Archive for the ‘Child Health’ Category

The Global Gag Rule, a harmful human rights violation

March 12, 2017

The Global Gag Rule (GGR) is harmful to women and families and violates human rights. Originally known as the “Mexico City Policy” because it was enacted by Ronald Reagan in 1984 at a conference in Mexico City, the policy is more commonly known as the Global Gag Rule because of how it silences NGOs and health care workers. Specifically, the original policy dictated that no USAID family planning funds could be awarded to organizations that performed or promoted abortion and therefore prohibited them from even speaking about abortion.

The GGR is highly partisan- every Democrat president since Reagan has rescinded the policy and every Republican has reinstated it. The current administration, however, has not only reinstated the GGR but has dramatically expanded the funds that are affected.

Reagan’s version applied to USAID family planning funds; G.W. Bush’s version limited the GGR by exempting USAID HIV/AIDs related work. The latest iteration, however, greatly expands the affected funds to cover all foreign aid arising from any agency or department. The current version restricts up to $9.5 billion in aid, or 16x the amount of funds that would have been affected by previous versions.

Worse yet, beyond being a clear example of religious overreach in US politics and a violation of human rights, evidence suggests that the policy reduces sex education and contraception use while increasing both abortions and the proportion of abortions that result in health complications- maternal, family, and child health all suffer. There is a large coalition of organizations that oppose the GGR. You can take action today by learning more information about the GGR and volunteering or donating to organizations like IPPF, PAI, and the Bill and Melinda Gates Foundation who, together with UN member countries, are attempting to counteract the extreme funding deficit.

Sugar-Sweetened Beverages’ Low Taxes in Maryland May Be a Poison for Children and Adults

March 12, 2017

Other group member: Mujan Varasteh Kia

In 2015, 30% of the people in Maryland were clinically obese. Sugar-Sweetened Beverages (SSB) is strongly associated with obesity which can lead to the number one leading cause of preventative deaths (1 in 4 deaths) due to heart disease, stroke, type 2 diabetes, and certain types of cancer, and can play a role in preterm delivery.

A constructive SSB taxation policy can help to reduce many of the obesity-related health problems and alleviate the amount of money spent to treat these cases long-term. The goal is that “increasing [the tax] will discourage individuals, especially children, and teenagers, from excessive consumption of these beverages.” Currently, Maryland imposes a 6% sale tax on SSBs. No significant reduction in obesity has been recognized as a result of this taxation. It has been argued that the sales tax is too little to prevent people from reducing their bad habits which urges the need for a more substantial taxation to reduce soda consumption. In a study, they found that participants would buy fewer SSBs with 20% tax and would completely eliminate their SSB consumption if 50-100% tax was implemented.

Shortly after Mexico passed soda tax law in 2013, there was an average 12% decline in soda sales and a 4% increase in bottled water purchases. The soda industries have argued that soda taxation is not going to “change the behaviors that lead to obesity,” and that the public will find their calories elsewhere. However, in the studies they referred to the taxes were too small or they were applied in the form of sales taxes that could have gone unnoticed by the consumers.

Philadelphia was the first big city in the nation to pass a soda taxation policy in 2016. Despite the approximate $5 million advertisements against this taxation by The American Beverage Association, a non-profit campaign was created with the help of the former New York City Mayor, Michael Bloomberg to support the soda taxation law. We also urge the Maryland state legislature to support and follow the same initiatives as those of Philadelphia mayor’s 1.5-cents-per-ounce levy on SSBs. These policies may not fully eliminate the obesity crisis, but even a small reduction in soda consumption will make a difference.

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Image credit: Philly.com

 

 

Rescinding the Mexico City Policy

March 12, 2017

The Mexico City Policy, also commonly known as the “Global Gag Rule,” was first introduced in 1985 during the Reagan administration and has been rescinded by most Democratic presidents and reinstated by most Republican presidents since then. This policy was most recently reinstated by President Trump, and prohibits foreign NGOs that receive US government funding from performing abortions, providing counseling and information on abortions as a method of family planning, or promoting any changes in a country’s legislation regarding abortion. The Trump administration’s reinstatement, however, does not apply only to family planning assistance. It expands to limit all U.S. global health funding, including global HIV and maternal child health (MCH) assistance.

Many organizations, including Marie Stopes International, Doctors Without Borders, Population Action International, and International Planned Parenthood Federation, have released statements in opposition to the Global Gag Rule. Foreign governments have also stepped forward, with some creating international funds or pledging money in an effort to fill the funding gap. While these are a good start, we need greater mobilization to fight for women’s health and empowerment.

