House lifts ban on federal funding for needle exchange programs - The Boston Globe

House lifts ban on federal funding for needle exchange programs - The Boston Globe

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Social Media: A Health Educator's Friend or Foe?

I am truly overwhelmed by the social media frenzy and the advances in new technology. More so, there’s the whole subset of “vocabulary” that needs to be learned to effectively stay in the loop. Sometimes I want to throw my hands in the air and give up on trying to stay in touch with it all, but then I realize by being culturally relevant, I become a better health educator.

Now the question is: are social media like Facebook, Twitter, blogging, and texting my friends or foes? I think if social media can be harnessed and used appropriately it can be a very effective health education tool. However, like your mother always told you “Everything in moderation.” I think if overused or used improperly, we could have a global disaster on our hands. Okay, maybe that’s an exaggeration. But the results wouldn’t be good.

Example 1: The CDC on Twitter

The Centers for Disease Control and Prevention have multiple sub-centers/departments on Twitter, tweeting updates to their followers. This is a pretty effective way of keeping the general public (at least those on Twitter) updated to any breaking public health news like a new publication or report or “Hooray! It’s International Eat-Your-Veggies Day!” But probably the section that may have the most purpose with Twitter is the Disaster Preparedness section of the CDC. Twitter is potentially a good channel for communicating information (albeit, brief) on preparing yourself for, well, disaster. One situation where this may have back-fired, however, is with the swine flu. Tweeters panic and make assumptions since there’s no way to get the whole story due to the 140 character limits. Plus, there’s no room for a post-script “Don’t Panic.”

Example 2: Online Forums

Gobs and gobs of research have shown that social support in its various forms is an effective way of managing chronic disease. If you Google Scholar or do a PubMed search of “Social Support and Disease" you’re bound to be overwhelmed with the search results. Online support groups, such as those for type 2 diabetes or breast cancer, have had great impact on mental and physical well-being of their participants. You might even know someone who participates in one and can attest to how much they love their online support system. Some benefits of online support groups are:

1. Common interest. Not feeling alone in your suffering is a good thing.

2. Anonymity. Participants don’t feel judged by people who already know them and have preset opinions.

Some health issue support groups, however, aren’t destined for greatness. Studies have found that support groups of teenagers suffering from anorexia or bulimia are counterproductive because the teens share their “methods” for staying thin. I give an “A” for effort, though.

Example 3: Texting Health Messages

I hate texting. I’m so glad I’m not a middle or high school teacher because I’d probably hate it more. I think we’ll have an emerging pandemic of “texter’s thumb” on our hands (no pun intended) in the next few years. And I think it teaches teenagers bad grammar and inappropriate use of the acronym. However, realizing we live among the “text generation,” I think it can be an important avenue for health messages. I’m currently working on a project that works with multiple sites doing diabetes self-management studies. One of our studies is using text messaging as a means of reminding participants of upcoming doctor appointments, medication reminders, healthy eating tips, and the list goes on and on. I’m very interested to see the results of this study. Several studies have already been done (mostly international) that have found text messaging (or SMS) to have a positive impact on certain behavior changes. However, several studies have also been deemed “inconclusive,” so more research needs to be done in this area.

Okay, so I haven’t covered all forms of social media. I tried to be objective, but let’s face it, I’m a fan of you, social media. Let’s be friends.

Fireworks, Food, and the Fourth of July!

The Fourth of July is right around the corner and there are a lot of things that can go wrong when you’re camping, picnicking, or family reunioning. Not to rain on anyone’s Fourth of July parade, but there are some things everyone should be wary of in the midst of the festivities. I’ve seen a lot of crazy Independence Day celebrations and seen a lot of things go wrong. Here are some mistakes people make on the Fourth of July:

1. Drinking too much. Many adults raise a glass in celebration of our nation’s independence, and unfortunately, many adults will binge drink. Binge drinking means drinking more than 5 alcoholic beverages in one sitting for men and more than 4 alcoholic beverages in one sitting for women. According to the CDC, excessive alcohol use is the 3^rd leading lifestyle-related cause of death.

Like drinking and driving, drinking and fireworks DO NOT MIX. If you’re drinking feel free to go to a professional fireworks show, but don’t try to set them off yourself. Please.

2. Carelessly using fireworks. 60% of injuries related to fireworks occur on or around the 4^th of July (Green & Joholske, 2006). In the months of June and July, firecrackers, sparklers, and rockets account for most injuries seen in emergency departments, and sparklers are associated with half of the injuries seen in children under 5 (Green & Joholske, 2006). And the best way to prevent firework-related injuries? Leave them to the professionals!

