The IAPHS Blog is a virtual community that keeps population health professionals connected and up to date on the latest population health news, policy, controversies, and relevant research from multiple fields.
An Interview with Kristin Harper
Kristin Harper, who led the development of the IAPHS blog and brought it to life in February, talked with Executive Director Christine Bachrach recently about her experience volunteering with IAPHS. Chris: Kristin, thanks for taking the time to share your experiences with me. Tell me first about your own career trajectory. You started your professional life as a biologist. What drew you into science communications? Kristin: I actually started out picturing myself as writer when I was in high school, but I fell in love with biology as a freshman in college. Biology was a whole new world for me. But even as I went through graduate school in biology, I kept writing. And along the way, I also got interested in anthropology, thanks to an adviser who chaired the anthropology department. That led me to the RWJF Health & Society Scholars program, which enabled me to combine both. Ultimately, science writing let me pursue my interests in both writing and science. Chris: What challenges did you face designing the IAPHS blog, and how did your committee contribute to this task? Kristin: The biggest challenge was starting with a blank slate! We could do anything, and we needed to find […]
Theory, Measurement, Inference, and Action: How to Advance Research on Neighborhoods & Health?
Where people live matters for their health: this is a fundamental conviction among population health scientists, but how much do we really know about how and why this is true? At the 2017 meetings of the Population Association of America, held in Chicago in late April, a panel of distinguished scientists discussed how sociological neighborhood research informs research on population health. The two sociologists on the panel were Rob Sampson, Professor at Harvard University and a leader of the landmark Project on Human Development in Chicago Neighborhoods (PHDCN), and Chris Browning, Professor at Ohio State and the leader of the Adolescent Health and Development in Context study. Ana Diez Roux, Dean of the Drexel Dornsife School of Public Health and an early and prolific leader of research on neighborhoods and health, provided an epidemiologic perspective. Kate Cagney, Professor at the University of Chicago, expertly moderated the discussion. Neighborhood Impact on Health Is Complex What do we know about neighborhood effects on health? Most scientists agree that places have properties that transcend the individuals who live in them and that these properties – be they social cohesion, the mix of commercial and residential uses, or safety – matter for […]
Gossip as Data
The AIDS epidemic in Africa looks much like the medieval Black Death did, beginning with a rise in mortality, followed eventually by a decline. One big difference between the two, however, lies in the amount and quality of data now available to track epidemics. Scholars studying the Justinian Plague that occurred many centuries ago have estimated that roughly 40% of the population died. Estimates of AIDS mortality in sub-Saharan Africa are more precise; UNAIDS modelling of deaths from AIDS-related illnesses, based on figures provided by the affected countries, gives us a more accurate picture of the yearly number of deaths. A second major difference is in the greater means by which we are now able to combat epidemics. Contemporary epidemics have spurred concerted efforts by national and international organizations to mount behavior-change interventions that may reduce transmission and mortality. Initially, these included information campaigns promoting the ABCs of HIV prevention: Abstinence, Being Faithful, and Condoms. A central component of these efforts has been to track change in the ABCs by conducting large-scale surveys of the populations who received these informational interventions. I don’t know the exact number of behavior-change AIDS-related surveys conducted in Sub-Saharan Africa but they certainly number in […]
How to Talk About Population Health
Elsewhere on the Blog you can find a definition of population health. A useful starting place, for sure, but no place you’d care to end up. Population health is one of the concepts that acquires its meaning as much from how we talk about it as what we say. In these polarizing political times, it is essential that we find a way to discuss population health that unites rather than divides. In 2010, The Robert Wood Johnson Foundation released a report entitled A New Way to Talk about the Social Determinants of Health, which begins with this insight: “It turns out that trying to figure out how to say something simply can be a complicated process.” Indeed! That’s why it’s always worth choosing our words carefully. The report offers concrete techniques to help bring your audience on board with the idea that creating health is a collective project, one that we all have a stake in and some control over. It contains many useful suggestions for phrasing, such as appealing to universally-shared values, like equal opportunity or investing in children. Another good tip is avoiding jargon. Of course, it’s easy to point out things not to do. But what do effective […]
