HHS WEEKLY REPORT
August 9 - 14, 2004

THIS ISSUE AVAILABLE ONLINE WITH EXPANDED INFORMATION AND PHOTOS AT:
   http://www.hhs.gov/news/newsletter/weekly

IN THIS ISSUE:
1) HHS is Providing New Interactive Book of Health Information to Women of Afghanistan and Their Families
2) PREVENTION: President Announces $100 Million in Grants to Support Substance Abuse Treatment
3) SCIENCE IN THE NEWS: Landmark Survey Reports on the Prevalence of Personality Disorders in the United States
4) MEDICARE MINUTE: The History of Medicare
5) Secretary Thompson's Public Schedule

HHS is Providing New Interactive Book of Health Information to Women of Afghanistan and Their Families

Secretary Tommy G. Thompson announced on Tuesday that the U.S. Department of Health and Human Services (HHS) will distribute pioneering interactive women's health books built with the LeapPad learning system technology throughout Afghanistan this year, aimed especially at helping Afghan women who cannot read or write.

Secretary Thompson has visited Afghanistan three times since September 11, 2001, to review and evaluate the health needs of the Afghan people and help target assistance to people throughout the country -- especially Afghan women, whose health care was virtually ignored under the Taliban. Based on his fact-finding trips, Secretary Thompson led the campaign to engage HHS as a financial and instructional supporter of the Rabia Balkhi Hospital and associated clinics serving women in Afghanistan, and eventually to a partnership with LeapFrog Enterprises, Inc., and the creation of this interactive tool.

Developed jointly by HHS and LeapFrog Enterprises, Inc., the 42-page interactive books deliver important basic health information through state-of-the-art audio and point and touch technology. Books are available in both of Afghanistan's two major languages Dari and Pashto. Illiteracy is a common problem in Afghanistan where only half of the men and one in five women can read and write. The book allows users to point to pictures, then the book speaks to the user incorporating a literacy tool with health information.

"This promising new technology is easy to use and an effective way to provide important health information to women, both for their own personal benefit and for their families," Secretary Thompson said. "It will be especially helpful in Afghanistan, where almost 80 percent of women cannot read or write, and where infant and child mortality, as well as maternal mortality are all shockingly high. We want to help Afghan women and families to improve the health in their country rapidly, and these 'talking books' will be an important tool in reaching that goal."

The book presents more than 350 items of recorded information concerning 19 personal health subjects. Basic health information covered includes diet, childhood immunization, pregnancy, breastfeeding, sanitation and water boiling, treating injuries and burns, and preventing disease.

HHS will initially disseminate 2,000 books to Afghan households and primary health care centers through an initial distribution program used to evaluate both usability and behavior change measures. Results of this initial distribution will be used to determine the best dissemination method for the 20,000 books that the United States is giving to Afghanistan.

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PREVENTION

President Announces $100 Million in Grants to Support Substance Abuse Treatment

President Bush announced on Tuesday $100 million in Access to Recovery grants to provide people seeking drug and alcohol treatment with vouchers for a range of appropriate community-based services. By providing vouchers, the grant program promotes client choice, expands access to a broad array of clinical treatment and recovery support services, including services provided by faith- and community-based programs, and increases substance abuse treatment capacity.

The grants are being awarded to 14 states and one tribal organization. Three-year grants are being awarded to California, Connecticut, Florida, Idaho, Illinois, Louisiana, Missouri, New Jersey, New Mexico, Tennessee, Texas, Washington, Wisconsin, Wyoming, and the California Rural Indian Health Board. In fiscal year 2005, President Bush has proposed doubling the funding for Access to Recovery to help even more of those seeking treatment.

“Giving people the power to choose a treatment program that reflects their values and needs can help them triumph over addiction and achieve recovery,” HHS Secretary Tommy G. Thompson said. “Access to Recovery will help Americans who are seeking treatment but are unable to obtain care. This program is designed to help people reach recovery in body, mind, and heart.”

In their applications, grantees delineated a process for screening and determining appropriate services for the individual client. Clients will be assessed, given a voucher for identified services, and provided with a list of appropriate service providers from which to choose. Grantees proposed a broad range of innovative approaches and target populations. The grantees were competitively chosen from applications from 44 states and 22 tribes and territories.

For a complete listing of grantees and their programs, please go to: http://www.hhs.gov/news/press/2004pres/20040803c.html

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SCIENCE IN THE NEWS

Landmark Survey Reports on the Prevalence of Personality Disorders in the United States

An estimated 30.8 million American adults (14.8 percent) meet standard diagnostic criteria for at least one personality disorder as defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, according to the results of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) reported in the current issue of the Journal of Clinical Psychiatry.

