Health Programs - FAQs:

The Administration on Healthcare Research and Quality (AHRQ) offers an advice column on "Navigating the Health Care System" written by Dr. Carolyn Clancy. She has a column that can answer this and other related questions about compliants

Read her column: How to Complain--and Get Heard!

The HHS Heart Health Program has resources from many sources:

• The Heart Truth Campaign
  The Office of Women's Health provides resources for heart health Initiatives, including national campaigns, minority programs, meetings and conferences, publications, and evaluation programs.

• Heart Health and Stroke (Office on Women's Health)
  Learn about your risk for a heart attack or stoke with the resources on this site.

• Heart Health Online (Food and Drug Administration)
  This Web site gives you reliable information about the products used to prevent, diagnose, and treat cardiovascular disease. It includes full descriptions and patient instructions for many medications, medical devices, and diagnostic tests for cardiovascular disease.

• Heart and Vascular Diseases (National Heart, Lung, and Blood Institute)
  Learn about cholesterol, congenital heart defects, heart attack, high blood pressure, and other heart-related information.

• Lower Heart Disease Risk (National Heart, Lung, and Blood Institute, NIH)
  Find out about the risk factors for heart disease and what to do to learn if you are at risk.

• Understanding Your Body (Agency for Healthcare Research and Quality)
  Find the keys to heart health on this site which provides easy-to-understand explanations of body systems and disease conditions.

• Latino Cardiovascular Health Resources (National Heart, Lung, and Blood Institute)
  Learn about the Salud para su Corazon site which offers many educational materials in English and Spanish for the general public and community health planners.

• When Delicious Meets Nutritious: Recipes for Heart Health (PDF - 4 Pages) (National Heart, Lung, and Blood Institute)
  This brochure offers eight great recipes and tips to keeping the "heart" in your favorite recipes.

The Air Pollution and Respiratory Health Program (APRHB) leads HHS's fight against environmental-related respiratory illnesses, including asthma, and studies indoor and outdoor air pollution. For more information, you may want to visit these sites:

• Air Pollution and Respiratory Health (CDC)
  Learn about the CDC surveillance program that tracks asthma, influenza, and chronic obstructive pulmonary diseases, and find guidance for preventing environmentally-caused diseases.

• Indoor Air Pollution (NIH)
  Find information on indoor air pollutants, molds, radon, tobacco smoke, and volatile organic compounds.

• Outdoor Air Pollution (NIH)
  Learn about public and private partnerships addressing outdoor air pollution, research, laws, and

• Air Quality, Fires, and Volcanic Eruptions (CDC)
  Find prevention guidelines and other resources to help you protect yourself and your family from poor quality air caused by fire, volcanic eruptions, and other hazards.

• Air Pollution (MedlinePlus)(healthfinder)
  Learn the basics of air pollution and how they affect you and your family on MedlinePlus; and find a wide variety of air pollution information resources from healthfinder.

• Air Pollution Control Self-Inspection Checklist for Schools (CDC)
  With this tool, schools can self-check their indoor air equipment and learn if their situation complies with law or needs help from an outside expert.

• Indoor Air Quality Self-Inspection Checklist for Schools (CDC)
  This tool helps school districts determine the need for indoor air quality management plans.

• Smoking and Tobacco Use Health Effects (CDC)
  Learn about the impact of smoking on the health of your lungs, as well as the health of your family and friends.

• Respiratory Health & Air Pollution (CDC)
  Find resources on transportation-related air pollutants and other respiratory health issues.

• Environmental Hazards and Health Effects (CDC)
  Learn how the CDC works with state grantees to reduce death, hospitalizations, and missed work/school days due to environmental hazards.

Research Findings/Activities

• Air Pollution and Cardiovascular Disease in Women (NIH)
  This study describes the high impact of air pollution on the hearts of post-menopausal women.

• Air Pollution-Associated Changes in Lung Function among Asthmatic Children in Detroit (NIH)
  This research fond that lung function in children decreased when exposed to air pollutants.

