Blood Disorders Are a Public Health Issue

Public health officials need to give more attention to needs of people with blood disorders: American Journal of Preventive Medicine supplement


San Diego, CA, November 16, 2011 – Public health should focus not only on reducing the burden of common diseases but also address the needs of people with blood disorders, experts say in a supplement to December's American Journal of Preventive Medicine.

Even relatively common blood disorders fly below the public health system’s radar with no established mechanisms for surveillance, supplement editors Scott D. Grosse, PhD, of the US Centers for Disease Control and Prevention (CDC); Andra H. James, MD, of Duke University; and Michele A. Lloyd-Puryear, MD, PhD, of the US National Institutes of Health, write in an introductory essay with Hani K. Atrash, MD, MPH, also of the CDC.

The authors contend that although most of the blood disorders discussed in the supplement are considered rare in the US and Western Europe—defined as affecting about 1 in 1,500 people—they should be ranked as a public health concern. "A public health framework is needed to address public health services and functions for all rare disorders, including blood disorders, regardless of the incidence or prevalence of a given disorder," they say.

The most common blood disorder, venous thromboembolism (VTE), consists of deep vein thrombosis and pulmonary embolism. It involves blood clots that occur in veins, usually in the legs, which can break up and move to the lungs and kill. VTE affects at least 1 million people in the US and is a major cause of death in adults, but “little is definitively known about the magnitude of [its] public health burden.”

Hereditary hemochromatosis is a genetic disorder present in about 1 million Americans but “the opportunity to detect iron overload at an early stage and intervene … to prevent the development of clinical disease … remains a challenge,” they add. And while at least 3 million Americans have sickle cell trait or are carriers of the sickle cell gene mutation, “the extent to which the carrier status poses health threats is not well established.”

The supplement, comprised of 13 research papers and five workshop/meeting summaries, is authored by top medical educators and public health professionals. Its publication was supported by the CDC through a cooperative agreement with the Association for Prevention Teaching and Research. 

Two papers focus on sickle cell trait screening policy in college athletes and military recruits, while seven address hemophilia and bleeding disorders, the most common of which are hemophilia A and B, and the hemoglobinopathies—sickle cell disease and thalassemia.

Grosse and his colleagues propose a public health framework to address such often-overlooked conditions. The framework is similar to the 10 essential public health services but focuses on rare disorders rather than common exposures or common health problems. The framework calls for public health officials to:

"Blood disorders have a vital importance to public health and vice versa,” the authors conclude. “Whether relatively common or relatively rare, people with blood disorders have health challenges specific to their conditions that require knowledgeable healthcare providers, access to screening and diagnostic testing, and information to help them manage their conditions." 

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Note
The full table of contents for the supplement is available to credentialed journalists upon request, as are individual articles. Contact Beverly Lytton in the AJPM editorial office at eajpm@ucsd.edu. To reach Drs. Grosse or Atrash at CDC, contact Conne Ward-Cameron, goa4@cdc.gov, +1 404 498 3976.

About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine ( www.ajpmonline.org) is the official journal of The American College of Preventive Medicine ( www.acpm.org) and the Association for Prevention Teaching and Research ( www.aptrweb.org). It publishes articles in the areas of prevention research, teaching, practice and policy, official policy statements from the two sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials. With an Impact Factor of 4.110, AJPM is ranked 10th out of 140 Public, Environmental & Occupational Health titles and 18th out of 151 General and Internal Medicine titles, according to Thomson Reuters’ 2010 Journal Citation Reports® 2011.


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Media contact
Beverly Lytton
American Journal of Preventive Medicine
+1 858 534 9340
eJJPM@ucsd.edu