High Lifetime Costs for Type 2 Diabetes

Diabetes for the young and old has been an ongoing issue for Americans.  This article, “High Lifetime Costs for Diabetes 2,” from Science Daily talks about a study that was done to evaluate how much money patients need to spend if  they get diagnosed with Type 2 Diabetes in their lifetime.  Those who get diagnosed with diabetes at a younger age end up spending more money on supplies and medical expenses.  “The model revealed that a man diagnosed with type 2 diabetes between ages of 25 and 44 can be expected to incur related costs of $24,000 over his lifetime” (Science Daily).

Diabetes can be linked to obesity. Types 2 diabetes is usually diagnosed if a person is over weight. Insulin is used only as needed. Type 1 diabetes is insulin dependent. Insulin is needed daily. Also, a person must check their blood sugar before and after every meal.  The expensive supply used when having diabetes is the test strips. This is a global issue since diabetes increasing all over the world. If diabetes can be decreased, less money will be spent on it. 

"What will your verse be?"

As we finish up our work during this first portion of the quarter and gear up for midterms, I thought a story from NPR might be relevant, helpful, and comforting. Those around us in academia can be a source of inspiration, providing us a model of professionalism that is composed, confident, and something we hope to emulate. However, there may also be times when we feel as though we are impostors, that we do not belong, and that our contributions are not worthy. If our survey of the work in global health teaches us anything, I think it is the opposite: the task is huge, we need all hands on deck, YOU have a valuable, important perspective and we need to hear your voice.

KFF YouToons

One of your fellow students suggested this cartoon as a helpful review of ACA- enjoy! (Thanks Hanna!)

Global Aging and Future Trends

According to a global study just released by the United Nations(UN), “by the year 2050, for the first time in history, seniors older than 60 will outnumber children younger than 15”(as cited in Gelineau 2013). This unprecedented shift in global demographics has significant consequences for global health. Seniors have unique healthcare and lifestyle needs. Currently many countries around the world have social programs for the elderly(Gelineau 2013), but many developing countries do not have such programs and will need to implement policies before the demographic shift in the future.

How Will the U.S. Government's Shutdown Impact Global Health?

Just saw this article from Maryn McKenna in Wired outlining how a shutdown of the U.S. government will have massive impacts on health, locally & globally. It's pretty obvious, really: how can the 3 core functions of public health be achieved if the DHHS and FDA have sent home roughly 50% of their staff, and the CDC has furloughed 68% of its employees?

Who will keep the public healthy now?

image: BMills (CC), Flickr

Fighting Polio in Israel

Did anyone catch this story awhile back? Due to polio spreading through the sewage system in Israel, they're working overtime to vaccinate children under the age of 9. That's one billion children, folks!

David Buimovitch/AFP/Getty Images

Child Soldiers

Childhood innocence has been a common phrase used to describe a pure and true subject. However, in some developing countries where the political climate is unstable, children (under the age of 18) are stripped of their rights to innocence when forced into an armed faction, political group, or any other form of a combat organization regardless of whether there is a current ongoing armed conflict or not. It is important to note that the definition of child soldier applies to any position the child may hold (including cooks, messengers, porters, and spies) despite being directly involved in hostilities. The initiation process is brutal and inhumane; where children are forced to perform vile and violent acts against both their targets and upon one another.      

MERS Outbreak

The MERS coronavirus (Middle Eastern Respiratory Syndrome) has been quickly spreading throughout the Middle East. This is a big problem because the disease is spreading around the time of Ramadan, when millions of Muslim pilgrims journey to Mecca. Since it is a contagious disease, large crowds will only increase the spread of disease. The WHO has set up an emergency committee regarding MERS to address the state of travel for pilgrims during Ramadan. They have determined that along with the cases that have turned fatal, there are also other cases that have been undetected. And as of right now, this is what the WHO is most concerned with.

The LifeStraw® Water Filtration System

The LifeStraw® Water Filtration System

Over 70% of Earth’s surface is covered in water, and although this seems like a lot, only 2.5% is considered freshwater. That means that <1% of the world's freshwater (~0.007% of all water on earth) is accessible for direct human uses. Earth’s freshwater supply is decreasing rapidly due to climate change. Many aquifers have been over-pumped and are not recharging as rapidly as in the past. Although the total fresh water supply has not been depleted, much has become polluted, salted, unsuitable or otherwise unavailable for drinking, and/or use in industry and agriculture. Low income nations are especially vulnerable to water scarcity; an estimated 884 million people in the world, 37% of whom live in Sub-Saharan Africa, still use unimproved sources of drinking water.

Effects of Hepatitis B, HIV/AIDS, and Tuberculosis on Motherhood and Breastfeeding

Infectious diseases pose a serious health risk for pregnant women and their infants because they are easily transmitted from the mother to the child. This process of passing the virus from mother to baby is called mother-to-child transmission (MTCT) or perinatal transmission.  Women infected with a communicable disease must take certain precautions to prevent transmitting it their child.  Some women do not experience symptoms of being infected so it vital that the mother is tested for a wide range of communicable diseases as part of her prenatal care—the sooner the mother is diagnosed and treated, the higher the chance the fetus will not become infected. 
Each disease requires unique preventative measures but treatment include vaccination for the mother as well as the child.  Some MTCT communicable diseases are so prevalent that the World Health Organization (WHO) recommends as part of routine childhood immunizations, such as hepatitis B.

