Author: Arshya Gurbani

Normalization and Solidarity in Mass Communication–what are the impacts of the #MeToo posts?

As a student in health communication, I cannot help but be curious of the health impacts of the massive sharing of #MeToo stories on social media this past week. It’s rapid and broad spread globally is significant. The Hindustan Times reports that within 24 hours, the hashtag had been used more than 500,000 times and on Facebook an additional 12 million (the linked article is also an interesting take from a global perspective) . A few days later, this number was much closer to 10 million.

Here are some questions that have been floating around since last Sunday:

  • What is the impact for victims/survivors (source: CNN)?

For some, this may be therapeutic–it may create a safe space and a sense of solidarity that encourages catharsis and reflection on an often stigmatized and complicated issue. However, it can also be an emotional trigger for those who are not prepared to speak publicly or feel compelled to share a personal and traumatic experience.

  • How does this sentiment translate into action?

A Washington Post contributor discusses that while speaking out on social media is encouraging, it remains to be seen whether the dialogue initiated will lead to actual actions. It’s hard to  measure the how and if such a socially embedded problem changes. It is also worth considering social circles–the fact that while our friend groups on social media are supportive, in some cases they may not be the ones that need to hear the message most. As the Hindustan Times article linked above asked, what do we need to do to make sure there is no reason to tweet MeToo years from now?

  • What makes a movement viral, and how can this be harnessed to improve health outcomes?

This is non-specific to the topic of sexual abuse, but in general, what are the factors that made the MeToo hashtag catch on so quickly? It’s personal nature? It’s ubiquity? Recent news? Media studies say most hashtags are created ad hoc, perhaps that is more genuine and reflective of users’ needs, though efforts have been made to generate disease specific discussions…but I wonder what the role of these hashtags and surrounding dialogue will be in a few years. As people rely increasingly on social media for information in addition to sharing content, how will this be leveraged by those who wish to propagate information?

Interested to hear your thoughts about social media and health-related campaigns/movements–this one in particular, or others.

Maps are not uncharted territory!!

Ignoring how corny the title of this post is, you must admit it’s true. Odds are you have looked at a map sometime in the last week–probably on  a GPS, maybe in a research or news article, perhaps on the globe that sits idly in your office or living room? Did that map catch your eye?

A map is charted territory, but it doesn’t have to be limited to a Mercator projection showing geographic data. Maybe it’s been off my radar, but I don’t think I’ve reflected enough on just how powerful a map can be in communicating about health-related topics. In a public health seminar class this evening, our eyes were opened to just how much information can be presented powerfully by effectively manipulating a map. Here are a few of the maps we discussed:

Source: https://www.businessinsider.com.au/countries-that-drink-the-most-2015-1

source: http://brilliantmaps.com/population-circle/

source: https://www.vox.com/2014/8/26/6063749/38-maps-that-explain-the-global-economy

 

If you’re interested in poring over a few more, this site has 38! Also, I know I’ve posted this TED talk on this blog before, but it really is pretty amazing for Hans Rollin’s remarkably effective story-telling using data. I’d go so far as to  say some popcorn wouldn’t be uncalled for –stat!–but data is just my opinion. (Sorry)

 

CHIP in or out?

When it comes to healthcare coverage in the US….well, let’s just say it hasn’t had a historically smooth path. Among the political debates have been to whom the government should provide aid, how much, and how for how long…but everyone agrees that children should be have health insurance. Politically speaking, they are an easy group to support.

CHIP, The Children’s Health Insurance Program, was  created in 1997 as part of the Balance Budget Act of 1997. By 2000, every state had enrolled in CHIP-financed coverage. The cost of the program is split between states and the federal government via a formula called the Medicaid Federal Medical Assistance Percentage. But the split is actually more 71-29ish than 50-50, as Congress had also enhanced funding to match 15% more than what a state would cover–basically giving states a bigger incentive to enroll in the program.

Funding for CHIP expired on September 30th. The Affordable Care Act extended CHIP and further enhanced the federal matching rate, which should have continued through September 2019. Many states relied on this in their budgeting, and will face huge shortage if Congress does not extend federal funding.While Congress tries to pass legislation to rescue the program, states like Minnesota and Utah have already applied for emergency funding, and 27 additional states are expected to need more funds by March.

Legislation went through the Senate earlier today, but financial negotiations will need to be sorted across party lines before the vote can pass in the House.

Kaiser Health News  is a reliable source to stay up-to-date on the progress of the bill. It’s unlikely that a final decision will be made before the end of this month, but the bottom line is–nearly 9 million children’s insurance status depends on a successful resolution of this bill.

Emerging Emojis–the fight for a seat at the table

Do you sometimes feel like an emoji is the only way to perfectly embody the message, or the face, you are trying to convey?

It’s no secret that emojis are changing the way we communicate. They don’t just appear on our phones, either. Popularized emojis are iconic, appearing on clothing, in advertisements, and other outlets. They allow for a creation of meaning and personalization, as a readily accessible tool with which to join a dialogue.

