Archive for the ‘Patient Education’ Category

Why 21 to Purchase Tobacco Products?

March 11, 2018

The Master Settlement Agreement of 1999 imposed major restrictions on tobacco industries, proved to be a victory for public health workers in the United States and their efforts in tackling the tobacco epidemic.

However, the rise of the use of electronic cigarettes prove to be yet another strategy with tobacco companies in promoting tobacco use. The NIH defines electronic cigarettes, or e-cigs, as battery operated devices that contain aerosol flavorings and other chemicals that mixes with health, producing a vapor.

Due to its’ lack of long term consequences and it’s gateway to adult smoking, I support the bill for increasing tobacco sales from 18 to 21 years old in Washington state.

According to Washington21, 17, 800 Washington kids try smoking for the first time each year, 3, 900 kids become daily smokers with a third of them dying prematurely. The marketing of flavors for electronic cigarettes makes this product more appealing, with majority of teens not knowing exactly what is even in these e-cigs which makes e-cigs all the more dangerous in this population. The IOM Report in 2013 reported that there would be a 25% reduction in 15-17 year olds smoking tobacco and a 10% decrease in smoking related deaths if the age was raised to 21.

Like the effects of increasing the drinking age to 21, I believe that we would see similar effects when raising the age of 21 in purchasing tobacco in Washington, including e-cigs. By supporting the Washington21 campaign we are able to prevent further use of tobacco products among teens and also reduce health related tobacco issues such as cardiovascular/lung diseases, and cancer Participating in advocacy campaigns will also help with providing advocacy tools that can be used at your own state to enact policies to save lives.

On March 8, 2018, Washington house has passed SB 6048  raising the age to buy tobacco products to 21.Given this victory, it is promising that Washington state’s bill will hopefully pass the Washington senate! To support this cause and to protect the health of the youth, contact your district legislator and vote for Tobacco 21!

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Title X Funding and Teen Pregnancy in Baltimore City

March 10, 2018

Teen pregnancy has a profound impact at multiple levels, including negative impacts to the physical and mental health of both the mother and child and worsened economic outcomes related to decreased maternal education and lost tax revenue. Although overall rates of teen pregnancy continue to decrease nationwide, the rate in Baltimore continues to be elevated above the national average. This is indicative of the social and environmental factors that differentiate it from the rest of Maryland and the rest of the United States and the clear need for continued intervention. The Baltimore City Health Department has made maternal child health and teen pregnancy a key target of intervention.

Title X is the only federal grant that provides funding for family planning health services. This funding is essential for low-income and high risk patients to receive family planning resource and is a single but critical program to combat teen pregnancy. Title X does not fund for abortion services, but rather, provides contraceptive services, education, STI screenings, and healthcare resources for pregnancy. Because it is funded by the Department of Health and Human Services, programs like this are always at risk of being de-funded or underfunded depending on the goals of the presidential administration. Currently, there has been significant resistance to the $300 million in funding that is provided by the HHS and efforts have been in place to decrease the funding. As this is the sole federal source of funding, continued advocacy is needed to ensure that Title X programs continue to be funded. Without it, low-income and high risk teens are deprived of resources that are necessary for their continued well-being.

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Source

Could Biology Explain Racial Health Inequalities?

March 10, 2018

The consistently greater risk for infections and cancer among men of African ancestry compared to all other ethnic groups in the world suggests fundamental biologic causes that supersede social and geographic influences. One of the most popular arguments for the notion that race is a “social construct” is derived from the point made by the geneticist Richard Lewontin, to the effect that intra-racial genetic similarity among individuals classed within any given “race” typically accounts for only about 7% of genetic similarity. Lewontin concluded from this that racial classification is “meaningless.” While his data concerning intra-racial vs. interracial genetic similarity were correct, the inference from this data that racial classification is meaningless is widely referred to by evolutionary biologists today as “Lewontin’s fallacy.” Indeed, 7% of the genetic material consists of several thousand genetic loci, which is quite an impressive amount of genetic material.

