Commentary

Framing Matters: How Sharing Personal Stories May Help Dismantle Addiction Stigma and Increase Access to Treatment

Amy Edmonds

Sheena is a young woman raising two young sons on her own in North Carolina. She ferries her children to daycare, prepares their meals, and every week makes her way to UNC Horizons at Sunrise Drug Treatment Center for substance-use screening. Sheena was introduced to opioids as a teenager and struggled with addiction until after the birth of her younger son, who was born with neonatal abstinence syndrome (NAS). His birth was a critical time for intervention; it wasn’t until after her son’s birth that she received the integrated and supportive addiction care she needed. Tragically, although substance-use disorder is preventable and treatable, only a small fraction of people with addiction issues receive care. Sheena was recently featured in a segment by PBS that highlights both her immense struggles and her bright outlook; the story concludes with Sheena telling the special correspondent, “I’ve come so tremendously far.” Sheena’s challenges with opioid addiction during pregnancy are not uncommon. In the midst of an opioid epidemic, NAS is becoming a growing burden across the U.S., especially in rural communities. In West Virginia, over 3% of babies are born with NAS; as a nation, NAS incidence has increased by 300% between 1999 and […]

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Syndemics and Population Health: A Q&A with Anthropologist Emily Mendenhall

Kristin Harper

This week, IAPHS member Kristin Harper interviews medical anthropologist Emily Mendenhall (Georgetown University) about a recent series of articles on the concept of syndemics that she spearheaded in The Lancet. In these articles, Mendenhall and co-authors explore what syndemics are and how the concept can aid population health research and help us work toward a healthier future. Here, Mendenhall answers questions about how this series came to be, and the effect she hopes it has on the field. What is a syndemic? When you consider the concept of a syndemic, you can think about it at two levels, the individual level or the population level. First, if you’re a clinician, you think about it at the individual level. The concept of the syndemic is similar to the concepts of co-morbidity or multi-morbidity, but it takes seriously social conditions. One of the easiest examples is HIV and tuberculosis. What drives the link between these two infections? Poverty, low social status, living conditions, and the immunosuppression of HIV increase a person’s risk for activated TB and worsen their overall health. When you walk into a clinic, you have to understand that people are having these syndemic experiences, where social and health problems are […]

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Bringing Population Health into Medical Education: Q&A with Mark Schwartz of NYU School of Medicine

Elaine Meyer

By incorporating population health into medical education, educators are aiming to bring together medicine and public health, which over the past hundred years or so have taken different approaches. The goal is to unite medicine’s focus on the individual doctor-patient relationship based in the healthcare system with public health’s interest in creating policies and programs for health prevention. Population health acknowledges that we spend the majority of life outside of the healthcare system — at work, at home, in our neighborhoods — and that our health is influenced by a host of factors in our lives, ranging from nutrition to early childhood education to discrimination. For these reasons, the healthcare system needs to incorporate public health approaches. “What I discovered in mid-career, is that policy-makers welcome and need insights and advice from physicians. I wish I learned in medical school about how the health policy apparatus works.” ~Mark D. Schwartz, MD, FACP In the past, most doctors learned little if anything about population health in medical school, but that is changing.  This past fall, for example, NYU School of Medicine made population health a core part of the curriculum for all medical students, integrating it into all stages of their degree programs. […]

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Population Health Lessons from the Black Death

Sharon DeWitte

The Black Death, an outbreak of bubonic plague (caused by the bacterium Yersinia pestis), killed tens of millions of people in 14th-century Asia, the Middle East, Africa, and Europe. This epidemic has inspired novels, movies, even Black Death “tour” tee shirts, but what real relevance does it have for us now? The Black Death occurred over 650 years ago in an ecological, social, economic, and political context that might seem very different from that of today. However, it does provide a startling example of the consequences that arise from highly contagious and deadly disease and other disasters. It may also reveal factors that produce extraordinarily high epidemic mortality. Understanding the context and effects of the Black Death might benefit living populations given that: Our species will continue to face old and new diseases for the foreseeable future; Conditions at the time of the Black Death persist or are at least possible today; and Increasing globalization connects far-flung human populations, making diseases that occur anywhere on the globe relevant to us all. (This is true regardless of how much you care, or don’t, about the well-being of strangers.) Bioarchaeology of the Black Death Research using the skeletons of people who died in […]

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My start in science & public policy: California’s vaccination bill – SB 277

