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Feeding Ourselves: Food Access, Health Disparities, and the Pathways to Healthy Native American Communities

January 1, 2015

This report explores the complex historical and contemporary challenges to Native American healthy food access, childhood obesity, and health disparities. Looking first at the historical context of colonization, the treatment of Native Americans as sovereign Tribal Nations, and the evolution of Federal Indian policy, Feeding Ourselves frames the work ahead to engage and assist Native communities in moving beyond this condition.

Parents Support Healthier School Food Standards

September 9, 2014

A new poll shows that parents of school-age children overwhelmingly support national nutrition standards for all foods and beverages sold to students during school. The findings come as school districts implement the U.S. Department of Agriculture's "Smart Snacks in School" standards, which set basic limits on the fat, salt, and calories in items sold through vending machines, school stores, and a la carte cafeteria menus. Both student health and school food service revenue can benefit from these changes.

Residential Proximity to Major Roadways Is Associated With Increased Levels of AC133+ Circulating Angiogenic Cells

August 6, 2014

Objectives?Previous studies have shown that residential proximity to a roadway is associated with increased cardiovascular disease risk. Yet, the nature of this association remains unclear, and its effect on individual cardiovascular disease risk factors has not been assessed. The objective of this study was to determine whether residential proximity to roadways influences systemic inflammation and the levels of circulating angiogenic cells.Approach and Results?In a cross-sectional study, cardiovascular disease risk factors, blood levels of C-reactive protein, and 15 antigenically defined circulating angiogenic cell populations were measured in participants (n=316) with moderate-to-high cardiovascular disease risk. Attributes of roadways surrounding residential locations were assessed using geographic information systems. Associations between road proximity and cardiovascular indices were analyzed using generalized linear models. Close proximity (

Acrolein exposure is associated with increased cardiovascular disease risk

August 6, 2014

Background Acrolein is a reactive aldehyde present in high amounts in coal, wood, paper, and tobacco smoke. It is also generated endogenously by lipid peroxidation and the oxidation of amino acids by myeloperoxidase. In animals, acrolein exposure is associated with the suppression of circulating progenitor cells and increases in thrombosis and atherogenesis. The purpose of this study was to determine whether acrolein exposure in humans is also associated with increased cardiovascular disease (CVD) risk. Methods and Results Acrolein exposure was assessed in 211 participants of the Louisville Healthy Heart Study with moderate to high (CVD) risk by measuring the urinary levels of the major acrolein metabolite?3-hydroxypropylmercapturic acid (3-HPMA). Generalized linear models were used to assess the association between acrolein exposure and parameters of CVD risk, and adjusted for potential demographic confounders. Urinary 3-HPMA levels were higher in smokers than nonsmokers and were positively correlated with urinary cotinine levels. Urinary 3-HPMA levels were inversely related to levels of both early (AC133+) and late (AC133?) circulating angiogenic cells. In smokers as well as nonsmokers, 3-HPMA levels were positively associated with both increased levels of platelet?leukocyte aggregates and the Framingham Risk Score. No association was observed between 3-HPMA and plasma fibrinogen. Levels of C-reactive protein were associated with 3-HPMA levels in nonsmokers only. Conclusions Regardless of its source, acrolein exposure is associated with platelet activation and suppression of circulating angiogenic cell levels, as well as increased CVD risk.

Broken Promises to Our Children: The 1998 State Tobacco Settlement 15 Years Later

December 9, 2013

On November 23, 1998, 46 states settled their lawsuits against the nation's major tobacco companies to recover tobacco-related health care costs, joining four states -- Mississippi, Texas, Florida and Minnesota -- that had reached earlier, individual settlements. These settlements require the tobacco companies to make annual payments to the states in perpetuity, with total payments estimated at $246 billion over the first 25 years. In addition to the billions of dollars they receive each year from the tobacco settlement, the states collect billions more in tobacco taxes. In the current budget year, Fiscal Year 2014, the states will collect $25 billion in revenue from the tobacco settlement and tobacco taxes. Since the 1998 settlement, our public health organizations have issued annual reports assessing whether the states are keeping their promise to use a significant portion of their tobacco dollars to attack the enormous public health problems posed by tobacco use in the United States. Fifteen years after the tobacco settlement, this year's report finds that states continue to spend only a miniscule portion of their tobacco revenues to fight tobacco use. The states have also failed to reverse deep cuts to tobacco prevention and cessation programs that have undermined the nation's efforts to reduce tobacco use.

