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Archived Messages

Messages from State Health Officer Dr. Thomas M. Miller


World TB Day 2016 Emphasizes Working Together to Eliminate Tuberculosis (TB)

"Find TB. Treat TB. Working together to eliminate TB" is the theme the Centers for Disease Control and Prevention selected for World TB Day 2016. TB is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the disease.

World TB Day, annually held on March 24, marks the day in 1882 when Dr. Robert Koch detected the cause of the disease, the TB bacillus. This was a first step toward diagnosing and curing TB. World TB Day can be traced back to 1982, when the International Union Against Tuberculosis and Lung Disease launched World TB Day on March 24 that year, to coincide with the 100th anniversary of Dr. Koch’s discovery.

TB is still a life-threatening problem in this country, and much work is needed to eliminate this devastating disease. Anyone can get TB, but thanks to public health TB control programs, essential services are being provided to prevent, detect, and treat it.

General symptoms of TB include the following:

  • Cough lasting more than two weeks
  • Shortness of breath
  • Fever
  • Night sweats
  • Weight loss
  • Fatigue

A person may be infected with the TB germ, however, and have no symptoms. Children, elderly persons, immunosuppressed persons, and persons with lung disease or diabetes who have been infected with the TB germ are at higher risk of developing TB disease. Fortunately, patients can be treated preventively before becoming ill.

While the number of TB cases reported nationally every year is continuing to decline, TB has certainly vaulted to the forefront of public health awareness in Alabama because of the ongoing TB initiative in Perry County. Dozens of public health employees have been a part of this bold initiative through the Alabama Department of Public Health Division of TB Control in a county with many low-income residents and what was considered a hard-to-reach segment of the population.

From the outset of the Perry County initiative, one goal was to ensure the TB message was conveyed in a way that would not lead to fear within the community. Monetary incentives were offered to encourage screening and treatment, and community leaders were involved. Thanks to this special effort, more than 2,000 people were screened in January 2016, more than 150 patients with latent TB infection in the county are receiving preventive therapy, and individuals with TB infection are receiving life-saving TB treatment.

It is important to note that there were 133 TB cases in 2014 and 119 cases in 2015, so the situation in Perry County might easily have occurred in other areas of the state without prompt identification and evaluation of contacts at risk of exposure. TB services are provided to all people in Alabama, regardless of their ability to pay. For more information about TB, visit Tuberculosis or call 334-206-5330.

Thomas M. Miller, M.D.
State Health Officer

(March 2016)

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Promote Heart Health During American Heart Month

February is American Heart Month, an observance to increase our focus on cardiovascular disease (CVD), the leading cause of death in the United States and Alabama. CVD includes diseases that affect the heart or blood vessels, including heart disease, hypertension (high blood pressure), and stroke.

Consider these facts:

  • More than 1 in 3 U.S. adults have at least one type of CVD.
  • In the U.S., 1 in every 3 deaths is from heart disease and stroke--equal to 2,200 deaths per day.
  • In 2014, the death rate from heart disease in Alabama was 257.6 per 100,000 population, a rate much higher than the rate for the nation of 189.8 per 100,000.
  • The 2014 stroke rate in Alabama was 36.2 per 100,000, while the U.S. rate was 53.6 per 100,000.1

This month, we are highlighting Million Hearts™, a public-private initiative dedicated to preventing the nation's leading killers and empowering everyone to make heart-healthy choices. Million Hearts™ involves many federal agencies and key private organizations.

Launched in September 2011 by the Department of Health and Human Services, Million Hearts™ aims to prevent 1 million heart attacks and strokes in the U.S. by 2017.

Million Hearts™ emphasizes that to decrease CVD, we must make responsible and appropriate long-term lifestyle changes and take fundamental steps as individuals. The good news is that we can modify and control risk factors, which include the following:

  • High blood pressure
  • High blood cholesterol
  • Diabetes
  • Overweight and obesity
  • Smoking
  • Physical inactivity
  • Inadequate fruit and vegetable consumption

CVD and its risk factors are not distributed evenly across the U.S. population, and some risk factors cannot be changed. Certain groups defined by age, sex, race, ethnicity, or geography, have higher levels than others do.