Marla Shaivitz, a communication specialist at Johns Hopkins University’s Bloomberg School of Public Health, and Jeff Chertack, a malaria expert with the Bill & Melinda Gates Foundation, are appealing to the Unicode Consortium–an organizing body that approves characters an emojis for standardized usage–to consider adding a female mosquito to the list of emojis that will be added to smartphones next year. Apparently, the mosquito is among a list of 67 finalists that will be further considered.

Anticipated uses of the emoji include pairing the image with other symbols–a rain cloud, for instance, to encourage people to stay dry indoors and to encourage insecticide application–or to indicate that eradication efforts are under progress. As mosquitoes are key in infectious disease transmission (for viruses including dengue, Zika, malaria, and yellow fever), a recognizable symbol might encourage more dialogue about preventative behaviors or information-seeking behaviors.

Shaivitz and Chertack make their case by estimating seven times more usage of the mosquito emoji than of the beetle emoji on Twitter. In fact, they claim there is a pretty high demand for it.

When you think about the truly random emojis that do exist, it would seem far-fetched not to include one that has the potential to actually make a  positive change. Time will tell if Unicode bites.

Sources:

http://www.latimes.com/science/sciencenow/la-sci-sn-moquito-emoji-health-20170922-story.html

hhtps://ccp.jhu.edu/2017/09/18/creating-buzz-proposing-mosquito-emoji-public-health/

 

Soda warning label ordinance fizzles out

The First Amendment protects commercial speech. There are a number of associations dedicated to protecting consumer health. Sometimes, these two interests go head to head.

An ordinance recently reached the US 9th circuit court of appeals–The American Beverage Association, the California Retailers Association and the California State Outdoor Advertising Association urged the court to refuse a mandate requested by the City and County of San Francisco to put warning labels on soda. They wanted advertisements on buses, billboards, and city structures to say:

“WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.”

The judges ruled that advertisements do not have to display the recommended warning because it “unduly burdened and chilled protected speech”. One judge wrote that targeting sodas only implied that they were more harmful in causing obesity, diabetes, and tooth decay than other products that have added sugars in them. Like these other sugary products, they are okay if consumed in moderation.

The  City of San Francisco maintains that it will continue to find ways to protect the health of its residents. It makes you wonder what the line is between promoting health and hindering speech and choice.

Sources:

http://cdn.ca9.uscourts.gov/datastore/opinions/2017/09/19/16-16072.pdf

http://www.latimes.com/local/lanow/la-me-ln-soda-san-francisco-20170919-story.html

http://abcnews.go.com/Health/wireStory/appeals-court-blocks-san-francisco-warning-law-soda-49955601

Guest Speaker: Dr. Allison Lazard talks about eHealth Design

The UpstreamDownstream Health Communication blog is run by students enrolled in a seminar class within the Interdisciplinary Health Communication program at UNC Chapel Hill. A core aspect of this class is the opportunity provided studentes to hear about the work and the journey of leaders and leaders-to-be in the field. Dr. Allison Lazard, an Assistant Professor at the School of Media and Journalism at UNC, started off our semester of guest speakers with an engaging and informative presentation on the importance of communicable materials in interactive interventions.

Dr. Lazard sees opportunities in the world to use design manipulation to create a subjective experience for individuals with needs and wants, in order to influence better health outcomes. To prioritize the user experience, she asks specific questions about aesthetics, usability and content. She has found that tone matters, users respond well to interactive design features, and that the importance of images that match a health message cannot be understated. Her research findings also indicate that responsive websites (that automatically react to be readable for a phone screen vs a computer or tablet screen) are increasingly valuable, and that there is a clear preference for classical aesthetics when it comes to delivery of health information.

As more and more people turn to web or app-based sources of information, designing effective information sources is central to effective health communication. eHealth is a new but quickly expanding field, informed by the innovative work of researchers like Dr. Lazard. We loved hearing from her, and are excited for a semester of inspiring talks!

The Aftermath of a Hurricane– public health concerns after a storm

Hurricane Harvey hit Texas hard last week. CNN says it was the strongest hurricane since Charlie hit the Southeast in 2004 (they have also shared some striking images of the damages and flooding if you want to click that link). New sources today have the current casualty total at least 70. As entire communities of people regather and begin to rebuild their lives, there are concerns to consider beyond immediate damage. Times of chaos, grief, and mass movement are ripe for poor health conditions. What health problems do hurricanes leave behind?

NPR interviewed Dr. Ruth Berggren, an infectious disease specialist who has had a lot of experience treating patients post-natural disasters. After all, she was a physician in New Orleans when Hurricane Katrina hit in 2005, and has been dealing with the aftermath of Hurricane Harvey this week. She talks about violence, mental health, and infectious diseases issues as being of particular concern in the immediate aftermath of such a storm.

