Does a One-Size-Fits-All Approach Work When It Comes to Reducing Sodium Intake?

DASHNY Emerging Evidence, FEATURED ARTICLES, Food Policy, Prevent Chronic Disease 0 Comments

FROM THE URBAN HEALTH MATTERS BLOG BY AMANDA LI

Cardiovascular disease (CVD) currently ranks as the number one killer in the United States. In fact, one out of every four deaths can be attributed to CVD. In New York City, more than one in three adults lives with cardiovascular disease. Many factors contribute to CVD, but most research suggests that one of the major risks can be attributed to something we eat every day: salt.

Our bodies need sodium to function as it helps regulate fluid balance, transmit nerve impulses, and control muscle function. Yet, when consumed in excess, sodium can cause severe damage to our heart and blood vessels. With 75 percent of the population eating nearly two times the amount of daily recommended sodium, and almost 1.65 million CVD-related deaths in the world associated with high sodium consumption, there’s a critical need to find an effective way to lower the amount of salt in our national and international diet.

Multiple government and community-based initiatives have attempted to help people reduce excessive sodium intake. This includes the American Heart Association’s #BreakUpWithSalt Campaign, New York City’s sodium warning label requirement for chain restaurants, and recommendations encouraging health professionals to advise patients on reducing their sodium intake. New research suggests, however, that a one-size-fits-all approach may not be effective.

A 2017 study conducted at The New York Academy of Medicine by Yan Li, PhD, José Pagán, PhD, and Julia Berenson, MS, along with Andrew Moran, MD, from Columbia University Medical Center, investigates this question. The research team identified key characteristics (i.e., age, geographic location, income, ethnicity, race, body mass index, and self-reported hypertension status) that they used to categorize people into subgroups based on how likely they might be to heed professional recommendations to reduce sodium consumption. The study was based on survey data on 125,764 respondents to the 2013 Behavioral Risk Factor Surveillance System.

Li and colleagues found that age was the most significant predictor for whether a person would follow recommendations from their health professional on sodium intake. The study results also revealed that within each age group, predictors of sodium intake were quite different. For instance, for people ages 18 through 64, the predictors of sodium intake behavior were linked to geographic location, income, and self-reported hypertension status. For the younger group, under age 45, BMI was also a factor. Yet, for people 65 and older, diabetes, hypertension, race, ethnicity, and geographic location shaped their sodium-intake choices.

Findings like these suggest that a one-size-fits-all approach to reducing sodium intake at the population level, such as simply informing people about the sodium content of popular foods, may not be enough to get people to act. When it comes to reducing sodium consumption, a more productive approach may be to segment populations into different groups based on demographic, clinical, and geographic characteristics, and tailor interventions to the needs and interests of each subgroup.

Earlier work by Pagán and Li found that among New York City residents, cutting salt intake could actually add years to life. With this new research, the Center for Health Innovation team may be a few steps closer to figuring out the best ways to convince people to shake off the salt for better health.

Partners in Health: Community Food Programs and Hospital Partnerships in New York

DASHNY Clinical and Community Linkages, Food Policy, HOMEPAGE LATEST NEWS, Prevent Chronic Disease 0 Comments

Heart disease, diabetes, and obesity are among the serious conditions that can result from a poor diet. Creating healthy food environments is vital to preventing these serious conditions and promoting the well-being of our communities.

Hospitals and community-based organizations play a critical part in promoting food environments that support healthy eating. This is why, on May 15, 2017 from 10 am – 4 pm, the New York Academy of Medicine, in partnership with the Community Food Funders, hosted the Partners in Health: Community Food Programs and Hospital Partnerships in New York convening. This event created a place for CBOs working to improve the food system and hospital/health system leaders across New York State to come together, share information, and explore potential partnerships.

It is our hope that by bringing hospital/health system leaders and community-based organizations together, we can help foster potential partnerships that will promote greater access to healthy food across our state’s communities.

The convening included a keynote speech on The Good Food Purchasing Policy: A Holistic Approach to Food as a Determinant of Health by Paula Daniels, J.D., co-founder and Chair of the Center for Good Food Purchasing. There were also panels on the following topics:

  • Health Care: What value can CBOs bring to population health?
  • Food: How and why to partner with a hospital?
  • Hospital-CBO Partnerships that address food and nutrition

Following our panelists, the convening participants gathered together in small group breakout sessions around topics like emergency food, local procurement, and hospital food environment.

