Category: Recommendations

Health Benefits of Going Green

House plants have always been a staple of many people interior and exterior design. Our fascination and attraction to greenery is long-ingrained in human history. However, new research is show that there may be serious health benefits to being exposed to greenery. A UCLA study has shown that increasing “greenness” in urban settings can improve mental health.

In addition to this, there are a number of other studies which suggest positive relationships between greenness and a number of disease outcomes, such as obesity, preterm birth outcomes, depression and Alzheimer’s disease. These studies provide interesting and exciting glances into an emerging field, which highlights the importance of greenness and preserving natural landscapes. These things can improve public health, and likewise benefit our natural environment.

 

 

http://dailybruin.com/2019/04/09/ucla-study-suggests-spending-time-in-green-spaces-may-improve-mental-health/

https://journals.lww.com/epidem/Abstract/2017/11000/Interrelationships_Between_Walkability,_Air.4.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181932/

http://med.miami.edu/news/residential-blocks-with-greater-greenness-linked-to-lower-risk-for-alzheime/

 

 

 

 

A Need to Address Student Stress

For both collegiate and graduate students, stress is a commonplace experience. Research findings are showing that students are experiencing anxiety at troubling and increasing rates. Nearly one in five American college students is burned with an anxiety disorder. Stress – specifically financial stress – is expected to be one of the factors underwriting this epidemic.

Although stress is traditionally defined as “how the brain and body respond to any demand”, particularly those which are negative – such as traumatic events, major life changes, etc. However, with stress can come a range of unexpected physical side effects. This includes but is not limited to: headaches, low energy, aches and pains and insomnia. Over time, when someone endures prolonged stress, it can lead to more serious consequences, such as anxiety and mental health deficits.

Experiencing some stress is a normal and necessary part of everyone’s lives. However, as mentioned above, excess stress can yield serious adverse health consequences. It’s important to keep one’s stress in balance, and healthline.com has provided a short list of ways to help reduce stress:

  • Talk about your stress to a friend, or family member
  • Listen to music
  • Eat nutritious food
  • Exercise
  • Be mindful
  • Get better sleep

 

https://www.iflscience.com/health-and-medicine/anxiety-epidemic-hits-american-college-students-at-campuses-nationwide/

https://www.nimh.nih.gov/health/publications/stress/index.shtml

https://www.webmd.com/balance/stress-management/stress-symptoms-effects_of-stress-on-the-body#2

https://www.healthline.com/health/10-ways-to-relieve-stress

 

 

 

Opioid Policy

Continuing this week’s focus on opioids, we discuss some of the policies that have been attempted to stem the tide of the opioid epidemic. Check them out below!

Local and non-Governmental.

Lock-in Programs. Insurance companies, hoping to limit the staggering financial burden the opioid crisis has placed on them, have implemented several strategies to prevent the overuse of opioid medications. One such strategy is called patient review and restriction or Lock-in. This strategy requires that patients suspected of misusing opioids and other controlled substances use a single prescriber or pharmacy to obtain their controlled substance prescriptions. These programs look to have significant cost savings and may be more widely implement in the future.

Take-back Events.­­ Many municipalities have introduced drug take-back events that encourage patients to properly dispose of unused medication. States have sponsored messaging campaigns about the safe storage and disposal of opioids. These interventions are designed to educate patients on the dangers of keeping unused opioids and to make it easier to dispose of them. Evidence on their effectiveness is mixed.

Education.  Other interventions have been aimed at changing knowledge and attitudes related to SUD. These interventions range from handing out pamphlets to intensive counseling programs. While many of these programs appear to be effective, they are by nature small in scope and resource intensive to scale up.

Safe Injection Facilities. Safe injection facilities are places where individuals can inject drugs in a safe location, typically with treatment services located nearby and with medical personnel available to treat any issues. These facilities reduce drug related mortality and needle-borne infections. They currently face zoning restrictions, legal challenges, and community disapprobation. However, because of their effectiveness, some states are creating policies that support their creation.

State and Federal.

Naloxone. One change that has proven successful at decreasing deaths from opioid- induced respiratory depression (OIRD) is making naloxone, a medication that reverses OIRD, more easily available. Current recommendations suggest that naloxone be co-prescribed with opioids, especially when patients have a history of opioid misuse. As of 2016, forty-seven states had passed legislation designed to increase lay-person access to this life saving drug. These laws take on three forms. First, they may provide naloxone prescribers, dispensers, and administrators with protection from criminal and civil lawsuits related to the drug. Second, allowing naloxone to be prescribed by providers to individuals outside of their practice. This may mean that providers can prescribe to third parties or that there are standing orders making the drug available without a prescription. Third, Good Samaritan laws provide protection to individuals who seek emergency help for some experiencing overdose. Because many people who witness an overdose may be engaging in illegal behavior themselves, they may be hesitant to contact emergency responders in the case of an overdose. These laws provide limited immunity from prosecution for minor drug-related offenses.