Random studies have found higher Testosterone levels in African American men and higher Testosterone and Estrogen levels among African American women together with low Dehydroepiandrosterone levels (DHEA) compared to their racial counterparts, could explain the health inequality. DHEA levels decrease with old age and low levels are said to reduce body’s immunity against diseases increase the risk for infections and cancer; DHEA levels have been found to be particularly low in African Americans, increasing their vulnerability to diseases. This understanding is key to prioritizing health services to this community. We need policies to address early childhood education including health education; access to healthy food and eating right, and performing work and out of work activities according to your biological capabilities. We need to help people understand their biology and how it affects their health and behaviour and they can take advantage of their differences.racial differences

I advocate for health education and services to reach out to African American communities in their homes, work, schools, and churches. Early screening of African American women, for Breast cancer, Endometrial cancer, and Ovarian cancer and earlier screening of Lung cancer Prostate cancer and other common cancers among African American men; after reaching the age 40.

Featured picture by KANGSTAR

Florida High Schools Initiative for Community Engagement (ICE)

August 20, 2017

At a time when interracial turmoil and ideological divides are at a boiling point, it is incumbent upon us to introduce our young people to an alternative to bigotry and violence. What better way to do this than provide a platform from which students can engage their communities through mutually transformative service projects?

We are proposing the implementation of a service-learning program that will be fully integrated into Florida’s high school curriculum – the Florida High Schools Initiative for Community Engagement (ICE). Students will be introduced to the skills of community engagement in the classroom and linked with organizations in the community with whom they can collaborate.

Central Florida Urban League 2

 

The evidence for the benefits of service-learning abound.  Other states have successfully adopted similar initiatives.  While currently there are no statewide community service requirements for high school students in Florida, aspects of the infrastructure for the initiative are already in place through the Florida Bright Futures Scholarship Program (BFSP), making Florida ripe for the roll-out of the initiative.

Important stakeholders include high school students, parents, The Florida School Boards Association, the Florida Department of Education (DOE), the Corporation for National and Community Service (CNCS) and local businesses that employ high school students. Students will be introduced to the program through student champions recruited from BFSP. Parents will be engaged through newsletters, parent-teacher conferences and special forums. A grant proposal submitted to CNCS will request funding and logistical support.

Central Florida Urban League 1

Florida AmeriCorps volunteer. AmeriCorps is one of many initiatives of  CNCS

What Can I do to support the Initiative?

We’re so glad you asked!

  1. Contact your local school board and let them know you support the ICE program!
  2. Call or email  the Florida DOE and tell them you support the initiative!

Teen Pregnancy Prevention Program Defunded in Baltimore…and Beyond

August 20, 2017

The teen pregnancy rate in Baltimore is 2-3 times the national average, with rates reaching upwards of 64 pregnant teens for every 1,000 female adolescents in 2009. According to the Center for Disease Control, teen pregnancy costs taxpayers $10 billion annually in health care and foster care costs. On the personal level, unplanned pregnancies significantly reduce life opportunities for teen moms, with the CDC finding that only 50% of teen moms graduating from high school by age 22. This lack of education causes a ripple effect, and teen moms have more chronic health problems and higher rates of incarceration.

Courtesy of the Baltimore Sun

Courtesy of Baltimore Sun

Teen pregnancy in Baltimore has seen a steady decline over the last decade, joining a national downward trend. This comes in no small part to programs such as the Health and Human Services’s Teen Pregnancy Prevention Program (TPPP). With funding from the TPPP, 80 city health departments have been empowered to create science-based prevention programs for teens to understand contraception and sexuality.

Unfortunately, the TPPP was abruptly defunded last week. The Trump administration offered little explanation, leaving pro-abstinence groups such as The Abstinence and Marriage Education Partnership to justify such cuts with claims that abstinence is correlated to lower rates of teen drug abuse.