A huge thank you to everyone who joined us on May 15, 2017 for this important work!

Supervised Injection Facilities: A Controversial but Proven Solution to a Deadly Epidemic

DASHNY Clinical and Community Linkages, HOMEPAGE LATEST NEWS, Prevent Substance Abuse, Promote Mental Health 0 Comments

By Amanda Li and Michele Calvo

In 1995, at the peak of the United States’ HIV/AIDS epidemic, 43,115 people died from the disease within that one year alone. Now, in 2017, we are facing an even deadlier epidemic: the opioid crisis. Drug overdoses are currently taking more lives than the HIV/AIDS epidemic did at its peak; in 2015 alone, over 52,400 people died from a drug overdose in the U.S., with almost two-third of those deaths related to opioid use.

How do we confront this growing crisis that is now outpacing some of the current leading causes of death? Although controversial in the U.S., supervised injection facilities (SIFs) have existed in Europe and Canada for decades as a tool in combatting overdose death and drug-related harms. SIFs are hygienic locations where people who use drugs can legally consume pre-acquired drugs under the supervision of trained professionals. Not only do SIFs provide medical supervision and a safe, sterile environment for injection, but they also provide linkage to primary health care, information on how to reduce the harmful effects of drugs, and treatment referrals among other valuable services.  In order to make them more inclusive to other kinds of drug use and not just limited to injection-based drugs, SIFs have also been referred to as supervised/safer consumption spaces (SCS).

There are currently no SIFs/SCSs present in the United States as the idea of providing legal spaces for illicit drug use is highly controversial. However, there are over 100 SIFs located around the globe across 60+ cities and ten countries. The great news is that across these 100+ SIFs, some of which been around for more than 30 years, no known overdose-related deaths have occurred in these facilities. In fact, studies show that these SIFs effectively promote safer conditions for injecting, improve access to health care and drug treatment, reduce overdose deaths, and decrease the frequency of public injections without increasing the rate of drug trafficking, injecting, or crime.  Further, people who use drugs often face tremendous social isolation and stigma, and SIFs help provide a place where these people can feel respected, valued, and cared for.

Knowing the potential public health benefits that SIFs can bring to New York City (which had about a 60% increase in fatal opioid overdoses in 2016), the New York Academy of Medicine is a proud member of SIF NYC, collaborating with the other members of the coalition to advocate for the implementation of SIFs/SCSs in the city. The Academy is also partnering with the New York Community Trust and the NYC Department of Health and Mental Hygiene on a feasibility study around using SIFs to help address the city’s opioid epidemic. A report of the study’s findings will be available this summer 2017.

Fortunately, the push to bring SIFs into New York has been gaining momentum. On April 25, 2017, the Safe Consumption Spaces Campaign Launch began with the release of a letter signed by more than 100 healthcare professionals across NYC declaring their support for SIFs as an evidence-based public health intervention to reduce overdose and blood-borne infections. The campaign continues with a 10-day Safe Shape tour that showcases a SCS model and documentary about public injection in the state. This campaign will hopefully help create the public awareness and dialogue needed to finally bring a much-needed resource into New York.

Place Based Approaches to Health Disparities Learning Collaborative

DASHNY Clinical and Community Linkages, Environment, HOMEPAGE LATEST NEWS, Prevent Chronic Disease 0 Comments

By Amanda Li, B.A., Junior Policy Associate

Did you know:

  • That African Americans represent 43% of New York State’s AIDS cases, even though they make up only 14% of New York’s total population?
  • That Asian Americans are three times more likely to have liver cancer than non-Hispanic Whites?
  • That over a third of Hispanics in the country do not have health insurance?
  • That people living in the more rural parts of New York are more likely to suffer from a chronic illness?
  • That people of lower socio-economic status are more likely to experience poor health outcomes because of factors like living in environmentally poor conditions?

Health disparities are undeniably a major issue that our country and our state face. Not only do health disparities negatively impact the health and well-being of people who face them, but they also lead to unnecessary costs and hinder healthcare improvements for the population at large. With over 40% of New York belonging to a racial or ethnic group, and the population becoming increasingly more diverse, health disparities present an issue that cannot be ignored. Fortunately, one of the goals of New York State’s Prevention Agenda 2013-2018 is “to reduce health disparities for racial, ethnic, disability, and low socioeconomic groups, as well as other populations who experience them.

