Saturday, November 28, 2009

House of Hope Holiday Cards For Sale!

This past summer I traveled to Nicaragua and Costa Rica to meet with organizations that were trying to help women leave prostitution and that were providing health, education, and other services to women and girls would had been exploited sexually. One of the organizations that I spent the most time at was House of Hope (see my first blog post on my experience).

One of the weekly House of Hope activities is a large group activity where women come from around the city to make greeting and holiday cards each Tuesday. I brought home a bag full of cards to sell here in the States and am hoping that some of you might be interested in buying a pack or two.

Sampling of Christmas/Holiday Cards

Each pack contains 10 cards and envelopes and has been handmade by women, young and old, who are seeking an alternative to prostitution and an opportunity to hear about God and Jesus. Some of the cards use recycled paper that is made right at House of Hope, as well. I'm selling each pack of cards for $6 or two packs for $12, all of the money will go directly to House of Hope.

You can let me know if you prefer to buy Christmas, holiday, or greeting (thank you, happy birthday, even wedding!) cards. House of Hope has pictures of all the Christmas cards and the messages inside or click here for pictures of other greeting cards. I will check my stock if you are interested in a particular design.

Sampling of Birthday/Wedding Cards

House of Hope relies on generous giving in order to provide shelter and free education and health services to the children and families that live at their residential site. When I was there most of the bodegas (homes) were full, but they were unable to expand because they need a committed sponsor before allowing another family to join them.

If you are in the Boston area and interested in buying cards, please comment to the post or send me an email. If you would like me to send you cards somewhere else in the US, contact me, and we can try to work something out!

Sampling of Thank You & Blank Cards

Hope you had a Happy Thanksgiving and enjoy this holiday season!

Friday, November 20, 2009

Making Mammography Screening Guidelines: Two approaches

So how did the "experts" at the US Preventive Services Task Force (USPSTF) come up with the "new" mammography guidelines, anyway?

As you read in yesterday's post, the decision was based primarily (or fully) on the findings from epidemiological data (i.e. population-level health research, rather than medical case studies, case histories).

While an epidemiologist (...a "social epidemiologist," really) at heart, I am taking a decision sciences class that is completely fascinating and speaks to the pitfall of relying on critical research reviews and other ways to "understand the evidence" in a traditional way. For example, rather having the USPSTF make recommendations based on their understanding of epidemiological literature alone, it could use that literature to inform a decision sciences or decision analysis approach, instead.

Here's what I'm thinking...

So without getting to far into it, here's the basic decision science methodology, as I (a newbie) understand it. You create a lot of "trees" that reflect the probability of a particular outcome for a decision that you may make. For example, you can model the survival (the outcome) of a woman with breast cancer that receives a mammogram every year (decision #1) versus a woman that receives a mammogram every two years (decision #2). You can determine how survival is difference given certain predisposing characteristics (or risk factors -- family history of breast cancer, for example) and also consider what her survival would be if she tests positive and truly has breast cancer, as well as if she tests positive and does not have breast cancer.

There are problems with this approach, of course -- for example, if you are basing your decisions off of faulty probabilities or inaccurate scientific data. Nonetheless, decision analysis is well poised to deal with issues related to testing (or screening, such as mammography) where receiving a false positive result (you are told you have the disease when you really don't) is common or when a false negative result (you are told you don't have the disease when you really have it) is common.

I doubt USPSTF used a decision analysis approach given what I've read on their website. What do you think about it? Should we move in a decision analysis direction or should the traditional epidemiological approach be sufficient to make these public health decisions?

Now I get to complete my decision sciences mid-term. Yippee!

Thursday, November 19, 2009

Mammography Screening Myths Exposed

The US Preventive Services Task Force (USPSTF) released "new" mammogram guidelines this week. The guidelines have received major backlash from the American Cancer Society and many cancer survivors.

Below is are some of the mammography screening myths floating around:

Monday, November 16, 2009

It's Del-i-CIOUS!

If you haven't noticed my posts on (linked on the sidebar to the right) you should check it out. Many of the posts are discussed in the Veritas Health blog, but many more of the bookmarks reference websites and news articles that I have never gotten to writing about.