Here in Maryland, the Baltimore City Health Department expressed frustration at losing $3.5 million out of the $214 milling being cut. Health Commissioner Leana Wen called the cuts “shocking.” The Health Department has joined the Big Cities Health Coalition, comprised of the 80 beneficiary cities of TPPP funds, in decrying the budget cuts. Even the American Academy of Pediatrics has joined the plea, adding a link to its website for pediatricians to contact their congressmen in protest.

There’s good news. The National Campaign to Prevent Teen and Unplanned Pregnancy found that 83% of adults support teen pregnancy prevention programs. Now is the time to tell Congress that the constituency wants the TPPP funded. Call your congressman today!

A Questionable Solution to Maryland’s Opioid Crisis

March 11, 2017

In 2015, over 1,000 Marylanders died due to opioid-related overdoses. This week, in response to increasing opioid-related deaths, Senate Bill 868 will be heard. This bill increases the scope of the Overdose Response Program (ORP), which provides education and reduces overdose by certifying and training Marylanders to assist overdose victims.

The bill allows healthcare professionals to dispense naloxone to individuals without any of the previously required education. The intent is remove the barrier of attending an educational session for obtaining naloxone, with the hope of curbing the opioid-overdose epidemic.

While naloxone is not difficult to administer, an overdose cannot be treated by just administering naloxone once. Naloxone wears off quickly, and it is critical to call emergency medical services and understand how to initiate CPR. Allowing access to the drug without education may not improve outcomes, and may become a financial burden to those trying to help.

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Image Credit: The Harm Reduction Coalition

While the Department of Hygiene and Mental Health, the Institute for Emergency Medical Services System, and The American Pharmacists Association are invested in this bill, other associations have yet to make formal statements. The American Medical Association has a task force increasing access to naloxone, the American Society of Addiction Medicine, and the Substance Abuse and Mental Health Services Administration recommend and encourage individuals who carry naloxone to receive a comprehensive overdose-related education.

While the bill’s intention is noble, removing education is not the right way forward. There are other possibilities, including requiring healthcare professionals to provide a standardized pamphlet each time they provide or dispense naloxone – which would please all stakeholders.

Nelson Mandela said, “Education is the most powerful weapon which [we] can use to change the world.” In our attempt to save lives, Maryland should be cautious in skipping education.

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.

Regulation of the food industry is needed to ensure healthier foods and healthier food choices – A new law regulating salt reduction of commonly consumed goods comes into effect 30 June 2016 in South Africa

August 19, 2016

Hypertension affects a significant proportion of the South African population with the 2010 National Household Survey reporting a measured hypertension prevalence of over 40% in adults aged ≥25 years. Today, South Africa continues to have one of the highest hypertension prevalence rates in the world.

Excessive salt intake can cause raised blood pressure known to be associated with non-communicable diseases like heart disease, stroke and renal disease. On average, South African’s are reported to consume double the daily recommended salt limit. In 2011, the South African Minister of Health declared to set targets to reduce the populations’ average salt intake to 5g/day per person by 2020 by implementing a public health campaign and regulating the food industry. On June 30, 2016 lower salt targets became mandatory by food producers with stricter targets to be achieved by 2019. Commonly consumed foods targeted include bread, cereals, margarines and butter, savoury snacks, potato crisps, processed meats, sausages, soup and gravy powders, instant noodles and stocks.

Recommended daily salt intakeSource: Salt Watch

The South African Association for Food Science and Technology (SAAFoST) advised in official comment to the proposed law that an educational campaign capable of changing the salt habits of consumers was needed if salt intake was to be successfully reduced. To assist the public to make healthier food choices more easily, healthier options need to be more easily recognized. Most food labels declare sodium/salt content by mass not allowing consumers to easily identify the salt level of products at a glance.

