Feds Reject Petition To Ban BPA In Food

I recently stumbled onto this article regarding bisphenol A (BPA) regulation (or lack of) while exploring the National Center for Toxicological Research (NCTR) website (http://www.npr.org/blogs/thesalt/2012/03/30/149683556/feds-to-decide-on-banning-bpa-from-food-and-other-products). The article was was posted in March 2012, but the findings have had a lasting impact on bisphenol A and other endocrine disrupting chemicals (EDC) regulation. Since learning about EDCs, I have been in favor of increasing funds for EDC research and regulation since the chemicals are associated with diabetes, immune dysfunction, subfertility, obesity, and neurobehavioral disorders in humans. A basic understanding of the endocrine system is crucial in understanding how chemicals disrupt it (skip the next two paragraphs if you want to just read about the NPR article).

The endocrine system is composed of the thyroid, pancreas, and approximately 28 other glands that use trace amount of chemical messengers, or hormones, to communicate with and regulate our bodies. The endocrine system regulates a number of bodily processes that range from female reproduction to neurological development. An endocrine disruption occurs whenever a chemical mimics, blocks, or interferes with these hormones, thereby altering bodily regulation. The three most daunting features of these chemicals are their hormonal interferences at low dosage levels, their persistence due to long half-lives, and their associated deleterious bodily and mental afflictions as wide and varied as the processes controlled by the human endocrine system.

Perhaps the most well-known EDC is dichlorodiphenyltrichloroethane, or DDT. Studies in the 1950s linked DDT exposure to harmful physiological effects in lab animals, and yet it took critical examination by Rachel Carson in Silent Spring to finally halt production of this pesticide in 1972. The most well-known EDC today is bisphenol A, which is present in the urine of 92.6% Americans and has been linked to obesity, cancer, and cardiovascular disease in laboratory animals. BPA is used in polycarbonate and epoxy production and is found in a variety of products, but predominately food and drink packaging. Some of these effects have been known since 1930, yet the Food and Drug Administration (FDA) considers BPA safe because of scientific uncertainty regarding their adverse effects. The uncertainty argument is appropriate from the skeptical perspective of science; however, scientific certainty is sufficient but not necessary for taking public policy action. In 2010, the FDA did ban BPA containing baby products, but only after retailers like Wal-Mart began removing the products from their shelves.

The NPR article discusses the refusal of the FDA to ban BPA primarily on the basis of two recent studies that were funded by the FDA. One experiment lead by Teeguarden at Pacific Northwest National Laboratory studied the amount of bioactive BPA that 20 men and women had in their urine after having a diet supposedly loaded with BPA from canned foods and juice in plastic containers (Abstract and article can be found here: http://www.ncbi.nlm.nih.gov/pubmed/21705716). The overall finding was that there were minimal BPA levels in the blood of the participants. One flaw that I immediately noticed in this study was that the initial BPA contained in the food was unknown and thus the BPA urine concentration wasn’t normalized to anything. In biochemical research, absolute values must be normalized to a control or the data doesn’t tell you much. It’s possible that the participants consumed different amounts of BPA containing food or that the measurement techniques processed the sample differently. The limited population size also limits the scope of the study. In fact Frederick S. vom Saal et al. published a critique of Teeguarden work and stated that it “contains numerous flawed assumptions, omissions, and misrepresentations of the published literature on bisphenol A (BPA) that demand our rebuttal.” I highly recommend reading it (http://toxsci.oxfordjournals.org/content/125/1/318.long#ref-19).  An article in Mother Jones labels Teeguarden as a “researcher who has collaborated with and been funded by the chemical industry, and works for an organization that also has worked with to the chemical industry.”

A second study by Dan Doerge at NCTR found that unlike mice and rat newborns who are more susceptible to BPA, newborn monkeys had no trouble inactivating the compound and only had greater BPA metabolism capabilities (Abstract and article can be found here: http://www.ncbi.nlm.nih.gov/pubmed/21983029). Other peer review studies contradict this work as well.

