The Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ) are pleased to release this report, Women at High Risk for Diabetes: Access and Quality of Health Care, 2003-2006, on behalf of the U.S. Department of Health and Human Services (HHS). This collaboration examined the quality of preventive health care received by U.S. women at high risk and not at high risk for diabetes, using the most scientifically based measures and national data sources available. The report presents measures of health care quality showing the use of services in several areas: access to care, general health and well-being, and preventive care and behaviors. Diabetes is a chronic disease that is very common, serious, and costly. Diabetes can lead to serious complications, such as heart disease and stroke, high blood pressure, blindness, and kidney disease. However, people with diabetes can control the disease and reduce their likelihood of developing complications. An estimated 24 million people in the United States, or 8% of those age 20 years and over, have diabetes; of those, almost half are women. At least one-fourth of adults in the United States are also known to have prediabetes, a condition in which people have blood glucose levels higher than normal but not high enough to be diagnosed with diabetes. People with prediabetes have an increased risk of type 2 diabetes, heart disease, and stroke. Women are more likely than men to develop chronic diseases, such as diabetes, and to suffer disproportionately from disability compared to men. It is important to target women at high risk for diabetes for intervention to reduce their risk of diabetes. Evidence shows that people with prediabetes who lose 5 to 7% of their body weight and increase their physical activity can prevent or delay diabetes. Early interventions and access to preventive care services are important for women to reduce the risk of developing other diseases, such as cardiovascular disease. However, very few studies have examined preventive care measures for women at high risk for diabetes. To address this gap, CDC collaborated with AHRQ to develop this report, which assesses and describes the quality of care that women at high risk for diabetes receive in the United States. This report can be used to identify areas in which intervention can help women at high risk for diabetes across the lifespan, and to focus attention on possible gaps in public health programs, policies, research, and surveillance. Similar to the 2008 report, Women With Diabetes: Quality of Health Care, 2004-2005, this report analyzes a wide variety of measures selected by experts at CDC and AHRQ as highly relevant to an examination of the quality of health care for women at high risk for diabetes. Due to data availability and other constraining factors, the measures discussed in this report are not necessarily comprehensive. Still, they highlight important areas of health care quality of particular relevance to women at high risk for diabetes. Throughout the report, the comparison groups are: Women at high risk for diabetes; Women not at high risk for diabetes.

Falls represent a serious hazard to workers in many industries. Workers who perform tasks at elevation-workers in the construction, structural metal working, and tree trimming industries, for example-are at risk of falls from heights, with frequently grave or even fatal consequences. Many more workers, in nearly every industry, are subject to falls to floors, walkways or ground surfaces. These falls, characterized as fall on the same level, are responsible for well over half of nonfatal injuries that result in days away from work. The etiology of falls as injury-producing events is multi-factorial, and encompasses multiple mechanisms of exposure. Working at heights involves completely different fall risks than those found on workplace surfaces and floors. The different exposures represent serious safety risks in both cases, resulting in fatal and serious nonfatal injury. To address the various causes of multi-factorial events such as these, there needs to be wide-ranging and multidisciplinary injury-mitigation approaches provided to practitioners based on a wide variety of research methods. To advance our knowledge of occupational fall injuries, the International Conference on Fall Prevention and Protection (ICFPP), held in May of 2010, was convened to provide a forum for researchers from NIOSH, its stakeholders, and the community of fall-prevention specialists and experts to present research findings, recommendations and expert advice on the latest tools and methods to reduce the incidence of injury from falls. At the conference, a wide variety of research approaches and methods were presented, and these approaches reflected the multidisciplinary orientation of the different stakeholders in attendance, as well as the individual interests and expertise of participating researchers. This document represents a wealth of knowledge from experts and informed stakeholders on the best way to understand, prevent, and control fall-related risk exposures. It is anticipated that these presentations will serve to bring together the communities of interest that attempt to prevent and ameliorate fall-related injuries, and will spur efforts that will continue in the form of joint and supported research investigations, research consortia, and informed dialogue in support of a common goal. NIOSH hopes to continue to sponsor forums for the presentation of methods and findings related to occupational fall injury protection and prevention in the future.