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Source: Salt Watch – A tool to help consumers decide if a food is low, moderate or high in sodium by looking at the value in the nutritional information table on the product label

New food labelling regulations addressing this, formulated by the SAAFoST (as a representative on the Food Legislation Advisory Group (FLAG) contributing towards the formulation and revision of food regulations as published by the Department of Health), to be implemented by the food industry would empower the South African public to make healthier food choices more easily.

Why telemedicine is limited in Japan?

August 19, 2016

Telemedicine is getting more required in Japan because some people don’t see doctors just because they are busy or reluctant to take time or it is very difficult to see doctors for patients living in isolated islands and extremely local areas. If stable patients consult doctors on video, they may continue to take medications.  However, Medical Practitioners Act in Japan requires doctors see patients in person. Therefore, it has been believed that seeing patients on video and prescribing medications can be illegal.

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Ministry of Health, Labor and Welfare (MHLW) tried to promote telemedicine because they are thinking that without telemedicine, there will be people who don’t see doctors from any reason and get ill in the end. Last year, director general of Health Policy Bureau of MHLW announced that telemedicine is open even for first visit. The Government of Japan is also promoting innovation in healthcare industry. As a member of committee of Japan healthcare ICT, I presented how to spread teleconsulataion and data sharing in community health.

Japan Medical Association, which is a strong political power composed of general practitioners at once pressed to retreat this announcement because they are afraid of losing their patients. They are thinking that teleconsultation may destroy reliable and continuous relationship between general practitioners and patients.  Seven months after the first announcement, the director delivered the second announcement to prohibit telemedicine for first visit patients.

Some patients and doctors feel reluctant to the second announcement. Patients who are have limited  access to universal healthcare services such as living on isolated places need telemedicine. Innovative doctors wants to bring the technology and system in order to save more patients more effectively and less costly for patients. Japanese Telemedicine and Telecare Association (JTTA) is a professional organization which consists of doctors and academia to promote telemedicine.

I think we should elaborate how to introduce “healthy” telemedicine in Japan. JMA needs to be convinced to this policy. Now I am proposing to them positioning telemedicine the way to strengthen relationship between GPs and patients. The system can be used at outpatient and home care settings. It will motivate patients to see doctors, listen to their advice and take medications without drop out. It may also improve input from patients or caregivers.

Low HPV Vaccination Rates in Tennessee: A Call for Patient Education

August 18, 2016

The Gardasil Vaccine, which has been available to both boys and girls aged 9-26 in United States for years, is a three-shot series defensive against four strains of the Human Papilloma Virus (HPV), a sexually transmitted infection which can lead to anal warts, and vaginal, vulvar, cervical and anal cancers.  After vaccination, 50-90% of these conditions can be protected against, and since the initial release of the vaccine, rates of HPV among adolescent girls have fallen.

Despite the apparent benefits, less than 40% of American adolescents in 2014 had completed the vaccination series, with some states, such as Tennessee, experiencing rates of less than 30%. Public support for the vaccine has been given by the Tennessee Commissioner of Health, yet unlike the Centers for Disease Control, the vaccine does not appear on Tennessee’s current immunization schedule, even as a recommendation.

Tennessee is also a state noted not to require public education regarding the vaccine, but studies have shown that improved education can increase rates of vaccine uptake. If the Tennessee Department of Health (TN DOH) were able to fund it, an educational campaign to increase awareness of what HPV is and how Gardasil works could help boost the rate of vaccine series completion.  Other advocacy groups working in the state, such as Team Up TN, have already created and been distributing educational materials about HPV and the vaccine to families and healthcare providers; they could prove a useful resource to the TN DOH. Concurrently, it will be important to find sources of outdated or incorrect information that are circulating, especially from groups fighting against routine Gardasil administration, to better address specific concerns consumers may have. For families deterred by cost, information about the Vaccines for Children program will be imperative. The campaign, occurring via television and radio PSAs, as well as pamphlets in public schools and clinics, may be the start to raising HPV vaccine compliance rates within Tennessee.