MAT. Medication assisted treatment—MAT—is the most effective treatment for opioid use disorder. MAT combines traditional counseling approaches with the use of certain opioids—methadone, buprenorphine, and naltrexone. Despite its effectiveness, MAAT faces stigma, legal limitations, and a lack of prescribers. Patients who can find providers willing and able to treat OUD may be unable to afford the treatment. Historically, very few insurance plans have provided coverage for MAT, especially those for lower income individuals. The Affordable Care Act (ACA) attempted to address these issues, but treatment is still limited and the ACA’s future is unsure.

PDMPs. Prescription Drug Monitoring Programs (PDMPs) are one solution that states are using to try and monitor who is providing opioids and who is receiving them. These programs are designed to both prevent physicians from over-prescribing and to prevent patients from doctor shopping. Currently, 49 states, Washington D.C. and Guam have operational PDMPs. Data on PDMP effectiveness varies, but suggests that they are effective at reducing controlled substance prescribing. After implementation of PDMPs, doctor shopping has decreased by at least 41%, prescribing either leveled off or decreased, and overdoses, overall, have dropped.

ESOOS. In addition to monitoring prescriptions, many states are implementing enhanced monitoring of drug overdoses. Starting in 2016, the CDC funded 32 states to participate in the Enhanced State Opioid Overdose Surveillance (ESOOS) program. The ESOOS collects hospital billing data to determine overdose visits. While the data gathered thus far shows mixed results in state efforts to decrease opioid overdose, the ESOOS has created a national database of information and encourages state accountability.

Outside the U.S.

The opioid epidemic extends beyond national borders. Many western countries are dealing with the new proliferation of opioids and the associated increase in OUD. There are two major policies that have been enacted by countries outside of the United States in order to stem the increase in opioid misuse.

Marketing Limits. In Western European countries, marketing of drugs is strongly regulated compared to the United States. Specifically, pharmaceutical companies are not allowed to offer any kinds of benefits to physicians or the organizations that govern them. This is a broad regulation that prohibits not only the direst transfer of funds or presents, but also things like the all-expense paid conferences that were an important part of marketing in the U.S. This policy is enforced by both governments and medical associations, and has resulted in significantly less heavy marketing of prescription drugs.

Decriminalization. Many of the harms associated with drug addiction come not from the addiction itself, but from the stigma attached to it. This stigma has been codified through laws that punish addicts. Changing the law—or its enforcement—to decriminalize the use of opioids is one policy that attempts to address this problem. Various forms of decriminalization have been enacted throughout the globe, including Australia, Portugal, the UK, Canada, and the U.S. When these changes have been made, there has been no increase in the use of controlled substances, but significant drops in the rates of overdose and overdose death.

Have you seen other policies implemented to address opioids? Which ones do you support?

For more information, check out these sources:

  1. Haegerich TM, Paulozzi LJ, Manns BJ, Jones CM. What we know, and don’t know, about the impact of state policy and systems-level interventions on prescription drug overdose. Drug and Alcohol Dependence. 2014;145:34-47. doi:10.1016/j.drugalcdep.2014.10.001.
  2. Gostin LO, Hodge JG, Gulinson CL. Supervised Injection Facilities. Jama. 2019;321(8):745. doi:10.1001/jama.2019.0095.
  3. Davis CS, Carr DH. The Law and Policy of Opioids for Pain Management, Addiction Treatment, and Overdose Reversal. Indiana Health Law Review. 2017;14(1). doi:10.18060/3911.0027.
  4. Questions and Answers. State Prescription Drug Monitoring Programs. https://www.deadiversion.usdoj.gov/faq/rx_monitor.htm. Accessed April 16, 2019.
  5. Prescription Drug Monitoring Program Center of Excellence at Brandeis. Briefing on PDMP Effectiveness.http://www.pdmpassist.org/pdf/COE_documents/Add_to_TTAC/Briefing on PDMP Effectiveness 3rd revision.pdf. Published September 2014. Accessed April 16, 2019.
  6. CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) Program, 32 states and the District of Columbia reporting, https://www.cdc.gov/drugoverdose/pdf/data/CDC_ESOOS_April2018_508.pdf. April 2018.
  7. Vokinger KN. Opioid Crisis in the US – Lessons from Western Europe. The Journal of Law, Medicine & Ethics. 2018;46(1):189-190. doi:10.1177/1073110518766033.

