My First Public Health Book
In 1995, as a high school student, I read the first edition of Joan Ryan's book "Little Girls in Pretty Boxes". I picked it up because I figure skated for many years (from age 2-14). Little did I know that I was starting my first exploration into public health.
The book examined public health issues like eating disorders and sports injuries. It argued for policies that would protect young figure skaters and gymnasts from injury and from exploitation by their coaches, families, and industry. Ryan conducted intensive interviews for the book, which allowed her to highlight several cases like that of Christy Henrich. Henrich was a talented and promising U.S. gymnast who died from anorexia at the age of twenty-two.
I thought of this book today when I read a beautiful and honest blog post by Jennifer Kirk called, "An Unrealized Dream". Jennifer Kirk is a decorated, elite U.S. figure skater who retired from competitive skating in August 2005. She retired in order to focus on her health and to recover from bulimia, alcoholism, and cutting. Her post highlights the complexities of these health problems. They were influenced by her sport, her family, her support system, her early independence, and the pressure that was put on her to have a successful career.
While some safeguards for elite skaters and gymnasts have been put in place since "Little Girls in Pretty Boxes" (e.g., the hotly debated minimum age standards for competition), we still have improvements to make. Jennifer talks about the strong influence of family and coaches regarding athlete safety and self esteem:
"A few months before I quit skating, my dad and coaches found out about my eating disorder, but nothing was done to get me the help I needed. This reinforced my belief that skating and my career held paramount importance over other aspects of my life."
Recently, much of the discussion of elite athlete safety has been focused on the National Football League (NFL), but the same questions are applicable here. Are athletes putting themselves at risk by playing with injuries (e.g., concussions)? What is the current organizational culture and does it support an intervention to protect athletes? Do the coaches and trainers really have the athletes' best interests at heart or are they focused on winning and protecting their investment?
What do you think? What more can we do to protect athletes at all levels (from recreational to elite)?
The book examined public health issues like eating disorders and sports injuries. It argued for policies that would protect young figure skaters and gymnasts from injury and from exploitation by their coaches, families, and industry. Ryan conducted intensive interviews for the book, which allowed her to highlight several cases like that of Christy Henrich. Henrich was a talented and promising U.S. gymnast who died from anorexia at the age of twenty-two.
I thought of this book today when I read a beautiful and honest blog post by Jennifer Kirk called, "An Unrealized Dream". Jennifer Kirk is a decorated, elite U.S. figure skater who retired from competitive skating in August 2005. She retired in order to focus on her health and to recover from bulimia, alcoholism, and cutting. Her post highlights the complexities of these health problems. They were influenced by her sport, her family, her support system, her early independence, and the pressure that was put on her to have a successful career.
While some safeguards for elite skaters and gymnasts have been put in place since "Little Girls in Pretty Boxes" (e.g., the hotly debated minimum age standards for competition), we still have improvements to make. Jennifer talks about the strong influence of family and coaches regarding athlete safety and self esteem:
"A few months before I quit skating, my dad and coaches found out about my eating disorder, but nothing was done to get me the help I needed. This reinforced my belief that skating and my career held paramount importance over other aspects of my life."
Recently, much of the discussion of elite athlete safety has been focused on the National Football League (NFL), but the same questions are applicable here. Are athletes putting themselves at risk by playing with injuries (e.g., concussions)? What is the current organizational culture and does it support an intervention to protect athletes? Do the coaches and trainers really have the athletes' best interests at heart or are they focused on winning and protecting their investment?
What do you think? What more can we do to protect athletes at all levels (from recreational to elite)?