3. Eating contaminated or spoiled food. Be wary of food that’s been sitting out in the sun too long, especially if it’s a mayonnaise-based salad, dairy product, or meat product. Even if a food has been washed and cooked thoroughly, bacteria flourish at room (and warmer) temperature. If you can, try to keep leftovers cool or throw them away.

Also, even if you love your burgers rare, ground beef is a common culprit for food-related illness. Make sure the internal temperature of your hamburgers is a balmy 160 degrees Fahrenheit to keep yourself safe from bacteria.

Obviously these aren’t the only things that can go wrong on the 4^th. I urge you to be safe and wary as you “eat, drink, and be merry!”

THIS is Public Health

When I lived abroad, people always asked what is my profession. I would always reply, "I work in public health." Which is a phrase that unfortunately doesn't translate well into other languages. "Public Health" either is equated to medicine or sanitation...neither of which I do.

Even in America, people aren't quite sure what Public Health is or what it means to be a public health worker. In America, people usually think I'm a health inspector or do stuff related to AIDS. Wrong again. I don't do those things either! For those of you with lingering questions, check out this video!

http://www.thisispublichealth.org/

"I'm healthy! I went to college!"

Back in May, a report was released by the Robert Woods Johnson Foundation that ranked states according to the gap between college graduates and non-college graduates who rate themselves in “less than very good” health. Meaning, the states ranked the highest had the smallest gap in self-reported health status between those with college degrees and those without. Top-ranked states were Delaware, Hawaii, and Maryland. Lowest-ranked states were California, West Virginia, and Kentucky.

Click Here to download the report.

This report is chocked full of other data about self-reported health status among American adults, but I want to focus on the relationship found between education and health status. What they found was that as education levels rise, health improves.

As someone who’s been in the health field for years, I can look at these finding and say “Well, duh!” But is it all that intuitive? Let’s deconstruct it:

College Education > More Knowledge > Awareness of Health Risks > Healthy Behaviors > Reporting Good Health

OR

College Education > Higher Income > Ability to Regularly Access Health Care Services (by health insurance or out-of-pocket expenses) > Reporting Good Health

OR

Both?

I think the gap between college-educated and non-college-educated folks is somewhat a combination of the two models proposed above, but I think the main factor is probably linked to income. We know that people with higher education levels get paid more (check census data: http://www.census.gov/hhes/www/macro/032008/perinc/new03_000.htm)

I would venture to say that most Americans have access to basic health knowledge. Most children learn basic health behaviors all through primary school, from teeth-brushing to healthy eating. And there are so many public service announcements and news reports related to health nowadays (providing you have a television), so the basic knowledge is there. However, people who make more money are more able to access healthier foods (fresh veggies cost more!), physical activity (e.g. gym membership), and regular health care.

One thing that concerned me about the release of this report is that the chairman of the commission that put out this report said that in order to improve our nation’s health we need to improve education quality and education attainment. I’m all for improving the nation’s schools and giving every child the opportunity to go to college if they want, BUT…

-Do we really know that education actually precedes health status? I mean, which came first, the chicken or the egg? Maybe kids who already value health and consider themselves to be healthy, physically and mentally, go to college. Many college-bound kids are able to stay on their parents’ health insurance during their college years and maybe they see health insurance and regular health care as important. Who knows?

-Maybe before correcting the educational system in the US we need to fix the health care system. We ought to consider striving toward getting every person, regardless of age, equal access to health care. We’ve missed the boat on folks who will not go back for an education, so why not seek to meet their current needs? In the coming years, people over 80 will become the fastest growing age group in America and people over 50 will represent 35% of the population. Let’s meet the ever-increasing need for access to health care.

-Keeping in mind, access to health care and education alone will not fix the problem. Both issues need to be tackled to move toward improving the health status of the American people.

Weight Loss for Real

So I’m getting married in a few weeks, and I was recently browsing a bridal discussion board. One woman said she wanted to lose 45 pounds for her wedding. While the time frame of 8 months was perfectly reasonable and healthy – most experts consider 1-2 pounds per week to be healthy weight loss – this goal concerned me.

For one, did your fiancé propose to you as you are? Don’t your friends and family love you as you are?

Presumably, there was no ultimatum for this girl from other people, and she wants to lose the weight for herself.

BUT…

She said she wanted to lose the weight for the wedding. And to me, this means “I want to look skinny in pictures,” or “I want to look amazing on my wedding day (because I think I look slightly less than amazing currently).” Don’t get me wrong, I want to look amazing on my wedding day too.

HOWEVER…

As a health educator, I get concerned when people want to lose weight for a particular event, e.g. wedding, reunion, etc. While those are good jump-start motivators and provide a specific and measurable timeline for a weight loss goal, losing weight for an event does not necessarily translate into life change and enduring weight loss.