BPA and endocrine disruptors remain highly debated in the scientific community for numerous reasons. The primary cause of the discrepancy is that it is difficult to determine nanonmolar concentrations of EDCs and that there is no sure means to translate the impact of EDCs on experimental animals to humans. The ultimate question is how much proof do we need from the scientific community to instate regulatory policies? Data driven public health measures are the logical thing to do, but what happens when the data is ambiguous or nonexistent? A similar problem seems to be happening in Mayflower, where the Arkansas Department of Health wasn’t able to measure many toxic compounds immediately after the oil spill. According to “science” the town was not affected, but the respiratory problems and other health issues of Mayflower residents seem to tell a different story.

From a public health viewpoint, it’s likely that all populations are affected, but some are more affected than others. One would expect that low income individuals may more likely to turn to packaged foods that contain BPA and that they may be unable to receive proper medical care. It’s also possible the price of a BPA replacement in food containers could cause food cost to rise and do more harm than good. Since little is known about EDCs, the potential harmful effects could be mislabeled as another disease or chronic condition. Even if BPA is banned someday, it’s likely that another class of chemicals will take its place. In today’s modern world, we are exposed to thousands of chemicals, for better or for worse. 

Food Stamp Cuts Create High Demand for Food Bank Supplies

The Supplemental Nutrition and Assistance Program (SNAP), more commonly known as the food stamp program, recently found itself without new funding from Congress. This resulted in approximately 47 million Americans having their food stamp benefits cut. In an interview with a family receiving food stamp assistance, a mother feels her monthly cut will affect the health of her family in a very negative way. This mother says her $53 monthly cut will prevent her from purchasing fresh fruits and vegetables. She plans on buying packaged fruits and freeze dried vegetables now in order to stay within her tighter budget.

I feel the interview with this mother paints a vivid picture of the social determinants of health, specifically income. This single mother has two children, and her main source of income is an $830 per month babysitting job. With SNAP, she is able to somewhat overcome her income barrier and provide healthy, fresh foods for her family. With the recent cuts to SNAP, her available funds are reduced, and those fresh, healthy foods that kept her family in good health can no longer be purchased. The article details that one in seven Americans receives benefits through SNAP, and a $40 billion program cut is currently being debated in Congress. If the program is cut, many Americans will find themselves living less healthy lives, because they simply cannot afford to do so. Seniors, children, veterans, and diabetics tend to rely on SNAP assistance the most, and these at-risk groups will become even more vulnerable. The cuts made to SNAP will become a public health issue because income will be a greater determinant of health than before, and the health of nearly 47 million Americans will suffer because of it.

The food stamp cuts are of great concern for food pantries and food banks across the nation. Many worry that demand will far exceed supply. Spokespersons for various food banks have agreed that this demand will require food lines to be cut once the maximum number of people has been served, and food bags will have to be reduced in quantity and quality in order to serve more people. Many are concerned that the lack of support through food organizations will cause a major stepping stone to independent living to be destroyed. This idea plays into the multi-faceted view of health. If one’s food and nutrition needs are not taken care of, then many other aspects of life, such as physical activity, caring for a family, and finding and maintaining a job, will suffer.

http://www.usatoday.com/story/news/nation/2013/11/02/food-stamps-cuts-food-banks/3356667/

Typhoon Haiyan

http://www.usatoday.com/story/news/2013/11/13/philippines-typhoon-haiyan-relief-aid-problems/3514709/

This article from USA Today is about the aftermath of the recent typhoon that hit the Philippines. Due to the destruction and chaos, communication has been an issue between many different attempts to bring aid. Similar articles from immediately after the storm estimated a total death toll of 1,200, but the current estimation has risen to 5,000 -10,000 possible deaths in just the city of Tacloban. The article describes that the central government is attempting to improve relief efforts by flying in teams of doctors and psychological health workers. However, many of the response teams’ supplies have been stuck at the airport. On the world news tonight I also saw that doctors were running low on medication, bandages, and sanitation supplies, while the flow of severely injured patients seems never-ending. An additional link found on this article (http://www.ksdk.com/story/weather/2013/11/12/philippines-typhoon-haiyan-relief-and-survivor-search/3504077/) further addresses public health concerns, including that the United Nations is asking for $301 million in aid. This article discusses the concern about power outages, and that some hospitals without power will lose all their vaccines. It is estimated that the city of Tacloban may not have power for three months. The shortage of medication and vaccines may increase future deaths due to infection and disease. These two articles show the many areas needed in a relief effort of this caliber. Food, water, medical care, and debris removal are just a few areas that need immediate attention in this crisis.