Vitamin B15 or Pangamic acid
Ping your blog
What Vitamin B15 (Pangamic Acid) does and what it has been historically used for:
What Vitamin B15 (Pangamic Acid) does and what it has been historically used for:
- Acts to detoxify poisons and free radicals
- Extends the life span of cells in the body
- Helps angina and asthma
- Helps synthesize protein
- Helps to reduce a craving for alcohol
- Lowers cholesterol levels
- Protects against cirrhosis of the liver
- Stimulates the “anti-stress” hormones
- Stimulates the carriage of oxygen to the blood from the lungs, and from the blood to the muscles and vital organs of the body
So Who Else Caught the Brain Surgery on Twitter Today?
If you were on twitter today, you may have seen the hashtag #MHbrain. That stood for Memorial Hermann-Texas Medical Center in Houston (@houstonhospital). Today they live-tweeted a brain surgery which removed a cavernous angioma tumor from a 21-year-old female patient.
According to the hospital's press release, the goal of the "twittercast" was to (1) educate the public about brain tumors and (2) demystify brain surgery by giving a look inside an operating room. The surgeon, Dr. Dong Kim, added "Someone may have a loved one who is considering a similar procedure and perhaps they can glean some information from this twittercast that may help them make a decision about whether surgery is the right choice for them."
In authentic social media style, the hospital did not just send out information and images. They also had another neurosurgeon, Dr. Scott Shepard, serve as an online moderator who could respond to questions and comments from twitter followers in real time.
While there was much excitement over this event today, it is not the first time we have heard about surgeons tweeting from the operating room. Back in 2009, CNN picked up a story about surgeons at Henry Ford Hospital in Michigan tweeting the removal of a cancerous tumor from the kidney of a male patient. Just last February, Memorial Hermann was in the news for the first live tweeted open heart surgery.
A few thoughts on this trend:
How is Memorial Hermann evaluating their twittercast efforts?
According to the hospital's press release, the goal of the "twittercast" was to (1) educate the public about brain tumors and (2) demystify brain surgery by giving a look inside an operating room. The surgeon, Dr. Dong Kim, added "Someone may have a loved one who is considering a similar procedure and perhaps they can glean some information from this twittercast that may help them make a decision about whether surgery is the right choice for them."
In authentic social media style, the hospital did not just send out information and images. They also had another neurosurgeon, Dr. Scott Shepard, serve as an online moderator who could respond to questions and comments from twitter followers in real time.
While there was much excitement over this event today, it is not the first time we have heard about surgeons tweeting from the operating room. Back in 2009, CNN picked up a story about surgeons at Henry Ford Hospital in Michigan tweeting the removal of a cancerous tumor from the kidney of a male patient. Just last February, Memorial Hermann was in the news for the first live tweeted open heart surgery.
A few thoughts on this trend:
How is Memorial Hermann evaluating their twittercast efforts?
- Was this a huge marketing event or do they actually have health education goals?
- Are they simply looking at the numbers? For example, the number of twitter followers (up to 13,400 from 5,100 in the past 3 months). Or the number of visitors to Storify, a site which archives both the heart and brain surgeries.
- Are the demographics of twitter users reflective of their target audience?
- I would hope that they are thinking about how to evaluate the goals they explicitly laid out in their press release. How will they show that a twittercast can increase knowledge about brain tumors? How will they show that the public or potential patients have less anxiety about the procedure or choose it more often? As always, it is important to state goals (for any public health activity) that are measurable.
- I read an interesting blog post recently called, "Why social media may not be worth it for doctors." The author was concerned about already burned-out doctors trying to learn and make time for ever-changing technology...with no guarantee that the technology will give them "return on investment". Do the challenges outweigh the benefits?
- If physicians view themselves as "educators", how much value could twitter bring?
- Although the patient's name was protected and she gave permission for the twittercast, is it possible that any confidential information could be accidentally shared during the event?
- Although safeguards are in place, errors do happen in the operating room and throughout the hospital. With the additional staff/equipment (and possible distraction?) in the operating room to conduct the twittercast, could we face an increased risk of error?
What do you think?
Facebook Adds Organ Donation To Timeline: Should We "Like" It?
