Author: Crystal Bentley

green plants spilling out of a mortar and pestle

Free, all-natural, non-pharmaceutical intervention named the “blockbuster drug of the century”

The “Blockbuster Drug of the Century,” is all natural, has no negative side effects and is not the least bit new.  However, it’s getting more and more attention.  It’s nothing as sexy as a cure for cancer.
This drug isn’t a drug at all- it’s patient engagement.  Studies have shown that patients who are engaged in their care have better outcomes and incur less healthcare costs.

Unfortunately, we’re still having difficulties engaging patients.  Part of the issue could be that most practicing clinicians don’t receive formal training to communicate effectively. Additionally, patients with limited health literacy are less likely to speak up and engage in their care.

In patient engagement, we’ve found a tool that costs nothing and saves lives, and most of its implementation centers around communication.  While it may feel like it takes longer to slow down and communicate effectively, it can help keep patients out of the hospital and save you time in the form of less follow-up calls and visits.  While overall, increased patient engagement will likely come over time with a culture shift from patients and clinicians, we can start by employing a few communication techniques to start:

  1. Use simple language
  2. Use the teach-back method to check for understanding
  3. Focus in the most important information

These three things can go a long way to blockbuster results.

Picture of the North Carolina State flag in the shape of the state

NC Medicaid Expansion- A quick look at pros and cons

In North Carolina’s State of the State address Monday night, Governor Roy Cooper encouraged the state legislature to expand Medicaid.  Among other reasons,  he cited that North Carolinians federal tax dollars pay for Medicaid expansion in other states, so our residents should have access to those services as well.  Medicaid expansion has been on many people’s minds since the Affordable Care Act made it possible in 2014.  In honor of this, let’s highlight some of the arguments for and against it in North Carolina.

Against Expansion

For Expansion

These are some of the main pros and cons to Medicaid expansion.  What are some other arguments, both for and against, that you’ve heard?






House made of puzzle pieces with one piece missing

Housing First helps homelessness and saves money

Housing First is catching on across the county with great results. In this model, homeless and housing-unstable individuals are provided with permanent housing before the organization attempts to address other issues like substance use and employment.

The Housing First Model has seven core tenets:
1. There are few if any prerequisites to permanent housing
2. There are few barriers to entry.
3. They allow for rapid entry to housing
4. Supportive services are encouraged but are ultimately voluntary
5. Tenants have full legal rights, responsibilities, and legal protections
6. They include policies, like installment payments for missed rent, that help prevent evictions.
7. This model can be applied in many housing types.

The University of Illinois Hospital started a Housing First modeled program as they a direct connection between housing and health. In November 2015, they committed $250,000 to re-housing their homeless frequent emergency department users. Among the program recipients the hospital has seen a 57% reduction in inpatient stays and a 67% decrease in emergency department utilization since its inception.  This means healthier people and less cost on the already strained medical system.

Though some may find the idea of providing housing without additional stipulations controversial, even our federal government has started endorsing this practice.  On the United States Interagency Council on Homelessness’s website, the first item listed under “solutions” is to deploy a system-wide housing first program. By providing homes without additional barriers, Americans save up to $23,000 per participant compared to the cost of traditional housing programs.

As this model spreads across the country, support it with your votes and actions.  Look for politicians who support this model and want to allocate city funds toward housing first.  Its just one more way we can help our fellow humans.




Cartoon with 6 arms. Holding a wrench, light bulb, clock, magnifying glass, and USB stick

Boost your productivity and your health without taking any extra time out of your day

Have your ever gotten to the end of your work day and wondered where your time went?  Some research suggests that during an eight-hour workday, most Americans are only productive for 2 hours and 53 minutes.  This means we’re spending over five hours at work surfing the web, posting on social media, and being otherwise distracted.

Productivity experts suggest that after focusing on one task for twenty-five minutes, we benefit from taking a short break.  Others say that we can productive time can extend up to 90 minutes before we need a break.  Either way, for many companies, their most productive employees take more breaks than anyone else.

If you’re looking for ways to spend this new downtime, consider taking a snack break.  While this may elicit thoughts of chocolate and potato chips, “exercise snacks” are one other way to use this time.  Exercise gets your blood moving, which can improve focus, increase energy, and improve your memory– all of which can help your get more done in the day.  Your exercise time doesn’t have to take up your whole lunch break, instead it can be just a short burst of activity.  One article from the New York Times says that “as little as 20 seconds of brisk stair climbing, done several times a day might be enough to improve fitness.”

If you’re feeling yourself slump, take a break and get moving.  Both your body and your boss may thank you for it.