• Effect of Particulate Air Pollution on Emergency Admissions for Heart Attack (NIH)
  This multi-city, case-crossover analysis found increased hospitalizations among the elderly in areas of high air pollution.

• Environmental Genome Project (NIH)
  This project is focusing on how human genetic variations impact on the tendency to have environmental health problems.

HHS programs specifically related to women's health can be found in several HHS agencies, including AHRQ, CDC, FDA, HRSA, and NIH. Check out the links below for additional information.

Women's Health (General)

• Women's Health (MedLinePlus)
• Women's Health (IHS)
• Women's Health Topics A-Z (CDC)
• Free Publications for Women and Their Families (FDA)
• Women's Health (AHRQ)

Preventive Health

• The Heart Truth, A National Awareness Campaign for Women about Heart Disease (NIH)
• Information for Women on Food Safety, Nutrition and Cosmetics (FDA)
• Women's Reproductive Health (CDC)
• Physical Activity and Health (CDC, Surgeon General)
• All Women Need Folic Acid, Every Day (CDC)
• Women's Safety and Health Issues at Work (CDC)
• Bladder Control for Women (NIH)

Diseases

• HIV/AIDS and Women (CDC)
• Women and HIV/AIDS (womenshealth.gov)
• HIV/AIDS Basics (AIDS.gov)
• Bleeding and Clotting Disorders in Women (CDC)
• Women's Cancers (NIH)

Research/Statistics

• Women's Health Initiative (NIH)
• Women's Health Statistics (womenshealth.gov)

Specific Populations

• Women with Disabilities (CDC)
• Minority Women's Health (womenshealth.gov)
• Women and Mental Health (NIH)

HHS Offices on Women's Health

• HHS Office of Women's Health
• CDC/ATSDR Office of Women's Health
• FDA Office of Women's Health
• National Women's Health Information Center

Families who earn too much to qualify for low-income Medicaid insurance may be able to qualify for the State Children's Health Insurance Program (SCHIP). The Centers for Medicare & Medicaid Services administer funds to States who are responsible for the program at the local level.

Families that do not currently have health insurance are likely to be eligible, even if not working. The states have different eligibility rules, but in most states, uninsured children under the age of 19, whose families earn up to $36,200 a year (for a family of four) are eligible. For little or no cost, this insurance pays for:

1. doctor visits
2. immunizations
3. hospitalizations
4. emergency room visits

For contact information for your state or to read specific information regarding eligibility in your state please access the Insure Kids Now site.

About 300 health care facilities nationwide are obligated to provide free or reduced-cost care (called Hill-Burton Facilities). You must apply for assistance at the facility. There are no facilities in Alaska, Indiana, Minnesota, Nebraska, Nevada, Rhode Island, Utah, or Wyoming, and all US territories except Puerto Rico. You can find a list of the facilities at: http://www.hrsa.gov/gethealthcare/affordable/hillburton/facilities.html

For more information about this program, you may want to visit the following sites:

• Hill-Burton Free and Reduced Cost Health Care (HRSA)
• Frequently Asked Questions about the Hill-Burton Program (HRSA)
   

The Hill-Burton Hotline:

• 1-800-638-0742
• 1-800-492-0359 in Maryland

Ryan White CARE Act Program provides primary health care and support services to uninsured and under-insured people living with HIV/AIDS. Contact information is available:

• Find Ryan White HIV/AIDS Medical Care Providers (HRSA)
• AIDS Drug Assistance Program and State contacts
• Community early intervention services contacts
• Infants, children, youth and women program contacts
   

AIDS.gov is the central location for finding government information about HIV and AIDS, including prevention, testing, and treatment resources, and funding opportunities.

• Cares for patients at its facility at the National Hansen's Disease (Leprosy) Clinical Center in Baton Rouge, Louisiana. It is the only facility in the US devoted to the diagnosis, treatment, and research concerning Hansen's Disease.
• Oversees Ambulatory Care Clinics clinics in Arizona, California, Florida, Illinois, Massachusetts, New York, Texas, Washington, and Puerto and makes referrals for treatment.
• Consults with private sector physicians and accepts referrals for patients with Hansen's disease-related complications.
• Advances treatment and educates medical professionals about Hansen's disease.
• Conducts biomedical research on Hansen's disease.
• Reaches out to medical professionals with a comprehensive Hansen's disease training program.

