In a 2017 Health Affairs piece, Peter Buerhaus, David Auerbach, and Douglas Staiger discussed an approaching healthcare challenge—the reality that many nurses of the Baby Boomer generation will soon retire, creating a shortage of experience among the remaining RN workforce. The article caused me to reflect on the broader condition of caregivers in the US, particularly that of non-professional caregivers, who face many of the same scenarios that confront professional nurses but must do so without the training and expertise of the experienced RNs who will soon leave the healthcare field. As these caregivers play an ever-greater role in safeguarding the health of our aging population, a note on the physical and mental health of caregivers, and how public health can best support these individuals, and, by extension, the populations they care for.
The Public's Health: Food Justice | Public Health Post
One in six of our citizens experiences food insecurity. Forty-two million low income and working-class Americans—most of whom are elderly, disabled, or children—use Supplemental Nutrition Assistance Program (SNAP) benefits to buy groceries. That is, they don’t earn enough to feed themselves consistently. Food insecurity has dramatic effects on the health of children and the elderly in particular, influencing educational progress, family stress, and nutritional deficiencies.
At the same time we throw away 40% of our food every day. That’s 400 pounds per person per year.
What the Recent—and Maybe Future—Shutdown Teaches Us About Wealth in the U.S. | Fortune
The U.S. just emerged from the longest government shutdown in its history, and was on the brink of another shutdown that could start again in a week. Much has been written about the human costs of the shutdown, which include the halting of critical government services like food safety inspections.
While the temporary loss of these functions was bad for all of us, the harm of the shutdown was most acutely felt by the roughly 800,000 federal workers who were forced to go for weeks without a paycheck. Many of these workers were already socioeconomically vulnerable—the average federal worker’s salary is 32 percent lower than that of private sector workers.
Additionally, close to one in five federal workers are black, a population with significant economic challenges of its own. Centrally, black Americans are more than twice as likely as their white peers to have a net worth of zero or negative zero. And they have far less wealth, accumulating just seven percent of the wealth enjoyed by white Americans.
The Public's Health: Police and the Public's Health | Public Health Post
Police work is community work. Performed on the street, in public settings and private homes, police work shapes the health context of cities and neighborhoods, and affects the lives and behaviors of countless citizens. While there has been much concern in recent years—appropriately—about how some police activity has harmed health, particularly among minority communities, it is worth focusing on the potential for police work to improve the health of the public.
Most police interaction with the public does not involve major crimes or violence that requires arrest or use of force. Police beat work is filled with low intensity interactions in which officers serve as problem‐solvers. We think of this as public health work; police are one of the forces that generate health in many places.
The Public's Health: In Social Media We Trust | Public Health Post
We have grown accustomed to social media reading our thoughts. One day we are using Facebook to exchange notes about an upcoming wedding invitation, and the next day Facebook ads highlight discounts on potential wedding gifts. We post photos of a new item of clothing on Instagram and next we are receiving ads from the newest crop of design stars.
Of course our social media apps are not reading our thoughts—they are reading our photos, shopping patterns, and the actual words we write in our emails and posts. We have come to think of this type of targeted advertising as unremarkable, even as, in recent years, we have become aware of the potential havoc this type of micro-targeting can wreak on our democratic process.
The Public's Health: The Illusion of Clinical Success | Public Health Post
As doctors we have both had our fair share of patient success stories. A patient presents herself to our office or emergency room with a problem, we diagnose it, prescribe treatment, and the patient gets better. We can remember Lois who presented with vomiting, whom we diagnosed with gastroenteritis, treated and restored to health two weeks later. And Emmanuel who came to the emergency department with a cut on his forehead because he fell down the stairs. He was sutured up and the cut healed nicely. All clinicians have these stories. They are the reason why many of us went to medical school, to heal people, to make them better.
The Public's Health: Vaccines and Conspiracies | Public Health Post
Near the end of 2018, the Centers for Disease Control and Prevention data made clear that a small but increasing number of children in the United States were not getting recommended vaccinations. One in 77 infants born in 2017 did not receive any vaccinations; that’s more than four times as many unvaccinated children as we had at the turn of the century. Some of this may be due to lack of access as those without insurance and those living in rural areas have greater rates of non-vaccination. But part of it may be due to the dismissal of science and scientific evidence, the rising conspiracism in America and its move into the White House.
Ahead of Martin Luther King Day, Remembering That Health Is Impossible Without Justice | Fortune
Last month, President Trump signed into law the First Step Act, bipartisan legislation aimed at reforming the criminal justice system. Among other reforms, the Act increases the number of “good time” credits inmates can earn and apply towards a reduced sentence, modifies the “three strikes” rule so people with three or more convictions are automatically given 25 years in prison instead of life, and makes it easier for judges to opt out of delivering mandatory minimum sentences.
While the reach of these reforms is relatively modest, affecting only federal prison inmates—nearly 180,000 of the total incarcerated population of about2.2 million—the Act is nevertheless a step in the right direction. It points towards a justice system that is more what it was always supposed to be: just. It also points towards better health. Mass incarceration is a significant public health challenge in the US.
Read the full piece at Fortune.