U.S. Adult Obesity Rate Levels Off

There is finally (semi) good news relating to U.S. obesity rates----obesity among adults seems to be leveling off. At a time when over a third of adults are obese, or more than 35 pounds above ideal body weight, any change is welcome. In 2012, 78 million adults were obese, and according to the National Center for Health Statistics, over 50 million were white. There has not been a significant change in the percentage of obese adults in the U.S. since 2004, when the adult obesity rate was 32%; in 2012, it was reported to be 34.9%. This new analysis is based on data from the National Health and Nutrition Examination Survey, which is a survey of people whose weight and height are actually measured rather than being self-reported, making it more reliable. Some other statistics of interest include that there was no significant change in obesity in men or women, and that the obesity rate among Asians was the lowest out of all the demographics. While it is promising to hear that the adult obesity rate is leveling off and not increasing as it has in past years, we should not be too quick to celebrate. Over one third of all adults are still obese, and obesity is a harmful epidemic that can cause a multitude of diseases such as type 2 diabetes and cardiovascular problems. We need to concentrate on publicizing the downfalls of an unhealthy lifestyle and promote healthy eating and physical activity. Additionally, the U.S. needs to consider lowering the costs of organic foods and specialty items and placing a tax on unhealthy food, just as Canada and countries in the United Kingdom have. This would definitely eliminate part of the problem. 

http://www.usatoday.com/story/news/nation/2013/10/17/obesity-rate-levels-off/2895759/

South Asian Cholera Strain Spreading

A South Asian strain of Cholera was discovered in Haiti and the Domincan Republic three years ago, now it is not isolated in the Caribbean Islands. It was discovered in Mexico on September 9th. Cholera, once present in the water - especially in areas with poor sanitation, is very hard get rid of. Haiti and the Domincan Republic's case of this strain of Cholera was most likely from UN peacekeeping troops from Nepal, who were positioned long term, in a camp, which had very poor sanitary facilities/untreated water. 
Mexico has been the fourth country in the Western Hemisphere to experience this outbreak. Mexico's case was first found in through normal surveillance of hospital cases of severe diarrhea. Since September, there has been 171 reported cases found in Mexico, and one person who has died.
 It was not that long ago either since the last major cholera epidemic. 22 years ago, a cholera outbreak spread all the way up the South American continent, until stopping at the US- Mexico border, because of the US modern sanitation facilities. It sickened more than 1 million people and killing around 10,000. Officials are extremely worried a similar situation could play out with this South Asian Cholera strain. It took Mexico more than 10 years to bring the last cholera epidemic under control.
The World health Organization has a stockpile of oral cholera vaccines, costing $ 1.85 and requires two doses, however Mexico is not considering using them right now. The vaccine is mainly to use for epidemics (which this could turn into). But Mexico authorities are focused on monitoring the population and fast treatment of affected people.

If this turns into an epidemic, the public health implications would be huge. It won't just a regional impact, but a global health impact. Infectious diseases have away of bringing developing nations backward in time. It's not just having people sick - it's having people unable to go to work, to school, unable to live their lives. Public health officials agree that the only real solution is to have clean water and better sewage treatment to communities. In the article is states that Cholera is one of the few diseases that makes people listen. So hopefully this strain of Cholera will make people take action (as in provide funding to bring clean water and sewage treatment).
 In class we learned about the leading causes of death has changed (in the US), from infectious diseases and things that are from crowded spaces, poor water treatment, etc in the early 20th century, to chronic diseases in the 21st century. Thus the things public health has been focused on and targets has changed. I think this contributes to the idea that, for Americans, their is a view that Cholera was something that happened in the past, and it won't affect us now. Clean water and sewage treatment is such a basic human need, that it's hard to imagine not having that available - and that this is still a problem, and it's not just in far away places, it's in a place that the US share's a border with.



http://www.npr.org/blogs/health/2013/10/23/239803890/haitian-cholera-strain-spreads-to-mainland-with-mexico-outbreak

No Time for Toxins, Just Sleep.