Global Health Narratives for Youth
A Way to Introduce Global Population Health Issues to Middle School and High School Students As we witness millions of people worldwide suffering from preventable conditions such as malnutrition and tuberculosis, many of us ask: How can we foster empathy in our children? And in particular, how can we promote empathy for people living in poverty and suffering from poor health – in countries far away, as well as neighborhoods closer to home? We, the authors of this post, ask these questions both as parents and as educators dedicated to global health research and awareness. As college professors, we are deeply invested in cultivating well-rounded global citizens who not only think about the inequity in their backyards but also think about what inequity looks, feels, and tastes like in other cultures and places. We see value in this understanding because without that connection to the suffering of others, it becomes easy to ignore how that suffering came to be, and our obligation as global citizens to do something about it. Improving the health of populations around the world takes dedication and ingenuity, and it is essential that we foster a feeling of connection in our students, who must undertake the […]
Interpreting Conflict in the Past: Applying the Dirty War Index to a Bioarchaeological Setting
More and more, researchers are beginning to appreciate the importance of studying the effects of conflict on population health. As physical anthropologists looking for ways to assess violence against non-combatant civilians, we discovered the “Dirty War Index” (DWI), first introduced by Hicks and Spagat (2008). Used to determine the ‘dirtiness’ of combat, the DWI is generally considered a modern public health tool. However, we also found it effective in looking at past conflict, when paired with bioarchaeological methods and historic research. Recently, we have conducted a couple of case studies using the DWI, including one on the twenty-first century Syrian Civil War, and another on the mid-nineteenth century Mountain Meadows Massacre in Utah. The DWI is a simple ratio that empirically assesses “dirty” acts. This allows us to compare trends across different combatant groups, combat events, and armed conflicts. The denominator is the total potential times a certain undesirable action COULD occur, and the numerator is how many times it DID occur. For example, to assess the number of prisoners tortured, one would place the total number of prisoners taken in the denominator, and the total number of prisoners tortured in the numerator. A DWI of 100 would be extremely […]
Framing Matters: How Sharing Personal Stories May Help Dismantle Addiction Stigma and Increase Access to Treatment
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 […]
Syndemics and Population Health: A Q&A with Anthropologist Emily Mendenhall
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 […]
April Roundup: Population Health in the News
Want to catch up on the last month of population health news? We’ve got a bunch of reads for you! Wondering what’s going on around the world? Trump recruits controversial Bush-era global health official (Science, 3/27/2017) The campaign to lead the World Health Organization (NY Times, 4/3/2017) Trump pushes historic cuts in global health aid, stoking fears of new disease outbreak and diminished US clout (LA Times, 4/10/2017) Survivors of the gas attack in Syria face long-term illness (Scientific American Guest Blog, 4/12/2017) They’re just hiding: Experts say Puerto Rico may be underreporting Zika-affected births (STAT, 4/18/2017) Or how we are faring here in the US? Poor, sick, and addicted: Inequality’s effect on population health (Huffington Post, 3/31/2017) Don’t expect politics to derail population health, value-based care (Healthcare IT News, 4/3/2017) Cosas del estado: How immigration raids lead to avoidance of care (Pacific Standard, 4/5/2017) How communities are testing new strategies to address social determinants of health (AcademyHealth Blog, 4/7/2017) Why it’s a bad idea to space out your child’s vaccination shots (Washington Post, 4/17/2017) Population health improvement (A story on Maine Public Radio, featuring Ron Deprez of the Public Health Research Institute, Barbara Leonard of the Maine […]
Bringing Population Health into Medical Education: Q&A with Mark Schwartz of NYU School of Medicine
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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