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Medical and Research Library News - May 2019

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News and training opportunities
Cool websites and reports on hot topics*
Interesting journal articles* 
New books*

May 2019

mrl-diamondNews and training opportunities

National Library Week 2019 has concluded but webinar recordings of the programs held by the DSHS Library during National Library Week are available. The programs offered were:
Essentials of Grant Writing 
Planning for Departures: Staff Changes, Succession Planning and Records Management 
Meeting Management: How to Run Effective Meetings 
Going Beyond Google: What Library Services Can Do for You that Google Can’t! 
Can’t We All Just Get Along? Working with People Who Challenge Us 
Cambodia, Australia and the Lone Star State: Trust and Communication in Diverse Communities 

For additional information, please send an email to library@dshs.texas.gov, call 512-776-7559.

Note: The following webinars and online classes are not affiliated with DSHS or the DSHS Library. They are presented here as opportunities to learn more information of interest to public health personnel.

May 6, 2019; 11–12:30 p.m. Scaling Up PrEP Care to End the HIV Epidemic. The federal government is launching an initiative to end the HIV epidemic by 1) increasing the number of US Americans who know their current HIV status, 2) increasing the number of US Americans with HIV infection who are effectively treated and have sustained viral suppression, and 3) rapid expansion and reduced racial/ethnic disparities in PrEP provision to the estimated 1.2 million US Americans with sexual and injection behaviors that place them at substantial risk of HIV acquisition. This webinar will discuss what PrEP is, indicators for its use and how health departments can support its expansion and effective use. Presented by Emory University and Region IV Public Health Training Center. https://events-na1.adobeconnect.com/content/connect/c1/812723154/en/events/event/shared/default_template/event_landing.html?connect-session=na1breezcw4e285u24ay6e6s&sco-id=3084806315&_charset_=utf-8

May 7, 2019; 10–11 a.m. Connections between Opioid Use, Overdose, and Suicide. Join this webinar that will explore the intersection of opioid misuse, overdose, and suicide. Hosted by The Department of Veterans Affairs (VA) Health Services Research & Development Service (HSR&D). https://register.gotowebinar.com/register/5809413014527646467

May 8, 2019; 10–11 a.m. Eye Health Across a Lifespan. Eye health is important as it is often undetected by parents and doctors as young children do not know the difference between clear and blurry vision and in most cases, children do not experience pain nor can they differentiate good or bad vision as they were born with the vision they have. Participants of this session will get a quick look at how important eye health is from infancy to the elderly. We will discuss topics which may affect all ages and cover issues which may have no symptoms. Presented by the National Network of Libraries of Medicine South Central Region. https://nnlm.gov/class/eye-health-across-lifespan/10253

May 14, 2019; 1–2 p.m. Social Determinants on the Local Level: Housing and Health. This webinar will explore the relationship between housing and health as well as ways to assess housing as a social determinant in your community. Housing stability, quality, safety, and affordability all affect health outcomes. Poor-quality housing is associated with various negative health outcomes, including infectious disease and psychological distress. This webinar will discuss specific quality affordable housing strategies that can lead to improvements in physical and mental health. https://events-na10.adobeconnect.com/content/connect/c1/1053915029/en/events/event/shared/1096389343/event_landing.html?connect-session=na10breezycrhp8nsufrc5852&sco-id=1358934345&_charset_=utf-8

May 15, 2019; 12–1:30 p.m. HRSA Public Health Webinar Series - Maternal Mortality. The purpose of this webinar is to understand federal projects, clinical research, and available resources to improve maternal mortality rates. The Health Resources and Services Administration (HRSA) will review agency level projects and funding. The Centers for Disease Control and Prevention (CDC), along with the Illinois Department of Public Health, will discuss their work to create or improve Maternal Mortality Reviews. Sarosh Rana, MD, MPH, will discuss her experience as a high-risk pregnancy provider and preeclampsia researcher. Presented by Health Resources and Services Administration (HRSA). https://www.eventbrite.com/e/hrsa-public-health-webinar-series-maternal-mortality-tickets-59327070866

