Rapid Health Policy Response Project 
The Rapid Health Policy Response Project of the School of Public Health and Health Services at The George Washington University presents data and other background information on breaking public health stories. The goal is to educate the public, policymakers, legislators, health care providers, the media and others in order to promote informed decisionmaking. Karyn Feiden, an independent consultant who writes about public health and health care, provides editorial support for this project. Financial support comes from the Public Health and Policy Group of Pfizer, Inc.
The threat of the new H1N1 influenza A virus (also known as a swine flu virus) provides the first real-time test of the preparedness activities developed over the past few years. A new report released jointly by The George Washington University School of Public Health and Health Services (GW/SPHHS) and the GW Homeland Security Policy Institute (HSPI) reviews plans, strategies, directives, and guidance documents in place globally and domestically to meet the challenge of a long-anticipated, widespread influenza outbreak.
A new report on embryonic stem cell research from The George Washington University School of Public Health and Health Services (GW/SPHHS) reviews key issues likely to be debated in the coming months as Congress and The National Institutes of Health (NIH) determine how the research will move forward.
President Barack Obama signed an executive order lifting the ban on federal funding for embryonic stem cell research on March 9, 2009 and asked the NIH to revise its existing guidelines within 120 days. While these steps alone will undoubtedly expand research significantly, choices made in Congress and at the NIH could promote further research activity, or change its direction.
Recent federal court decisions concerning the potential link between the
measles-mumps-rubella (MMR) vaccine and autism are explored in a new
report issued by The George Washington University School of Public
Health and Health Services (GW/SPHHS).
In a decision announced Feb. 12, 2009, the U.S. Court of Federal Claims,
acting under the authority of the National Vaccine Injury Compensation
Program, ruled that a causal link had not been established.
A new GW/SPHHS Rapid Health Policy Response paper puts the recent legal
decisions on vaccines and autism in an historical and scientific
context, describing the role of the federal vaccine court and the
origins of autism-related vaccine safety concerns.
Congress is poised to include some $20 billion for health information technology in the pending economic stimulus package. While sharing patient data electronically has the potential to improve health care quality and save money, it also raises significant concerns about patient privacy.
"No one thinks existing HIPAA privacy rules are fine the way they are, but there is disagreement on what the problems are and how to fix them," observes Phyllis C. Borzi, JD, MA, research professor at the School of Public Health and Health Services at The George Washington University. "Many consumer groups and patient advocates say the rules are way too lax. The industry people say they are barriers to creating effective health information systems and need to be loosened."
This paper reviews the scope of current federal privacy laws, the proposed privacy requirements in the stimulus legislation, and the perspectives of industry and consumer groups on electronic health information privacy.
Unemployment jumped to 7.6 percent in January 2009, with the economy shedding 598,000 jobs that month alone. Over the past year, a total of 3.2 million jobs have been lost. Given the established links between employment, higher family income, and better health, the current recession may have grave consequences for Americans' health and health care.
This paper explores the potential health consequences of the current recession. It also reviews opportunities to provide new safeguards against impoverishment, diminished health, and reduced access to health care that are currently being considered as part of federal efforts to stimulate an economic recovery.
For ten days after Motl Brody had been declared dead by physicians, the 12-year-old boy lay in an intensive-care unit of Children's National Medical Center, sustained by drugs and a ventilator. His Orthodox Jewish parents insisted that, according to religious law, Motl remained alive because his heart continued to beat. District of Columbia law said he did not.
Although statutes on the books of every U.S. state allow a determination of death when all functions of the brain, including the brain stem, have irreversibly ceased, there is continued debate, especially in religious, philosophical, and bioethics contexts, about how, or even if, brain death should be defined. This paper reviews current law, the debate over a statutory "conscience clause" that allows cessation of cardiopulmonary function to be the sole basis of a declaration of death, and the impact of the discussion on organ transplantation.
More than 100 college presidents have called for lowering the legal drinking age, claiming that current restrictions encourage binge drinking among students. While their proposal has sparked widespread controversy, it has also called attention to a broad public health problem -- almost half of all college students regularly engage in binge drinking and almost 80, 000 adults and 4,600 people under the age of 21 die every year from alcohol-related events.
A clinical tool called screening and brief intervention (SBI) has proven highly successful in reducing college binge drinking. A new report by The George Washington University School of Public Health and Health Services (GW/SPHHS) describes the consequences of alcohol misuse, the proven benefits of screening and a brief intervention, and the opportunities to widen its routine use in clinical settings.
The well-publicized pregnancy of a political candidate's teenage daughter has drawn attention to the sexual behavior of American adolescents, and to the fact that about one-third of all girls in the United States get pregnant before age 20, according to the Centers for Disease Control and Prevention. Most of these pregnancies are unintentional. That story follows on the heels of a study in spring 2008 by the Centers for Disease Control and Prevention (CDC), which found that 26 percent of American girls, ages 14 to 19, have at least one sexually transmitted infection.
