New Health Assessment Literacy Tool

"Current health literacy screening instruments for health care settings are either too long for routine use or available only in English. Our objective was to develop a quick and accurate screening test for limited literacy available in English and Spanish. ...The final instrument, the Newest Vital Sign (NVS), is a nutrition label that is accompanied by 6 questions and requires 3 minutes for administration. ...NVS is suitable for use as a quick screening test for limited literacy in primary health care settings."

Citation: Weiss BD, Mays MZ, Martz W, et al. Quick assessment of literacy in
primary care: The newest vital sign. Ann Fam Med. 2005;3:514-522. Full text available at http://www.annfammed.org/cgi/content/full/3/6/514

Hospitals Accounted for 12.1% of Southern California Economy in 2004

Hospitals in Southern California in 2004 accounted for about 12.1%, or about $85.5 billion, of the region's economy, according to a study by the Los Angeles County Economic Development Corporation http://www.laedc.org/

The Hospital Association of Southern California commissioned the study to examine the financial impact of 212 hospitals in Los Angeles, Orange, Riverside, San Bernardino, Santa Barbara and Ventura counties.

Chronic Diseases Leading Cause of Death in Los Angeles County

According to a report the Los Angeles County Department of Health Services released, chronic diseases including heart disease, stroke, cancer, and diabetes (in 2002) accounted for 80% of deaths and $48 billion in health care costs in Los Angeles County. The report found that heart disease and stroke accounted for 40% of premature deaths and were the leading causes of premature death and disability. In addition, the report found that a lower percentage of people in affluent communities in Los Angeles County die prematurely from heart disease or stroke than in lower-income communities.

"Premature Deaths from Heart Disease and Stroke in Los Angeles County: A Cities and Communities Health Report," January 2006, is available at
http://lapublichealth.org/epi/docs/CHR_CVH.pdf

Treatments Prescribed Despite Blackbox Warnings

Many patients are prescribed drugs with "black box" warnings (the strictest warning FDA can administer) even if the drugs are not appropriate for their medical needs, according to a study published in the Archives of Internal Medicine. The study found that patients who were female and older than 75 and who took several medications were more likely to be given a drug in violation of a black box warning.

Although the overall number of patients who received a drug in violation of a black box warning is relatively small, researchers said that when compared with the total number of outpatient prescriptions dispensed in the study, "the absolute number of outpatients at risk is substantial." Researchers said that one solution to decrease medical errors would be for the FDA to "make these warnings more specific so they are more readily understandable by providers."

Citation: Lasser, Karen E., et al. "Adherence to Black Box Warnings for Prescription Medications in Outpatients." Archives of Internal Medicine. 2006;166(3):338-344.

Ortho Evra Patch Has Risks

FDA in November 2005 required a new, boldface warning on the Ortho Evra patch labeling, stating that users are exposed to about 60% more estrogen than a typical birth-control pill. Increased estrogen exposure has been linked to potentially fatal blood clots, strokes and heart attacks, especially in women who smoke cigarettes and are older than 35.

Health centers in the California State University system have sent letters to students who have prescriptions for the patch to alert them to the warning. Local Planned Parenthood clinics and many doctors are continuing to prescribe Ortho Evra but said they are carefully screening patients for risk factors and informing them of possible problems.

Biopsy More Effective Than Noninvasive Tests for Breast Cancer

Four common noninvasive tests for breast cancer are not accurate enough to routinely replace biopsies for women who receive abnormal findings from a mammogram or physical examination, according to a study released (February 9, 2006) by HHS' Agency for Healthcare Research and Quality (AHRQ). The report finds that each of the four tests—magnetic resonance imaging, ultrasonography, positron emission tomography scanning, and scintimammography—would miss a significant number of cases of cancer, compared with immediate biopsy for women at high-enough risk to warrant evaluation for breast cancer.

The report is available at http://effectivehealthcare.ahrq.gov/synthesize/reports/final.cfm.

Prevalence of Adult Obesity is Still Rising

Adults in Los Angeles County have gained an average of six pounds each over the past eight years, and 25% of county adults will be obese by 2010 if current trends continue, according to a study the county Department of Health Services released Thursday (February 9, 2006).

Latinos had the highest rate of obesity at 29%, compared with 28% of black adults, 17% of whites and 6% of Asians, the study found. The percentage of overweight school children increased to 22% in 2003 from 18% in 1999, according to the study.

For more information on the survey results call (213) 240-7785 or for information about nutrition programs in L.A. County, call (213) 351-7889 or visit http://www.ladhs.org/.