Disproportionately high rates of avoidable CVD deaths are found among black men and among adults aged 30–74 years living in the Southeast, highlighting the need for targeted efforts to alleviate disparities and improve health. Black men experience a death rate attributable to CVD that is about 2.7 times higher than that of the lowest rate, found among white women.

The initiative asks everyone to protect themselves and their loved ones from CVD by understanding the risks, making healthful choices, and taking these steps:

  • Know and follow the ABCS that address the major risk factors for CVD.
        - Ask your doctor if you should take an Aspirin every day.
        - Find out if you have high Blood pressure or high Cholesterol, and if you do, get effective treatment.
        - If you Smoke, get help to quit.
  • Get up and get moving by being physically active for at least 30 minutes on most days of the week.
  • Make your calories count by eating a heart-healthy diet high in fresh fruits and vegetables and low in sodium and trans fat.
  • Take control of your heart health by following your doctor’s prescription instructions.
    To learn more about lowering your risk of CVD and for more information, visit Million Hearts and Cardiovascular Health.

Thomas M. Miller, M.D.
State Health Officer

1 National Center for Health Statistics, Health, 2015

(February 2016)

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National Birth Defects Prevention Month

Birth defects affect one in every 33 infants born in the U.S. each year. This accounts for approximately 120,000 infants that require costly, long-term care annually. Additionally, birth defects are the leading cause of infant deaths in the U.S., accounting for 20 percent of all infant mortality. Each year, total hospital costs for U.S. children and adults with birth defects exceed $2.6 billion, not including costs for outpatient care or many provider charges. The Alabama Department of Public Health Center for Health Statistics for 2013 indicates that the leading causes of death in infants less than 1 year of age are associated with congenital anomalies and birth defects. One hundred sixty-five of the 500 infant deaths in 2013 were attributed to birth defects; affecting one out of every three infants that died before reaching their first birthday.

Birth defects are congenital medical disorders caused by complex factors, which include genetic makeup, health behaviors and lifestyles, and environmental exposures. Examples of birth defects may include heart defects, cleft lip/palate, Down syndrome, and spina bifida. Some births defects have minor life-altering effects, while others cause lifelong disabilities.

January is National Birth Defects Prevention Month and the ADPH wants to make people aware of some steps that can be taken to reduce the risk of having a child born with birth defects. Making an effort to have a healthy lifestyle, visiting a health care provider before planning to get pregnant, planning your pregnancy, and taking a multivitamin every day can go a long way.

Not all birth defects can be prevented. But, women of childbearing age are encouraged to:

  • Consume 400 micrograms of folic acid at least three months before planning to become pregnant and continuing through the early months of pregnancy
  • Reach and maintain a healthy weight before becoming pregnant
  • Talk to a health care provider about taking proper medications
  • Avoid alcohol, smoking, and illicit drugs
  • Discuss family history
  • See a health care provider early and regularly if you think you might be pregnant

Hispanic women are about 20 percent more likely to have a child with a neural tube defect than non-Hispanic white women. Although the reasons for the disparity are not well understood, Hispanic women have lower intake of folic acid overall, compared to white women, according to the National Birth Defects Prevention Network. In 1998, folic acid was added to the grain food supply, resulting in a 26 percent decrease of neural tube defects in the U.S. and an estimated cost savings of over $300 million per year.

Improving the ability to prevent birth defects is an important public health priority that requires commitment. The Alabama Newborn Screening program currently screens for 31 disorders of the newborn and conducts extensive follow-up on infants who have any abnormal results. Early intervention is vital to improving outcomes for these babies.

Please join ADPH as we spotlight National Birth Defects Prevention Month and ways to reduce risk factors associated with birth defects. Reducing the human and economic costs of birth defects is a vital part of improving the overall quality of life for all Alabama families.

Thomas M. Miller, M.D.
State Health Officer

(January 2016)

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World AIDS Day Commemoration 2015 Strives to ‘Get to Zero’

Every year World AIDS Day events take place across the country to raise awareness and show support for people living with HIV. "Getting to Zero" is the theme selected by the World AIDS Campaign to commemorate this year’s World AIDS Day on December 1. The new theme echoes the United Nations’ AIDS vision of achieving "Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths."