A picture of a model of a the Beatles Yellow Submarine Cover Art

5 contributions the Beatles made to healthcare today

“Lord of the Rings” director Peter Jackson recently announced he will work from 55 hours of footage from 1969 to remake the Beatles documentary, “Let it Be.”  This announcement reminds us of how much “The Fab Four” has shaped our world.  Though we think of their contributions toward advancing music and changing ideas of acceptable hair lengths, we rarely celebrate their contributions to medical science.  In honor of the documentary remake, let’s take a moment to countdown some of the biggest ways they influenced healthcare today.


Number 5: Blood Pressure Research

In one study, researchers wanted to know how different types of music affected blood pressure after heart attacks.  They pitted the Beatles against Mozart and found that Mozart lowered blood pressure more.

Number 4: Psychotherapy

In 1976, one researcher decided to study the lyrics of Beatles songs.  He found that the words helped describe many issues facing his adolescent patients.  Once he examined the lyrics, he felt that not only could they help facilitate patient-provider connection and conversations in group settings, but he also argued that understanding the song lyrics allowed providers to “understand in greater measure the psychodynamics of this age group, and thus empathize more effectively with them.”

Number 3: Music Therapy.

For decades, music therapists have used the Fab Four’s music to help reduce disruptive classroom behaviors and promote dancing and movement in children with disabilities.  They have also used Beatles’ songs, among others, to help families of cancer patients express their feelings and work through their grief as they watch family members’ conditions worsen.

Number 2: Complementary and Alternative Medicine

The Beatles practiced transcendental meditation, and often spoke about it.  This led others to travel to India to try it themselves, which ultimately helped further the consciousness of complementary medicine.  Through this consciousness, Western Society became more comfortable with other forms of medicine the Eastern culture has relied upon for centuries.

Number 1: CT scans

In the 1960’s, the parent company for the Beatles record label also owned EMI Central Research Laboratories.  The company funneled royalty money from Beatles record sales back to the science laboratories, which in turn allowed scientists to advance the CT-scan technology we rely upon today.

The Beatles will forever shape so many parts of our history.  Are you seeing any other non-musical effects of Beatlemania?




many lines of complex source code cover the entire screen

Data visualization and health communication

Data visualization uses charts, graphs, maps, and other visuals to better understand data sets that are either very large or complex.  With the growth of big data, more and more companies need ways to understand all the information we collect.  Considering the world doubles the amount of data created every two years, the ability to visualize and understand this information is becoming increasingly important.

Data visualization helps health communicators as well. As we show disease outbreaks or chronic disease trends to the general public, we also rely on data visualization tools that help people digest this complex information.  However, we don’t always remember to develop these data skills as we’re learning to use plain language, active voice, and visuals with lots of white space.

Last week, UNC data visualization librarian, Lorin Bruckner, presented a data visualization workshop to this semester’s Upstream Downstream blog editors. While we learned many bits of information specific to data, this lecture also reminded us of some basic communication questions:

  1. Does everything on the page add to your message?
  2. Is there any way to make this work look less cluttered?
  3. Can your audience understand the information?

In data, design, or content writing it’s easy to forget to stop and ask these fundamentals.  Are you still using them in your work?

photo of buses and a bicycle stacked on each other

Public transit can help with your new year’s resolution

The recent new year brought the usual onslaught of new years resolutions, and for many people, this meant increasing their activity levels.  Of course, there are the usual ideas of joining a gym or getting work-out equipment for the home, but did you know that taking public transportation can also help with this goal?

Studies have shown that people who take public transportation are more likely to utilize active travel methods, and they are typically more active than those who drive. Additionally, some are suggesting that if you take the time to relax while you commute, you may be able to reduce your stress levels, which has been shown to help weight loss efforts.

On top of the personal health benefits, when people opt for public transit instead of driving, they help reduce the amount of air pollution we breathe in.  Air pollution has negative effects on our lungs and cardiovascular systems.

So if you can, ride the bus. It helps you and your community.

A Beginner’s Experience with Container Gardening

We’re often encouraged to eat fresh veggies as part of a healthy diet (1), but the produce section can be expensive (2). Container gardening may be a cheaper alternative (3).  This is my second year attempting to grow plants in containers, and I have found that plants require a little more than just sun, dirt, and water.  Below are some of the lessons I’ve learned.

Lesson #1: Choose the Right Plants
Make sure to choose plants that will grow in your area at the time you’re trying to grow them.  For the second year in a row, I’ve had the vision of growing my own tomatoes, peppers, and cilantro for salsa, but I’ve planted all of these plants outside at the same time.  After planting, I learned tomatoes grow in the summer (4), but cilantro turns to seed in the heat (5).  This means I won’t be able to make salsa from my garden again this year.