May 21, 2019; 2—3 p.m. Housing as a Foundation for Good Health. The 2019 County Health Rankings take a closer look at how a secure, affordable home is a critical foundation for good health. Join us to explore the connection between housing and health and how where we live affects how well and how long we live. Sarah Norman, Director of Healthy Homes & Communities with NeighborWorks America, will highlight the ways in which partnerships among health, housing and community development stakeholders can strengthen affordable housing opportunities. Then, learn how Chelsea, MA, a 2017 RWJF Culture of Health Prize winner, is implementing a comprehensive housing strategy to address homelessness and housing in their community.  https://chrr.zoom.us/webinar/register/5215557012268/WN_EMmUpTUNQXqvbZlZulimCQ

May 22, 2019; 12:30–1:30 p.m. Addressing Medication Complexity Through Innovative Community-Based Strategies and Partnerships. Complicated drug regimens - which may include multiple drugs, multiple prescribers, and differing instructions for use - can be confusing and dangerous. In the U.S., 119,000 annual deaths are linked to prescription medication-related issues. The concern is compounded for individuals with complex needs, who may take as many as 15 - 20 medications daily. Presented by the Center for Healthcare Strategies, Inc. https://www.chcs.org/resource/addressing-medication-complexity-through-innovative-community-based-strategies-and-partnerships/?utm_source=CHCS+Email+Updates&utm_campaign=819d38d8e8-CMMC+Webinar+4%2F23%2F19&utm_medium=email&utm_term=0_bbced451bf-819d38d8e8-15213157

May 23, 2019; 2–3 p.m. Putting It Together: Combining Measurement Based Stepped Care for Suicide Prevention. After describing the key dimensions of systems thinking, including complexity, feedback, and system behavior over time, this session reviews and compares a team's hypotheses, findings, and decisions in response to a team's question: 1) What happens if we implemented both measurement-based care and stepped care? The session ends by pointing the learners to additional resources for using Modeling to Learn to guide improvements in clinical care. Presented by the U.S. Department of Veterans Affairs. https://register.gotowebinar.com/register/8211140039483066625

mrl-diamondCool websites and reports on hot topics*

A Guide to the Fundamentals of Economic Evaluation in Public Health – This guide from The University of North Carolina at Chapel Hill presents an overview of methods and tools that can help to inform public health decisions based on economic principles. Although the guide’s perspective is economic, the principles address health outcomes. The guide is intended for public health program planners, managers, and funders who are not familiar with economic evaluation but want to become familiar with its fundamentals. https://www.measureevaluation.org/resources/publications/ms-19-162

How a Public Health Goal Became a National Law: The Healthy, Hunger-Free Kids Act of 2010 – This case study provides insights into policy strategy and advocacy best practices that resulted in passage of the Healthy, Hunger-Free Kids Act of 2010 (HHFKA), a public health law that removed soda and other junk food from schools and resulted in unprecedented improvements to school meals with more whole grains, fruits and vegetables, and less salt and trans fat. From the Robert Wood Johnson Foundation (RWJF). https://healthyeatingresearch.org/research/how-a-public-health-goal-became-a-national-law-the-healthy-hunger-free-kids-act-of-2010/

The Return on Investment of Public Health System Spending – Improving the public’s health through prevention of disease is a strategy that makes good clinical and conceptual sense. But does it also make economic sense? This issue brief from AcademyHealth looks at the benefits of PHSSR spending on population health. https://www.academyhealth.org/sites/default/files/roi_public_health_spending_june2018.pdf

Southern States Slowly Embracing Harm Reduction to Curb Opioid Epidemic - Since the 1990s, activists in cities such as Chicago, San Francisco and New York have led the nation in practicing harm reduction, a set of tools such as needle exchanges and naloxone distribution designed to help people addicted to drugs make incremental improvements to their health. But in the Bible Belt, many Southerners who held conservative views often criticized harm reduction as something that encouraged — not ended — the use of drugs. Those practices, in many states, were banned outright. From Pew Charitable Trusts. https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2019/04/15/southern-states-slowly-embracing-harm-reduction-to-curb-opioid-epidemic

State of the ImmUnion Report - Every year, Vaccinate Your Family (VYF) writes and distributes a State of the ImmUnion report to help examine the strength of our defenses against vaccine-preventable diseases, and what we can do, as public health advocates and legislators, to make our country stronger and more resilient in the face of emerging health threats. https://www.vaccinateyourfamily.org/join-us-in-support-of-vaccines/make-a-national-impact/state-of-the-immunion-report/