Typically, I post on Wednesdays. However, with so much chatter about Facebook's announcement, this felt more timely.
Starting today, you can add your organ donation status to your Facebook timeline using the "share life" tool. If you are already registered, you can share your story about where and why you decided to become an organ donor. If you are interested in registering, you can follow links to official donor registries.
ABC has been a primary news source for this announcement, interviewing Facebook CEO Mark Zuckerberg, demonstrating how to use the "share life" tool, and discussing myths and facts about organ donation.
Scanning Facebook and Twitter today (especially among my public health colleagues), the response seems to be overwhelmingly positive. From my perspective, the Facebook tool has the potential to be effective (i.e., increasing the number of registered donors) because it focuses on action. The tool is not for education. The tool actually links to registries so that you can sign up. The tool aims to increase the visibility of already registered donors, which in turn will influence others to sign up. The tool aims to decrease the stigma and secrecy of talking about end of life decisions by putting it right up there next to your birth date and relationship status. This may also influence others to sign up. In previous posts, I have written about public health campaigns that use social media in order to reduce the stigma around an "undesirable" topic (e.g., STD testing).
Although I am 100% supportive of the mission of increasing organ donors and am familiar with the dire need for donations (e.g., 18 people will die each day waiting for an organ), I have a few reservations about "share life":
In today's New York Times coverage of the Facebook announcement, I read a sentence that concerned me (I added the underlining):
"The company announced a plan on Tuesday morning to encourage everyone on Facebook to start advertising their donor status on their pages, along with their birth dates and schools — a move that it hopes will create peer pressure to nudge more people to add their names to the rolls of registered organ donors".
I consider declaration as an organ donor to be a medical decision. In public health and medicine, we strive for patients and the public to make such decisions from a position that is informed and lacks pressure from physicians or family or friends. Therefore, I have reservations about people signing up without educating themselves first and/or because they feel pressure on Facebook. Just a few weeks ago, I posted about "hashtag activism" and how easy it has become to get involved in causes via social media. Are we as thoughtful when we participate in causes on Facebook as when we participate in real life?
My other ongoing concern is regarding the proper security and use of personal information that is gathered by Facebook. Will your organ donation status result in particular advertisements being sent your way? I remember updating my Facebook status to "engaged" 4 years ago and being overwhelmed by the wedding planning advertisements on my page. There is increasing public outcry regarding privacy settings and the personal information you enter being used for Facebook to attract advertisers and other business opportunities.
Again, I am 100% supportive of the organ donation mission. I think the reach of Facebook offers tremendous public health opportunities (including the possible elimination of long wait time for organs). While that is an attractive outcome, we must always remember to focus on the ethics of the process as well.
What do you think?
Starting today, you can add your organ donation status to your Facebook timeline using the "share life" tool. If you are already registered, you can share your story about where and why you decided to become an organ donor. If you are interested in registering, you can follow links to official donor registries.
ABC has been a primary news source for this announcement, interviewing Facebook CEO Mark Zuckerberg, demonstrating how to use the "share life" tool, and discussing myths and facts about organ donation.
Scanning Facebook and Twitter today (especially among my public health colleagues), the response seems to be overwhelmingly positive. From my perspective, the Facebook tool has the potential to be effective (i.e., increasing the number of registered donors) because it focuses on action. The tool is not for education. The tool actually links to registries so that you can sign up. The tool aims to increase the visibility of already registered donors, which in turn will influence others to sign up. The tool aims to decrease the stigma and secrecy of talking about end of life decisions by putting it right up there next to your birth date and relationship status. This may also influence others to sign up. In previous posts, I have written about public health campaigns that use social media in order to reduce the stigma around an "undesirable" topic (e.g., STD testing).