How can you or your organization help address the health disparities in your community? Please join the Advancing Prevention Project on April 24, 2017 from 1:30-3:00 pm for our Place Based Approaches to Health Disparities Kick-Off Webinar to find out more. During this webinar, you will not only learn about health disparities in the context of New York State and our Prevention Agenda, but you will also hear from experts about how to leverage place-based approaches to address health disparities. Place-based approaches involve creating environments that are health-promoting, like parks, safe places for walking and biking, well-maintained homes, environmental protection, and grocery stores that sell healthy, affordable food. There is currently growing momentum around the idea that place-based approaches are required to address health disparities and build healthy, equitable communities.

We hope that the kick-off webinar will serve as an effective starting point for a productive learning collaborative around this issue, where participants have the opportunity to discuss, share, and partner with others across New York State to promote place-based initiatives and reduce health disparities in our communities.

Our expert speakers who will be presenting on this webinar include:

  • Margaret Casey, RN, MPH, Director, Bureau of Community Chronic Disease Prevention, New York State Department of Health
  • Kristen Pergolino, Deputy Director, Office of Minority Health and Health Disparities Prevention, New York State Department of Health
  • Harrison Moss, MPH, Director, State Partnership Initiative, New York State Department of Health
  • Jamie Konkoski, Program Manager, North Country Healthy Heart Network
  • Marie Dynes, LCSWR, Coordinator, Prevention Services, Dutchess County Department of Behavioral and Community Health
  • Kathy Mogle, MS, Program Coordinator, Onondaga Health Department

The panel will be moderated by Kimberly Libman, PhD, MPH, director of the Prevention and Community Development team at The New York Academy of Medicine.

Please register here by April 23, 2017 if you are interested in attending! We look forward to seeing you on April 24th.

A 750 Mile Plan to Safer Cycling and Better Health

DASHNY Active Communities, Economic and Community Development, Environment, HOMEPAGE LATEST NEWS, Prevent Chronic Disease 1 Comment

By Amanda Li, B.A., Junior Policy Associate

Increasing cardiovascular health, building muscle strength, enhancing flexibility, promoting joint mobility, reducing stress and anxiety…this is by no means an exhaustive list but gives you an idea of the health benefits that come with cycling. Cycling is a cheap, fun, and low-impact form of exercise that people of all ages can enjoy to stay physically active. When used as an alternative mode of transportation, it is also beneficial to our environment.

Although cycling is great for both our health and our environment, without Complete Streets and safe places to bike on, cycling can be dangerous. In 2014, in New York State alone, there was a total of 5,827 bicycle/motor vehicle accidents, 47 of which were fatal. We need a safer way to allow New Yorkers to enjoy the many benefits of cycling.

Governor Andrew M. Cuomo’s 750 mile long Empire State Trail might be the solution we are looking for. Back in January 2017, Cuomo proposed that the Erie Canalway and Hudson River Valley Greenway trails be completed by 2020 to form the Empire State Trail. Once completed, this will be the nation’s longest statewide multiuse trail, with one part running from Manhattan Battery up into Canada along the Hudson River Valley, and the other part running between Albany and Buffalo along the Erie Canalway Trail. In order to complete and connect the Erie Canalway and Hudson River Valley trails into a 750 mile long trail, 350 miles of additional trails will need to be constructed to fill in any gaps and form the long stretches of the Empire State Trail.

With 70 percent of the Empire State Trail located off the roads, it gives cyclists, hikers, and runners alike the opportunity to enjoy the beautiful scenes of nature while on the move, without the stress of vehicles and traffic. The health benefits of providing people across the state of New York with a safe and accessible way of staying active outdoors by creating the Empire State Trail are undeniable. According to Rose Harvey, commissioner of the state’s parks, studies show that adolescents who cycle have a 48% less chance of being overweight, and with each dollar devoted to developing trails, there results in $3 worth of savings in medical expenses. With Cuomo proposing to spend around $200 million on the Empire State Trail, New York State could be saving a potential $600 million in medical expenses.

DASH-NY sees this as a huge step towards making New York a better connected, more active, and healthier state.