Why Do People Oppose Vaccinations?

Photo via

Vaccines have been celebrated for years as public health's most cost-effective intervention. With little investment, vaccines can be administered to protect against a wide variety of communicable disease, many of which are still raging problems, globally. The more people get vaccinated, the higher the herd immunity, and the safer the community is. To health officials, vaccines are a no-brainer. Yet there is a growing trend of concerned parents fighting back. What's the deal?

The Zapatistas' Autonomous Zapatista Health System: World Leaders in Global Health Look at Change from Below

It is known that poor and marginalized people all over the world suffer the most in terms of health inequities. Communities around the world are addressing this in different ways. In the Mexican state of Chiapas a group of indigenous people have taken matters into their own hands. The Zapatistas are most known for taking up arms against the Mexican government in 1994 but have since gotten recognition for their efforts in promoting health, education, and human rights in communities around the state.

Genetically Modified Organisms (GMOs)

What are GMOs? 

All organisms have some sort of impurities or flaws that could be improved to make the organism more useful or stronger.  Genetically modified organisms are organisms that have had their DNA genetic makeup modified.  According to the World Health Organization genetically modified organisms are also known as “modern biotechnology” or “gene technology”. 

Effects of DDT

DDT Spray

Dichloro-diphenyl-trichloroethane, better known as DDT, was developed in the 1940s primarily to combat insect-borne diseases that were becoming rampant throughout many countries. Malaria, yellow fever, dengue fever, Japanese encephalitis and the West Nile virus are just a few example of the types of diseases that can be spread by these infectious insects, mainly the mosquito. Because of DDT’s chemical composition it became a successful weapon in combating these prevalent diseases by practically eradicating most species of the mosquito. However DDT’s purpose began to shift towards that of an agricultural insecticide with over usage deteriorating farmland ecosystems. Subsequently, it was banned from the United States and eventually worldwide. Now the question to consider is whether DDT should again be implemented to combat the diseases in which current efforts have proved insufficient before they reach epidemic proportions.

Toxic Food Environment: How Our Surroundings Influence What We Eat

This article from the Harvard School of Public Health highlights the environmental conditions that impact obesity and provides links that facilitate a deeper understanding of this topic.

Enjoy!

East Of 82nd: Raising Children In A 'Food Desert'

Oregon Public Broadcasting has begun a series entitled "East of 82nd." This series, through a collection of stories told on NPR, and through this Tumblr page will explore some of the unique characteristics and disparities that this rapid growing East Portland area faces. The first story East of 82nd: Raising Children in a "Food Desert" can be found here.

Cross-Cultural Comparisons of Alzheimer’s disease - Further Information

Introduction to Blog and Cross-cultural component 

Renee Henriques

Scientists have yet to discover the cause of Alzheimer’s disease, but it is suspected that an individual’s risk of developing the disease is determined by multiple factors, including genetic and personal components. The current belief is that there is not one single cause of AD, but that an individual’s risk is determined by the influences of multiple factors, including demographic, socio-economic, and cultural, and personal factors. Age is the most important known risk factor with the risk of developing Alzheimer’s disease doubling every 5 years after the age of 65 (http://www.alz.org/research/science/alzheimers_disease_causes.asp#age)

Research is currently underway to study the influence of family history, gender, education-level, and diet/nutrition for their influence on the development of AD http://www.cdc.gov/aging/aginginfo/alzheimers.htm. Although progress is being made in the identification of risk factors, there remain many important questions to be answered in order to understand the underlying causes of AD, and to develop effective treatments. There is currently no cure for Alzheimer’s disease, but there are some treatments that have yielded positive results for individuals diagnosed with AD, including medications as well as non-drug therapy.  Common medications to treat the psychiatric and behavioral symptoms include antidepressants, anxiolytics, and anti- psychotics. For a complete list of these medications, visit: http://www.alz.org/alzheimers_disease_standard_prescriptions.asp
The FDA has approved the use of five drugs to specifically treat symptoms of AD. Four of these medications are cholinesterase inhibitors – which treat cognitive symptom such as memory, language, judgment, and other cognitive processes. http://www.alz.org/national/documents/topicsheet_treatments.pdf
Global rises in morbidity and mortality due to this disease have led to increases in research that examine the presentation and progression of AD from an etiologic perspective. There are differences across ethnic groups, cultures, and geographic regions in the recognition, diagnosis, progression and treatment of AD (Gibbons et al., 2002; Hu et al., 2012)Age and family history are known risks, but cross-cultural studies have demonstrated significant differences in the recognition and treatment of AD (Karim et al., 2011; Chandra., 1996; Mangone., Shaji et al., 1996; Hendrie, 1999; Guo et al,. 2000)  A study in the International Journal of Geriatric Psychiatry found significant differences in affective symptoms, personality changes, and the ability to perform every day activities between Pakistani and Caucasian patients diagnosed with AD (Karim et al., 2011). The findings from these studies can provide important insights into the underlying causes of this complex, and lethal disease. 
Cross-cultural comparisons of Alzheimer’s disease can be challenging for several reasons. Although several studies suggest differences between different cohorts, there are doubts regarding the reliability of techniques used to conduct this research across cultures. One of the challenges inherent in cross-cultural research arises due to a lack of culturally-sensitive instruments, which can threaten a study’s reliability and validity. A primary concern of researches conducting cross-cultural studies is to minimize the effects of translation on test items. Some tests have been found to be fairly reliable across different cohorts, such as the Mini Mental State Examination (MMSE) http://www.utmb.edu/psychology/Folstein%20Mini.pdf  (Folstein et al., 1975), and the Montreal Cognitive Assessment MoCA-C http://www.mocatest.org/ (Nastreddine et al., 2005).