Although I am 100% supportive of the mission of increasing organ donors and am familiar with the dire need for donations (e.g., 18 people will die each day waiting for an organ), I have a few reservations about "share life":
In today's New York Times coverage of the Facebook announcement, I read a sentence that concerned me (I added the underlining):
"The company announced a plan on Tuesday morning to encourage everyone on Facebook to start advertising their donor status on their pages, along with their birth dates and schools — a move that it hopes will create peer pressure to nudge more people to add their names to the rolls of registered organ donors".
I consider declaration as an organ donor to be a medical decision. In public health and medicine, we strive for patients and the public to make such decisions from a position that is informed and lacks pressure from physicians or family or friends. Therefore, I have reservations about people signing up without educating themselves first and/or because they feel pressure on Facebook. Just a few weeks ago, I posted about "hashtag activism" and how easy it has become to get involved in causes via social media. Are we as thoughtful when we participate in causes on Facebook as when we participate in real life?
My other ongoing concern is regarding the proper security and use of personal information that is gathered by Facebook. Will your organ donation status result in particular advertisements being sent your way? I remember updating my Facebook status to "engaged" 4 years ago and being overwhelmed by the wedding planning advertisements on my page. There is increasing public outcry regarding privacy settings and the personal information you enter being used for Facebook to attract advertisers and other business opportunities.
Again, I am 100% supportive of the organ donation mission. I think the reach of Facebook offers tremendous public health opportunities (including the possible elimination of long wait time for organs). While that is an attractive outcome, we must always remember to focus on the ethics of the process as well.
What do you think?
- Facebook has become directly involved with several public health issues (e.g., suicide, bullying, organ donation). Are their strategies effective? Why or why not?
- Do you foresee any unintended consequences from the organ donation tool?
- Will you include your organ donation status on your Facebook timeline? Why or why not?
The Biggest Loser: Who's Really Winning?
This week's guest post for Pop Health was written by Elana Premack Sandler, LCSW, MPH. Elana writes a popular blog for Psychology Today called, "Promoting Hope, Preventing Suicide". Written from both personal and professional perspectives, her blog explores suicide prevention, intervention, and postvention. Often using current events as a starting point, the blog poses questions about what could be done better or differently, what contributions research can make to practice, and challenges and opportunities inherent in new technologies. Elana earned a Master of Social Work and a Master of Public Health at Boston University and is a licensed social worker in the Commonwealth of Massachusetts.
There’s a lot of TV I don’t watch, but there’s one show in particular. “The Biggest Loser.”
It’s true - I systematically avoid watching one of the most popular reality TV shows in history. What seems to have drawn in viewers is what bothers me so much about most reality TV. It’s like a car wreck you can’t stop staring at, even though you know it’s a tragedy.
But watching a car wreck is watching an accident, something that wasn’t designed for an audience. With an accident, there’s something very human about wanting to see what’s happened, wanting to know if everyone’s okay.
That’s very different from what I think happens when people watch “The Biggest Loser.”
The few times I watched (I kept trying - people I love and trust told me it was such a good show!), I just wasn’t able to get behind the premise of the show. Yes, I believe that people who have struggled to lose weight can benefit from personal training and major lifestyle changes. Sure, the power of competition can drive some people to work harder than they ever imagined possible.
But, shame? Does shame really help people change their behavior?
When I watched, I witnessed trainers shaming contestants, over and over, in different ways. I heard contestants talk about the shame they experienced as a part of being obese or overweight. The whole show was a shame-fest. Which made me extremely uncomfortable.
Because, when it comes down to it, “The Biggest Loser” is a game show. And I just can’t watch people shamed into losing weight just to win a game show. “But it’s not just a game show!” my friends-who-are-fans would say. “People change their lives.”
Oh, wait, you’re right. It’s not just a game show. It’s a franchise.
So, I guess what I really have a hard time with is people being shamed into losing weight to support a game show-Wii-resort-1,200 calorie-a-day diet franchise.