Texas Public Health Association and Public Health Region VI Feature Section: ‘Oral Health: Targeting Rural Areas’ - The Texas Public Health Journal (TPHJ) devoted their spring journal issue to National Public Health Week, and offers a series of papers discussing oral health access and outreach to rural communities. https://cdn.ymaws.com/www.texaspha.org/resource/resmgr/docs/journal_files/tpha_oral_health_feature_nph.pdf

mrl-diamondInteresting journal articles*

Chaparro MP, Crespi CM, Anderson CE, Wang MC, Whaley SE. The 2009 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package change and children's growth trajectories and obesity in Los Angeles County. Am J Clin Nutr. 2019; pii: nqy347. doi: 10.1093/ajcn/nqy347. 
BACKGROUND: In 2009, for the first time since the program's inception in 1974, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) changed their food packages, providing food options better aligned with the 2005 Dietary Guidelines for Americans.
OBJECTIVE: The aim of this study was to evaluate whether the 2009 WIC food package change was associated with changes in growth trajectories from age 0 to 4 y or obesity at age 4 among children who participated in WIC in Los Angeles County between 2003 and 2016.
METHODS: Children were grouped into 1 of 4 exposure groups: full-dose, new food package group (participating in WIC from birth to age 4, post 2009, N = 70,120), full-dose, old food package group (participating from birth to age 4, pre 2009, N = 85,871), late-dose, new food package group (participating from age 2 to 4 y, post 2009, N = 8386), and late-dose, old food package group (participating from age 2 to 4 y, pre 2009, N = 18,241). Children were matched across groups on gender, race/ethnicity, maternal education and language, family income, and initial weight status, and matched analyses were performed. Longitudinal growth trajectories were modeled using piecewise linear spline mixed models, and differences in obesity at age 4 were compared using Poisson regression models.
RESULTS: Children receiving a full dose of the new food package had healthier growth trajectories and a lower obesity risk at age 4 than children receiving a full dose of the old food package (RR [95% CI]: 0.88 [0.86, 0.91] for boys, 0.90 [0.87, 0.93] for girls). Boys, but not girls, in the late-dose, new food package group had a lower obesity risk at age 4 compared with boys in the late-dose, old food package group (RR = 0.89, 95% CI = 0.81, 0.98).
CONCLUSIONS: The WIC food package change appears to be associated with improved childhood obesity outcomes. These findings are important in informing policymakers considering further improvements to the WIC food packages.

Chen F, Du M, Blumberg JB, et al. Association among dietary supplement use, nutrient intake, and mortality among U.S. adults: a cohort study. Ann Intern Med. 2019 Apr 9. doi: 10.7326/M18-2478. 
Background: The health benefits and risks of dietary supplement use are controversial.
Objective: To evaluate the association among dietary supplement use, levels of nutrient intake from foods and supplements, and mortality among U.S. adults.
Design: Prospective cohort study.
Setting: NHANES (National Health and Nutrition Examination Survey) data from 1999 to 2010, linked to National Death Index mortality data.
Participants: 30,899 U.S. adults aged 20 years or older who answered questions on dietary supplement use.
Measurements: Dietary supplement use in the previous 30 days and nutrient intake from foods and supplements. Outcomes included mortality from all causes, cardiovascular disease (CVD), and cancer.
Results: During a median follow-up of 6.1 years, 3,613 deaths occurred, including 945 CVD deaths and 805 cancer deaths. Ever-use of dietary supplements was not associated with mortality outcomes. Adequate intake (at or above the Estimated Average Requirement or the Adequate Intake level) of vitamin A, vitamin K, magnesium, zinc, and copper was associated with reduced all-cause or CVD mortality, but the associations were restricted to nutrient intake from foods. Excess intake of calcium was associated with increased risk for cancer death (above vs. at or below the Tolerable Upper Intake Level: multivariable-adjusted rate ratio, 1.62 [95% CI, 1.07 to 2.45]; multivariable-adjusted rate difference, 1.7 [CI, -0.1 to 3.5] deaths per 1000 person-years), and the association seemed to be related to calcium intake from supplements (≥1000 mg/d vs. no use: multivariable-adjusted rate ratio, 1.53 [CI, 1.04 to 2.25]; multivariable-adjusted rate difference, 1.5 [CI, -0.1 to 3.1] deaths per 1,000 person-years) rather than foods.
Limitations: Results from observational data may be affected by residual confounding. Reporting of dietary supplement use is subject to recall bias.
Conclusion: Use of dietary supplements is not associated with mortality benefits among U.S. adults.

