TIME Innovation

Five Best Ideas of the Day: April 16

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. Go ahead and start a new career in your fifties. It’s easier than you think.

By Donna Rosato in Money

2. This is what sex-ed would look like if it took place entirely on social media.

By Kate Hakala in Mic

3. Here’s why the FDA doesn’t really know what’s in our food.

By Erin Quinn and Chris Young at the Center for Public Integrity

4. What critical resource helps the sharing economy make billions? People trusting people.

By the editorial board of the Christian Science Monitor

5. Could a continent-wide CDC for Africa stop the next Ebola outbreak?

By Jim Burress at National Public Radio

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Infectious Disease

African CDC to Open in 2015

The goal for the agency is to support the continent with active disease surveillance and response

Secretary of State John Kerry signed an agreement Monday to help establish a Centers for Disease Control and Prevention (CDC) in Africa.

The memorandum of cooperation, signed by Kerry and African Union Commission (AUC) Chairperson Nkosanzana Dlamini Zuma, makes formal the relationship between the United States CDC and AUC, and mandates the establishment of an African CDC. The new institute, set to launch in 2015, will work to prevent and respond to future outbreaks in the continent, like the Ebola epidemic.

“The West African Ebola epidemic reaffirmed the need for a public health institute to support African ministries of health and other health agencies in their efforts to prevent, detect, and respond to any disease outbreak,” said CDC director Dr. Tom Frieden, in a statement. “This memorandum solidifies the commitment by the United States to advance public health across Africa and global health security.”

The formation of an African CDC has been under development for a few years, and the physical launch of the health institute will happen later this year. An African Surveillance and Response Unit will be established with an emergency operations center. Five regional centers will also be identified with a coordinating center in Ethiopia’s capital, Addis Ababa. Like the U.S. CDC, there will be epidemiologists at the various locations who will perform disease surveillance, investigation and tracking of infection trends. The new unit will also provide response expertise during large outbreaks.

“With the African CDC in place, these volunteers and others can be organized to form a deployable force ready to serve Member States during future health emergency responses on the continent,” said a CDC statement.

TIME Sex/Relationships

Teens Aren’t Using the Most Effective Birth Control

IUD birthcontrol
Photo Illustration by Mia Tramz for TIME; Corbis

A new CDC report reveals few teens use IUDs and implants

American teenagers are getting better at practicing safe sex, but a new federal report reveals very few teens are using the most effective forms of birth control.

In the new report, the Centers for Disease Control and Prevention (CDC) looked at 2005–2013 data from the Title X National Family Planning Program on teen contraceptive use and found that teen use of long-acting reversible contraception (LARC)—such as the intrauterine device (IUD) and the implant—are up but still very low. The numbers show that U.S. teen LARC use increased from under 1% in 2005 to 7% in 2013. Implants were used more than IUDs by women of all ages. The state with the highest use of LARC among its teens in 2013 was Colorado at 26%. All other states ranged from use of less than 1% to 20%.

Currently, teens are opting for methods like condoms and birth control pills, which while still good options, are less effective and more prone to incorrect or inconsistent use.

MORE: Why The Most Effective Form of Birth Control is the One No One Uses

The benefit of contraceptives like the IUD and implant are that they are low maintenance and highly effective. For example, the typical use failure rate of the IUD is 0.2% and for the implant it’s 0.05%. By comparison, the birth control pill and vaginal ring have a failure rate of 9% and condoms have a fail rate of 18%.

In 2012, the American Congress of Obstetricians and Gynecologists (ACOG), considered an authority on reproductive health, concluded that IUDs and implants are safe and appropriate for adolescents and teens. In 2014, the American Academy of Pediatrics (AAP) agreed and said it recommends LARC for adolescents.

“Long-acting reversible contraception is safe for teens, easy to use, and very effective,” said CDC principal deputy director Ileana Arias in a statement. “We need to remove barriers and increase awareness, access, and availability of long-acting reversible contraception such as IUDs and implants.”

CDC

According to the new CDC report, there are a variety of reasons why a young person may not opt for the IUD or implant. Many teens don’t know very much about them and they often think they are too young to use them. As TIME reported in June, some physicians may remember the IUDs of past, which caused severe problems for women and were discontinued. Modern-day IUDs are safe and appropriate but there are still misperceptions about the device that persist within the medical community. Many providers are also not properly trained on insertion or removal of the IUD and implant. However, a recent report showed that among female health care providers 42% use LARC, which is much higher than both the general population of teens and adult women.

