas where children may be at higher risk of lead poisoning.  CLPPP determines risk by county, and in some areas, by zip code to provide a more accurate depiction of children’s risk.  These areas are designated as either Universal (High Risk) or Targeted (Non-High Risk) Testing Areas, and are displayed in five maps, one for each of the following areas:  statewide, southeast Missouri, St. Louis County, Jackson County, and Kansas City.  This year Lafayette County along with Kansas City zip codes 64106, 64123, 64126, and 64128, 65131, have been changed from Universal (High Risk) to Targeted (Non-High Risk) screening areas.  Congratulations to these areas.  The new maps can be viewed at the following website: http://www.dhss.mo.gov/ChildhoodLead/Maps.html.  If you would like additional information regarding lead poisoning, please contact Christy Inskip at 573-751-6102 or Christy.Inskip@dhss.mo.gov.

Trends in Child Health 1997-2006: Assessing Racial/Ethnic Disparities in Low Birthweight
Joint Center for Political and Economic Studies
Leigh, Wilhelmina A.; Anna L. Wheatley

Examines the prevalence of low birthweight among African-American, Latino/Hispanic, and white children born in 1997-2006 and whether insurance status or type, region, family type, or parents' education, marital status, employment, or poverty are factors.
Published: April 2009
Funder(s): W.K. Kellogg Foundation

California's Safety-Net Clinics: A Primer
California HealthCare Foundation
Saviano, Elizabeth C.

Provides an overview of the state's public hospitals, community health centers and clinics, and other providers of free or discounted care. Discusses topics including licensure, services provided, patient demographics, reimbursements, and challenges.
Published: March 2009
Funder(s): California HealthCare Foundation

Health Care Costs: A Primer 2009: Key Information on Health Care Costs and Their Impact
Henry J. Kaiser Family Foundation

Outlines trends in U.S. healthcare spending, compared with other countries and per capita; what it pays for; who pays; and how healthcare costs affect families and employers. Examines why healthcare costs outpace economic growth and how to address it.
Published: March 2009
Funder(s): Henry J. Kaiser Family Foundation

Integration of Mental Health/Substance Abuse and Primary Care - Downloadable Report from the Agency for Healthcare Research and Quality, US Dept of Health and Human Services

Recommended Adult Immunization Schedule --- United States, 2009
The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule to ensure that the schedule reflects current recommendations for the licensed vaccines. No new vaccines were added to the schedule. However, several indications were added to the pneumococcal polysaccharide vaccine footnote; clarifications were made to the footnotes for human papillomavirus, varicella, and meningococcal vaccines; and schedule information was added to the hepatitis A and hepatitis B vaccine footnotes.

At the Brink: Trends in America's Uninsured: A State-by-State Analysis
Robert Wood Johnson Foundation

Provides the number and percentage of uninsured in each state in 2006 by age group, gender, work status, and insurance type, as well as average employee premiums for employer-sponsored coverage and median income. Includes comparisons with 1996 data.
Published: March 2009
Funder(s): Robert Wood Johnson Foundation

Reducing Enrollee Churning in Medicaid, Child Health Plus, and Family Health Plus
New York State Health Foundation
Perry, Michael

Examines the reasons a high percentage of beneficiaries of the state's public health insurance programs do not complete the annual recertification process and the consequences of their loss of coverage. Suggests improvements for simplifying the process.
Published: February 2009
Funder(s): New York State Health Foundation

Snapshots From the Kitchen Table: Family Budgets and Health Care
Kaiser Commission for Medicaid and the Uninsured

Based on interviews, explores the financial and health concerns of low- and middle-income families with and without coverage. Examines the impact of the recession, high out-of-pocket costs, and medical debt on household budgets and access to health care.
Published: February 2009
Funder(s): Henry J. Kaiser Family Foundation

Senior Health Matters

Currently, 13.5% of Missouri’s population is aged 65 and older. This will increase to 20% by 2030. Not only will there be more seniors but they will be living longer. Aging is an individual issue but it is also a community issue. Our aging population will have a major impact on Missouri’s communities affecting health and human services, transportation, housing, volunteer efforts, employment, and the local economy. Communities need to plan if they are going to be prepared to meet the needs of this growing population. And, policy makers at all levels – local, state, and national need to make critical decisions that will support caregivers and communities.

