Author: Hannah Tuttle

Dr Lisa on the Streets: An approach to improve health literacy

Health literacy has become a buzzword not only in the public health world but in general. As the technologies, treatments and advancements are improving the quality of medicine, the way that these new discoveries are communicated are not. One physician and public health professional has made it her mission to increase the awareness of the health literacy crisis here in the United States by taking it to who it affects the most, Americans. She has launched a “Dr. Lisa on the Streets” campaign to increase awareness and gather support to improve the way health information is communicated. In her TedX talk “Are you confused about health information? You’re not alone” she discusses the economic consequences of low health literacy and how as a nation we can attempt to improve this. She refers to the “grapevine” (casual conversations, internet etc.) as one of the most powerful educators and needing to capitalize on this as a means of sharing health information.

Here are few strategies mentioned in the video about improving health literacy:

  • Manage the grapevine, it’s like ivy if it isn’t maintained it will get out of control
    • Need grapevine to counteract misinformation through verification before spreading information
  • Doctors need to embrace technology
    • Change is inspired by the masses
  • Health literacy is up to you!
    • Avoid gaps in care
    • Find your provider
    • Be persistent

To learn more about this movement and health literacy watch the full TedX talk: https://www.youtube.com/watch?v=-x6DLqtaK2g

Bed shortages result in waiting for days in North Carolina ED’s

In recent years the phenomenon of boarding psychiatric patients in emergency departments has not only become a nationwide problem but a growing problem here in North Carolina. Psychiatric boarding refers to the phenomenon of patients with primary behavioral health complaints experiencing excessive waiting times in emergency departments (EDs). Many claim that the root of this problem arises from the continued cutting of funding for psychiatric institutions. Currently, North Carolina falls below the national average with the number of available inpatient psychiatric beds and ranks 40th number of beds per person in the country. An addition, the average wait time for a patient with a psychiatric compliant to be either discharged or be admitted is 2.5 days. This number is even worse for individuals who are waiting to be admitted to an inpatient bed at one of the psychiatric hospitals in the state, patients wait almost 4 days. How do we go about fixing this problem? This is a question that psychiatrists, policymakers and mental health professionals are striving to answer but with limited funding from the state it is challenging to do so.

References

http://www.charlotteobserver.com/news/local/article161034564.html

http://www.treatmentadvocacycenter.org/evidence-and-research/studies

 

Bring on the zinc oxide!

As the temperatures begin to rise and the sun starts to shine means many of us will be flocking to the nearest body of water whether that’s the neighborhood pool or the breezing beach. As I am getting ready for my beach weekend, I head to the nearest drug store to stock up on all the essentials: diet coke, snacks, trashy tabloids and of course sunscreen. I always look dumbfounded in the sunscreen aisle since there are so many to pick from and how do you know which one works best? For those with fair skin like me I burn fairy quickly after being in the sun so I’m always looking for the highest SPF to protect my skin. Many dermatologists such that any SPF over 50 doesn’t significant protect much more against UVA/UVB rays and folks using the higher SPF sunscreens and feel more protected and therefore don’t practice other protective behaviors such as wearing hats and seeking shade. However, there is a new mineral that provides your skin an additional layer of protection, zinc oxide. Zinc oxide provides a physical barrier between your skin and the sun and deflects the sun off your skin while traditional sunscreens absorb the rays. So next time you are purchasing sunscreen make sure to check out those with zinc oxide!

 

References:

http://www.businessinsider.com/do-high-spf-sunscreens-work-better-50-2017-5?r=UK&IR=T

https://www.huffingtonpost.com/entry/mineral-sunscreen_us_591e8d33e4b03b485cb0543b

Free Lyft to the Pharmacy

Blue Cross and Blue Shield Institute has started a partnership with the ride sharing company Lyft to provide their members with free rides to pick up their medications. The Blue Cross Blue Shield Institute is a new organization that’s mission is to reduce the barriers of accessing healthcare. One of the largest identified barriers to accessing healthcare is transportation. Last year, their big initiative was a similar program with Lyft to provide free transportation for their patients to their doctors’ appointments. By investing in these types of programs, the organization is hoping to reduce costs in the long -term and improve the health outcomes of their consumers. With this newest imitative they are also partnering with pharmaceutical organization such as CVS Health and Walgreens to increase medication adherence. These programs are still under pilot testing and are currently funded by CVS and Walgreens in Chicago and Pittsburgh with patients who are living in “transportation deserts”. These types of unique partnerships are allowing for creative solutions and addressing the social determinants of health in order to solve the most dire healthcare problems. Let’s hope to see more of these types of collaborations in the future.