Overall, the CDC report shows that American teens are waiting to have sex, and when they are sexually active, nearly 90% report using birth control. The teen pregnancy rate in the United States appears to be steadily dropping, though in 2013 over 273,000 babies were born to girls between ages 15 and 19. The CDC says encouraging young women to consider LARC is an important strategy for further reducing teen pregnancy.

TIME Infectious Disease

Travelers Are Bringing a Superbug into the United States

CDC

The bug is resistant to the antibiotics used to treat it

Some international travelers are bringing back and spreading a bacteria that’s resistant to the drugs used to treat it, the U.S. Centers for Disease Control and Prevention (CDC) reported on Thursday in an investigation published in the CDC’s Morbidity and Mortality Weekly Report.

The bug, called shigella sonnei, causes an estimated 500,000 cases of diarrhea in the U.S. each year, and the CDC reports that between May 2014 and February 2015, a drug-resistant strain infected 243 people in 32 states and Puerto Rico. When investigating clusters of shigellosis—the infection caused by shigella—in Massachusetts, California and Pennsylvania, the CDC discovered that 90% of the cases were resistant to an antibiotic called ciprofloxacin (Cipro), which is the drug of choice when treating shigellosis.

Most shigella strains are already resistant to other drugs used to treat it, and public health experts have noted that a Cipro-resistant strain is spreading worldwide. The bacteria can spread very quickly and are commonly discovered in places like childcare centers and nursing homes, according to the report.

“Drug-resistant infections are harder to treat and because Shigella spreads so easily between people, the potential for more—and larger—outbreaks is a real concern,” said CDC director Dr. Tom Frieden in a statement. Frieden added that the recent outbreaks reveal a “troubling trend” of infections in the U.S.

The CDC was first alerted to a new strain of shigella in December 2014 and discovered in the lab that it was resistant to Cipro. The CDC then investigated several large clusters of shigella infections across the United States. Nearly 100 cases were from an outbreak among homeless people in San Francisco, and others were related to international travel. Infection can be common among people who travel to developing countries.

The CDC says international travelers should wash their hands “meticulously” and be cautious about food and water consumption. Travelers can download the CDC’s app, “Can I Eat This?” as a guide for what’s safe to eat while traveling.

Antibiotic resistance is becoming a growing global problem; in September 2014, President Obama signed an executive order to create a task force to tackle the issue of antibiotic-resistant bacteria.

TIME Addiction

A New Government Anti-Smoking Campaign Includes E-Cigs

Past campaigns have increased calls to quitlines by 80%

A new federal ad campaign against smoking features e-cigarettes for the first time.

The U.S. Centers for Disease Control and Prevention (CDC) released its latest ad in its ongoing “Tips From Former Smokers” campaign. The campaign features real Americans who have experienced serious health or social consequences from smoking. Often the ads are explicit. On March 30, the first ad about e-cigarettes, as opposed to traditional tobacco, will air.

The ad features a 35-year-old woman named Kristy who picked up e-cigarettes as a way to quit smoking. She ended up using both products. Eventually she had a collapsed lung and was diagnosed with lung disease. She’s a married mother of three who works as a truck driver.

Kristy's Tip Print Full Page Ad
CDC

“Nationally, about 3 in 4 adult e-cigarette users also smoke cigarettes,” the CDC says in a statement. “If you only cut down the number of cigarettes you smoke by adding another tobacco product, like e-cigarettes, you still face serious health risks.”

Other ads focus on side effects like vision loss and colorectal cancer.

In 2014, the CDC says the national quit line received 80% more calls when the ads were on the air, and since 2012 the ads have generated more than 500,000 additional calls. The ads will run for 20 weeks on TV, radio, online, billboards, in theaters and in magazines and newspapers. Kristy’s ads will be on the radio and in print.

The ads encourage smokers to call 1-800-QUIT-NOW or visit www.cdc.gov/tips.

Read next: These 4D Ultrasound Photos Show How Fetuses Respond to Their Mothers’ Smoking

Listen to the most important stories of the day.

TIME Research

High Blood Pressure Related Deaths Are Way Up: CDC

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Hypertension is a factor in many U.S. deaths

Deaths related to high blood pressure, have risen significantly over the last 13 years, according to new federal data.

A new report from the U.S. Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics shows the number of hypertension-related deaths increased 61.8%, from 2000 to 2013. The researchers analyzed national cause-of-death data files and defined hypertension-related death as any mention of hypertension on the death certificate. They found that over the 13 year period, the rate rose for both sexes age 45 and older.