Once you’ve decided what to plant, you’ll need to decide between plants and seeds.  If you’re using seeds, start them in small containers and then transfer them to your larger container once they’ve grown several pair of leaves (6).  It’s hard to tell how many seeds will survive from the original planting (6).  If you try to start them directly in the final container, you could end up like me with way too many peas to trellis and no surviving spinach.  If you are buying plants from the store, make sure the leaves look whole, green and healthy, and the plant is compact and full (7).

Lesson #2: Choose the right containers
Most plants come with a tag stating how far apart they should be spaced.  This spacing allows plants to get enough nutrients and keeps them from casting too much shade on each other (8).  Your containers should be large enough to accommodate this spacing and allow for proper planting depth.  This year, we almost planted tomatoes in a 5” high pot when their roots need to grow 12” deep.

Lesson #3: Location, Location, Location
Even if you have space for containers, make they get enough sun.  Most vegetables require at least 8 hours of sunlight each day (9).  However, sun may not be your only location issue.  Unless you want to rub your plants with cotton swabs (10), you may want to consider how your plant gets pollinated.  Carrots and spinach typically rely on the wind to help pollinate them (11).  This means they need to be far enough away from the building that the wind can reach them.  Other plants like cucumber and squashes like insects to help pollinate them (11).  Therefore, there needs to be enough flowers in the area to attract pollinators (12).  Last year, my tomatoes were too close to the house and I didn’t have any flowers around my garden.  I only harvested 4 tomatoes, and I didn’t get a single pepper.

Lesson #4: Beware of Dog
Your pets may be curious about the new smells and fresh dirt.  Especially, if your fertilizer has a strong scent or your containers are light, watch pets around fresh plantings.  I have had to re-plant some plants and clean up overturned buckets.

Container gardening can be a cheap way to get your veggies.  Hopefully, my lessons learned will help you have fresh veggies all summer.


  1. United States Department of Agriculture. Why is it important to eat vegetables? [Online] January 12, 2016.
  2. Increasing Access and Affordability of Produce Improves Perceived Consumption of Vegetables in Low-Income Seniors. Abusabha, Rayane, Namjoshi, Dipti and Klein, Amy. s.l. : Journal of the American Dietetic Association, 2011, Journal of the American Dietetic Association, Vol. 111, pp. 1549-1555. Research and Professional Briefs.
  3. Cancler, Carole. How to start a vegetable garden on the cheap. Living on the Cheap. [Online]
  4. The Old Farmer’s Almanac. Growing Tomatoes. The Old Farmer’s Almanax. [Online]
  5. Burpee. All About Cilantro. Burpee. [Online]
  6. The Old Farmer’s Almanac. Starting Seeds Indoors. The Old Farmer’s Almanac. [Online]
  7. Ianotti, Marie. How to Choose Healthy Plants. The Spruce. [Online] 2 17, 2017.
  8. The Importance of Plant Spacing. Grow Great Vegetables. [Online]
  9. Banks, Shawn and Bradley, Lucy. Vegetable Gardening: A Beginner’s Guide. NC State Extension. [Online] September 4, 2015.
  10. VegiBee. Garden Pollinators. VegiBee. [Online]
  11. University of Georgia Extension. Pollination of Vegetable Crops. University of Georgia Extension. [Online] November 30, 2014.
  12. Admin. Attracting Bees To The Vegetable Garden. VeggieGardener. [Online] April 8, 2010.
  13. Jones, Gardening. Vegetable Crops That Do Not Need Pollinators. Horticulture Magazine. [Online] January 21, 2014.


Looking at Our Health Care System

By now, we’ve probably all heard statements comparing United States’ health care against other countries- we have the most expensive healthcare (1), we have many suffering due to lack of access (2), medical bills are the leading cause of bankruptcy  (3), etc.  Then we’re met with opinions who like our healthcare system stating that Americans have choice (4), we have better technology (5), we treat patients quickly (6), and the list goes on.

Many Americans seem to take pride in our capitalist healthcare system. I know that I grew up hearing that all other systems were socialized medicine which removed the incentives to innovate and increased wait times for patient care.  However, I have recently looked more closely into other health care systems, and it has caused me to re-examine the stories of my youth.

For today, I would like to examine Germany’s healthcare system.  Even though everyone has health insurance, they still use a mix of public and private insurance companies (7), their costs are lower than American healthcare (8), they have similar wait times (8), no one is going bankrupt due to medical bills (9), and they continue to innovate (10).