References

https://www.forbes.com/sites/brucejapsen/2018/03/14/cvs-and-walgreens-partner-with-lyft-to-get-blue-cross-patients-to-pharmacies/#34f4fa0f76c8

https://www.bcbs.com/news/press-releases/blue-cross-and-blue-shield-and-lyft-join-forces-increase-access-health-care

California: The Robin Hood of Mental Health

This week’s blog post was inspired by a reading from my health policy and management course about California’s tax on the wealthy and using the revenue to fund community based services for mental health. The state of California is acting as Robin Hood for mental health to take from the wealthy to help those who need the most. According to the article published by Kaiser Family Foundation, The Mental Health Services Act (or formerly known as Proposition 63) taxes 1% of California citizens whose annual income exceeds $1 million. It was passed into law in January 2005. Annually, this tax generates around $2 billion and since its inception has raised around $16.53 billion. The two major initiatives that are funded by this endeavor include prevention and early intervention for young adults and outcome improvement in individuals with severe mental health conditions. Results have shown that this tax has had a positive effect on the outcomes of individuals with mental health conditions. Hopefully we start to see more results come out of California and the positive outcomes that may encourage other states to adopt similar policies and move towards a culture of prevention instead of treatment of mental health.

To learn more about the law here is a link to the bill: http://www.dhcs.ca.gov/services/mh/Pages/MH_Prop63.aspx

References

https://khn.org/news/californias-tax-on-millionaires-yields-big-benefits-for-people-with-mental-illness-study-finds/

 

Doctors are humans too

In binge watching the newest medical show “The Resident” this past weekend, the show made me consider the role of medical error and transparency. The show portrays an arrogant surgeon with a secret tremor unwilling to give up his career despite his inability to perform successful surgeries. While the story plot line is dramatized and designed to pull viewers in for higher ratings, it highlights the importance of medical error and transparency. According to The BMJ, medical error is the third leading cause of death in the United States. Examples of medical error include medication errors (wrong dose, wrong drug) and hospital infections. Medical errors are challenging to comprehend since healthcare providers are only human and they are bound to make mistake just like the rest of us. The amount of stress and pressure these providers face all while working at all hours undoubtedly will result in mistakes. However, their mistakes have much more severe consequences. The show discusses transparency as a way to address the stigma surrounding medical error and by having more transparency could result in lower rates of medical error. An interesting fact to note is that these are errors are not recognized as cause of death on death certificates. To me, this further stigmatizes the errors and places blame on the healthcare provider and doesn’t change the narrative that providers are human and errors will happen. We treat these healthcare providers as superhuman but we need to remember that they are just like us and as a humans we make mistakes and hopefully we learn from them.

References:

https://health.usnews.com/health-news/patient-advice/slideshows/5-common-preventable-medical-errors?slide=4

https://www.bmj.com/content/353/bmj.i2139.full

“The Angelina Effect”

In this day of age celebrities dominate our world. They hold elected office, they are activists, they are social media entrepreneurs, they are everywhere. Whether we like to believe it or not they have influence over our behaviors and how we make decisions. I’m guilty that most of the accounts I follow on Instagram are former Bachelor contestants and catch myself wanting to mimic their fashion and fitness routines. In fact, there has been research that has examined this phenomenon. Back in 2013, esteemed actress Angelina Jolie announced that she carries the a genetic mutation that greatly increases your risk of breast and ovarian cancer (BRCA1). In her New York Times opt ed piece, Jolie reveals that she lost her mom, aunt and grandmother to cancer and that influence her decision to undergo preventive surgery to remove both of her breasts (mastectomy) and ovaries. After this announcement, several researchers explored what came to be known as “The Angelina Effect” and how her decision influenced other women’s decisions about their own health. In a study published in Health Services Research journal, hospital data from both New York and the UK revealed that three months after Jolie’s announcement there was a significant increase in preventive mastectomies prior to the announcement. This trend has been seen with other celebrities after announcements of diagnoses and provides incentives for both public figures and healthcare providers to use these instances as teachable moments and bring awareness to employ preventive healthcare.