Frequently Asked Questions about Hansen's Disease

To find detailed information about the past performance of Medicare and Medicaid certified nursing homes, visit the Nursing Home Compare site. You can search by state, county, city, zip code, and/or facility name.

Learn More:

• Frequently Asked Questions about Nursing Home Compare (Medicare.gov)

Nursing Homes serve as permanent residences for people who are too frail or sick to live at home or as a temporary facility during a recovering period. However, many people need a nursing home level of care but would prefer to remain in their own home with the help of their family and friends, community services, and professional care agencies. The Medicare program offers limited access to two unique programs for certain beneficiaries who need a comprehensive medical and social service delivery system. The two programs currently available are:

• Program of All-Inclusive Care for the Elderly (PACE) provides detailed information on the PACE program
• Social Managed Care Plan provides detailed information on the Social Managed Care Plan program

There are some people, however, who require less than skilled care, or who require skilled care for only brief periods of time. In most communities, people can choose from a variety of living arrangements that offer different levels of care. Before deciding on a care setting, talk to a doctor or maybe a social worker about your care needs. Most people want to stay in their home for as long as possible. If you are considering staying at home make sure you know the amount of responsibility and work involved. If you cannot live independently, but don't want to live in a nursing home, you may want to consider some of the other alternatives.

• About Other Alternatives: provides more detailed information on other available alternatives.

Find and compare information about the services and quality of care provided at dialysis facilities in any state. You can also find addresses and phone numbers for each facility at the Centers for Medicare and Medicaid Services' Compare Dialysis Facilities site.

To find a doctor that accepts Medicare and Medicaid payments, you may want to visit the Centers For Medicare and Medicaid Services' Physician Compare. You can search by State, County, City, Zip Code, and doctor's name. This tool will provide you with a list of physicians in the specialty and geographic area you specify, along with detailed physician profiles, maps and driving directions.

Hospital Compare (Centers for Medicare & Medicaid Services) provides information about Medicare participating hospitals that compare quality measures of Heart Attack (AMI), Heart Failure Care, and Pneumonia Care.

There are many other directories that will help you find health professionals, services, and facilities, some of which may serve Medicare or Medicaid payments. A complete list of these directories is available at: http://www.nlm.nih.gov/medlineplus/directories.html

HHS sponsors a number of online training programs in many categories. To learn more, select from the following:

Library of Online Training Programs

• CDC Learning Connection
  CDC Learning Connection launched in November, 2010, is designed to help you locate learning products developed by CDC and CDC partners for the public health community. Check back often to access the growing collection of free products in a variety of media formats, including podcasts, e-learning, electronic publications, and live events.
• National Heart, Lung, and Blood Institute Educational Tutorials (NHLIB)
  The National Heart, Lung, and Blood Institute offers tutorials for the public on heart and vascular, cholesterol, high blood pressure, overweight and physical activity, and sleep disorders.

Healthy Lifestyles

• Understanding Your Body (AHRQ)
  Understanding Your Body provides easy-to-understand explanations of body systems and disease conditions. This material can be used for patient education, life sciences curriculum development, or to enhance public understanding of general health concepts. Permission for such use is not required, but citation as to source is requested.
• Make Your Calories Count: Use the Nutrition Facts Label for Healthy Weight Management (FDA)
  Make Your Calories Count is an interactive learning program that provides consumers with information to help plan a healthful diet while managing calorie intake. The exercises will help consumers use the food label to make decisions about which food choice is right for them. For simplicity, the program presents two nutrients that should be limited (saturated fat and sodium) and two nutrients that should be consumed in adequate amounts (fiber and calcium).
• Next Steps After Your Diagnosis, Finding Information and Support (AHRQ)
  Next Steps After Your Diagnosis offers general advice for people with almost any disease or condition. And it has tips to help you learn more about your specific problem and how it can be treated. The information here is presented in a simple way to help you scan the material and read only what you need right now. Organizations, publications, and other resources are included if you would like to know more. This online version has many additional resources with their Internet links. This document is also available in Spanish.
• Stryve, Striving to Reduce Youth Violence Everywhere
  Training opportunities are listed by date.