 

“Goop” Brand and Fake Health Products

Valued at $250 million dollars in 2018, the “Goop” brand has taken commercial health and beauty market by storm. While many of this company’s products are harmless – such as lotions and accessories – there are a number of products which have generated a lot of negative feedback. In 2018, Goop was charged for false claims regarding two of their products. At this time, the brand was selling “vaginal eggs” (made of rose quartz).  Supposedly, following vaginal insertion, these eggs could help balance hormones, regulate menstrual cycles, and increase bladder control. None of these claims are backed by research, and even came under direct criticism from a renowned gynecologist and other medical professionals. Similarly, another one of their products – an essential oil – was criticized for false claims of preventing depression.

Despite this, Goop brand has continued to grow, gaining more revenue and customers. Although this brand has gained an exceptional amount of media attention, it only represents one of many brands falsifying health-related products. Companies like Goop often claim they provide “alternative treatments” to mainstream or pharmaceutical agents. But in reality, many of these fake products can be completely useless or even harmful. Many of these products are expensive, and wrongfully solicit money for worthless/harmful products. Additionally, products or methods which make claims to prevent serious diseases – such as depression or cancer – are providing false hope and might delay needed medical treatments. With internet culture in full-swing, it’s important to research the legitimacy of any alternative health products/claims, and to trust expert advice when necessary.

 

 

https://www.cnn.com/2018/09/05/health/goop-fine-california-gwyneth-paltrow/index.html

https://www.nytimes.com/2017/07/29/style/goop-gwyneth-paltrow-dr-jen-gunter.html

https://www.healthline.com/health-news/how-fake-health-news-may-be-influencing-you-to-make-dangerous-decisions

 

 

 

To Vaccine or Not to Vaccine – A Legal Question

 

Between January and March of 2019, there were multiple measles outbreaks. As of March 22nd, seventy-two individuals were diagnosed with measles. Outbreaks like this one have shown that pockets of low vaccination rate can results in outbreaks that threaten life, limb, and pocketbook. However, it is unclear what the government can do to prevent them. In Kentucky, a teenager is suing to be allowed to attend school despite not having the chickenpox vaccine—and a current chicken-pox outbreak in the area. In New York, Rockland County declared a state of emergency, banning unvaccinated youth from public places. This leads us to ask the question:

What does the Supreme Court have to say about vaccine requirements?

The United States government has a well-established duty to prevent disease outbreaks. In Jacobson v. Massachusetts (1905), the Supreme Court ruled that states are constitutionally justified in requiring their citizens to be vaccinated against contagious diseases unless medically contraindicated. Specifically, the majority opinion determined that 1) states have a duty to protect the health of their constituents, 2) states and municipalities are justified in requiring individuals to get vaccinated to fulfill this duty, and 3) individual beliefs or opinions are not sufficient reason to disobey these requirements.

“We are not prepared to hold that a minority, residing or remaining in any city or town where smallpox is prevalent, and enjoying the general protection afforded by an organized local government, may thus defy the will of its constituted authorities, acting in good faith for all, under the legislative sanction of the state. If such be the privilege of a minority, then a like privilege would belong to each individual of the community, and the spectacle would be presented of the welfare and safety of an entire population being subordinated to the notions of a single individual who chooses to remain a part of that population.” — Majority opinion by Justice Harlan.

The right of the state to require vaccinations was upheld in Zucht v. King (1922), when a young woman in San Antonio was excluded from attending both public and private schools because she refused to be vaccinated. Since then, states have required vaccinations with varying degrees of strictness.

What do you think?

Should states be able to fine or otherwise enforce vaccination requirements? Should people be able to refuse vaccinations for moral or religious reasons? What do you think the future holds for vaccine laws?

More Resources

  1. Mariner WK, Annas GJ, Glantz LH. Jacobson v Massachusetts: It’s Not Your Great-Great-Grandfather’s Public Health Law. American Journal of Public Health. 2005;95(4):581-590. doi:10.2105/ajph.2004.055160.
  2. Measles Outbreak 2019. Washington State Department of Health. https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Measles/MeaslesOutbreak. Accessed March 1, 2019.
  3. Associated Press. Cost of Washington’s measles outbreak tops $1M. KGW8. https://www.kgw.com/article/news/health/cost-of-washingtons-measles-outbreak-tops-1m/283-874837a3-3f72-4637-9313-7719c5b39400. Published February 23, 2019. Accessed March 1, 2019.
  4. HENNING JACOBSON, v. COMMONWEALTH OF MASSACHUSETTS. (United States Supreme Court 1905). https://www.law.cornell.edu/supremecourt/text/197/11. Accessed March 1, 2019.
  5. The Supreme Court On Vaccination Laws. American Journal of Public Health. 1923;13(2):120-121. doi:10.2105/ajph.13.2.120.
  6. States with Religious and Philosophical Exemptions from School Immunization Requirements. http://www.ncsl.org/research/health/school-immunization-exemption-state-laws.aspx. Published January 30, 2019. Accessed March 1, 2019.