At my professional core, as a public health social worker, I know shame doesn’t work to change behavior. I had thought it was just me who thought that way, until I started reading researcher Brené Brown’s book, “I Thought It Was Just Me (but it isn’t): Telling the Truth About Perfectionism, Inadequacy, and Power.”
Brown has been researching shame for the past 10 years. But, even before she was a shame expert, she was a social worker, working with people. What did she learn? “You cannot shame or belittle people into changing their behaviors.”
She explains in the introduction to the book:
What’s extra-disturbing about how “The Biggest Loser” uses shame is that it doesn’t limit shame to contestants. The show projects shame into the viewing audience, reinforcing biases against people who are overweight or obese. The audience doesn’t root for contestants to work within the challenges inherent in their bodies to figure out a healthy, sustainable way to lose weight and maintain overall health. The audience roots for contestants to not be fat. (Please excuse my lax grammar- I hope it’s worth making the point.)
Finally, the drama of the show revolves around shame. There’s a big reveal every episode, when viewers find out who won’t continue to compete to be The Biggest Loser. If contestants can’t lose weight within the show’s parameters (which include unhealthy weight loss practices, like dehydration), they get kicked off. So, the ideal of working with a supportive trainer goes out the window - and you are shamed, shamed, shamed into returning home, still fat, and, well, not a winner. A loser.
“The Biggest Loser” raises several questions for me:
There’s a lot of TV I don’t watch, but there’s one show in particular. “The Biggest Loser.”
It’s true - I systematically avoid watching one of the most popular reality TV shows in history. What seems to have drawn in viewers is what bothers me so much about most reality TV. It’s like a car wreck you can’t stop staring at, even though you know it’s a tragedy.
But watching a car wreck is watching an accident, something that wasn’t designed for an audience. With an accident, there’s something very human about wanting to see what’s happened, wanting to know if everyone’s okay.
That’s very different from what I think happens when people watch “The Biggest Loser.”
The few times I watched (I kept trying - people I love and trust told me it was such a good show!), I just wasn’t able to get behind the premise of the show. Yes, I believe that people who have struggled to lose weight can benefit from personal training and major lifestyle changes. Sure, the power of competition can drive some people to work harder than they ever imagined possible.
But, shame? Does shame really help people change their behavior?
When I watched, I witnessed trainers shaming contestants, over and over, in different ways. I heard contestants talk about the shame they experienced as a part of being obese or overweight. The whole show was a shame-fest. Which made me extremely uncomfortable.
Because, when it comes down to it, “The Biggest Loser” is a game show. And I just can’t watch people shamed into losing weight just to win a game show. “But it’s not just a game show!” my friends-who-are-fans would say. “People change their lives.”
Oh, wait, you’re right. It’s not just a game show. It’s a franchise.
So, I guess what I really have a hard time with is people being shamed into losing weight to support a game show-Wii-resort-1,200 calorie-a-day diet franchise.
At my professional core, as a public health social worker, I know shame doesn’t work to change behavior. I had thought it was just me who thought that way, until I started reading researcher Brené Brown’s book, “I Thought It Was Just Me (but it isn’t): Telling the Truth About Perfectionism, Inadequacy, and Power.”
Brown has been researching shame for the past 10 years. But, even before she was a shame expert, she was a social worker, working with people. What did she learn? “You cannot shame or belittle people into changing their behaviors.”
She explains in the introduction to the book:
- Can you use shame or humiliation to change people or behavior? Yes and no. Yes, you can try. In fact, if you really want to zero in on an exposed vulnerability, you could actually see a swift behavior change.
- Will the change last? No.
- Will it hurt? Yes, it’s excruciating. [I cringed when I read that part.]
- Will it do any damage? Yes, and it has the potential to sear both the person using shame and the person being shamed. [More cringing.]
- Is shame used very often as a way to try to change people? Yes, every minute of every day.