Senior Health Matters was written by the Missouri Rural Health Association’s Senior Health Task Force. This task force was formed as a result of a two-year grant project funded by the National Library of Medicine. The grant was written by the Mid-Missouri Area Health Education Center (Mid-MO AHEC) in collaboration with the Missouri Rural Health Association (MRHA). While this report might be of interest to state policy makers and mental health professionals, it was written with community leaders and local mental health advocates in mind. Senior Health Matters consists of a series of short fact sheets. The Welcome provides a summary of the paper. Individuals can read all the fact sheets or only those of most interest. They can also read them in any order.

Rural Mental Health Matters

Having a mental illness can be tough no matter where you live but it can be worse for those living in rural Missouri. The 1.5 million rural Missourians have the same kinds of mental health disorders and needs for services as Missourians living in urban centers. However, they are less likely to seek treatment or to have access to needed services. As a result rural individuals with mental illness enter care later in their illness, have more serious and disabling symptoms, and require treatment that is more long-term and expensive.1

Rural Mental Health Matters was written by the Rural Mental Health Task Force; one of three such work groups formed as a result of a two-year grant project funded by National Library of Medicine. The grant was written by the Mid-Missouri Area Health Education Center (Mid-MO AHEC) in collaboration with the Missouri Rural Health Association (MRHA). While this report might be of interest to state policy makers and mental health professionals, it was written with community leaders and local mental health advocates in mind. The briefing paper provides a quick overview of the issue. Rural Mental Health Matters consists of a series of short fact sheets. Individuals can read all the fact sheets or only those of most interest. They can also read them in any order.

Finding and Evaluating Health Information on the Internet - a powerpoint presentation to help you evaluate the information you are finding.

PubMed® a service of the National Library of Medicine, includes over 14 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE® and additional life science journals.

MedlinePlus® - MEDLINEplus will direct you to information to help answer health questions. MEDLINEplus brings together, by health topic, authoritative information from NLM, the National Institutes of Health (NIH), other government, non-profit and other health-related organizations. It also provides you with a database of full-text drug information and an illustrated medical encyclopedia.

MEDLINEplus® Espanol (Spanish)le dirigirá a información que ayuda a responder preguntas de salud. Catalogada por tema de salud, MEDLINEplus® reúne información oficial de NLM, Institutos Nacionales de la Salud (NIH, por su sigla en inglés), y otras organizaciones de gobierno y sin fines de lucro relacionadas con la salud. También le proporciona una enciclopedia médica ilustrada y programas interactivos de instrucción de salud.

Missouri Rural Health Association (MRHA) and Mid-MO AHEC are collaborating on a two year National Library of Medicine grant funded project that will bring together rural residents and social services/health care professionals in a variety of ways.

Three white papers focusing on mental, dental and elder health issues facing rural Missourians are being developed as a result of this project. Each of these topics was identified as critical at regional MRHA meetings held through out the state. Online communities are being used to bring together experts to generate solutions for access to care and integration of services problems by promoting cooperation among local and state health and social service professionals. The white papers will be a starting point to begin community dialog on the health issues impacting rural residents.

Oral Health White Paper

Mental Health White Paper

Elder Health White Paper

Training & Events

CURRENT ADOLESCENT HEALTH ISSUES - 2009 TRAINING - May 7
Conference speakers will address Adolescent Brain Development; Cutting/Self-Mutilation Behaviors; Suicide Prevention and Mental Health Resources; Best Practices for Reducing Teen Pregnancy, STDs, and HIV; Contraception and STDs; and Adolescent Immunizations.  Co-sponsors include the Missouri Department of Health and Senior Services, Missouri Chapter American Academy of Pediatrics, Children’s Mercy Hospital, and The Delta Area Economic Opportunity Corporation (DAEOC).

The training will be held at the Delta Center, 147 State Highway T, Portageville, Missouri on May 7.  The training is free, but pre-registration is required.  The training is posted at http://www.dhss.mo.gov/AdolescentHealth/AHTraining.html and includes a link to the online registration.  For more information, contact the Adolescent Health Program at 573-751-6210.

MOALPHA TO SPONSOR MAY MEDICAID AND MEDICARE BILLING WORKSHOPS
Learn how to maximize your LPHA’s funding by billing for all allowable services.  Presenters will include representatives from the MO HealthNet Division and the health plans for MoHealthNet clients.  Workshops (co-sponsored by Sanofi Pasteur) will be held in May in five locations:  Shelbyville, Cameron, Rolla, Springfield, and Poplar Bluff.  The agenda and registration form are attached.

 A Rural Hospital Performance Improvement Workshop Exploring Frameworks: Balanced Scorecard, Lean Systems, Studer Pillars

2009 Missouri Clinical and Quality Conference

May 28-30, 2009

Big Cedar Lodge near Branson, MO

Click here for more information!