The bond market, public health, and the future

Some may view public health and the bond market as opposites, but they are surprisingly intertwined.  This week the yield curve inverted, meaning that yields from long-term bonds dropped lower than those from short-term bonds.  Historically, this inversion signals a likely recession in the next 1-2 years.  While this news may lead to thoughts of recession preparation tactics such as getting a side job or diversifying investments, it may not necessarily trigger public health concerns.

However, this is a time to build our public health programs.  Higher unemployment numbers often accompany recessions.  These higher unemployment numbers are associated with individuals choosing fast food and junk food over fruits and vegetables.  Additionally, without jobs (and their associated health insurance), people seek medical and dental care less often.  Job loss, including recession related loss, is associated with increased housing and food insecurity– both of which are associated with poor health outcomes.  Suicide rates also increase during recessions.  Therefore, it may be time to start investing in programs for mental health, nutrition, and housing stability.  Surprisingly, during recessions all-cause mortality typically decreases. Some predict that this is due to fewer accidents, including on the job and commuter traffic accidents.

Though people face negative health effects associated with economic hardship during recessions, some evidence suggests they try to mitigate these issues through increased exercise and appropriate sleep habits.  Public health practitioners should find this news encouraging as unemployed people may have time to adopt and normalize healthy behaviors into their lifestyles (action or maintenance stage of the transtheoretical model for the theory fans out there).  However, the focus shouldn’t end there.  Though there is a dearth of literature outlining the impact of job re-entry on the healthy behaviors adopted during unemployment, it is plausible to believe that if available time led to healthier behaviors, then additional time devoted to a job may impede continued behavior practice.   As we want people to return to work, public health practitioners may focus on interventions that include implementation intentions, specifically “if-then” statements championed by P.M. Gollwitzer.  For instance, If I get a full-time job, then I’ll exercise after work.  These statements have been shown to help people overcome changes that would otherwise be barriers to maintaining health lifestyles.

 

 

 

https://www.barrons.com/articles/yield-curve-inversion-51553272263

https://money.cnn.com/2018/08/13/pf/recession-ready/index.html

 

https://journals.sagepub.com/doi/pdf/10.1177/0002716213500212?casa_token=k0nHCQU-ijcAAAAA:YuUEPiqY76g0TFLawgdQB4ObzmOeh4-8zJniLJ-YR2WP7swJVy6gLQN4UZrpXBr86q32d1HcLrU

 

http://kops.uni-konstanz.de/bitstream/handle/123456789/10101/99Goll_ImpInt.pdf?sequence=1&isAllowed=y

Media Misconceptions: Why Juicing is NOT a Healthy Trend

Misleading health trends are nothing new in the age of social media. Every week there seems to be a new diet to “cleanse” or lose weight. Amongst these things, “juice cleanses” are a trend which have been popularized multiple times. There is a common misconception that drinking only fruit juice is as good for you as eating whole fruits. Drinking fruit and vegetable juice can provide some health benefits in moderation. However, a recent Harvard study shows that juicing may cause more harm than good. Consuming whole fruits does bestow a number of health benefits and can actually reduce risk for type 2 diabetes. In comparison, drinking juice alone does not provide the same benefits and can actually increase risk for type 2 diabetes.

Much of this has to with nutrient loss in the juicing process. When fruits and vegetables are juiced down, the final product contains concentrated amounts of minerals, vitamins, and nutrients. However, important nutritious components – such as fiber and antioxidants – are left behind. This is problematic because it omits some of the key elements which make fruits and veggies so healthy. In addition to this, juice is very concentrated, and so there are relatively higher levels of sugar when drinking juice than when eating whole fruits. It is important to take everything in moderation, and to not jump on trends before understanding the issue.

 

 

 

https://tonic.vice.com/en_us/article/pa34n7/juice-diets-are-bullshit

https://www.ncbi.nlm.nih.gov/pubmed/23990623

https://www.cnn.com/2019/03/21/health/juicing-fruit-vegetables-food-drayer/index.html

 

 

 

Early Dietary Interventions May Reduce Allergy Development

With increasing rates of allergies in kids, it’s not surprising that parents are looking for more information on how to reduce their child’s risk. The determinants of a child’s potential allergic development are still unclear. However, a youth’s surrounding environment, pharmaceutical intake and lifestyle are suspected to play major roles in this narrative. Specifically, food allergies are on the rise, and affect 5.6 million children in the United States alone. Many of these allergies are to common foods – like dairy, fish, and peanuts – and can be life threatening.