Christensen DL, Maenner MJ, Bilder D, et al. Prevalence and characteristics of autism spectrum disorder among children aged 4 years - early autism and developmental disabilities monitoring network, seven sites, United States, 2010, 2012, and 2014. MMWR Surveill Summ. 2019; 68(2):1-19. 
PROBLEM/CONDITION: Autism spectrum disorder (ASD) is estimated to affect up to 3% of children in the United States. Public health surveillance for ASD among children aged 4 years provides information about trends in prevalence, characteristics of children with ASD, and progress made toward decreasing the age of identification of ASD so that evidence-based interventions can begin as early as possible.
PERIOD COVERED: 2010, 2012, and 2014.
DESCRIPTION OF SYSTEM: The Early Autism and Developmental Disabilities Monitoring (Early ADDM) Network is an active surveillance system that provides biennial estimates of the prevalence and characteristics of ASD among children aged 4 years whose parents or guardians lived within designated sites. During surveillance years 2010, 2012, or 2014, data were collected in seven sites: Arizona, Colorado, Missouri, New Jersey, North Carolina, Utah, and Wisconsin. The Early ADDM Network is a subset of the broader ADDM Network (which included 13 total sites over the same period) that has been conducting ASD surveillance among children aged 8 years since 2000. Each Early ADDM site covers a smaller geographic area than the broader ADDM Network. Early ADDM ASD surveillance is conducted in two phases using the same methods and project staff members as the ADDM Network. The first phase consists of reviewing and abstracting data from children's records, including comprehensive evaluations performed by community professionals. Sources for these evaluations include general pediatric health clinics and specialized programs for children with developmental disabilities. In addition, special education records (for children aged ≥3 years) were reviewed for Arizona, Colorado, New Jersey, North Carolina, and Utah, and early intervention records (for children aged 0 to <3 years) were reviewed for New Jersey, North Carolina, Utah, and Wisconsin; in Wisconsin, early intervention records were reviewed for 2014 only. The second phase involves a review of the abstracted evaluations by trained clinicians using a standardized case definition and method. A child is considered to meet the surveillance case definition for ASD if one or more comprehensive evaluations of that child completed by a qualified professional describes behaviors consistent with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) diagnostic criteria for any of the following conditions: autistic disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS, including atypical autism), or Asperger disorder (2010, 2012, and 2014). 
For 2014 only, prevalence estimates based on surveillance case definitions according to DSM-IV-TR and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) were compared. This report provides estimates of overall ASD prevalence and prevalence by sex and race/ethnicity; characteristics of children aged 4 years with ASD, including age at first developmental evaluation, age at ASD diagnosis, and cognitive function; and trends in ASD prevalence and characteristics among Early ADDM sites with data for all 3 surveillance years (2010, 2012, and 2014), including comparisons with children aged 8 years living in the same geographic area. Analyses of time trends in ASD prevalence are restricted to the three sites that contributed data for all 3 surveillance years with consistent data sources (Arizona, Missouri, and New Jersey).
RESULTS: The overall ASD prevalence was 13.4 per 1,000 children aged 4 years in 2010, 15.3 in 2012, and 17.0 in 2014 for Early ADDM sites with data for the specific years. ASD prevalence was determined using a surveillance case definition based on DSM-IV-TR. Within each surveillance year, ASD prevalence among children aged 4 years varied across surveillance sites and was lowest each year for Missouri (8.5, 8.1, and 9.6 per 1,000, for 2010, 2012, and 2014, respectively) and highest each year for New Jersey (19.7, 22.1, and 28.4 per 1,000, for the same years, respectively). Aggregated prevalence estimates were higher for sites that reviewed education and health care records than for sites that reviewed only health care records. Among all participating sites and years, ASD prevalence among children aged 4 years was consistently higher among boys than girls; prevalence ratios ranged from 2.6 (Arizona and Wisconsin in 2010) to 5.2 boys per one girl (Colorado in 2014). In 2010, ASD prevalence was higher among non-Hispanic white children than among Hispanic children in Arizona and non-Hispanic black children in Missouri; no other differences were observed by race/ethnicity. Among four sites with ≥60% data on cognitive test scores (Arizona, New Jersey, North Carolina, and Utah), the frequency of co-occurring intellectual disabilities was significantly higher among children aged 4 years than among those aged 8 years for each site in each surveillance year except Arizona in 2010. The percentage of children with ASD who had a first evaluation by age 36 months ranged from 48.8% in Missouri in 2012 to 88.9% in Wisconsin in 2014. The percentage of children with a previous ASD diagnosis from a community provider varied by site, ranging from 43.0% for Arizona in 2012 to 86.5% for Missouri in 2012. The median age at earliest known ASD diagnosis varied from 28 months in North Carolina in 2014 to 39.0 months in Missouri and Wisconsin in 2012. In 2014, the ASD prevalence based on the DSM-IV-TR case definition was 20% higher than the prevalence based on the DSM-5 (17.0 versus 14.1 per 1,000, respectively). Trends in ASD prevalence and characteristics among children aged 4 years during the study period were assessed for the three sites with data for all 3 years and consistent data sources (Arizona, Missouri, and New Jersey) using the DSM-IV-TR case definition; prevalence was higher in 2014 than in 2010 among children aged 4 years in New Jersey and was stable in Arizona and Missouri. In Missouri, ASD prevalence was higher among children aged 8 years than among children aged 4 years. The percentage of children with ASD who had a comprehensive evaluation by age 36 months was stable in Arizona and Missouri and decreased in New Jersey. In the three sites, no change occurred in the age at earliest known ASD diagnosis during 2010-2014.
INTERPRETATION: The findings suggest that ASD prevalence among children aged 4 years was higher in 2014 than in 2010 in one site and remained stable in others. Among children with ASD, the frequency of cognitive impairment was higher among children aged 4 years than among those aged 8 years and suggests that surveillance at age 4 years might more often include children with more severe symptoms or those with co-occurring conditions such as intellectual disability. In the sites with data for all years and consistent data sources, no change in the age at earliest known ASD diagnosis was found, and children received their first developmental evaluation at the same or a later age in 2014 compared with 2010. Delays in the initiation of a first developmental evaluation might adversely affect children by delaying access to treatment and special services that can improve outcomes for children with ASD.
PUBLIC HEALTH ACTION: Efforts to increase awareness of ASD and improve the identification of ASD by community providers can facilitate early diagnosis of children with ASD. Heterogeneity of results across sites suggests that community-level differences in evaluation and diagnostic services as well as access to data sources might affect estimates of ASD prevalence and age of identification. Continuing improvements in providing developmental evaluations to children as soon as developmental concerns are identified might result in earlier ASD diagnoses and earlier receipt of services, which might improve developmental outcomes.