Are you on Delicious? If so, I'd love to join your network. Just let me know!

Sunday, November 15, 2009

Sugar-Sweetened Beverages the Next Tobacco?

Image from the NY City Department of Health Anti-Obesity Campaign

In class this week, we discussed strategies for reducing the consumption of sugar-sweetened beverages at home. Sugar-sweetened beverages are exactly what they sound like: any drink sweetened with sugar (sodas, fruit juices, "vitamin" or flavored waters, sports drinks, energy drinks....etc.).

The larger question at hand was: Can we utilize the same strategies that brought down the tobacco industry for reducing the consumption and availability of sugary drinks?

The idea of a "soda tax" has come under scrutiny by conservatives who don't like the idea of taxing anything, as well as groups that are strongly supported (i.e. funded) by the food and beverage industry, like the Center for Consumer "Freedom." And, yes, the quotes are my doing...

However, many in public health believe that taxation will curb consumption of sugar-sweetened beverages, particularly among those who consume the most and are most likely to suffer poor health and overweight because of it. Nonetheless, soda is just the tip of the iceberg when it comes to liquid, non-nutritive calorie consumption, especially among kids. There are many other beverages that provide just as many calories and can contribute to weight gain. What will happen when the beverage industry just switches production (and all its marketing!) to these other sugary beverages? Another tax?

Taxation of tobacco has been a primary strategy in reducing its consumption and preventing people from starting to use it. Yet, taxation of tobacco has gone extremely high! Right now the federal tax on tobacco is $1.00 per 20-cigarette pack, and states can tax tobacco even higher ($3.46). Would a soda tax ever get that high? Not likely. Harvard researchers suggest that just a $0.01 per ounce of soda would be enough to change consumption patterns of consumers; a typical 20 oz. soda would be marked with a 20 cent tax.

However, the strategy that I am most excited about is social marketing -- advertising that promotes healthy behaviors and discourages unhealthy ones. If you haven't seen the sugar-sweetened beverage ads out of New York City, check out my other post on this topic. Marketing can't just tell you that something is bad, it must suggest alternatives.

If you are looking for alternatives to sugary drinks here are a couple promoted on the Harvard Nutrition Source website:
  • Plain (or Infused) Water -- I think this means throwing some lemons or cucumbers in with the plain water to add flavor without the calories.
  • Tea -- Go light on the sugar and honey, of course.
  • Coffee -- Choose milk over cream, go sugar-free.
  • Sparkling water -- add a splash of 100% fruit juice for flavor, without packing in the calories.
The website even has a recipe for a healthy "fresh fruit cooler," which is a great alternative to store-bought smoothies. Notice, drinks that are "sugar-free" because they utilize artificial sweeteners are NOT included in this list.

Right now there is a national movement to get junk foods and soft drinks out of schools. While I believe this needs to happen soon, most kids get unhealthy foods outside of schools. A 2006 study by Harvard researchers found that 60-80% of sugar-sweetened beverages were consumed by kids at home.

This suggests that we need a national movement, not just to change school environments to provide healthier beverages, like water and low-fat milk, but also change social norms around providing sugary drinks to kids in homes.

What would sway parents to pass up purchases in the beverage aisle and stick to **free** tap water and nutrient-rich milk for kids?

That's a tough question. The strategy needs to incorporate environmental change, excellent social marketing of the health dangers of daily consumption of sugary drinks, and grassroots/community efforts. If we can get sugar-sweetened beverages out of schools (where they have no right to be!), perhaps we can raise awareness about the issues so that we can get them out of homes, too!

Could the tobacco model work? Perhaps. It may be important to look to other public health campaigns; however, to get the most insight into what public health strategies will be most effective. How about alcohol control campaigns?

Thursday, November 12, 2009

Wednesday, November 11, 2009

APHA Concluded

The 2009 APHA Annual Meeting is officially over. It was an exciting meeting for me. I loved networking and talking with folks from all over the country who are doing work in food and nutrition policy, public health communications, and the use of social media.

Here I am, in the picture above, presenting my summer work from Nicaragua and Costa Rica and a study that was recently published looking at the intersection of sex work and human trafficking in the International Journal of Gyneacology and Obstetrics. About 60 people were in attendance.