Unsafe abortion is one of the main causes of maternal mortality worldwide, and disproportionately affects women in low- and middle-income countries and in vulnerable contexts such as refugee camps and conflict zones. Research has shown that policies preventing providers from educating women about abortion and family planning methods lead to more unwanted pregnancies, more unsafe abortions, and higher rates of STIs. This policy also threatens progress on many other fronts, such as HIV, child malaria, tuberculosis, and immunizations. Healthcare providers, public health professionals, and all concerned citizens need to speak out for global reproductive rights, support international aid organizations, and push Trump and US Congress for the repeal of the Mexico City Policy.

The Overlooked Mental Health Needs of Refugee Children

March 12, 2017
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Image Source: http://unhcr.org/FutureOfSyria

Since 2011, the Syrian Civil War has caused an unprecedented mass displacement of 11 million Syrians. Out of the 4.95 million Syrian refugees who moved to neighboring countries, more than half are children under the age of 18. Among Syrian refugees under the age of 12, around 40% underwent trauma related to war or persecution, tumultuous migration, the resettlement process, or death of family or friends.

Refugee children face a wide array of mental health issues ranging from post-traumatic stress disorder (PTSD) to severe emotional disorders to intellectual and developmental disorders. While they are in dire need of mental health care, these children often face several barriers to accessing services. Barriers include the limited availability of services, limited financing for services, and a lack of skilled mental health providers. Within Syria, the situation has been aggravated by the systematic destruction of medical facilities, so there is only one partially functioning hospital providing mental health care. In addition, host countries do not have national strategies for coping with the health care needs of Syrian refugees, and face many other challenges such as budgeting (Jordan) or language barriers (Turkey).

Given the current level of political, social, and financial burden, stakeholders such as the WHO, UNHCR, and MercyCorps should assist the Syrian and host country governments with an internationally coordinated effort to address the mental health needs of refugee children. International stakeholders can offer cross-regional technical guidance, monitoring and evaluation, and skilled human resources
to support the development and implementation of policies that ensure the provision of adequate mental health services in
page-22-image-104Baldwin_131010_IMG193refugee children in Syria and host countries.These efforts must include the training of Syrian psychologists and the expansion of mental health workforce, who could provide culturally appropriate, community-based psychosocial support. Doing so will strengthen the mental health care system, providing more and higher quality care to refugee children in the long run.

Image Source: UNHCR. The Future of Syria: Refugee Children in Crisis http://unhcr.org/FutureOfSyria/scarred.html  This picture was drawn by a nine-year-old boy while his family were registering as refugees at Tyre registration centre, Lebanon. The bus that he and his family took to flee their home in Syria was stopped and robbed by armed men. To the right of the bus, the boy has written the word ‘death.’

Liquid Calories: Fighting Childhood Obesity due to Sugar-Sweetened Beverages

March 11, 2017

The Baltimore City Health Department states that 1 in 3 school aged children are clinically overweight or obese. One of the major causes of this is the consumption of sugar sweetened beverages (SSBs). SSBs are drinks that contain high sugar content with little nutritional value such as sodas, energy drinks, and sports drinks, which due to their unfulfilling nature cause children to consume much more than their daily recommended caloric intake.

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Image Cred: The Capher

 

Research compiled by the Department of Nutrition at Harvard has shown that for every 12oz soda, children have a 60% increased odds of becoming obese, a 26% increased odds of developing diabetes, and a 20% and 75% increased risk, respectively, of heart disease and gout as an adult. Consequently, the U.S. spends roughly $190 billion treating children for traditionally adult obesity related complications yearly.

There are, however, interventions that are effective in curbing this epidemic. A 2016 study demonstrated that when SSBs are simply accompanied by a warning label that states “Drinking beverages with added sugars contributes to obesity, diabetes, and tooth decay”, almost 20% fewer adolescents chose to drink an SSB compared to SSBs without labels. In January of 2016 Nick Mosby, Baltimore City Councilman, proposed a bill to the City Council requiring billboard advertisements, restaurants, transit adds, retailers and food service facilities post this warning label, with a $500 fine for noncompliance.

Although scheduled for a committee voting session in November of 2016, the legislation has stalled and it’s not clear presently when it will be voted on. This stagnancy makes it vital that the Baltimore City Health Department increase their own campaigns in support of the legislation, in addition to their support of NGO’s like The Sugar Free Kids Coalition which has testified for the Health Committee and continues to advocate for passage of the bill.