Dunlop DD, Song J, Hootman JM, et al. One hour a week: moving to prevent disability in adults with lower extremity joint symptoms. Am J Prev Med. 2019; 56(5):664-672. 
INTRODUCTION: Physical activity guidelines recommend minimum thresholds. This study sought to identify evidence-based thresholds to maintain disability-free status over 4 years among adults with lower extremity joint symptoms.
METHODS: Prospective multisite Osteoarthritis Initiative accelerometer monitoring cohort data from September 2008 through December 2014 were analyzed. Adults (n=1,564) aged ≥49 years at elevated disability risk because of lower extremity joint symptoms were analyzed for biennial assessments of disability-free status from gait speed ≥1meter/second (mobility disability-free) and self-report of no limitations in activities of daily living (activities of daily living disability-free). Classification tree analyses conducted in 2017-2018 identified optimal thresholds across candidate activity intensities (sedentary, light, moderate-vigorous, total light and moderate-vigorous activity, and moderate-vigorous accrued in bouts lasting ≥10 minutes).
RESULTS: Minimal thresholds of 56 and 55 moderate-vigorous minutes/week best predicted disability-free status over 4 years from mobility and activities of daily living disabilities, respectively, across the candidate measures. Thresholds were consistent across sex, BMI, age, and knee osteoarthritis presence. Mobility disability onset was one eighth as frequent (3% vs 24%,
RR=0.14, 95% CI=0.09, 0.20) and activities of daily living disability onset was almost half (12% vs 23%, RR=0.55, 95% CI=0.44, 0.70) among people above versus below the minimum threshold.
CONCLUSIONS: Attaining an evidence-based threshold of approximately 1-hour moderate-vigorous activity/week significantly increased the likelihood of maintaining disability-free status over 4 years. This minimum threshold tied to maintaining independent living abilities has value as an intermediate goal to motivate adults to take action towards the many health benefits of a physically active lifestyle.