My fellow presenters from Massachusetts General Hospital and the Hispanic Health Council were excellent. Each of us had different approaches to the problem and/or were working with different strata of the sex worker population. The audience asked some great questions about the implications of our findings, for instance -- how can public health practitioners meet the needs of both trafficking victims and sex workers?

I hope I was able to communicate effectively the ripe opportunity for research in this area, as well as organizations' enthusiasm in Central America to partner with researchers to improve their programs and prevention activities (for instance, to inform and evaluate social marketing campaigns).

Safe travels, fellow attendees.

Tuesday, November 10, 2009

APHA Day 2: Exhibit Explorations

After two hours of perusing the hundreds of booths and five blisters later, I made my way through most (though notably, not all) of the exhibits housed in the Philadelphia Convention Center for the American Public Health Association Annual Meeting. The exhibits promote health and educational products, provide information on the latest medical and online technologies, share program activities and job information, and highlight academic programs in the public health arena.

Here are a few photos of my favorites.

Choosy Kids - a promotional product and education service that uses a character, Choosy, to encourage physical activity and healthy eating among kids. They even sell CD's.

T-fal ActiFry -- free samples of granola and french fries that used a fraction of the typical amount of oil to cook crisp. It cooks food crisper than the oven and doesn't require a deep fry!

PharmaJet - a needle-less injection system that hooks right up to the normal medicine bottle. No more pricks! The medicine is injected by force alone through the skin. Crazy!

Harvard Vaccination Guru Speaks Swine

Still confused about whether the swine flu vaccine is safe?

Don't know whether you should be vaccinated?

Here's an interview published in today's Boston Globe with Dr. Marie McCormick, professor of maternal and child health at the Harvard School of Public Health and the lead advisor on an expert committee that reviewed data related to the safety of the swine flu vaccine.

In response to whether she will get vaccinated, McCormick said, "When it becomes available, I will certainly have it. I do see patients in the fall, and all my patients are younger than 3, so it’s really both for their protection and mine."

Sunday, November 8, 2009

APHA Day 1: Environment Matters for Health

Mayor Nutter described Philadelphia, "the city of brotherly love and sisterly affection," as a city of public health firsts during today's Opening Address at APHA. He and several other speakers talked about the many public health "firsts" that Philadelphia can pride itself with: the first medical school, the first water and sanitation bureau, the first city to require water flouridation.... 

Friday, November 6, 2009

APHA 2009 Bound!

Veritas Health will be tweeting and blogging from the 137th American Public Health Association Annual Meeting in Philadelphia, PA -- right near her hometown! The conference begins Saturday, November 7th and will last until Wednesday, November 11th.

The theme of this year's conference is Water and Public Health. Dr. Mirta Roses, Director of the Pan American Health Organization will be speaking at the opening session, and the beloved Dr. Howard Koh will be closing the meeting on Wednesday.

If you will be in attendance, come see my presentation on Human Trafficking and Sex Work in Nicaragua and Thailand on Monday, November 9th from 12:30-2:00pm in a session titled "The Good, the Bad and the Ugly of the Sex Worker Industry" Session 3261.1.

Public Health Practioners for Reform, a group started by students at the Harvard School of Public Health, will be marching to CIGNA headquarters on Monday, November 9th at 4pm in support for a public option in health care reform (and demanding that health insurance companies stop lobbying against a public option). If you'd like to join them, you can find more information about the march/rally here.

See you at the conference!

Monday, November 2, 2009

Can What You Eat Prevent Depression?

Did you know that eating a lot of processed foods (most of the foods in the center aisles) may be related to developing depression? A study recently reported by BBC News and passed along to a fellow colleague at Harvard School of Public Health (thanks Rachael!) has reached this conclusion -- and I am apt to agree.

Take-Home Message
Eat a diet rich in whole foods (fruits, vegetables, unprocessed meats, natural fats, and whole grains) and forgo the traditional diet of refined sugars and wheat, artificial fats, and *deli* meat and cheese.

Why should you? 
Because you can might not just impact your waist line, but also your mental health.