Conducted by the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, the NESARC is a representative survey of the U.S. civilian noninstitutionalized population aged 18 years and older. More than 43,000 American adults participated in the survey. Designed to assess prevalence and comorbidity, or co-occurrence, of multiple mental health disorders, the NESARC is the first national survey conducted in the United States to estimate the prevalence of selected personality disorders — stable patterns of inner experience and behavior that are inflexible and maladaptive that begin in early adulthood and are displayed in a variety of contexts — that often co-occur with other mental health disorders such as substance use disorders and anxiety and mood disorders.

The NESARC found that the personality disorders are pervasive in the general population: In 2001- 2002, fully 16.4 million individuals (7.9 percent of all adults) had obsessive-compulsive personality disorder; 9.2 million (4.4 percent) had paranoid personality disorder; 7.6 million (3.6 percent) had antisocial personality disorder; 6.5 million (3.1 percent) had schizoid personality disorder; 4.9 million (2.4 percent) had avoidant personality disorder; 3.8 million (1.8 percent) had histrionic personality disorder; and 1.0 million (0.5 percent) had dependent personality disorder.

The researchers found that risk of having avoidant, dependent, and paranoid personality disorders is greater for females than males, whereas risk of having antisocial personality disorder is greater for males than females. They found no gender differences in the risk of having obsessive-compulsive, schizoid, or histrionic personality disorders. In general, other risk factors for personality disorders included being Native American or Black, being a young adult, having low socioeconomic status, and being divorced, separated, widowed, or never married. With the exception of histrionic personality disorder, all the personality disorders assessed in the survey were associated with considerable emotional disability and impairment in social and occupational functioning.

“The first-time availability of prevalence information on personality disorders at the national level is critically important,” Dr. Ting-Kai Li, M.D., Director, National Institute on Alcohol Abuse and Alcoholism said. “Personality disorders consistently have been associated with substantial impairment and decreased psychological functioning among alcohol and drug abusers.”

Full text of the Journal of Clinical Psychiatry article is available to media representatives from the NIAAA Press Office and to journal subscribers at www.psychiatrist.com. For interviews with lead author Bridget F. Grant, Ph.D., Ph.D., please call the NIAAA Press Office.

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MEDICARE MINUTE

The History of Medicare

In 1965, the Social Security Act established both Medicare and Medicaid. Medicare was a responsibility of the Social Security Administration (SSA), while Federal assistance to the State Medicaid programs was administered by the Social and Rehabilitation Service (SRS). SSA and SRS were agencies in the Department of Health, Education, and Welfare (HEW). In 1977, the Health Care Financing Administration was created under HEW to effectively coordinate Medicare and Medicaid. In 1980 HEW was divided into the Department of Education and the Department of Health and Human Services (HHS).

The first U.S. President to propose a prepaid health insurance plan was Harry S. Truman. On November 19, 1945, in a special message to Congress, President Truman outlined a comprehensive, prepaid medical insurance plan for all people through the Social Security system. The plan included doctors and hospitals, and nursing, laboratory, and dental services; it was dubbed "National Health Insurance." Furthermore, medical insurance benefits for needy people were to be financed from Federal revenues.

Over the years, lawmakers narrowed the field of health insurance recipients largely to social security beneficiaries. A national survey found that only 56 percent of those 65 years of age or older had health insurance. President John F. Kennedy pressed legislators for health insurance for the aged. However, it wasn’t until 1965 that President Lyndon B. Johnson signed H.R. 6675 (The Social Security Act of 1965; PL 89-97) to provide health insurance for the elderly and the poor.

On July 30, 1965, President Johnson signed the Medicare and Medicaid Bill (Title XVIII and Title XIX of the Social Security Act) in Independence, Missouri in the presence of former President Truman, who received the first Medicare card at the ceremony; Lady Bird Johnson, Vice-President Hubert Humphrey, and Mrs. Truman also were present. President Johnson remarked: "We marvel not simply at the passage of this Bill but that it took so many years to pass it."

Medicare extended health coverage to almost all Americans aged 65 or older. About 19 million beneficiaries enrolled in Medicare in the first year of the program. Medicaid provided access to health care services for certain low-income persons and expanded the existing Federal-State welfare structure that assisted the poor.

The 1972 Social Security Amendments expanded Medicare to provide coverage to two additional high risk groups—disabled persons receiving cash benefits for 24 months under the social security program and persons suffering from end-stage renal disease.

On December 8, 2003 President George W. Bush signed the Medicare Prescription Drug Improvement and Modernization Act into law. This landmark legislation provides seniors and people living with disabilities a prescription drug benefit, more health care choices and better benefits. “By reforming and modernizing this vital program, we are honoring the commitments of Medicare to all our seniors,” President Bush said.

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SECRETARY THOMPSON’S PUBLIC SCHEDULE

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Last updated: August 9, 2004
United States Department of Health and Human Services
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