Breathing Easy: A Strategic Plan to Reduce Childhood Asthma Rates in New York City

March 11, 2017

Asthma is one of most common childhood illnesses across the United States, particularly among children living in low income housing. New York City is a prime example of a large urban city in which asthma continues to be a major problem, with nearly 17% of children having been diagnosed with asthma at some point in their lives; many of these children living in some of the more condensed and low income neighborhoods.

Screen Shot 2017-03-11 at 5.08.59 PM In 2016, two community based coalitions in New York City, WE ACT and Coalition for Asthma Free Housing, collaborated to create a bill that would speak to reducing asthma rates within neighborhoods that offer affordable housing called the Asthma-Free Housing Act of 2016, Intro 385B.

 

Image credits: NYC Health

Below are a few objectives the act intends to address;

  • Screen Shot 2017-03-11 at 5.09.15 PMprioritize prevention measures in homes of susceptible persons – (asthma, COPD, etc)
  • require landlords to inspect for Indoor Allergen Hazards and correct them and their causes using approved methods
  • require NYC Housing and Preservation Department (HPD) to inspect for Indoor Allergen Hazards and their causes, and issue appropriate violations

Image credits: NYC Health

The City of Portland has pushed similar legislation to improve affordable housing for their community members. The City Council approved an agreement that resolved concerns of cost, time, collaboration, & employment by establishing a partnership between various stakeholders. This partnership allowed for the creation of a Community Workforce Agreement that lead to construction and upkeep of thousands of high quality pollutant free housing within historically low income communities. To tackle the potential concerns that stakeholders and city council members in New York may have in a constantly changing economy, I would recommend modeling the work done in Portland, OR.

The people of New York’s health should be a major concern to City Council and Mayor Bill de Blasio, especially with the current restructuring of the Affordable Care Act in the U.S. Neighborhoods such as East Harlem, Flatbush, the Lower East Side, Bushwick and the South Bronx and many more, would benefit if Intro 385-B is passed and signed into law, this would be a proactive action that would begin to bridge the gap of health disparities in the city.

The Global Gag Rule

March 11, 2017

The Mexico City Policy, introduced at the 1984 United Nations International Conference on Population, was an expansion of the 1973 Helms Amendment that restricted NGOs receiving US federal funds from providing abortions as a family planning method. This policy, commonly known as the Global Gag Rule (GGR), prevents NGOs from performing or promoting abortion as a condition of receiving US federal funds earmarked for family planning purposes. This controversial policy has been repealed or reinstated by Executive Order with each presidential administration since the 1990s.

The Trump Administration iteration of the GGR goes a step further and applies the same limits to all US global health funding.

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via NPR

Groups currently receiving US global health funds are either remaining quiet about the policy or speaking against it. Those rejecting the policy stand to lose millions of dollars typically allocated to sexual and reproductive health (SRH) services globally, which could result in the closure of clinics, decreased access to care, and the associated increases in unplanned pregnancies, unsafe abortions, and maternal mortality.

Organizations working in SRH not reliant on US funding are coming out in opposition to the policy, signaling to other organizations their resistance to limitations on free speech in the delivery of care. Despite not receiving funds, these organizations will be indirectly impacted by the GGR as women seek care in areas where access is limited as a result of the GGR.

In the face of the GGR, the international community has stepped forward, with governments pledging funds for SRH organizations in an effort to cover the loss of funds, services, and care resulting from the policy.

To continue to undermine the efficacy of the policy, international NGOs and governments should reject the Mexico City policy while advocating for women’s rights and health globally. The US government should follow the lead of other western nations, permanently block the GGR (and Helm’s Amendment)and fight for the quality of SRH services, rather than their existence.

New Child Marriage Law in Bangladesh Can Undo Decades of Progress

March 10, 2017
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A child bride with her newborn daughter (Photo credit: Sam Nasim/Creative Commons)

Child marriage, usually defined as individuals married or in union before the age of 18, is a common occurrence in many countries globally. Girls who marry before the age of 18  are not as likely to finish secondary education, and more likely to experience domestic violence, die due to complications of pregnancy and childbirth, and produce children with a higher risk of neonatal mortality and/or morbidity when compared to women in their 20’s.

Though often cited as a development success in terms of poverty and mortality reduction, the nation of Bangladesh ranks 5th highest in prevalence of child marriage, with an estimated 52% of women married by age 18. Common drivers of child marriage are poverty, beliefs that marriage will ensure economic and social security for girls, and an emergency response to natural disasters.

Bangladesh’s current law on child marriage prohibits marriage before the age of 18 for women and 21 for men, as dictated by the Child Marriage Restraint Act 1929. Despite child marriage being illegal, the law is not often enforced, especially in rural areas of the nation.