Early diet is suspected to play a role in allergy development, and new parents are desperate to know how introducing foods at specific times may or may not prevent food allergies. This dynamic can be difficult to navigate, but fortunately there is an abundance of research and literature on this topic. Just recently, the American Academy of Pediatrics has published a report which can serve as a guide for nutritional interventions in the context of allergy prevention. The report shows that there is no evidence to support that waiting to introduce allergenic foods beyond 4-6 months might prevent allergy development. Rather, on the contrary, an earlier introduction of such food to high-risk children (with a family history of allergies) may in fact be protective to allergy development. Overall, the study promotes that habitual eating habits and diversity in food choice are the best way to promote an infant’s healthy diet and reduce risk of allergies.

 

https://www.aaaai.org/conditions-and-treatments/library/allergy-library/prevalence-of-allergies-and-asthma

 

https://www.foodallergy.org/life-with-food-allergies/food-allergy-101/facts-and-statistics

 

https://pediatrics.aappublications.org/content/early/2019/03/15/peds.2019-0281

 

https://www.cnn.com/2019/03/18/health/food-introduction-allergies-report/index.html

 

 

 

 

New Study Confirms No Link Between MMR Vaccine and Autism

 

A Danish study released Monday found no evidence to support a link between the vaccine that protects against measles, mumps and rubella (MMR) and autism.

The connection between the MMR vaccine and autism was first introduced in a fraudulent, but well-publicized, 1998 study by British doctor Andrew Wakefield. Despite decades of research and messaging to inform parents on the safety and importance of vaccination, a 2014 national study found that one-third of parents in the US still believe that vaccines can cause autism.

“The idea that vaccines cause autism is still around despite our original and other well-conducted studies,” the study’s first author, epidemiologist Anders Hviid, wrote in an email to National Public Radio. “Parents still encounter these claims on social media, by politicians, by celebrities, etc.”

This is not the first study of its kind to disprove Wakefield’s claims, but it is one of the largest MMR studies in history. Researchers collected data from over 650,000 children born in Denmark between 1999 and 2010. Throughout the study, 6,517 of these children were diagnosed with autism. However, researchers found that children who received the MMR vaccine were not at increased risk for autism, compared to those who did not.

The publication comes at a time when vaccination rates in the United States have dipped, and there have been recent outbreaks of measles, mumps, whooping cough and chicken pox in the US. Hviid and the other researchers hope that this evidence will continue to educate and encourage parents to vaccinate their children against these and other diseases.

 

By:

Brittany Frew

What’s Actually Bad For Our Skin?

In today’s age, it’s hard to keep up with what things are good for our skin, bad for our skin, or don’t affect it at all. Skin care is tied into beauty, and thus many people are often searching for a “secret trick” or “hack”. Due to this, many different products and techniques have been recommended. Many of these approaches have are rumored to provide drastic improvements in one’s skin clarity, texture, and overall health. Alongside these claims, we see many people generating fear around certain exposures, and it’s important to examine what can actually harm our skin.

There are many negative things in our lives that can have unexpected side effects. Stress, for one, can play a large role in the health of one’s skin. Experiencing excessive stress can prompt new outbreaks or aggravate pre-existing conditions, like psoriasis, eczema and hives. As many already know, smoking is a habit with many negative health outcomes. However, few often attribute smoking to skincare, and are unaware of the damage it can cause. Nicotine reduces blood flow to one’s skin, and thus smoker’s often have skin which is more wrinkled, thin and less likely to heal if injured.

Alongside these negative factors, there are those which are a bit more complicated. UV rays – coming from sunshine – are a mixed bag. A little sunlight is good for you, it prompts one’s skin to make Vitamin D, which is essential to many bodily processes. However, without proper protection , sunlight can be extremely damaging to skin. Excess exposure to UV rays can cause mutations in your DNA, which can later lead to cancer. Because of this, it’s important to wear protective sunscreen, clothing, and protective gear when exposing oneself to strong sunlight for long hours.

 

https://www.cnn.com/2019/02/27/health/skin-myths-truths-partner/index.html

https://www.webmd.com/beauty/the-effects-of-stress-on-your-skin

https://www.webmd.com/beauty/features/bad-skin-habits#1

https://www.cancer.net/blog/2015-07/10-tips-protecting-your-skin-sun