According to the New York Post, Harvey sunk the crest of the Earth by about 0.75 inches! Combine that heavy water burden with people living in close proximity in emergency shelters in less than ideal hygienic conditions, and you can see why the IDSA (Infectious Diseases Society of America) is concerned with the spread of viruses. In particular, they are worried about infections that spread quickly like norovirus, and those that might affect unvaccinated populations who now have more exposure to pathogens. This is especially concerning as mosquitoes, temporarily scared off by the storm, come back to stagnant water, possibly carrying diseases with them. Access to medications to treat chronic illnesses is also expected to be more difficult. For some populations, like those living with HIV, it’s really important not to disrupt treatment. Finally going home to mold and disarray increases the likelihood of asthma and respiratory tract illnesses.

The Carribean Islands, currently facing similar conditions as Hurricane Irma unfolds, are witnessing similar public health crises.

As we hope for a quick and wholesome recovery to those affected by these storms, consider donating if you can—this NYT article links to some organizations, both local and national, that are gathering funds.

Looking at the Hunter-Gatherer Gut

There are anywhere from 10-100 trillion microbes that thrive in the human body. They help maintain normal body conditions, facilitate with digestion, and are really important to our immune systems. Some of these are permanent whereas others are transient. Your own microbiota will change over the course of your life, strongly influenced by diet among other factors. An article published last week in Science magazine says these changes may even have once been seasonal.

Their logic is based on a study conducted with the Hadza community in Tanzania. These hunter-gatherers have a diet that must be much closer to that of our earliest ancestors, rooted in foraging as opposed to agriculture. The Hadza suffer much less from digestive illness–Chron’s, colitis, colon cancer–than do modern Westerners. Though the pattern of gut microbes found have yet to be more seriously researched, there seems to be health benefits of eating seasonally. Some scientists are tentatively naming this synchronization of food ingested and microbes in the gut a biorhythm of sorts.

This is certainly not the first time the hunter-gatherer diet has been looked to for inspiration. The Paleo Diet fad/trend is based in this vein of thought. It’s rich in natural proteins and fats, carbs from fruits and roots, and eliminates dairy, grains, and the cheap highly processed foods that so conveniently line our grocery stores. It has its critics certainly, but it would be interesting to see if the Paleo dieter’s microbiota is more similar to that of the Hadza.

As research in this field continues, it’ll be interesting to see how parallels in diet and its effects on the gut will continue to inform our favorite apt saying: You are what you eat.

 

Ebola vaccine-preliminary trials

Ebola is a severe virus disease that spreads to humans from wild animals (often those found in rain forests), and can then be transmitted from human to human. The virus will onset between 2 to 21 days of exposure, and can cause fever, muscle pain, headaches and sore throats, followed by vomiting, diarrhea, impaired kidney/liver function, and bleeding. Though there are treatments, and re-hydration helps, there is as of yet no cure or licensed treatment to neutralize the virus.

In March of 2014, the World Health Organization recognized an outbreak of Ebola in West Africa–the largest one to date, and fatal in an estimated 40% of cases. It spread quickly in both rural and urban communities. The CDC reported, as of April 2016, 11,325 deaths.

An article published in The Lancet-an infectious disease academic journal- this month says that this outbreak “highlighted the need for a safe, effective vaccine with a rapid onset of protection”. A phase 1 study (the stage of vaccine development in which a vaccine is administered to what is considered a small group of adults) was completed in June of 2015 and demonstrated some success. Nearly 500 participants finished the study, which lasted 360 days, and most of them showed promising amounts of lasting immunity starting about two weeks into the study. The study was led by scientists at the World Health Organization.

Of course, the study was just short of a year, and in a relatively small sample size, so there is future research to be done. Still, the potential protection offered by a successful vaccine is an exciting thought.

Sources-

World Health Organization: http://www.who.int/mediacentre/factsheets/fs103/en/

Lancet article: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30313-4/fulltext

CDC, Infectious Disease Adviser

GOP Bill Halts in Senate

Remember back in May when the GOP health bill passed in the House? The momentum stopped there.
The Senate failed to pass a GOP-proposed Health Law yesterday. Senate Majority Leader Mitch McConnell says they’re going to try again early next week, though it doesn’t seem like this will be a promising attempt either. Analysts attribute this to many deep-rooted factors:  the Republican party as a whole not unified behind an action plan other than repealing the ACA, the taking away of funding and resources without a viable exchange, and a severe lack of public hearings and drafting.
Provisions included in a draft of the bill last week including capping funding for Medicaid, and giving states the power to opt out of insurance regulations substantiated in the Affordable Care Act. This fielded much opposition from more moderate Republicans. They cite problems  such as too “deep cuts” to Medicaid, and an insufficient means to account for the expenses of changing the insurance system. This opposition was especially strong in Republican states like Ohio that had expanded Medicaid under the ACA.
Now, Republican Senators are working on re-drafting a “repeal and delay” bill that would phase out aspects of the ACA over a two year time frame–a version of this bill passed in 2015. Of note, the draft of this bill to be debated does not include an amendment proposed by Senator Ted Cruz. According to a report conducted by the Department of Health and Human Services, this amendment might actually result in broader coverage and lower premiums. The quality and correctness of this report is already under great criticism by healthcare and insurance analysts.
Sources: The New York Times, Kaiser Health News