What’s extra-disturbing about how “The Biggest Loser” uses shame is that it doesn’t limit shame to contestants. The show projects shame into the viewing audience, reinforcing biases against people who are overweight or obese. The audience doesn’t root for contestants to work within the challenges inherent in their bodies to figure out a healthy, sustainable way to lose weight and maintain overall health. The audience roots for contestants to not be fat. (Please excuse my lax grammar- I hope it’s worth making the point.)
Finally, the drama of the show revolves around shame. There’s a big reveal every episode, when viewers find out who won’t continue to compete to be The Biggest Loser. If contestants can’t lose weight within the show’s parameters (which include unhealthy weight loss practices, like dehydration), they get kicked off. So, the ideal of working with a supportive trainer goes out the window - and you are shamed, shamed, shamed into returning home, still fat, and, well, not a winner. A loser.
“The Biggest Loser” raises several questions for me:
- Should a game show be allowed to promote unhealthy weight loss practices?
- What kinds of messages does the show send to young people about their worth and value?
- In what ways are people at a healthy weight influenced by “The Biggest Loser”?
Integrating Public Health Content Into Media Coverage of Celebrity DUIs
Amanda Bynes is just the latest young female celebrity to be arrested for driving under the influence (DUI). The media coverage has been extensive, with some outlets even raising the question, "Is she the next Lindsay Lohan?" A fellow former child star, Lindsay Lohan has consistently been in the news the past 5 years with DUI arrests, rehab stints, and poor career decisions. However, just a few weeks ago we heard the good news that she has been taken off probation from her DUI case...so hopefully things are looking up.
Pop Health has written about related issues in the past: how soon is too soon to find a teachable moment in a celebrity DUI death? How does popular media help establish the public health agenda? How does media coverage of public health issues (e.g., suicide) affect the public's health?
So now let's put the pieces together and discuss the work of public health researchers that focuses specifically on media coverage of young female celebrity DUIs. In 2009, Smith, Twum, and Gielen published "Media Coverage of Celebrity DUIs: Teachable Moments or Problematic Social Modeling?" in the journal of Alcohol & Alcoholism. They conducted an analysis of US media coverage of four female celebrities (Michelle Rodriguez, Paris Hilton, Nicole Richie and Lindsay Lohan). The study examined media coverage in the year after their DUI arrests (December 2005 through June 2008). Among other things, the stories were coded for the presence of public health content (e.g., arrest, death, and injury statistics for DUI). The authors found that the coverage was primarily focused on the individual celebrities (i.e., their legal and professional repercussions) versus broader social or public health impacts. They recommended that future research examine both the news coverage and the comprehension and use of that content for policy and behavior change initiatives.
Coverage of a celebrity DUI has the potential to be a teachable moment, but we as public health practitioners need to take advantage of it. We need to be monitoring pop culture news so that these teachable moments can be identified. We need to partner with journalists in order to make sure that a "public health frame" is incorporated in the development of the articles. Most importantly, we need to continue to evaluate the media content and use that data to develop effective interventions and policy recommendations.
What do you think?
Pop Health has written about related issues in the past: how soon is too soon to find a teachable moment in a celebrity DUI death? How does popular media help establish the public health agenda? How does media coverage of public health issues (e.g., suicide) affect the public's health?
So now let's put the pieces together and discuss the work of public health researchers that focuses specifically on media coverage of young female celebrity DUIs. In 2009, Smith, Twum, and Gielen published "Media Coverage of Celebrity DUIs: Teachable Moments or Problematic Social Modeling?" in the journal of Alcohol & Alcoholism. They conducted an analysis of US media coverage of four female celebrities (Michelle Rodriguez, Paris Hilton, Nicole Richie and Lindsay Lohan). The study examined media coverage in the year after their DUI arrests (December 2005 through June 2008). Among other things, the stories were coded for the presence of public health content (e.g., arrest, death, and injury statistics for DUI). The authors found that the coverage was primarily focused on the individual celebrities (i.e., their legal and professional repercussions) versus broader social or public health impacts. They recommended that future research examine both the news coverage and the comprehension and use of that content for policy and behavior change initiatives.