According to BBC, Recent research suggests that lack of sleep could lead to deteriorative mental health issues later in life. For many years, evolutionary biologists have wondered why, in a predator-prey food chain environment, animals maintain sleep above other functions when it so clearly exposes them to harm. Now there is evidence that it is due to the restorative processes occurring during sleep. These studies are centered on the function of the glymphatic system of mice while they sleep, including the shrinking of the glial cells, which enables the interstitial space to open and fluid to wash away toxic chemicals that build up during the day.

This has led the way for studies to track the mental health of those running daily on little to no sleep. Included in this sleep-deprived population are students ranging from middle school through college-aged, whose ration of homework each night keeps them from getting the sleep they require. This has serious implications for those in secondary education, during the critical formative years for brain and neuronal development, who are staying up until the early hours doing homework and playing video games. The grade-driven and technologically consumed culture has become over-bearing and stressful for younger generations and in several decades, could lead to an older population plagued with neurodegenerative disorders.

The article did not clarify the interstitial fluid composition nor did it qualify what toxins were building up in the brain, so I would be curious to know the biochemical pathways associated with this process.  If cleaning mechanisms or lipid metabolics are influenced/inhibited by these toxins, then the possibility for causation of neurodegenerative disorders is more than likely true. And if that is the case, then there most definitely needs to be a stronger campaign for youth to spend less time stressing about schoolwork, and more time resting, meaning classes and teachers may have to reevaluate their techniques to maximize time in the classroom to reduce time spent outside the classroom. Schools should spend more time teaching students how to study and work, rather than piling on lectures and expecting the students to process the information on their own.  It has always been said that sleep is critical to good mental health, but now those words may be truer than ever.

http://www.bbc.co.uk/news/health-24567412 

Chronic Kidney Disease

According to this article, kidney disease in America is actually the cause for more deaths (90,000) than breast cancer and prostate cancer combined annually. Obviously, great strides have been made in cancer research but to almost abandon funding and research for kidney disease and prevention presents a huge public health issue. Kidney disease is very preventable and with the correct diet and treatment can be very manageable.  Limiting the soft drink, red meat and fast food consumption could have a very large effect on the number of deaths resulting each year from kidney disease. If people can take such proactive measures to do research for cancer and make an effort to limit the contributing factors to the disease, then  why can't they focus on doing the same for kidney diseases? Because this is such a preventable disease it just makes sense to stop it before it's too late as opposed to waiting until you already have it. By that time, type 1 or 2 diabetes could have set in leaving you to pay for treatment that most of the time exceeds the average Medicare pay out by nearly 5 times for patients 65 and older.

http://well.blogs.nytimes.com/2013/07/15/kidney-disease-an-underestimated-killer/?_r=0

Fat and Thin Find Common Ground

There has been a lot of controversy in regards to diagnosing patients with eating disorders like anorexia and bulimia and obesity. There are a lot of factors to consider, so although the symptoms of the patients exhibit the disorder, their image might say otherwise. Both were always considered two distinct problems, but with the number of people dealing with binge eating disorder increasing, this disorder seems to be a way to bridge the gap between the two health problems. Those who suffer from binge eating disorder or any other eating disorder are usually seen as thin, but according to the National Co-Morbidity Survey Replication, about 39.8% of respondents were obese.This goes to show that there are many mistakes being made in diagnoses and proper treatments because differences in physical characteristics and symptoms are not being seen. In a pediatric study back in September, it was found that almost half of all adolescents with a eating disorder had a history of obesity, but because their weight was so high from their past, their symptoms were not recognized as eating disorder symptoms and were often unrecognized and untreated as well.