"A Closer Look at African American Men and High Blood Pressure Control: A Review of Psychosocial Factors and Systems-Level Interventions" highlights resources and systems-level interventions that focus on high blood pressure control among African American men. The information in this book will provide valuable guidance to state and local government agencies, health care organizations, nonprofit organizations, and other decision makers that work to facilitate positive changes in their states and communities. A systems-level intervention is defined as a change in policy, legislation, training, or environmental supports that impacts individual and community-level outcomes. In this book you will find information on lessons learned, considerations, and recommendations for public health programs, in hopes that the information will not only increase the number of systems-level interventions for African American men and blood pressure control, but also provide answer to questions that exist for current interventions. This book summarizes what other public health programs are engaged in and provides the contact information of those programs to support efforts of cross-program learning. Systems-level interventions can focus on organizations, providers, patients, and the health care system as a whole, and also includes media campaigns. The Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention contracts with RTI International to gather information on system-level interventions through input from an expert panel, key informant interviews conducted with individuals implementing interventions, and from a search of the peer-reviewed and non-peer-reviewed literature. The review also summarizes data on the burden of high blood pressure and discusses the psychosocial factors associated with having the condition and accessing treatment. Lastly, the review identifies resources on men's health that may be useful when considering the implementation of a new program or expanding and existing one.

In 1964, the first Surgeon General's report on the effects of smoking on health was released. In the nearly 50 years since, extensive data from thousands of studies have consistently substantiated the devastating effects of smoking on the lives of millions of Americans. Now, this 2010 report of the Surgeon General explains beyond a shadow of a doubt how tobacco smoke causes disease, validates earlier findings, and expands and strengthens the science base. Armed with this irrefutable data, the time has come to mount a full-scale assault on the tobacco epidemic. More than 1,000 people are killed every day by cigarettes, and one-half of all long-term smokers are killed by smoking-related diseases. A large proportion of these deaths are from early heart attacks, chronic lung diseases, and cancers. Every year, thousands of nonsmokers die from heart disease and lung cancer, and hundreds of thousands of children suffer from respiratory infections because of exposure to secondhand smoke. There is no risk-free level of exposure to tobacco smoke, and there is no safe tobacco product. This new Surgeon General's report describes in detail the ways tobacco smoke damages every organ in the body and causes disease and death. We must build on our successes and more effectively educate people about the health risks of tobacco use, prevent youth from ever using tobacco products, expand access to proven cessation treatments and services, and reduce exposure to secondhand smoke. Putting laws and other restrictions in place, including making tobacco products progressively less affordable, will ultimately lead to our goal of a healthier America by reducing the devastating effects of smoking. The Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and other federal agencies are diligently working toward this goal by implementing and sup-porting policies and regulations that strengthen our resolve to end the tobacco epidemic. CDC has incorporated the World Health Organization's MPOWER approach into its actions at the local, state, and national levels. MPOWER consists of six key interventions proven to reduce tobacco use that can prevent millions of deaths. CDC, along with federal, state, and local partners, is committed to monitor-ing the tobacco epidemic and prevention policies; protecting people from secondhand smoke where they live, work, and play; offering quit assistance to current smokers; warning about the dangers of tobacco; enforcing comprehensive restrictions on tobacco advertising, promotion, and sponsorship; and raising taxes and prices on tobacco products.In 2009, the Family Smoking Prevention and Tobacco Control Act was enacted, giving FDA explicit regulatory authority over tobacco products to protect and promote the health of the American public. Among other things, this historic legislation gave the agency the authority to require companies to reveal all of the ingredients in tobacco products-including the amount of nicotine-and to prohibit the sale of tobacco products labeled as "light," "mild," or "low." Further, with this new regulatory mandate, FDA will regulate tobacco advertising and require manufacturers to use more effective warning labels, as well as restrict the access of young people to their products. FDA will also assess and regulate modified risk products, taking into account the impact their availability and marketing has on initiation and cessation of tobacco use. This 2010 Surgeon General's report represents another important step in the developing recognition, both in this nation and around the world, that tobacco use is devastating to public health. Past investments in research and in comprehensive tobacco control programs-combined with the findings presented by this new report-provide the foundation, evidence, and impetus to increase the urgency of our actions to end the epidemic of tobacco use.