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Disease/Condition-Related Training

• Fetal Alcohol Spectrum Disorders Education/Training Courses and Materials (SAMHSA)
  Information on this site is primarily for professionals working with Fetal Alcohol Spectrum Disorders.
• Ryan White HIV/AIDS Program Education and Training Centers
  The AIDS Education and Training Centers (AETC) Program of the Ryan White HIV/AIDS Program supports a network of 11 regional centers (and more than 130 local associated sites) that conduct targeted, multidisciplinary education and training programs for health care providers treating people living with HIV/AIDS. The AETCs serve all 50 States, the District of Columbia, the Virgin Islands, Puerto Rico, and the 6 U.S. Pacific Jurisdictions. The AETC Program increases the number of health care providers who are effectively educated and motivated to counsel, diagnose, treat, and medically manage people with HIV disease, and to help prevent high-risk behaviors that lead to HIV transmission.
• Sexually Transmitted Diseases (STD) Curriculum Self-Study Modules for Clinicians (CDC)
  Seven web-based educational modules, each based on a specific STD topic. Each module is considered to be an individual course, and a student may complete as many modules as he or she chooses.
• Smallpox: What Every Clinician Should Know (CDC)
  The purpose of the Smallpox: What Every Clinician Should Know video is to provide clinicians with information on the virology, epidemiology, clinical features, and diagnosis of smallpox; the characteristics and use of smallpox vaccine; and proper management of smallpox vaccine recipients.
• National Sudden and Unexpected Infant/Child Death & Pregnancy Loss Resource Center Training Toolkit
  A number of resources are available to assist professionals, first responders, and parents to reduce the risk of sudden death in young children.

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Public Health and Health Care

• NIH Offic of Intramural Training and Education
  The NIH Office of intramural Training & Education (OITE) is a division of the Office of Intramural Research (OIR), Office of the Director (OD). The mission is to enhance the training experience of students and fellows on all of the NIH campuses. The staff works closely with the Training Offices in the NIH Institutes and Centers to help trainees in the Intramural Research Program (IRP). The intramural program is the sum of all the research projects carried out by NIH investigators and trainees in NIH facilities) develop scientific and professional skills that will enable them to become leaders in the biomedical research community.
• Public Health Assessment Process Interactive Learning Program (CDC/ATSDR)
  This program provides an overview of the public health assessment process that the Agency for Toxic Substances and Disease Registry (ATSDR) uses to evaluate whether people will be harmed by hazardous materials from waste sites or from other places where hazardous substances have been spilled or released into the environment.
• Environmental Health and Medicine Education (ATSDR)
  Environmental medicine education products present current environmental medicine content drawn from peer-reviewed medical literature. These products are accredited for free continuing education.
• Health Information Technology Knowledge Library (AHRQ)
  In an effort to ensure that stakeholders are on the same page when talking about health IT, we have developed a series of key topic articles. Each article includes beginner-level background information on the topic, a description of current activities in this part of the field, and lessons emerging from the array of projects sponsored by AHRQ. These articles also include recommended tools and resources for individuals engaged in health IT projects.
   

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Drug and Food

• Training & Continuing Education Courses from the FDA
  Information on state-level resources for food investigators; online training for health professionals about the safe use of medicine and the drug regulatory process; and online courses for industry on safety and effectiveness of medical devices and exposure to radiation from medical devices.
• Make Your Calories Count: Use the Nutrition Facts Label for Health Weight Management (FDA)
  Make Your Calories Count is an interactive learning program that provides consumers with information to help plan a healthful diet while managing calorie intake. The exercises will help consumers use the food label to make decisions about which food choice is right for them. For simplicity, the program presents two nutrients that should be limited (saturated fat and sodium) and two nutrients that should be consumed in adequate amounts (fiber and calcium).
• National Institute on Alcohol Abuse and Alcoholism Online Training (NIAAA)
  NIAAA offers online training for CME/CE credit on Helping Patients Who Drink Too Much.