But report also found that the proportion of deaths where heart disease was the underlying cause of death dropped by about 6%. The proportion of deaths where stroke was the underlying cause also dropped by about 5%.

“In the areas we’ve been focusing on for the last two to three decades we really have seen a reduction in deaths,” says Dr. Clyde Yancy chief of the division of cardiology at Northwestern University’s Feinberg School of Medicine. “The lens has to increase now. This is an important message to get out that there are multiple reasons you want to get rid of hypertension, not just reducing stroke and heart disease, but minimizing the impact on diabetes and reducing your risk for cancer.” Yancy was not involved in the research.

While it is generally accepted that high blood pressure can lead to heart-related problems, studies have also shown links between hypertension and other chronic diseases. For instance, prior data has shown that hypertension can increase the risk of dying from cancer and developing the disease in the first place. The researchers report that heart disease, stroke, cancer and diabetes accounted for 65% of all the deaths with a mention of hypertension in 2000 and 54% in 2013.

Overall, the report shows that one out of six hypertension-related deaths was due to high blood pressure as the underlying cause. In the other deaths, high blood pressure was listed as a contributing factor.

TIME public health

Scathing Report Calls Lab Safety at CDC ‘Insufficient’

The Centers for Disease Control Buildings in Atlanta on June 20, 2014.
Tami Chappell – Reuters The Centers for Disease Control Buildings in Atlanta on June 20, 2014.

A new public report from outside experts assessing laboratory safety at the U.S. Centers for Disease Control and Prevention (CDC) comes down severely on the government agency.

In 2014 and early 2015, the CDC was the site of a series of mishaps, from a lab technician the agency thought was potentially exposed to live Ebola virus through an accidental tube swap to the possible release of anthrax. In response, the agency formed an external laboratory safety workgroup to assess the CDC’s internal protocols and provide advice and recommendations. The CDC just publically posted the report, which describes the CDC’s commitment to safety as “inconsistent and insufficient at multiple levels,” to its website.

“Safety is not integrated into strategic planning and is not currently part of the CDC culture, enterprise-wide,” the report says. “Interviews and surveys demonstrated that many employees neither understand the agency’s response to accidents nor how that information is communicated to the larger agency community outside immediately affected labs.”

The authors write that “disturbingly” many of these responses were among people who work in the CDC’s highest biosafety level labs. “Laboratory safety training is inadequate,” the report authors write, adding that across the CDC, workers say they fear negative repercussions for reporting instances where there may have been an exposure to hazardous material. Staff at the CDC view the Environment, Safety, and Health Compliance Office (ESHCO)—the office meant to protect CDC workers and create a safe working environment—as having “inadequate expertise” in lab safety, the report says.

The report makes recommendations, like “staffing [ESHCO] with scientists with professional qualifications in research and/or laboratory safety” and establishing consistent safety practices across the agency.

“CDC concurs with these recommendations, has made progress towards implementing them, and will soon report on that progress,” the CDC says in a statement on its website. “CDC’s aim is to improve the culture of laboratory safety across the agency and minimize the risks associated with laboratory work.”

“It should be noted that although the [workgroup] presented its findings to the full committee in January, it began its review of CDC’s laboratories last August and did the bulk of its assessment at CDC in August and September,” CDC spokesman Tom Skinner told TIME. “So the said report reflects observations of the workgroup made several months ago.”

Skinner the CDC has made progress, and is implementing actions to “address the root causes of recent incidents and to provide redundant safeguards across the agency.” Some of these changes include establishing new positions for lab safety oversight and implementing new training procedures and safety protocols.

TIME Cancer

66% of People Diagnosed with Cancer Survive At Least 5 Years

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Two out of three people with invasive cancer survive five years or more

Two out of three Americans with invasive cancer—the kind that has spread to nearby healthy tissue—are living five years or more after diagnosis, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC).

Data has shown that early detection and innovation in cancer treatment have increased the number of cancer survivors over the last several years, and the new report, published in the CDC’s Morbidity and Mortality Weekly Report, shows that even patients with invasive cancer have encouraging survival rates.

To reach these numbers, CDC researchers looked at the number of cancer cases reported to U.S. cancer registries in 2011, the year of the most recently available data. That year saw 1,532,066 invasive cancer cases, or 451 cases per 100,000 people.

The CDC reports that the most common cancer sites were prostate, breast, lung, and colon and rectum. The five-year survival rates for those cancers came out to 97% for prostate cancer, 88% for breast cancer, 63% for colorectal cancer and 18% for lung cancer. While the rates were relatively even among men and women, racial disparities existed; 65% of white people had a five-year relative survival rate, and 60% of black people had the same.

