Online-only: Public health extras: News on walking, TB, reform, apps, infections
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## Walking is up, but more is needed

More U.S. adults are walking to get physically active, but for most it is still not enough, according to an August “Vital Signs” report from the Centers for Disease Control and Prevention.

Sixty percent of adults reported walking at least once for 10 minutes or more in the previous week in 2010, which is up from 56 percent in 2005. But while an increase in physical activity is good news, CDC reported that fewer than half of U.S. adults are participating in enough physical activity to improve their health.

The CDC report found that the highest percentage of people who walk live in western regions, while people in the South showed the largest improvements in walking rates, up from 49 percent in 2005 to 57 percent in 2010. Also, more adults living with arthritis and hypertension reported walking. No increases in walking were found among adults with Type 2 diabetes.

“People who are physically active live longer and are at lower risk for heart disease, stroke, Type 2 diabetes, depression and some cancers,” said CDC Director Thomas Frieden, MD, MPH. “Having more places for people to walk in our communities will help us to continue to see increases in walking, the most popular form of physical activity among American adults.”

For a copy of the report, visit [www.cdc.gov/vitalsigns](http://www.cdc.gov/vitalsigns).

## Laypeople a boon to TB detection

A new study finds that non-health professionals — or laypeople — can significantly help efforts to identify tuberculosis cases.

To increase uptake of free tuberculosis diagnosis and treatment in Pakistan, researchers implemented a year-long mass marketing strategy and invited local residents to apply to be screeners, according the study published in June in the Lancet. Screeners were trained in national tuberculosis program guidelines and stationed at 54 geographically dispersed family clinics that served 50 or more patients per day. Screeners received cash incentives for case detection and used mobile phone software to assess patients and visitors in family clinic waiting rooms and in a hospital outpatient department.

From January 2011 to December 2011, screeners assessed more than 388,000 people at family clinics, identifying more than 6,000 people suspected to have tuberculosis. Throughout the entire intervention area, the number of tuberculosis notifications doubled when compared to 2010 numbers.

“Engagement of community members as drivers of case detection…can create highly productive links between the public sector, private practitioners and communities,” study authors wrote.

To read the full study, visit [www.thelancet.com](http://www.thelancet.com).

## Health reform good for Maryland economy

In Maryland, the nation’s health reform law is projected to boost the state’s economy.

According to a report released in July, implementation of the 2010 Patient Protection and Affordable Care Act will benefit the state budget by more than $600 million through 2020, produce more than $3 billion in annual economic activity and create more than 26,000 jobs.

By 2020, the health reform law is projected to generate $237 million in additional state and local tax revenue annually, according to “Maryland Health Care Reform Simulation Model: Detailed Analysis and Methodology,” which was conducted by the Hilltop Institute at the University of Maryland-Baltimore County. Expanded insurance access via health reform is expected to bring health coverage to 333,000 more Maryland residents by fiscal year 2020.

“By moving forward with implementation, we are supporting healthy and strong citizens, families, communities and businesses,” said Maryland Gov. Martin O’Malley in a news release.

For a copy of the report, visit [www.hilltopinstitute.org](http://www.hilltopinstitute.org).

## Sinks tied to hospital infections

Dirty sinks were the culprits in rash of hospital-acquired infections in a Toronto hospital from 2006 to 2011, according to a study published in the August issue of Emerging Infectious Diseases.

From October 2006 to March 2011, 66 patients were infected with Klebsiella oxytoca, a pathogen primarily picked up in health care settings and involving patients with compromised immune systems or those in intensive care. Infections continued despite reinforcing infection control practices, periodic screenings and limiting contact with infected patients. At the beginning of the outbreak, a number of potential environmental sources were tested, such as shared medical equipment, ice machines and soap. But none were identified as the source. Eventually, cultures taken from hand-washing sinks in the hospital’s intensive care unit matched those taken from the clinical cases. No more infections occurred after a thorough sink sanitation regimen was put in place.

“This outbreak also emphasizes the challenges associated with limited space and sinks in older hospitals,” the study stated. “Presumptively, these hand-washing sinks became contaminated because they were used for the disposal of body fluids from colonized patients.”

To read the entire study, visit [www.cdc.gov/eid](http://www.cdc.gov/eid).

## Weight loss, exercise top health apps

Health-focused mobile phone apps related to weight loss and exercise top the app download list, according to a recent study conducted by a marketing firm.

The apps comprised more than half of downloads surveyed, followed by apps related to women’s health, sleep and meditation, pregnancy, tools and instruments, medical reference and medical emergencies. Top-grossing apps for both iPhone and Android were related to exercise, weight loss, sleep and meditation, and women’s health. However, the top 150 health apps for iPhone far outpaced downloads of Android’s top 150 health apps.

“Be it Android, Apple…or Google Play, the potent proliferation of these devices have become the springboard to the growth of the (health) applications market,” said study authors, who were with the Verasoni Worldwide.

To read the full study, visit [www.verasoni.com](http://www.verasoni.com).

*   Copyright The Nation’s Health, American Public Health Association