New Year Resolutions: 2009

For many Americans the New Year ushers in a day (or maybe two...) of thinking about what they want to do differently or achieve in the next 365 days. While I don't plan on making any half-hearted declarations that I will start exercising every day or eating more veggies (we should all do that anyway), I do think that this would be a good time to outline a few goals for Veritas Health.

Veritas Health Resolutions for 2009:

1. Create at least 5 posts a month.

2. Start posting video blogs - 4 for the year.

3. Have an average of 25 hits/post.

4. Organize a community public health blog -- TBA.

5. Build a better audience-friendly Veritas Health.

I hope that you have enjoyed my posts, thus far. Please send me messages with any thoughts on how I might improve this blog. 

Happy New Year!

Merry Christmas!

Merry Christmas, readers! Hope you have a fantastic holiday, full of joy and laughter. If you need any tips for staying healthy through the holiday check out the post by Modern Forager here.

See you in the New Year!

Biking for Health

It really was not until we moved to California that I was introduced to a bike culture. Many people we met were committed to traveling by bike; they rode everywhere  - to school, to work, even to sporting events. The roads were wide, the bike lanes were well marked and well maintained (no debris, no dangerous obstacles to maneuver around) and young and old partook in this type of activity. Was it exercise? Yes! Did it necessarily feel like it? No! For many, riding was a lifestyle, not an exercise routine. 

A recent study (reported in the press here) examined modes of transportation across several countries and rates of obesity. Countries where more people walked, cycled, or took mass transit to get around found lower rates of obesity. Obviously this study gives us no insight into why this is the case. While I don't expect that we can just start building bike lanes everywhere and expect communities to up and start riding bikes overnight, I see great promise in each place that I have lived to put in bike lanes to make it easier to get around without needing a car. Especially in the suburbs, where owning a car is assumed to be necessary. 

How do public health professionals, especially in suburban communities, change these transportation norms? What might be the impact for community health? 

R. Shephard provides an excellent article discussing the "active commuting" debate. Another study by scholars in Scotland examined adolescents' walking and biking commuting behaviors (to school, obviously) with regards to distance as a potential barrier. The authors found that adolescents were more likely to walk or bike to school if they lived within 2.5 miles, living farther than that was considered a sufficient barrier to active commuting. I wonder what that threshold would be in active cities in the US. This is a ripe area for future research and public health activity.

Mobile Phones for Health Surveillance

An article in the Yale Journal of Public Health recently reported on the use of mobile technology to improve public health surveillance activities. Advances in technology are not always quick to be adopted in public health, though the computer and Internet have exponentially increased the efficiency and productivity of information management and risk communication. How else could one so quickly be informed about a SARS outbreak or the current state of Avian flu?

My husband, after returning from a 2-week trip to Kenya, told me stories about the widespread use of mobile phones, even in the most rural and poor regions of the country. He noted that he never saw them actually talking on the phone, it was a device used for text messaging. "Minutes" are just too expensive.

Given the penetration of mobile technology - how might cell phones be used solve pressing public health issues? This article describes two CDC activities; one aimed at using PDAs to collect surveillance information for its "Household Morbidity Surveillance Survey" in Kibera, the other is to use text messaging to improve inter-governmental communication about disease outbreaks. 

There is certainly an irony on the use of PDAs to collect information from some of the poorest people in the world. However, if it is able to collect better data, more quickly, and to improve the delivery of health services and prevention information I am in full support! 

How else might mobile phones be used to collect or communicate health information?

If interested, check out the following websites

• Texting4Health - A conference held at Stanford University, February 2008
• MobileActive.org - Blogs, information, and a directory for activists using mobile technology worldwide

AIDS Sutra: Untold Stories from India

When you see the word AIDS what comes to mind?

Africa? Disease? Death?

Sex? Drugs? Prostitution?

Mothers? Orphans?

Treatment?

We know so much more today about the etiology of HIV/AIDS than when the epidemic began in the early 1980s. In some parts of the world, the stigma of having AIDS or being HIV positive has begun to weaken. We now have effective (albeit expensive and complex) treatment for the disease, more people are more aware of how the disease is spread, and today we know that if certain conditions are met women who are HIV+ can even give birth to babies unaffected by HIV/AIDS. In this day, in this place, one need not equate AIDS with death.

In India 2.5-3 million people are infected with HIV/AIDS. India has the 3rd largest number of HIV+ people in the world, behind sub-Saharan Africa, and the spread of HIV among women is increasing. (click here for more facts -- published 2006)

In many other countries, however, there is still great denial about just how widespread are the effects of AIDS. The Bill & Melinda Gates Foundation's Avahan India AIDS Initiative just released a book entitled "AIDS Sutra: Untold Stories from India". It is a collection of essays that brilliantly portrays the lives of people dealing with AIDS and facing its stigma in India. The stories uncover the brutallity and fear that come with social margnizalization, violation of privacy, and discrimination. 

Two authors, Nikita Lalwani and Sonia Faleiro, and an editor from Avahan visited the Harvard School of Public Health today to discuss the book. It was a fantastic event, with about 30 people in attendance. The stories told by the authors were heart wrenching.

Many Harvard affiliates, such as Jay Silverman and Felton Earls, are committed to preventing the spread of HIV/AIDS as well as serving populations who already have the disease. Though, I want to note that the work of my colleagues really seeks to inform the broader picture of how poverty, gender relations, family violence, and sex trafficking perpetuate the spread of HIV/AIDS beyond what service provision in "high risk" communities can provide. It is fascinating work and its implications are great, as the stories "AIDS Sutra" tell. Not only will understanding AIDS in India help those who are currently suffering, but it will provide a basis for future prevention efforts and cultural change that can halt the epidemic, save lives, and restore hope.