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Emergency Preparedness & Response

• Radiological Terrorism: Medical Response to Mass Casualties (CDC)
  The purpose of this training is to prepare clinicians in first receiver settings to: (1) Identify factors impacting immediate medical response to mass casualties following major types of radiological incidents, and (2) Demonstrate appropriate patient assessment, triage, treatment and disposition decision-making required during a radiological mass casualty incident.
   
• Radiation Emergency Training & Education Webcasts (CDC)
  Topics include basic components of
  • radiological population monitoring guidelines,
  • key radiation principles & procedures,
  • protective measures and evacuation and sheltering guidelines
  • signs and symptoms of radiation syndrome
  • decontamination of patients

• Video: The History of Bioterrorism (CDC)
  These videos describe the Category A diseases: smallpox, anthrax, botulism, plague, tularemia, and viral hemorrhagic fevers. If these germs were used to intentionally infect people, they would cause the most illness and death. Watch these videos to learn how some of these agents have been or can be used as bioterrorist weapons.

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Research/Researchers

• Human Participant Protections Education for Research Teams Login (NIH)
  This free, web-based course presents information about the rights and welfare of human participants in research. The tutorial is designed for those involved in conducting research involving human participants. Also see, Protecting Human Subjects Training (HRSA)
• Incorporating Cancer Clinical Trials Into Your Practice (NIH)
  A Web-based course for healthcare professionals who are new to the clinical trials research process. The course contains practical information for professionals interested in referring patients to clinical trials, or conducting clinical trials, for the first time.
• Clinical Research Training for Principal Investigators at the NIH Clinical Center
  This program responds to the federal mandate requiring human subjects protection education for research teams at the NIH Clinical Center.
• Research and Training Opportunities at the National Institutes of Health
  Information about career advancement and services, internships, and enrichment opportunities in research training.
• Quick Health Data Online Free Training
  The US Department of Health and Human Services’ Office on Women's Health provides free telephone training for the Quick Health Data Online system.
• National Human Genome Research Institute Training Programs
  The National Human Genome Research Institute provides a wide range of programs aimed at furthering the professional training and career development of students, educators, health professionals and research scientists. This page describes the various training and educational opportunities available for individuals at various stages of their careers.
• Stem Cell Training Programs
  NIH provides listings of trainings of stem cell research training programs.
• Research in NIH Labs & Clinics
  Learn about NIH training opportunities, lab research support, clinical research support, computational biology, and other Federal Resources.
• Diversity Training Programs
  The Center to Reduce Cancer Health Disparities (CRCHD) Diversity Training Branch (DTB), leads NCI’s efforts in the training of students and investigators from diverse populations who will be part of the next generation of competitive researchers in cancer and cancer health disparities research.
• Medical Informatics Training Program
  The Lister Hill Center provides training opportunities for individuals at various stages in their careers.
• National Institute of Neurological Disorders and Stroke Training and Career Development
  Information about the training programs and grant mechanisms for students and researchers.
• Extramural Training Mechanisms grants and Fellowships
  Funding opportunities for training programs.
  

The mortality categories show how individual hospital's risk-adjusted 30-day death rates compare to the national rate. A hospital's performance is reported as

• Better Than The US National Rate,
• No Different Than The US National Rate, or
• Worse Than The US National Rate.

Hospitals are only identified as better or worse than the U.S. national mortality rate if the 95% interval estimate for their risk-standardized mortality rate (RSMR) is completely above or below the U.S. national rate.

Better Than The US National Rate means the hospital has a 30-day risk-adjusted death (mortality) rate lower than the US national rate.

Worse Than The US National Rate means the hospital has a 30-day risk-adjusted death (mortality) rate higher than the U.S. National Rate.

No Different Than The US National Rate means there is no significant difference between the 30-day risk-adjusted death (mortality) rate and the U.S. National Rate.