Gourevitch MN, Curtis LH, Durkin MS, et al. The emergence of population health in US academic medicine: a qualitative assessment. JAMA Netw Open. 2019; 2(4):e192200. doi: 10.1001/jamanetworkopen.2019.2200.
IMPORTANCE: In response to rapidly growing interest in population health academic medical centers are launching department-level initiatives that focus on this evolving discipline. This trend, with its potential to extend the scope of academic medicine, has not been well characterized.
OBJECTIVE: To describe the emergence of departments of population health at academic medical centers in the United States, including shared areas of focus, opportunities, and challenges.
DESIGN, SETTING, AND PARTICIPANTS: This qualitative study was based on a structured in-person convening of a working group of chairs of population health-oriented departments on November 13 and 14, 2017, complemented by a survey of core characteristics of these and additional departments identified through web-based review of US academic medical centers. United States medical school departments with the word population in their name were included. Centers, institutes, and schools were not included.
MAIN OUTCOMES AND MEASURES: Departments were characterized by year of origin, areas of focus, organizational structure, faculty size, teaching programs, and service engagement. Opportunities and challenges faced by these emerging departments were grouped thematically and described.
RESULTS: Eight of 9 population health-oriented departments in the working group were launched in the last 6 years. The 9 departments had 5 to 97 full-time faculty. Despite varied organizational structures, all addressed essential areas of focus spanning the missions of research, education, and service. Departments varied significantly in their relationships with the delivery of clinical care, but all engaged in practice-based and/or community collaboration. Common attributes include core attention to population health-oriented research methods across disciplines, emphasis on applied research in frontline settings, strong commitment to partnership, interest in engaging other sectors, and focus on improving health equity. Tensions included defining boundaries with other academic units with overlapping areas of focus, identifying sources of sustainable extramural funding, and facilitating the interface between research and health system operations.
CONCLUSIONS AND RELEVANCE: Departments addressing population health are emerging rapidly in academic medical centers. In supporting this new framing, academic medicine affirms and strengthens its commitment to advancing population health and health equity, to improving the quality and effectiveness of care, and to upholding the social mission of medicine.

Krueger PM, Dehry IA, Chang VW. The economic value of education for longer lives and reduced disability. Milbank Q. 2019; 97(1):48-73. doi: 10.1111/1468-0009.12372.
POLICY POINTS: Although it is well established that educational attainmen improves health and longevity, the economic value of this benefit is unknown. We estimate that the economic value of education for longer, healthier lives is comparable to or greater than the value of education for lifetime earnings. Policies that increase rates of completion of high school and college degrees could result in longer, healthier lives and substantial economic value for the population. We provide a template for assigning an economic value to the health benefits associated with education or other social determinants, allowing policymakers to prioritize those interventions that yield the greatest value for the population.
CONTEXT: Policymakers often frame the value of educational attainment in terms of economic outcomes (eg, employment, productivity, wages). But that approach may understate the value of education if it ignores the economic value of both longer lives and the reduced disability associated with more education.
METHODS: In this article, we estimated the present value of the longer life and reduced disability associated with higher educational attainment at age 25 through age 84. We used prospective survival data and cross-sectional disability data from the National Health Interview Survey-Linked Mortality Files and drew on published estimates of the economic value of a statistical life. In addition, we used data from the Current Population Survey-Annual Social and Economic supplement to estimate the present value of education for lifetime earnings at age 25 through age 64 in order to provide a benchmark for comparing the value of education for health.
FINDINGS: Compared with those with less than a high school degree, the longer lives of those with a high school degree are worth an additional $450,000 for males and $479,000 for females, and the additional disability-adjusted life for those with a high school degree is worth $693,000 for males and $757,000 for females. By comparison, the additional lifetime earnings for those with a high school degree, rather than less than a high school degree, is $213,000 for males and $194,000 for females. Compared with those with a high school degree, the longer lives for those with a baccalaureate degree are worth an additional $446,000 for males and $247,000 for females. The value of the additional disability-adjusted life associated with having a baccalaureate degree rather than a high school degree is $611,000 for males and $407,000 among females. By comparison, the additional lifetime earnings for those with a baccalaureate degree, rather than a high school degree, is $628,000 for males and $459,000 for females.
CONCLUSIONS: The value of education for longer, healthier lives may surpass the value for earnings. Estimates of the economic value of the social determinants of health, such as education, can help policymakers prioritize those policies that provide the greatest value for population health.