The stigma and pressure that society and the media places on what the ideal figure should be creates such a big divide between the two and overall the both against the rest of society that is considered the "norm". Obesity is often a disorder more associated with the medical side of things and eating disorders are more often associated with psychology. What needs to be understood is that both medical and psychological means need to be addressed for both obesity and eating disorders and that the two actually have a lot of similarities and should use those similarities as a basis to work together for effective treatment. The focus needs to made on treating those who are obese or suffer from a eating disorder, and then shift that towards changing their behavior instead of worrying about the number on their scale. The two communities can be one powerful political force to the public to enforce education about making better and healthier food options and implementing messages about how to get access to these foods and that it is never to to late to get healthy to the public.


http://well.blogs.nytimes.com/2013/10/10/can-the-fat-and-thin-just-get-along/

Lunar Cycle Disrupts Sleep

According to a new study, a full moon could cause people to lose an average of twenty minutes of sleep compared to a new one. This study ran sleeping trials on 33 healthy volunteers, whose ages fell between 20 and 74. They limited their view of the moon by monitoring the patients inside of a laboratory with no windows. The trials lasted three and a half days for each participant. The researchers also controlled humidity and temperature inside the lab. At the time of the study, the participants and the researchers were unaware of the link to the moon. Along with the twenty minute loss of sleep during a full moon, researchers also found it takes around five minutes longer for a person to fall asleep and deep sleep was decreased by around thirty percent during a full moon. The participants sleeping in the lab also showed lower levels of melatonin, the hormone that helps the body determine day and night.

However, there are some limitations to this study. For example, the sample size was extremely small and individuals environments before entering the study were not controlled.  In order to find more proof in this study, each participant would need to spend a full lunar cycle to get the most accurate results possible which would become extremely expensive.

This study represents another instance of the importance of data in public health. While this study may not have the medical significance of other studies such as Framingham, interpreting data on the sleep patterns could have their own health effect. This article also briefly touches on the issues of funding such study. In order to do a complete study, it would cost too much money. During a time in which government cannot work together to decide on funding, deciding which studies need federal assistance could become a major issue in the near future.

http://thechart.blogs.cnn.com/2013/07/26/full-moon-may-disrupt-sleep-study-says/

Minnesota boasts of low coverage costs under Obamacare

On Friday, Minnesota insurance officials said that it will offer some of the lowest health insurance rates in the country on the state health exchange it will launch this fall to satisfy the passing of Obamacare.  Under this new law, insurers will not be allowed to turn down customers with pre-existing conditions. Maternity along with mental health services will also be covered.  Young, healthy citizens of Minnesota will be able to receive low-level coverage for about $90 per month.  Seniors can receive coverage from $244-$407, and these numbers do not take into account government subsidies that may even further reduce these prices for some.  Officials pitch that these numbers are proof that many people will gain access to health care coverage for the first time.  However, many Republicans look to studies that show for some states, premiums will actually RISE under Obamacare.   Analysts say that even though these low prices are attractive, there could be an unintended consequence of tempting consumers to purchase low-cost health insurances plans that don’t provide them with the coverage they need, which could leave people with bigger bills if they do end up needing significant care.

Overall, this is obliviously a positive sign that we are moving in the right direction toward lowering health care costs.  In turn, people will be more likely to receive basic care.  From this article we see a bright future for Minnesota implementing Obamacare, but the Republicans argue that some states will actually suffer with the new law and people may actually be unprotected from major, expensive treatments.  It’s important that we work toward finding a method that everyone will benefit from (if possible), which could be different on a state-to-state basis.  The implications of Obamacare will be huge, affecting all parts of our economy and changing public health in our country.  As we move forward in lowering health care costs, we must work to implement policy that works to limit negative effects/consequences and assure that the American people will be made better off.

http://www.washingtontimes.com/news/2013/sep/6/minnesota-boasts-low-coverage-costs-under-obamacar/

Decrease in cancer deaths within the married population

Studies show that being married could significantly reduce the likelihood of dying of cancer. The journal of clinical oncology recently published a study of 700,000 subjects who were diagnosed with the worst and deadliest types of cancer in the world. The research found that there was a 20% decrease indeaths amongst the group of patients who were married as opposed to patients who were unmarried. A direct link was never found to prove that being married reduces the likelihood of cancer deaths, but an association was made between marital status and cancer survival rates. This may be due to the social support a person receives from his or her spouse. If a wife is constantly prodding her husband about going to get a colonoscopy, chances are, he will. In turn, if the husband gets annoyed with her nagging and starts bothering her about getting a mammogram, she will probably end up getting her screening done as well. 17% of patients who lived by themselves were more likely to have their cancer spread beyond its original state and 53% were more likely to receive inadequate treatment. It’s also beneficial to have a partner present during the appointments to keep track of what the oncologist is saying since many patients tend to become overwhelmed with the information. On top of medical care and help with the appointments, a person with a spouse is more likely to be loved, encouraged and taken care of at home, and that may be one of the best things that can be done in this situation.