HHS's Substance Abuse and Mental Health agency sponsors programs that help persons with drug and alcohol addictions and abuse. You can locate a program to assist you at our Substance Abuse Locator site: http://dasis3.samhsa.gov/.

A medical loss ratio is the percentage of dollars paid out as benefits to policyholders in relation to the premiums collected for the policies.  For example, a state may require that an insurer spend at least 75 percent of the premiums they collect on medical claims.  Loss ratios can be calculated for a particular policy form or design, a line of business, or a health insurer’s overall business. 

Only a handful of states require all insurers in the individual market to spend at least 75 percent of every premium dollar on medical care (Families USA, June 2008).  Some states establish minimum loss ratios and reserve the right to review or approve the rates submitted by state-licensed insuring organizations.  Insurers must estimate what they will spend on medical claims over the course of a year and set their premiums accordingly.

To learn more see the Regulation of the Individual Health Insurance Market.

Hospital Compare offers the consumer information on hospitals performance on measures of quality. Some information is based on how well hospitals provided recommended and appropriate care to patients being treated for heart attack, heart failure and pneumonia, or who were receiving surgical care. These types of measures are called process measures. Another type of measure of the quality of care provided by a hospital is the outcome of that care. Hospital Compare began posting Adjusted Death (Mortality) Rates associated with hospitalizations for heart attack and heart failure in June 2007. In July of 2010 Hospital Compare added Imaging Efficiency Measures and Outpatient Measures. The purpose of these measures is to promote high-quality efficient care.

The website can be accessed by going directly to http://www.HospitalCompare.hhs.gov or using the link in the http://www.Medicare.gov website. Once on the Hospital Compare site, users can find hospitals by:

1. proximity to a city or ZIP code;
2. specific state or county; and
3. name.

After selecting the hospital or hospitals of interest, users can select the information about hospitals that they would like to see.

It is important to remember the information posted on this Web site should not be used as a decision making tool alone without consulting with your Doctor and your family regarding your medical care.

The Hospital Quality Alliance (HQA) is a public-private collaborative that has representation of hospitals and clinicians, consumer groups, purchasers, accrediting bodies and government agencies.

Its members include:

• AARP
• AFL-CIO
• Agency for Healthcare Research and Quality (HHS/AHRQ)
• America's Health Insurance Plans (AHIP)
• American Hospital Association (AHA)
• American Medical Association (AMA)
• American Nurses Association (ANA)
• Association of American Medical Colleges (AAMC)
• Blue Cross and Blue Shield Association (BCBSA)
• Centers for Medicare & Medicaid Services (HHS/CMS)
• Consumer-Purchaser Disclosure Project (CPDP)
• Federation of American Hospitals (FAH)
• General Electric Company (GE)
• The Joint Commission
• National Association of Children's Hospitals and Related Institutions (NACHRI)
• National Association of Public Hospitals and Health Systems (NAPH)
• National Business Coalition on Health (NBCH)
• National Quality Forum (NQF)
• U. S. Chamber of Commerce

Hospital Compare is designed to help consumers, patients, their loved ones to make better healthcare decisions. The information on the Web site should be used to:
 

• Talk to your doctor and other health care providers about the quality of care at hospitals. Some hospitals have more experience or better results treating certain conditions or performing certain procedures. Ask your doctor or health care provider which hospital has the best care and results for your condition. Ask why he or she prefers to use that hospital.
  
   
• If your physician is referring you for surgery, ask how well the hospital performs your kind of surgery, as well as about the surgeon who may work with you, and how many surgeries they perform each year. Your physician will want you to be confident about all of your health care decisions.
  
   
• Talk to your doctor or health care provider about other patients' experiences with the hospital. Some hospitals survey their patients in regards to hospital satisfaction. Try to get as much information as you are able about what other patients think of the care at the hospital.
  
   
• Look at the hospital information on this Web site, as well as other quality information and talk to your doctor about any questions or concerns you have.
• 
   
• Ask family or friends about their hospital experiences. Look on the Web site for the Hospital Checklist. It can help you ask important questions.