Together, these events raise an important policy issue: What is the most appropriate way to influence risky adolescent sexual behavior and reduce unwanted pregnancies and sexually transmitted infections? A new report by The George Washington University School of Public Health and Health Services (GW/SPHHS) reviews the challenges and describes the opportunities.
The report also outlines the:
- Current debate over abstinence-only sex education for youth, compared to a comprehensive approach that addresses both abstinence and contraception.
- Interventions recommended by the National Campaign to Prevent Teen and Unplanned Pregnancy, the CDC, the Institute of Medicine (IOM), and, among others.
Reports of illness linked to a Salmonella outbreak continue to grow, with 943 cases in 40 states and the District of Columbia identified from mid-April to July 4, 2008. Raw tomatoes remain the prime suspect but the investigation has been broadened to other produce as well. This is only the latest in a recent series of widespread, pathogen-linked outbreaks associated with fruits or vegetables along the "farm-to-fork" continuum that encompasses harvesting, packing, processing, transporting, distribution, and preparation. A new report by The George Washington University School of Public Health and Health Services (GW/SPHHS) reviews the points of vulnerability in the nation's vast food infrastructure; describes the fragmented regulatory system in place to safeguard food in the U.S.; documents resource shortfalls and statutory limitations at the FDA; and examines prevention strategies in lieu of the current approach, which dictates the FDA's response only after food safety challenges have occurred.
Earlier this year, a highly-publicized, five-month investigation by the
Associated Press brought renewed attention to evidence pointing to
pharmaceuticals entering the drinking water supplies serving numerous
American cities. A new report by The George Washington University School
of Public Health and Health Services provides a context for the
concerns, describing the extent of the contamination; the nature of the
health risks that could emerge; and action steps to consider.
The "silent epidemic" of dental diseases that disproportionately affect the nation's most vulnerable populations gained public attention early last year when a twelve-year-old Maryland boy died after an untreated tooth infection spread to his brain. A November ABC News investigation into a national dental chain that treats many children on Medicaid, and a New York Times front-page story in December reporting on the widespread dental problems in Kentucky -- where one in ten people have no teeth and half the state's children have untreated cavities -- underscored the national urgency of the problem.
The deaths of two previously healthy school children in October 2007 have focused the nation's attention on invasive infections from the strain of bacteria known as methicillin-resistant staphyloccous aureus (MRSA). Also fueling concern is a recent report indicating that the infection, which does not respond to many common antibiotics, is much more prevalent and much more dangerous than previously recognized. A new analysis issued by The George Washington University School of Public Health and Health Services (GW/SPHHS) examines the associated public health challenges.
Legislation introduced by two members of the District of Columbia Council on January 9, 2007 would require all girls to be vaccinated against the human papillomavirus (HPV), the primary cause of cervical cancer, by the time they enter the sixth grade, unless a parent or guardian specifically "opts out" of the mandate. A similar bill was introduced last week in Virginia, and Maryland and West Virginia are poised to consider legislation. To place the proposals in a broader context, this paper reviews some of the scientific, legal, ethical and financial issues surrounding the HPV vaccine and compulsory vaccinations. The paper is being issued through the Jacobs Institute of Women's Health, which is affiliated with the School of Public Health and Health Services.
President Bush has proposed in his fiscal year 2008 budget to cut more than 300,000 low-income people, primarily working families with children, from the Food Stamp Program to achieve a savings of more than $600 million over the next five years. As well, his proposed budget would eliminate funding for the federal Commodity Supplemental Food Program, which last year provided a monthly package of nutritious foods tosome low-income 423,000 seniors and 40,000 women, infants and children, at a cost of $107 million.
The Prescription Drug User Fee Act (PDUFA) authorizes the Food and Drug
Administration to collect fees from brand-name drug manufacturers that are
dedicated primarily to reviewing new drug applications for human use. The
law, first enacted in 1992 and twice reauthorized, will expire Sept. 30,
2007, unless Congress acts. Although FDA has met its primary PDUFA goal of
speeding the review of new products, questions about the law's impact on
drug safety and funding dominate current debate.
Under the Federal Deficit Reduction Act of 2005, most individuals eligible for Medicaid are required to document their U.S. citizenship or residency status, as well as to prove their personal identity, before receiving the health care benefit. Although eligibility standards are otherwise unchanged, some of the nation's most vulnerable and medically underserved populations have lost Medicaid coverage as a result, according to a new study by researchers at GW's School of Public Health and Health Services. It has also strained the system of federally funded community health centers, which provide high-quality, cost-effective care to 14 million people, many of them Medicaid beneficiaries or among the uninsured. This paper describes the mandated changes in Medicaid documentation requirements and their impact.