http://thechart.blogs.cnn.com/2013/09/23/marriage-may-improve-cancer-survival-odds/  

Food vs. Freedom

The American electorate loves the word "freedom"-and for good reason. No other notion has given birth to a country, successful bids for the presidency, and perhaps now, less food for the impoverished. As the author sites, many house republicans believe that the only objective they have this term is to end President Obama's expansion of "reckless government programs". Furthermore, Krugman suggests that the 2008 recession created two problems. First, with an increasing unemployment rate, far more citizens signed up and are now receiving SNAP benefits (a 22 million person increase since 2007). He views this as a good thing, especially considering that the point of the SNAP program is to temporarily aid those in need. Krugman's second point is a little less positive. He cites that some (the republican party) see that same population increase as a signal of an irresponsible expansion of a government program. Adding fuel to this fire is the increase in cost that the SNAP program carries in the midst of a growing national debit. There in essence is the issue of modern government. Some see federal activity as a prohibitor; a roadblock on the path to "freedom". Others see our known social differences (i.e., race, income, and geography) as roadblocks on the same path. This raises the question, which philosophy we choose? Some in the state of Arkansas would argue that the answer is both. Some would argue that hunger is a bipartisan issue that we should all be able to agree on. Evidently our House of Representatives didn't get that memo. Major congressional leaders such as Paul Ryan have spoken out in a borderline insensitive way and "the good guys [the democrats]" are turtling up as to win re-election. To further complicate the issue, when manifested by an action (such as the massive cuts to SNAP in the House Farm Bill), statements such as Rep. Ryan's could be counter productive to the G.O.P's efforts to bring in young voters. So here is the question we need to ask ourselves, is the expansion of freedom really the driver for cutting SNAP benefits to those in need? Are our  Representatives (in both parties) concerned with the public health, or their own political health? To answer these questions, we need a dialogue regarding the definition of freedom and how such a definition relates to the public health and the health of the nation. 

Link: http://www.nytimes.com/2013/09/23/opinion/krugman-free-to-be-hungry.html?_r=0

Antibiotic-Resistant Infections

With the development of vaccines and antibiotics, bacteria infections are not something people worry to much about.  But growing numbers of antibiotic-resistance infections have raised concern.  The Center for Disease Control conservatively estimated that two million people contract antibiotic-resistant infections and 23,000 die from it.  It is also said that many infections that are developed in hospital settings are resistant to some antibiotics.  A major concern for these drug-resistant bacteria is the industrial-scale farming procedures.  Most of the antibiotics given to the farm animals are unnecessary and could be leading to bacteria developing defenses against it. John Hopkins Bloomberg School of Public Health looked at 440,000 records and found that people who lived near farms were 38% more likely to develop a drug-resistant infection.  It, however, can't be concluded that living near farms increases your chance on contracting an antibiotic-resistant infection.  Nonetheless, the government should cut down on the amount of antibiotics farmers can feed their livestock. It was also stated that antibiotics are also inappropriately prescribed to patients.  Because the excess of antibiotics being used, it increases the numbers of those who don't complete their full dosage. It is known that not completing your antibiotic prescription can cause the bacteria to become immune to it, and come back stronger.  Other interventions should be used before antibiotics are prescribed. It is surprising the amount of antibiotic-resistant infections that are picked up at hospitals.  How can hospitals and health clinics decrease the spread of infections?