In the report, the researchers say they hope public health experts use the data to determine what groups of people have higher rates of cancer and lower rates of survival. These groups may benefit most from cancer control efforts. “Using these data to effectively develop comprehensive cancer control programs, including supporting the needs of cancer survivors, can help reduce cancer incidence and improve survival,” the authors write.

TIME Addiction

Heroin-Related Deaths Have Quadrupled in America

New federal data reports bad news for America's heroin problem

Correction appended, March 5

Heroin-related deaths nearly tripled in the U.S. within just three years and quadrupled in 13, according to new federal data.

The new report from the National Center for Health Statistics (NCHS) shows that from 2000 to 2013, drug-poisoning deaths involving heroin increased fourfold, from 0.7 deaths per 100,000 people to 2.7 deaths per 100,000 people. The rate was about four times higher among men than among women in 2013.

Heroin-related drug-poisoning deaths have increased in all age groups, races and ethnic groups, the data show. Every region in the U.S. also experienced an increase, and the Midwest experienced the biggest jump.

One reason for the spike is America’s growing painkiller problem. The NCHS released another report last month showing that significantly more people over age 20 are using opioids. The number of people who used a painkiller stronger than morphine increased from 17% to 37% from the early 2000s to about a decade later.

CDC/NCHS, National Vital Statistics System, Mortality.

People who are hooked on painkillers may make the switch to heroin since it’s cheaper and doesn’t need a prescription, according to Dr. Andrew Kolodny, the chief medical officer of the Phoenix House, a national nonprofit drug and alcohol-rehabilitation organization. Both drugs come from the opium poppy and therefore offer a similar high. “We are seeing heroin deaths sky rocketing because we have an epidemic of people addicted to opioids. There are new markets like suburbs where heroin didn’t used to exist,” says Kolodny. (He was not involved in the research.)

MORE Why You Don’t Know About the Heroin Vaccine

Prior data from the Centers for Disease Control and Prevention show that painkillers are a growing problem. In 2014, the CDC reported that physicians wrote 259 million painkiller prescription in a single year — the equivalent of a bottle of pills per American — and almost 50 Americans die every day from a prescription-painkiller overdose. The agency recommends that states run prescription-drug prescribing databases to track overprescribing and consider policies that reduce risky prescribing practices.

As states and the White House struggle to tackle opioid addiction, some experts are skeptical about whether such efforts are enough to solve the problem. “We are dealing with the worst drug epidemic in our history,” says Kolodny. “There’s no evidence it’s plateauing.”

Read next: Ohio Steps Up Fight Against Heroin Deaths

Listen to the most important stories of the day.

Correction: An earlier version of this article misstated the timeline of the U.S. heroin-related death rate.

TIME Addiction

America’s Pain Killer Problem is Growing, Federal Data Shows

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New data shows America's use of opioids hasn't declined

New federal data released Wednesday reveals the state of America’s pain killer use.

According to the numbers released by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS), the percentage of adults age 20 and over using prescription pain killers remains significantly higher than in the past, with people also taking stronger painkillers than before. Between 2011–2012, nearly 7% of adults reported using a prescription opioid analgesic in the past 30 days, compared to 5% in 2003-2006.

MORE: The Problem With Treating Pain in America

The report also shows that when comparing data from 1999–2002 with 2011–2012, the number of prescription pain killer users who took a medication stronger than morphine increased from 17.0% to 37%. Given the growth of pain killer addiction and related deaths, high usage makes many public health experts uneasy. Prior data from the CDC has also shown that nearly 50 Americans die from an overdose of prescription painkillers every day.

In 2014, the CDC found that doctors wrote 259 million prescriptions for pain killers in a single year, which is enough for every U.S. adult to have a bottle of pills.

The new data shows that women are more likely than men to be using prescription pain killers. Non-Hispanic white adults were more likely to use opioid analgesics than Hispanic adults. There was no difference between non-Hispanic white adults and non-Hispanic black adults.

MORE: Why You’ve Never Heard of the Vaccine For Heroin Addiction

As TIME has recently reported, the growing opioid addiction problem is seeding a heroin problem. Since both drugs come from the opioid poppy, they offer similar highs, but heroin, while illegal, is cheaper and doesn’t require a prescription. As states across the nation face opioid issues, the CDC will continue to recommend states step up to the task of keeping an eye on prescribing practices. Some strategies recommended by the CDC are implementing state-run databases that track prescriptions in order to determine any over-prescribing problems as well as introducing policies that discourage risky prescribing among pain clinics.

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