Debra Cooper

For many, the term “science policy” sounds almost like an oxymoron — an unnatural pairing of two different disciplines. Others may be aware of the marriage between ‘science’ and ‘policy,’ but don’t necessarily understand how that relationship functions. Throughout graduate school, I knew I had an interest in science policy but didn’t know exactly what that meant or what role I could play in the field. The turning point for me came after my postdoctoral work, when I took part in a science and technology policy fellowship through the California Council on Science and Technology (CCST), a fellowship that gives scientists the opportunity to work as legislative aides and consultants in the California State legislature. Of all the bills that were drafted and analyzed during my fellowship year, one bill stands out to me as the most fitting example of science policy. It’s a high-profile bill that would go on to have an important impact on population health in California: Bill SB 277. SB 277 removed the personal belief exemption from vaccination requirements for enrolling children in private or public school. (Medical exemptions, however, are still allowed.) This exemption had previously allowed parents who did not want to vaccinate their […]

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How the U.S. is taking the lead on preventing lead poisoning

Rachel Shaffer

The crisis in Flint, Michigan, returned our attention to a problem that we would have preferred to believe was behind us: lead poisoning. This incident highlighted the dangers of lead-lined water pipes, but, unfortunately, there are numerous other sources of lead exposure throughout the United States. I’ve written previously about risks from contact with contaminated soil or through the workplace. Lead-based paint, outdoor air, and manufactured products also pose risks. Because of these diverse sources, eliminating lead poisoning is challenging and requires coordination across multiple programs and policies. Understanding this complex need—and perhaps sensing the increased public concern regarding lead in the United States—the President’s Task Force on Environmental Health Risks and Safety Risks to Children released a report entitled “Key Federal Programs to Reduce Childhood Lead Exposures and Eliminate Associated Health Impacts” in November 2016. This report describes the numerous federal agencies, regulations, and programs that have been established to address lead exposures in children. It also marks progress towards the development of an enhanced lead strategy that will address existing policy gaps. The report is worth a read; you may be surprised by the number of existing policies and efforts aimed at mitigating lead exposure. There are almost […]

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Improving Population Health: Continuing the Journey

David Kindig

I am honored to have been asked to kick off the new IAPHS Forum with some reflections on population health and blogging. Some of you will recall my own weekly blog, ImprovingPopulationHealth, which I ran with Kirstin Siemering for 3 years. The initial post on my 70th birthday in 2010 began this way: “Why am I starting a blog on issues and perspectives in the field of population health? It is because I believe we are at a tipping point in which a convergence of scholarship policy and practice initiatives seem poised to bring an overdue population health perspective to thinking about and acting on health and health improvement. The challenge of the next decade will be to find practical ways in which new approaches to financial and nonfinancial incentives and multi-sectoral partnerships can be applied to improve population health outcomes here and elsewhere.” Today, as IAPHS and this Forum take up the responsibility and opportunity to help lead scholarship and advocacy for our field, I’m not sure I would say it any differently. I almost said “our emerging field” but paused to ask myself: Is “emerging” still an appropriate adjective? No and yes. No, in that the field certainly […]

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IAPHS – Three Steps Towards our Vision

Sandro Galea

I am deeply honored to serve as the inaugural president for the Interdisciplinary Association for Population Health Science (IAPHS). The purpose of IAPHS is to foster scientific innovation and discovery to improve the health of populations and reduce health disparities. It does this by advancing population health science, working to improve population health by promoting the communication and application of such science, and supporting population health scientists in their careers. This, to my mind is a worthwhile mission and set of efforts indeed, and it is with that in mind that I am excited to be a part of this next stage in IAPHS’s evolution. How will we go about achieving our vision? We build on an extraordinarily solid base, a legacy of the founders of IAPHS to whom we are indebted. The previous Board has left us with an excellent set of objectives, a dynamic website, and a sound organizational framework. Two Robert Wood Johnson Foundation-funded conferences have begun to give vital form to what our mission can mean. Moreover, the over 150 individuals and organizations who have joined IAPHS have created a diverse pool of expertise and support on which we can build. Over the next year, we will […]

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Why Write?

Fred Zimmerman

The IAPHS Forum aspires to be more than a website or a blog; it aspires to be a place where we all can write, and by writing, create a community. To be specific, it aspires to create a community that helps population health science grow stronger, and its translation more effective. IAPHS: A place for us to explore the upstream determinants of health together. Photo: Brian Fitzgerald. The purpose of the Forum is to create a space in which ideas can be shared—necessarily in written form, given our geographic dispersal—and in which commonalities can be recognized and differences productively worked through. Communities are networks of social trust, and this social trust can be forged only through frequent and candid airing of views. What’s essential about this process is the interaction it implies. This Forum will succeed only to the extent to which broad participation is achieved. We’re hoping that participation will be extensive among IAPHS members, as well as non-member colleagues with information and perspectives to share. The idea of population health is espoused by many individuals in public health departments, universities, and local governments. But numbers alone do not make a community. We propose this Forum as the place […]

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