Young workers warrant special consideration to foster a safe and healthful entree to the world of work. While there is consistent evidence that young workers are at increased risk for injury in the workplace, largely due to inexperience, the solutions and path forward are not straight-forward. Efforts to facilitate opportunities for youth to gain meaningful job experiences that foster development of marketable job skills for their future need to be balanced with efforts to protect them from work-related injury and illness. Additionally, work is just one component of youths' lives and their transitions into adulthood. Family and social relationships and education are other important components of young workers' lives that have complex relationships with work that need to be considered. Research on the impacts of youth work is conducted in multiple disciplines, with little interaction between them. These include the fields of business, law, psychology, public health, sociology, and youth development. NIOSH co-funded, with the Ontario Neurotrauma Foundation, a project that convened a unique series of symposia between 2007 and 2010 that brought together scholars from multiple disciplines, practitioners and business representatives from the U.S. and Canada to consider the implications of youth employment, and to make recommendations for moving forward, considering the complex relationships of work with other components of youth development. These Proceedings compile white papers (or subsequently published articles) that were developed to foster discussions at this series of symposia, along with an ambitious research and policy agenda that was spawned from these interdisciplinary discussions. White papers and articles were authored by business scholars, epidemiologists, health communicators, physicians, psychologists, and sociologists. These Proceedings serve as a foundation for fostering interdisciplinary attention to the complex issues surrounding young worker safety and health, and serve to inform the many stakeholders who did not attend the invitational series of symposia. These Proceedings will be useful to scholars from multiple disciplines, practitioners (e.g. safety professionals, unions, business leaders and educators), and policy makers interested in expanding their knowledge about young worker safety and health.

Alcoholism and drug dependence and addiction, known as substance use disorders, are complex problems. People with these disorders once were thought to have a character defect or moral weakness; some people mistakenly still believe that. However, most scientists and medical researchers now consider dependence on alcohol or drugs to be a long-term illness, like asthma, hypertension (high blood pressure), or diabetes. Most people who drink alcohol drink very little, and many people can stop taking drugs without a struggle. However, some people develop a substance use disorder-use of alcohol or drugs that is compulsive or dangerous (or both). This booklet is for you, the family member of a person dependent on alcohol or drugs. Whether your family member is dependent on alcohol, cocaine, heroin, marijuana, prescription medications, or other drugs, his or her dependence affects you and your family, too. This booklet answers questions often asked by families of people entering treatment. The "Resources" section, at the back of this booklet, lists a selection of sources for more information and support groups available to you during this stressful time. Take advantage of this help, ask treatment providers questions, and talk with supportive friends or other family members about your feelings. Millions of Americans abuse or are dependent on alcohol or drugs. All of these people have families-so remember, you are not alone. The fact that your family member is in treatment is a good sign and a big step in the right direction. People with alcohol or drug dependence problems can and do recover.

Take Charge of Your Diabetes was written to help you take important steps to prevent problems caused by diabetes. You'll learn many useful things: What problems diabetes can cause; How to work with a health care team to prevent Problems; Why it is important to get your blood glucose and blood pressure closer to normal; and How to find out about resources in your community to help you prevent problems. Diabetes touches almost every part of your life. It's a serious, lifelong condition, but there's a lot you can do to protect your health. You can take charge of your health-not only for today, but for the coming years. Diabetes can cause health problems over time. It can hurt your eyes, your kidneys, and your nerves. It can lead to problems with the blood flow in your body. Even your teeth and gums can be harmed. Diabetes in pregnancy can cause special problems. Many of these problems don't have to happen. You can do a lot to prevent them, and there are people in your community who can help. This book can help you find how to get the help you need to prevent problems. Today and every day, strive to balance your food, physical activity, and medicine. Test your own blood glucose (also called blood sugar) to see how this balance is working out. Then make choices that help you feel well every day to protect your health. Feeling healthy can allow you to play a big part in the life of your family and community. You may even want to join a community group in which people share their stories and help others deal with their diabetes.