Link:
http://www.nytimes.com/2013/09/17/health/cdc-report-finds-23000-deaths-a-year-from-antibiotic-resistant-infections.html?ref=health&_r=0

Telemedicine: Saving U.S. Health Care With Skype

Telemedicine is the use of telecommunications to provide clinical health care and to exchange medical information from a distance, and it may be the solution to the U.S. health care access problem. The University of Virginia Health System has implemented their new Center for Telehealth program, allowing physicians from 40 specialties to partner with over 100 community hospitals, clinics, and schools to provide care for people who otherwise would not have access. However, this program is not unique to Virginia; there is a telemedicine program in every state, involving everything from psychiatric evaluations to prenatal care. Telemedicine can provide primary care and specialist referral services, remote patient monitoring, consumer health information, and medical education. With the predicted doctor shortage and the insurance coverage of the Affordable Care Act, telemedicine is believed to have a positive influence on the health care system. Its benefits include reducing hospital readmission rates, saving patients time and miles in travel for health care, improved access to both rural and urban areas, and keeping costs low, all done through simple services such as Skype or instant-messaging.
However, this also raises questions to what regulations may be necessary to fully implement telemedicine, which could transform our health care system into a virtual health care system. There are currently restrictions in place for physicians practicing outside the state they are licensed in, and telemedicine results in many issues regarding HIPAA and the protection of patients' privacy. To be sure, telemedicine introduces huge implications for the future of technology, medicine, and health care in both public- and private-sector settings.


Link:
http://swampland.time.com/2013/09/16/saving-u-s-health-care-with-skype/

Treating the 'Body and Soul' in a Russian TB Prison

As we have read, Russia suffers from a variety of issues in the public health sector. In recent years, one of these issues has been tuberculosis: in the country's population in general, but especially in jails. About 10 years ago, Medical and Penal Institution Number One was opened for inmates infected with tuberculosis. In this center, the inmates receive medical care for their illness, but also receive unique correctional activities, such as the opportunity to perform in talent shows, spend time with other inmates in the jail's cafe, and become educated on taking responsibility of personal health for the good of the community as a whole.
This approach to treating inmates with a highly communicable disease is quite original, and has been wildly effective in reducing the frequencies of TB infections among individuals in jail. Additionally, pairing cultural and educational opportunities with the medical treatment lends the inmates a feeling of community and purpose within the jail. This can help with self-confidence and happiness in general, and both of these feelings are crucial for positive behavior change. Thus, the coupling of medical treatment with cultural and educational engagement not only cures them of tuberculosis, but also encourages them to become responsible social citizens once more upon their release from the institution.

Link
http://www.npr.org/blogs/health/2013/07/09/197739736/TB-IN-RUSSIAN-PRISONS

Israel Revaccinates One Million Children Against the Polio Virus

Health workers in Israel have found the poliovirus circulating in southern Israel’s water systems, an especially problematic health issue as Israel has not had a case of polio since 1988 and was labeled “polio free” by the World Health Organization (WHO) in 1992. The reemergence of the poliovirus, traced by geneticists and epidemiologists to having come from Pakistan, could infect Israeli children for the first time in over twenty years. To prevent this, Israeli health workers have started a huge public health revaccination campaign in which they plan to revaccinate a million children under the age of nine to keep polio at bay. Due to increased globalization, viruses can move more freely and quickly than ever before, with the risk of infecting entire populations around the globe. This issue in particular pertains to public health because of the way polio is transmitted as well as the fact that since polio has been eradicated in many countries around the world, communities in the developed world have their guard down and are not at all worried about contracting polio. If polio were to spread from Israel into Europe or the United States, it could have severe consequences, which is why public health workers in Israel have amped up the revaccination campaign in an effort to control the further spread of polio. Also, most developing countries use an oral vaccine version of polio, which contains a weak amount of live poliovirus and spreads through the environment. This is important because the oral vaccine may increase immunity for those children who have not been vaccinated, thereby affecting the community, while the injectable virus that most children in the developed world receive simply immunizes the individual from contracting the poliovirus.

Here is a link to the article, from NPR News: http://www.npr.org/blogs/health/2013/09/02/217194998/to-keep-polio-at-bay-israel-revaccinates-a-million-kids?sc=17&f=1001

This blog has been created for students in the Introduction to Public Health course at Hendrix college. Students in the course will be posting items periodically to discuss the ways in which public health is happening all around us.