Schizophrenia is a chronic, severe, and disabling brain disorder that affects about 1 percent of people all over the world. People with schizophrenia sometimes hear voices others don't hear, believe that others are broadcasting their thoughts to the world, or become convinced that others are plotting to harm them. These experiences can make them fearful and withdrawn and cause difficulties when they try to have relationships with others.

Learn More:

• Schizophrenia (National Institutes of Mental Health)
  Learn about the signs, symptoms, and treatment of this brain disorder; and locate treatment and support services.

• Schizophrenia (MedlinePlus)
  MedlinePlus provides basic information on a wide variety of diseases and conditions including schizophrenial

You may want to consult the HHS Health Resources Services Administration (HRSA) directory of health centers at http://findahealthcenter.hrsa.gov/ - these health centers provide care on a sliding fee scale so it is affordable for anyone. You can receive care even if you are uninsured or cannot pay. Search the directory by zip code to find the centers nearest you.

The Hill-Burton program, while limited in scope, provides funds to hospitals and other health care facilities in exchange for their provision of a specified amount of free or reduced cost health care to low-income people. To find out if you qualify for Hill-Burton assistance you must apply at the admissions or business office at a Hill-Burton facility. For more information and a directory of facilities, please see the HRSA Frequently Asked Questions about the Hill-Burton program .  

Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation (such as a fear of speaking in formal or informal situations, or eating or drinking in front of others) or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.

Learn More:

• Social Phobia (National Institutes of Mental Health)
• Women's Mental Health: Social Phobia (or Social Anxiety Disorder) (WomensHealth.gov)

Impulsiveness is the tendency to act without thinking through a plan or its consequences. It is a symptom of a number of mental disorders, and therefore, it has been linked to suicidal behavior usually through its association with mental disorders and/or substance abuse.

The mental disorders with impulsiveness most linked to suicide include borderline personality disorder among young females, conduct disorder among young males and antisocial behavior in adult males, and alcohol and substance abuse among young and middle-aged males. Impulsiveness appears to have a lesser role in older adult suicides.

Attention deficit hyperactivity disorder that has impulsiveness as a characteristic is not a strong risk factor for suicide by itself. Impulsiveness has been linked with aggressive and violent behaviors including homicide and suicide. However, impulsiveness without aggression or violence present has also been found to contribute to risk for suicide.

Learn more:

• National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
• Suicide Prevention (National Institutes of Mental Health)

The Healthy Living Innovation Awards is an HHS initiative designed to identify and acknowledge innovative health promotion projects within the last 3 years that have demonstrated a significant impact on the health status of a community. The initiative seeks to:

• Celebrate and share innovative health promotion practices across organizations, professions, and communities;
• Increase public awareness of creative approaches that can be used to develop and expand health promotion programs, and to replicate successful strategies in various settings;
• Encourage a culture of innovation, where creativity and cross-sectoral partnerships and knowledge-sharing are embraced, enabled, and enacted;
• Increase the number and diversity of individuals, organizations, and groups addressing community health promotion; and
• Encourage people to incorporate healthy living activities into their daily lives.

The awards process is conducted on http://www.challenge.gov/ and the latest results of the challenge are posted at: http://healthylivinginnovation.challenge.gov/submissions

The five major types of anxiety disorders are:

• Generalized Anxiety Disorder
  Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.

• Obsessive-Compulsive Disorder (OCD)
  Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety.

• Panic Disorder
  Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.

• Post-Traumatic Stress Disorder (PTSD)
  Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

• Social Phobia (or Social Anxiety Disorder)
  Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation - such as a fear of speaking in formal or informal situations, or eating or drinking in front of others - or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.

(National Institutes of Mental Health)

Bipolar Disorder, also known as manic-depressive illness, is a serious medical illness that causes shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe.

Learn More:

• Bipolar Disorder. (National Institutes of Mental Health)
• Women's Mental Health: Bipolar Disorder (WomensHealth.gov)

Bipolar disorder causes dramatic mood swings from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.