In 2017, parliament adopted a new act which would allow child marriage in “special cases”, with no definition as to what constitutes a special case (Child Marriage Restraint Act 2017). Additionally, it gives harsher punishment to individuals who marry children: two years of imprisonment and/or a 100,000-taka fee ($1200). The law has passed the parliamentary phase and is awaiting presidential approval.

Many Bangladeshis and the international community have stated that given the ambiguous wording of the act, such a law would practically authorize child marriages across the country as one could easily justify the marriage being a special circumstance, such as rape cases. International organizations such as the Human Rights Watch have openly spoken against the act,  citing it as a “destructive law”.

Other than direct presidential rejection of the law, some have suggested that added regulations to this act are the only way to prevent increased prevalence and acceptance of child marriage in Bangladesh. Though it would be ideal to abolish the ambiguous segment of the act completely, regulations can specify under what rare circumstances child marriage would be allowed in, require consent of the minor her/himself, assign social workers to such cases, and completely ban all marriages before the age of 16. Local NGOs, along with international organizations that specialize in protection of women and girls, can be involved in coordination with local judges and government officials to assign social workers to such “special cases”.

In the coming months, the president of Bangladesh will make a decision on the finality of the law.

Regulation And Commercialization Of Recreational Marijuana Raises Concerns About Adolescent Health

March 5, 2017
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Rising number of adolescents smoking pot.  Credit: Tomas Rodriguez/Corbis

Although medical marijuana has been legalized in Maryland, a controversial bill  has recently been introduced into the Maryland State legislature to legalize, tax and regulate the possession and recreational use of marijuana for adults. Six out of ten Marylanders  now favor further legalization of the recreational use of marijuana. Although several groups oppose this measure and argue it would lead to addiction and be a gateway to other drugs, the evidence is rather weak .  The decriminalization of marijuana has overcome great harms including unfair incarcerations, especially affecting young people who were burdened with a criminal record and significant racial disparity for marijuana possession.   Benefits of further legalization and regulation will control the quality and safety of the product, eliminate criminal dealers, provide jobs, develop a profitable industry and large tax base, and focus law enforcement resources on more pressing problems. The legalization of marijuana in several states has not led to significant adverse effects.  However, we should consider that recently, the American Academy of Pediatrics (AAP) has taken a strong stance against the legalization of marijuana arguing that this will lead to a significant increase in its use by adolescents which will adversely affect adolescent neurological development.

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Altered brain function smoking marijuana.  Credit: Ashtari et al, Children’s Hospital of Philadelphia

 

We support the further legalization and regulation of sales of marijuana for recreational use in the state of Maryland for adults, but recommend that the bill provide increased funding through the Maryland Department of Health to educate the public, youth and parents about the potential harmful effects of marijuana use by adolescents. This should include large media campaigns, increased educational programs in schools and counseling by pediatricians to their adolescent patients and their parents

Candy Flavored E-Cigarettes: Just Say No and Protect Our Children

August 19, 2016

Over the past decade, e-cigarettes have gained tremendous popularity in the U.S.  These products, which have been sold by both large and small tobacco companies, were only loosely regulated for years resulting in increased sales amongst adults and teenagers. The American Lung Association previously issued a statement against the sale of e-cigarettes, and specifically noted that flavored e-cigarettes glamorized their use. Furthermore, the Centers for Disease Control and Prevention has cautioned against exposing children and adolescents to e-cigarettes and e-cigarette commercials.  In contrast, proponents of e-cigarettes, such as the American Vaping Association, argue that e-cigarettes are safer and offer a healthier alternative to regular cigarettes as well as an innovative approach to smoking cessation.

In May, the FDA passed new, sweeping regulations placing e-cigarettes in the same family as cigarettes and subject to nearly all of the same legislation.  However, these new regulations do not extend to the production and sale of flavored nicotine products for e-cigarettes. This is in contrast to regulations for standard cigarettes, which restrict flavors to only regular and menthol. Research has clearly demonstrated the appeal of candy-like flavors to children and opponents of flavored e-cigarette products believe that tobacco companies will take advantage of this regulation loophole to target minors.  Whereas restrictions on e-cigarette flavors have not been put forth by the FDA, it is possible for them to be instituted in individual states.

Maryland is one such state that currently does NOT restrict the sale of flavored e-cigarettes. To take action, please contact your representative in the Maryland General Assembly and let them know that you support new regulations in the state of Maryland that would prohibit the production and sale of flavored e-cigarettes.