Broken Promises to Our Children: The 1998 State Tobacco Settlement Fourteen Years Later

December 6, 2012

Since the states settled their lawsuits against the tobacco companies in November 1998, our organizations have issued annual reports assessing whether the states are keeping their promise to use a significant portion of their settlement funds -- expected to total $246 billion over the first 25 years -- to attack the enormous public health problems posed by tobacco use in the United States.In addition to the billions of dollars they receive each year from the tobacco settlement, the states collect billions more in tobacco taxes. In the current budget year, Fiscal Year 2013, the states will collect a record $25.7 billion in revenue from the tobacco settlement and tobacco taxes.This year, our report finds that states continue to spend only a miniscule portion of their tobacco revenues to fight tobacco use. The states have also failed to reverse deep cuts to tobacco prevention and cessation programs that have undermined the nation's efforts to reduce tobacco use.Overall conclusions of this year's report include:In Fiscal Year 2013, the states will collect $25.7 billion in revenue from the tobacco settlement and tobacco taxes, but will spend only 1.8 percent of it -- $459.5 million -- on programs to prevent kids from smoking and help smokers quit. This means the states are spending less than two cents of every dollar in tobacco revenue to fight tobacco use.States have failed to reverse deep cuts that reduced tobacco prevention funding by 36 percent, or $260.5 million, from FY 2008 to FY 2012. The $459.5 million the states have allocated this year represents essentially flat funding compared to the $456.7 budgeted in FY 2012. It is still far below the $717.2 million spent in fiscal 2008 and the second lowest amount states have spent on tobacco prevention programs since 1999, when they first received tobacco settlement funds.States are falling woefully short of recommended funding levels for tobacco prevention programs set by the U.S. Centers for Disease Control and Prevention (CDC). The $459.5 million the states have budgeted amounts to just 12.4 percent of the $3.7 billion the CDC recommends for all the states combined. It would take less than 15 percent of total state tobacco revenues to fund tobacco prevention programs at CDC-recommended amounts in every state.

A Broken Promise to Our Children: The 1998 State Tobacco Settlement 12 Years Later

November 17, 2010

Examines states' fiscal year 2011 funding for tobacco prevention and cessation programs against recommended levels, points to the lowest level of funding since 1999 despite rising tobacco revenues, and calls for a federal campaign as well as state action.

A Broken Promise to Our Children: The 1998 State Tobacco Settlement Eleven Years Later

December 9, 2009

Ranks states on their fiscal year 2010 funding for tobacco prevention programs against recommended levels and examines spending cuts despite rising tobacco-generated revenue. Outlines potential consequences for smoking rates and recommended actions.

Could dirty air cause diabetes?

February 2, 2009

Diabetes is a growing epidemic, and it has become arguably one of the biggest health challenges of our time. Currently, more than 23 million Americans have diabetes, and the Centers for Disease Control and Prevention estimate that in the last 15 years, the number of people in the United States with diabetes has more than doubled. Diabetes is increasing at an alarming rate in Europe as well, and it is fast becoming a major health threat in developing countries such as India and China. Despite its high prevalence, however, diabetes remains somewhat of a mystery. Although type 1 diabetes mellitus could be attributed to insufficient insulin release by the ?-cells of the pancreas, the origins of type 2 diabetes mellitus (which accounts for >90% of the cases of diabetes) remain obscure. Insulin resistance is a cardinal feature of type 2 diabetes mellitus; however, it is not clear how whole-body insulin resistance develops, which specific tissues are affected first and which ones later, and how metabolic changes in individual tissues contribute to the overall development of the disease and its many secondary complications.

Environmental cardiology: studying mechanistic links between pollution and heart disease

September 28, 2006

Environmental factors are considered key determinants of cardiovascular disease. Although lifestyle choices such as smoking, diet, and exercise are viewed as major environmental influences, the contribution of pollutants and environmental chemicals is less clear. Accumulating evidence suggests that exposure to pollutants and chemicals could elevate the risk of cardiovascular disease. Many epidemiological studies report that exposure to fine particles present in ambient air is associated with an increase in cardiovascular mortality. Statistically significant relationships between particulate air pollution and ischemic heart disease, arrhythmias, and heart failure have been reported. Animal studies show that exposure to ambient air particles increases peripheral thrombosis and atherosclerotic lesion formation. Exposures to arsenic, lead, cadmium, pollutant gases, solvents, and pesticides have also been linked to increased incidence of cardiovascular disease. Mechanistically, these effects have been attributed to changes in the synthesis or reactivity of nitric oxide that may be caused by environmental oxidants or increased endogenous production of reactive oxygen species. Additional studies are urgently needed to: identify the contribution of individual pollutants to specific aspects of cardiovascular disease; establish causality; elucidate the underlying physiological and molecular mechanisms; estimate the relative susceptibility of diseased and healthy individuals and that of specific population groups; and determine whether pollutant exposure are risk correlates, that is, whether they influence major risk factors, such as hypertension, cholesterol, or diabetes, or whether they contribute to the absolute risk of heart disease. Collectively, these investigations could contribute to the emergent field of environmental cardiology.