I probably sound like an echo from the Biggest Loser when I say weight loss is about life change. For a bride who has 45 pounds to lose to be at a healthy weight for their body type, this is not about dropping pounds to fit into your dress, this has to be about changing habits and mindsets.

I understand full well the battle with weight – I’ve lived it. Just over 5 years ago, I weighed over 200 pounds and had a Body Mass Index (BMI = weight-height ratio) of 34 (30 and above is considered obese). I came to a point where I felt very unhealthy and decided to become more disciplined about my diet and exercise. In my first 6 months, I lost 25 pounds and felt awesome. For about 2 years, my weight plateaued and I was perfectly content. My diet and exercise routine were just that – routine. Then I decided to set a fitness goal for myself: to run a marathon. As a result of training for the marathon, I lost 30 pounds. I had changed very little about my diet, increased the intensity and duration of my daily exercise, and totally changed my mindset.

All of my weight loss has been very gradual and has come as a result of mindset not focused on weight loss, but focused on other goals: feeling healthy and fit. And this is what I would recommend to anyone.

You can say you want to lose X number of pounds by a certain date, but you’ll need smaller, specific goals and plans to reach your overall weight loss goal. So consider setting diet and fitness goals like these:

Run (and finish) the Annual Spring Fun Run 5K on April 23.

Play and walk 18 holes of golf with my son at the Father-Son Golf Tournament on June 11.

Starting Monday, cut back to 1 can of soda per day.

Eat a piece of raw fruit or vegetable with every meal for 1 week.

Notice these are SMART goals. SMART stands for:

Specific

Measurable

Attainable

Realistic

Timely

Obviously, diet and fitness goals won’t look the same for everyone. You’ll want to set goals based on your lifestyle.

Another key tip: It really helps when you have a partner in crime! Find someone (friend, co-worker, family member, spouse, or partner) who will work towards those specific diet and/or fitness goals with you. Social support is key to maintaining motivation and regular, mutual encouragement. And there’s a lot of research showing the effectiveness of peer support in long-lasting health behavior changes.

Note: I’m not a physician or a dietician, so I can’t make specific recommendations. I speak from personal experience. What worked for me, will not necessarily work for everyone.

Summer Tan-Tastic!

I find it terribly unfortunate that being tan is so glamorous. You may think I’m saying this because I’m of Northern European ancestry and couldn’t get a tan if my life depended on it. Hardly. I can tan with the best of ‘em. I’m saying this because it’s nearly summertime and Americans have terribly unhealthy skin care behaviors when it comes to the sun. I work on a college campus and have a pool in my neighborhood and I have seen so many people of Northern European ancestry out trying to get a tan. News Flash: If you’ve never gotten a tan in your life, why would this year be any different?

But I’m not just going to target the pale, pasty types – though fair skinned, light-eyed people are at greater risk for severe sun burns and skin cancer – no, EVERYONE needs to think about taking care of their skin for the long run.

As a 20 something, being tan may make you the envy of all your friends, and as a 30 something getting a tan can make you appear 5 pounds lighter. But what can extended and unprotected sun exposure do for you in your 40’s, 50’s, and beyond? Sun exposure (and tanning beds!) commonly leads to wrinkles, leathery skin, sun/age spots, increased risk for cataracts (eyes), and increased risk for skin cancer. Last I checked, none of these are glamorous.

According to the CDC, you are at an increased risk for skin cancer if you have:

• A lighter natural skin color.
• Family history of skin cancer.
• A personal history of skin cancer.
• Exposure to the sun through work and play.
• A history of sunburns early in life.
• Skin that burns, freckles, reddens easily, or becomes painful in the sun.
• Blue or green eyes.
• Blond or red hair.
• Certain types and a large number of moles.

Though most of these are not true for me, I did have serious sunburns as a teenager, which is one of the greatest predictors of skin cancer later in life. Now I Take precautions when I know I’ll be exposed to the sun for any length of time. Some things I do include:

· Seeking shade, whether it’s under a tree or the shadow of a building

· Wearing a hat when I’m doing work outside or going for a run

· Wearing sunglasses especially when I’m near water

· Slathering on sunscreen that’s a higher SPF than I probably need

Even though I’m not fair-skinned, I wear SPF 30 sun block or higher anytime I’m outside. I know everyone has their favorite sunscreens or sun blocks based on smell or functionality (e.g. oil-free, spray-on, waterproof), but to see how your sunscreen or sun block stacks up against the competition, check out reviews at http://www.consumersearch.com/sunscreen.

I hope I didn’t spoil the summer for the sun gods and goddesses out there…