Coverage of a celebrity DUI has the potential to be a teachable moment, but we as public health practitioners need to take advantage of it. We need to be monitoring pop culture news so that these teachable moments can be identified. We need to partner with journalists in order to make sure that a "public health frame" is incorporated in the development of the articles. Most importantly, we need to continue to evaluate the media content and use that data to develop effective interventions and policy recommendations.
What do you think?
- What strategies/information channels do you use to stay on top of public health-pop culture news?
- How can the public health and journalism fields partner to take advantage of teachable moments and cover public health issues safely and effectively?
"E-Lane" for Pedestrians: An April Fools' Day Prank With Real Public Health Implications
Earlier this week, Philadelphians were treated to an April Fools' Day prank courtesy of Mayor Michael Nutter and the city's Office of Transportation and Utilities. Across the street from city hall, an "E-Lane" was designated for pedestrians who use (and are distracted by) their electronic devices while walking. While the city only expects to keep the joke "E-Lane" around for a week, they also hope that it starts a dialogue about pedestrian safety and people looking out for themselves while walking around the city. Since this April Fools' week also happens to coincide with National Public Health Week (a time dedicated to recognizing the contributions and challenges of public health), I thought it was a great story for Pop Health. So I took a stroll down the "E-Lane" on Monday to take these pictures and to get the dialogue started.
While I have written about (and am a huge supporter of) the vast and ever expanding benefits of mobile devices for public health, I also acknowledge the challenges that they have created. Even though Philadelphia created the "E-Lane" as a joke, drivers and pedestrians distracted by electronic devices have become a serious issue.
The Centers for Disease Control and Prevention website on distracted driving tells us that each day, more than 15 people are killed and more than 1,200 people are injured in crashes that were reported to involve a distracted driver. Distracted driving occurs while doing another activity that takes your attention away from driving; these activities can increase the chance of a motor vehicle crash. While distracted driving can include talking on a cell phone, texting, or eating, texting is most dangerous because it takes your eyes off the road (visual), hands off the wheel (manual), and takes your mind off driving (cognitive).
As with any emerging public health problem, we are beginning to see:
What do you think?
While I have written about (and am a huge supporter of) the vast and ever expanding benefits of mobile devices for public health, I also acknowledge the challenges that they have created. Even though Philadelphia created the "E-Lane" as a joke, drivers and pedestrians distracted by electronic devices have become a serious issue.
The Centers for Disease Control and Prevention website on distracted driving tells us that each day, more than 15 people are killed and more than 1,200 people are injured in crashes that were reported to involve a distracted driver. Distracted driving occurs while doing another activity that takes your attention away from driving; these activities can increase the chance of a motor vehicle crash. While distracted driving can include talking on a cell phone, texting, or eating, texting is most dangerous because it takes your eyes off the road (visual), hands off the wheel (manual), and takes your mind off driving (cognitive).
As with any emerging public health problem, we are beginning to see:
- Research: papers on distracted drivers and pedestrians are being published in the peer reviewed literature.
- Education: cautionary tales of distracted driving are emerging in the popular media. Just in the past few months, the Today Show has hosted several sets of parents who lost children due to texting and driving.
- Celebrity Spokespeople: Teen sensation Justin Bieber is partnering with the Remember Alex Brown Foundation and Phone Guard's Drive Safe.ly application to promote responsible texting. The application reads text (SMS) messages and emails aloud in real time and automatically responds without drivers touching the mobile phone.
- Policy Change: Just a few weeks ago, Pennsylvania became the 35th state to enact an anti-texting law. The new law allows police to charge anyone caught text messaging while operating a vehicle with a primary offense and a $50 fine.
What do you think?
- How can we balance the benefits and challenges of mobile technology for public health?
- Do you think the "E-Lane" in Philadelphia is an effective strategy for initiating dialogue around distracted drivers and pedestrians?