Learn More:

• Bipolar Disorder (National Institute of Mental Health)
• Bipolar Disorder in Children and Teens (National Institute of Mental Health)
• What a Difference a Friend Makes: Bipolar Disorders: Beyond the Ups and Downs (SAMHSA)
• Symptoms of Bipolar Disorders May Go  Undiagnosed in Some Adults with Major Depression  (National Institute of Mental Health)

Researchers believe that both depression and suicidal behavior can be linked to decreased serotonin in the brain. Low levels of a serotonin metabolite, 5-HIAA, have been detected in cerebral spinal fluid in persons who have attempted suicide, as well as by postmortem studies examining certain brain regions of suicide victims.

One of the goals of understanding the biology of suicidal behavior is to improve treatments. Scientists have learned that serotonin receptors in the brain increase their activity in persons with major depression and suicidality, which explains why medications that desensitize or down-regulate these receptors (such as the serotonin re-uptake inhibitors, or SSRIs) have been found effective in treating depression. Currently, studies are underway to examine to what extent medications like SSRIs can reduce suicidal behavior.

Learn More:

• Suicide Prevention. (National Institutes of Mental Health)

How we measure 'good care' changes as the experts learn more from research. The change in the quality measures for the treatment of heart attack and heart failure for Left Ventricular Systolic Dysfunction (LVSD) is a change to keep quality measures up-to-date with the most recent evidence about effective treatments.

ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are medicines used to treat patients with heart failure, and are particularly beneficial for those patients with heart failure or who have had a heart attack and who have decreased function of the left side of the heart (with LVSD). Early treatment with ACE inhibitors and ARBs for patients who have heart failure symptoms or decreased heart function after a heart attack can also reduce risk of death from future heart attacks. ACE inhibitors and ARBs work by limiting the effects of a hormone that narrows blood vessels, and may thus lower blood pressure and reduce the work the heart has to perform. Since the ways in which these two kinds of drugs work are different and may have different side effects, your doctor will decide which drug is most appropriate for you. If you have a heart attack and/or heart failure, and you have decreased heart function, you should get a prescription for ACE inhibitors or ARBs before you leave the hospital. The rates posted on Hospital Compare in December 2005 reflect how well hospitals provide both of these treatments.

For more specific information about the changes, please see below:

The two quality measures that assess the use of ACE-inhibitors for patients with heart failure or who have had a heart attack have been changed to acknowledge the evolving evidence from recent clinical trials. Although many experts believe that ACE inhibitors should remain the first-line method of treating patients with heart failure, the accumulating evidence of therapeutic benefit indicates that ARBs are an acceptable alternative to ACE inhibitors.

The measures reported on Hospital Compare, beginning with the rates posted in December 2005, assess treatment with either of the two medication classes ??? ACE-inhibitors or ARBs -- in patients with heart failure or after an acute heart attack who have impairments in the contractile function of the left side of the heart. All such patients should be treated with either an ACE-inhibitor or an ARB unless there is documentation of a specific reason not to use both classes of drugs.



 

HHS National Institutes of Health has developed the Web site http://ClinicalTrials.gov to provide patients, family members and members of the public current information about clinical research studies. Other HHS sites with clinical trial information include:

• Educational Materials About Clinical Trials (National Cancer Institute)
• National Center for Complementary and Alternative Medicine Clinical Trials
• National Institute of Mental Health Clinical Trials
• Clinical Research & Clinical Trials (National Institute of Child Health and Human Development)
• National Institute on Aging Clinical Trials
• Women & HIV/AIDS Research and Clinical Trials (womenshealth.gov)

The State Children's Health Insurance Program (SCHIP) expands health coverage to uninsured children whose families earn too much for Medicaid but too little to afford private coverage. For more information, visit www.insurekidsnow.gov or call toll free 1-877-KIDS-NOW (1-877-543-7669). This Web site and toll free number also provides information on Medicaid.

Community health centers provide health care regardless of your ability to pay and even if you have no health insurance. Find the community health center closest to you. Phone the community health center for more information or to make an appointment.