To learn more about the BRCA1 gene visit the following site: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q1

 

 

 

“If your mother says she loves you, check it out”, Stephanie Brown’s guide to identifying false new stories

On Monday, our class had the pleasure of hearing UNC’s own Stephanie Brown discuss her most recent article “New Stories Credible or Clickable: Schema of Fake News to Corrections” featured in Communication: Journalism Education Today. Stephanie Brown is the director of the Parks Library at UNC’s School of Media and Journalism and is expert in news literacy and how to detect false news. Her presentation focused on the best ways to detect if an article is considered credible or in today’s newly coined phrase “fake news”. She began her presentation with an exercise “Would you share” to get our class thinking about the creditability of articles and if we would feel comfortable sharing them on our own social media platforms. This lively discussion brought up some of the consequences of sharing inaccurate news information and how we go addressing others who share these types of stories. Then she moved on how ways to identify articles that are “fake news” and unreliable sources through a comprehensive checklist. She went through the checklist with a few example articles that captive our class’s attention. The checklist was originally developed by the News Literacy Project and includes about seven items. A few examples of the items on the checklist include looking out for articles that are overly emotional, that use excessive punctuation, make a claim about a secret that the media is hiding from you and the types of sources the article cites. One interesting item on the checklist that she harped on was looking at the advertisements and sponsored content on the sides of the article. That can be a telling item if the advertisement is featuring “Lose 5 lbs in a week with this new pill” vs. “Visit Florida” in determining the credibility of the content.

Here is the full News Literacy project checklist: http://www.thenewsliteracyproject.org/sites/default/files/DontGetFooled_FINAL_020518.pdf

 

Dear Apple, Keep doing what you are doing

The new Apple Watch commercial “Dear Apple” has the world talking after its debut during this year’s Winter Olympics. It’s personal, heart wrenching and most importantly highlights the incredible impacts of it’s less advertised features. This commercial emphasizes that this technology could revolutionize healthcare and provide life-changing health support. It features anecdotes of a car accident survivor using the feature on the watch to call 911 after their phone was thrown from the vehicle and a child with Type 1 diabetes pairing the watch with her glucose monitor that alerts her when her blood sugars are at low levels. While the ad still features its more traditional feature of tracking physical activity, it was nice to see that the more innovative features of its products and it’s direct benefits. While I love a good selfie, it’s reassuring to know that Apple and other technology companies are using their technology for just more than just three dimensional emojis and higher quality selfies. I look forward to seeing what other technology these companies come up with in the future to help us lead healthier lives.

If you haven’t seen the commercial check it out here: https://www.youtube.com/watch?v=N-x8Ik9G5Dg

 

 

Teens for Gun Reform Make Their White House Appearance

The events that occurred at Marjory Stoneman Douglas High School in Parkside, Florida last week have sparked the gun control debate yet again in the United States. To me the past week has felt a little like déjà vu: Sandy Hook, Route 91 Festival and Pulse nightclub shootings. Thinking even farther back to Columbine shooting in 1997 when a school shooting seemed unthinkable and how that has changed to be almost a predictable occurrence today. Each shooting seems to spark the same cycle of outcry among our nation with folks pressuring change from policymakers. Yet each time there is no change from the people in power. A few weeks go by and there is another story that captives our attention and it is pushed to the back of our minds until the next shooting occurs and the cycle begins again. However one group is attempting to stop this hopeless cycle: Teens for Gun Reform.

Teens for Gun Reform is a student run group that appeared in front of the White House on Monday. They prepared a “silent lie-in” demonstration of 17 members lying down for three minutes in the streets in front of the White House (the amount of time it took the gunman to take the lives of the students and teachers). Around a hundred students and other advocates rallied and protested following the demonstration. These students are standing up for what they believe needs to be changed since policymakers aren’t listening to anyone else. It’s their lives that are in danger and hopefully protests and pressures from this group will lead to change regarding gun control.

To learn more about this group and the protest visit the following sites:

http://www.independent.co.uk/news/world/americas/us-politics/gun-control-lie-in-white-house-parkland-florida-shooting-donald-trump-protest-students-a8218686.html

https://www.npr.org/sections/thetwo-way/2018/02/19/587089773/teens-lie-in-at-white-house-to-protest-for-stronger-gun-control