Alabama continues to experience an HIV epidemic of moderate magnitude when compared with the experience of other states. More than 12,000 Alabama residents are known to be living with HIV infection, with at least 650 newly diagnosed cases reported each year.

Facts about HIV in Alabama

  • Although African Americans represent only 26 percent of the state’s population, they continue to be disproportionately affected by HIV, accounting for 68 percent of new cases and 65 percent of persons living with HIV.
  • Alabama is experiencing a downward shift in the age distribution of new infections, with adolescents and young adults (13-29 years) emerging as the most affected age group.
  • Male-to-male sexual activity continues to be the predominant mode of exposure for HIV transmission with young African American men who have sex with men between 15-29 years identified as a particularly high-risk target group.
  • An estimated one in six people living with HIV in Alabama (16 percent) are unaware of their infection and, thus, are not receiving medical care to manage their disease and achieve viral suppression.

Prevention education and testing remain two of the most important health activities to prevent new infections. The Alabama Department of Public Health, HIV/AIDS Division of Prevention and Care, convenes community network groups that meet, discuss local issues, and assist in deciding what issues should be prioritized in their community and the best solutions. Solutions can include HIV education awareness and testing activities.

The Centers for Disease Control and Prevention has declared “treatment as prevention” as the best way to prevent new infections. When people living with HIV receive appropriate medical care it can lead to suppressed viral loads, which means low levels of HIV in their system, creating a much healthier outcome. Persons with low viral loads also significantly decrease the chances of infecting others.

Many health care providers in the state treat people for HIV infection. Alabama also has 15 organizations and clinics, partners of ADPH, which are dedicated to providing treatment and support services for people living with HIV. Through the leadership of the HIV/AIDS Division of Prevention and Care, the health department continues to support the goal for all people in Alabama to know their HIV status, manage their health, and live their best life to "Know. Manage. Live."
For more information call 1-800-228-0469 or visit www.adph.org/aids.

Thomas M. Miller, M.D.
State Health Officer

(December 2015)

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National Prematurity Awareness Month

An estimated 15 million babies around the world are born premature each year and more than 1 million of them do not survive their early birth. Although the U.S. has seen sustained improvement in its preterm birth rate, 1 in 10 babies is born too soon and prematurity continues to be the number one killer of these babies. The good news is that over the past six decades we have gained a better understanding of some of the factors affecting fetal health, and we can inform mothers on ways to reduce factors associated with having a premature birth. Mothers who quit smoking, avoid alcohol or drugs, obtain timely prenatal care, follow appropriate birth spacing, and manage chronic diseases such as hypertension, diabetes, and obesity greatly reduce their chances of having a preterm delivery.

Preterm birth is the birth of an infant before 37 weeks of pregnancy. In 2013, preterm birth accounted for 16.4 percent of all infant deaths in Alabama. In 2013, Alabama’s infant mortality rate at 35 weeks gestation was 10.6 infant deaths per 1,000 live births compared to 2.4 infant deaths per 1,000 live births at 40 weeks gestation. Infants born too soon or too small cost society more than $26 billion a year and can take a high financial toll on families. Babies born just a few weeks early require longer hospital stays, have increased risk of long-term health problems, and lifelong learning and physical disabilities.

November is National Prematurity Awareness Month®. The Alabama Department of Public Health along with federal, state, and local partners is working to raise public awareness about prematurity and highlight work being conducted to reduce prematurity in Alabama. Ongoing collaboratives to reduce prematurity in Alabama include:

  • Getting preconception care so a woman is healthy both before she becomes pregnant and between pregnancies.
  • Eliminating non-medically indicated deliveries prior to 39 weeks gestation
  • Ensuring that mothers and infants deliver at the appropriate facility to meet specific medical needs of the mother and infant
  • Reducing unhealthy lifestyle choices and behaviors

Raising awareness about prematurity and reducing the number of preterm births are the first steps to defeating it. The Alabama Department of Public Health is dedicated to working with the March of Dimes and other partners to bring attention to this serious infant health problem with the goal of allowing every baby a healthy start in life. Join the effort and pledge purple for preemies in recognition of World Prematurity Day November 17, 2015.

To learn more about prematurity and to pledge your support, please visit the March of Dimes.

Additional Resources:

Thomas M. Miller, M.D.
State Health Officer

(November 2015)

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