Works Cited

1)      Karim, S. et al (2011). The Symptomology of Alzheimer’s disease: a cross-cultural study. International Journal of Geriatric Psychiatry, 2011; 26: 415-422

2)      Gibbons, L. et al (2002). Cross-cultural comparison of the mini-mental state examination in United Kingdom and United States participants with Alzheimer’s disease. International Journal of Geriatric Psychiatry,2002; 17: 723-728

3)      Hu, J.B et al, 2012. Cross-cultural difference and validation of the Chinese version of Montreal Cognitive Assessment in older adults residing in Eastern China: preliminary findings. Archives of Gerontology and Geriatrics, 2013; 56: 38-43

4)      Chandra, V. (1996). Cross-cultural perspectives India: behavioral and psychological sign and symptoms of dementia: implications for research and treatment. International Psychogeriatrics 

Infanticide

The term infanticide refers to the killing of a newborn baby. Infanticide is a practice that has deep roots within human civilization. In ancient times, infanticide was committed as a sacrifice to appease the gods, this particular practice was common to the Native populations in the Americas.

However, there are many different reasons why this practice occurred. It could have been an effort of basic survival if the family felt they could not adequately provide for the child.

It could also be tradition, as in the specific practice of killing twins as they were thought to be a bad omen in certain African countries. Read this piece on an inspiring Kenyan woman intent on challenging this norm.

While shocking, throughout history, infanticide has been the rule and not the exception.Through a Western lens, this practice and the logic behind it seems arcane, infanticide is very much still prevalent in many parts of the world.

What is most common today is "Gender Specific Infanticide". Gender specific infanticide, traditionally favors male children over female children. Examples can be seen in rural parts of China.  Click here for a general picture of the state of affairs.China's controversial "Family planning policy" otherwise known as the "One Child Policy" has been thought to contribute to gender selected abortion and abandonment, despite the fact that these practices are now illegal. This policy was implemented after China's population sky rocketed to unmanageable figures shortly after Mao Zedong came to power.  

Initially, when Mao Zedong had risen to power and created 

The People's Republic of China, birth rates slowly fell. The government then began aggressively advocating for large families to empower and strengthen the country.

This chain of events has made overpopulation itself a significant health concern in China. However, it is unacceptable to consider gender specific infanticide as having anything at all to do with solving the former issue. Nevertheless, infanticide is a complex issue that is tangled with many others.  Great care would need to be employed to maintain objectivity and cultural relativism.

In the interest of global health, where does one draw the line in crafting a solution to this?

Though it is clear that female children are perceived to be less valuable than male, it does not seem practical to convince others simply that that is not the case. Even so, any solution to this problem would, at its roots, challenge this very paradigm of thought.

Unfortunately, a true solution can not be realized after infants in danger have already been born, it would already be too late. Rather, an effective, long-lasting, more upstream solution would take place in the way of socially marketing the value of family planning education to young women and young mothers. Please read about social marketing here: http://www.social-marketing.com/Whatis.html.

New ways of thinking must be strategized as if they were products that people did not feel the need to buy. Innovative and engaging practices must be implemented to create the type of long term and global changes that would alleviate the suffering related to infanticide. 

Obstetric Fistula

Obstetric Fistula

"One of the most serious injuries of childbearing is obstetric fistula, a hole in the vagina or rectum caused by labour that is prolonged – often for days – without treatment. Usually the baby dies. Because the fistula leaves women leaking urine or faeces, or both, it typically results in social isolation, depression and deepening poverty. Left untreated, fistula can lead to chronic medical problems."

Malaria in Uganda

Uganda is a part of sub-Saharan Africa, a region that is most at risk for malaria due global warming that favors the existence, growth and spread of the malaria vectors. This region is very poor and lacks a lot of resources needed to control the spreading of malaria. Uganda has the highest incidence rate of malaria in Africa, being that 473 cases/1,000 people per year are reported. Malaria is also the leading factor in mortality and morbidity in Uganda.