I don’t presume to know how to change our health care system, but I do believe it is time to turn it upside down.  In the 1990’s, Switzerland successfully moved away from a system structured like ours to one that granted universal coverage (11).  I believe that if they can take care of their own, then so can we.

I know that an overhaul will take lots of conversations and time.  For now, I ask that we start questioning if this really is the best health care system for all Americans or is it just the best one for the healthy and wealthy.  If you think that we are no longer serving everyone, then I encourage you to be part of the conversation.  Even if you don’t have to wait a long time for a doctor, should another American have to wait because they don’t have insurance?



  1. Peterson-Kaiser. Total Health Spending. Kaiser Family Foundation. [Online] March 19, 2017.
  2. Centers for Disease Control and Prevention. Access to Health Care. Centers for Disease Control and Prevention. [Online] May 3, 2017.
  3. Backman, Maurie. This is the No. 1 reason Americans file for bankruptcy. USA Today. [Online] May 5, 2017.
  4. Speaker Ryan Press Office. The American Health Care Act: Fact Sheet. Speaker Paul Ryan. [Online] March 7, 2017.
  5. Evans, Maria. What Are the Benefits of the United States Health Care System? Pocket Sense. [Online] October 25, 2017. 2017.
  6. Dhand, Suneel. 5 things that make U.S. health care great. [Online] August 5, 2014.
  7. Carroll, Aaron E. and Frakt, Austin. The Best Health Care System in the World: Which One Would You Pick? The New York Times. [Online] September 18, 2017.
  8. Bernstein, Lenny. Once again, U.S. has most expensive, least effective health care system in survey. The Washington Post. [Online] June 16, 2014.
  9. Underwood, Anne. Health Care Abroad: Germany. The New York Times. [Online] September 29, 2009.
  10. German Foreign Ministry for Economic Affairs and Energy. Innovative German medical technology a key healthcare industry driver. German Foreign Ministry for Economic Affairs and Energy. [Online] January 5, 2018.
  11. Thacher, Emily. Switzerland: Regarding Health System Reform. The Yale Global Health Review. [Online] October 3, 2015.




Health Benefits of Video Games

For years, video gamers have gotten a bad rap.  They’re viewed as pasty hermits hiding in their parents’ basements, living off of cheese puffs and Mountain Dew.  However, the growing popularity of online cooperative games is finally overturning this stereotype.

Ten years ago, many of my friends played World of Warcraft, the ultimate stereotypical “gamer nerd” game.  Though these friends would wear the title “nerd” with honor, they didn’t fit the loner typecast that the media portrays.  For them, games were just another outlet for their already rich social lives.  Research has shown us that loneliness and social isolation can be detrimental to health by increasing stress hormones and inflammation (1).  My friends rightfully felt that they were caring for themselves by playing games.

The social benefit of games shouldn’t come as a surprise.  Kids started gathering to play Nintendo and Atari decades ago.  I spent much of my childhood getting laughed at by a cartoon dog because I was a poor shot in Duck Hunt.  Advances in internet technology now allow people to play together without sharing the same space, and this has led to a proliferation of online gaming.  Some say the explosion began with Call of Duty 2 in 2005, which has sold over 5,800,000 copies to date (2), and it continues with Fortnite: Battle Royal, which gained 10 million players in its first two weeks (3).  With these ever-increasing numbers, we can assume that players are getting something positive from their experiences.

As online gaming expands, more and more people are scrutinizing its possible health effects.  Critics often ignore games’ social benefits and fear that by exposing children to violent games, they may become violent themselves (4).  However, this theory has been debunked, and games are no more harmful than TV or movies (4).  Plus, some evidence suggests that games may actually be beneficial to health.  According to an article by the American Psychological Association, video games likely increase learning, health, and social skills (2).

So, if you’re wanting to pick up a copy of the next hot game, go for it.  It may be good for your health.




  1. Kluger, Jeffrey. 5 Ways Loneliness Can Hurt Your Health. [Online] November 13, 2017.
  2. Murphy, Richard. How significantly has Call of Duty changed gaming? Games Radar. [Online] November 1, 2013.
  3. Lumb, David. ‘Fortnite: Battle Royale’ claims 10 million players. Engadget. [Online] October 11, 2017.
  4. Gentile, Douglas (interviewee) and Shapiro, Ari (host). What Research Says About Video Games And Violence In Children. All Things Considered Radio Program. [Online] National Public Radio, March 3, 2018.
  5. Bowen, Lisa. Video game play may provide learning, health, social benefits, review finds. Monitor on Psychology. February 2014, Vol. 45, 2.
  6. Gerencer, Tom. How Much Money Has Every Call of Duty Game Made? Money Nation. [Online] December 23, 2015.