Segel JE, Shi Y, Moran JR, Scanlon DP. Revenue losses to state and federal government from opioid-related employment reductions. Med Care. 2019 Mar 5. doi: 10.1097/MLR.0000000000001107. [Epub ahead of print]
OBJECTIVE: The main purpose of this study was to estimate the tax revenue lost by state and federal governments as a result of adverse labor market outcomes attributable to opioid misuse.
METHODS: We pair existing, plausibly causal estimates of the effect of opioi misuse on the decline in the labor force from 2000 to 2016 with a variety of data sources to compute tax revenues lost by state and federal governments using the online TAXSIM calculator.
RESULTS: We find that between 2000 and 2016, opioid misuse cost state governments $11.8 billion, including $1.7 billion in lost sales tax revenue and $10.1 billion in lost income tax revenue. In addition, the federal government lost $26.0 billion in income tax revenue.
CONCLUSIONS: By omitting lost tax revenue due to labor force exits, prior studies have missed an important component of opioid-related costs borne by state and federal governments.
POLICY IMPLICATIONS: As more states and the federal government contemplate litigation for opioid-related damages, lost tax revenue represents an important cost that could be recouped and allocated to opioid prevention and treatment programs.

mrl-diamondNew books*

1. The Absolutely Essential Guide to Meeting Survival by Vic Parrish.
2. And Yet We Rise by David Borden.
3. Assessment of Autism Spectrum Disorder, 2nd ed., ed. Sam Goldstein.
4. Collaborating for Results: Silo Working and Relationships That Work by David Ian Willcock.
5. Fit Happens! Simple Steps for a Healthier, More Productive Life! by Todd Whitthorne.
6. A Guide to the Project Management Body of Knowledge (PMBOK guide), 6th ed.
7. Nurturing Personal, Social and Emotional Development in Early Childhood: A Practical Guide to Understanding Brain Development and Young Children's Behaviour by Debbie Garvery.
8. Opidemic: A Public Health Epidemic by J. Kimber Rotchford.
9. PMP Exam Prep: Rita's Course in a Book for Passing the Project Management Professional, 9th ed., Rita Mulcahy. 
10. R in Action: Data Analysis and Graphics with R, 2nd ed., by Robert L. Kabacoff.
11. Treating Infants and Young Children Impacted by Trauma: Interventions that Promote Healthy Development by Joy D. Osfsky.

*For More Information:  Employees may contact the Medical and Research Library at library@dshs.texas.gov, call 512-776-7559, or come by Moreton Building, Room M-652, to borrow a print book, receive password access to a journal, receive other research assistance, or to obtain full-text of the articles mentioned in this month's news. If you are not located on the main campus in Austin, simply let us know what you would like to borrow and we will mail it to you.

Fine print section: If any of the internet links do not open for you, please let us know and we will send you what you need. The MRL Library News e-mail is sent about once a month or when important library news or events occur. If you have co-workers who would like to subscribe, please e-mail library@dshs.texas.gov. If for any reason you would like to unsubscribe, please send an e-mail to library@dshs.texas.gov with Unsubscribe in the subject line. Recent issues of this newsletter are on the web at http://www.dshs.texas.gov/library/news.aspx. Thank you!

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Last updated May 2, 2019