- In addition to the strategies listed above, what can public health and the public do to reduce injuries and deaths from distracted drivers and pedestrians?
Germanium
Germanium is a much-acclaimed trace element. Nutritionally, organic germanium boosts the immune system by stimulating the production of interferon and other immune cells, increasing resistance to various diseases. It also lowers the oxygen requirements of body organs and is a powerful antioxidant, reducing peroxidation damage, and helping the debilitating diseases of ageing. As such, it was found to have a beneficial effect on ovarian malignancies, colon cancer and Hodgkin's disease. Organic germanium was also found to have anti-arthritic properties.
Trace amounts of germanium are present in most foods, but richer amounts are found in ginseng, garlic, aloe vera and comfrey, which may partially explain the health promoting effects of these foods. Germanium is also available as a supplement in health food shops, and online.
Trace amounts of germanium are present in most foods, but richer amounts are found in ginseng, garlic, aloe vera and comfrey, which may partially explain the health promoting effects of these foods. Germanium is also available as a supplement in health food shops, and online.
"Hashtag Activism"- Is It Working For Public Health?
Last year on Facebook, my timeline was suddenly filled with status updates of just one word. Red. Black. White. "What is this?" I thought to myself. It turned out that it was a breast cancer awareness campaign. Facebook users were listing their bra colors to help prevent breast cancer. And there are tons of these public health campaigns all over social networking sites. "Like" our Facebook page to prevent cancer! "Re tweet" this message to prevent heart disease! For those of you familiar with my blog, you'll remember that I think "raising awareness" is the most counter-productive phrase used in our work. It is not specific enough to measure for change and (on its own) it will not change health behaviors.
So I thought of my frustration with these campaigns as I read a great article in the New York Times this week called, "Hashtag Activism, and Its Limits". David Carr writes eloquently about the ease of supporting a variety of causes:
"If you “like” something, does that mean you care about it? It’s an important distinction in an age when you can accumulate social currency on Facebook or Twitter just by hitting the “like” or “favorite” button.
The ongoing referendum on the Web often seems more like a kind of collective digital graffiti than a measure of engagement: I saw this thing, it spoke to me for at least one second, and here is my mark to prove it".
I like that David brings up the question of engagement here. Many of these public health campaigns on social media just strive for "likes" on Facebook or "hits" on a website or "re tweets" on Twitter. And not that they mean nothing, but those measures are just the tip of the iceberg in measuring audience engagement. And audience engagement (beyond "raising awareness") is what could actually lead to public health activism, knowledge change, and ultimately behavior change. Leslie Lewis gives a great overview of Return on Engagement (ROE) on her blog "digital.good". According to Leslie, ROE measures tend to be more qualitative and measure message reach and spread. In addition to "likes", ROE also measures things like brand/campaign awareness, comments, shares, and returning visitors.
I certainly do not think that all public health campaigns delivered via social media are ineffective. On the contrary, I think that social media is an incredibly powerful tool for public health. David Carr makes similar comments later in his article. Challenging his initial skepticism of web activism, he lists several recent "campaigns" that have been quite effective (e.g., the reversal of Susan G. Komen de-funding Planned Parenthood).
However, to use social media effectively in public health, we must be strategic and we must evaluate.
Some sample questions that I ask program planners:
- What is the goal of the campaign? (e.g., to drive traffic to your website; increase hotline calls; increase specific behaviors like breast self examination?).
- How will the campaign activities (logically) lead to the desired goal/outcome?
- Are your goals/outcomes measurable?
- Have you thought about evaluation before launching the campaign?
- Besides the ideas listed above, how are you measuring "audience engagement"?
What other questions should we be asking?
The Vaccine War: Public Health vs. The Media
A few weeks ago, I had the pleasure of speaking with Laurie Edwards, a writer and blogger who examines chronic illness, healthcare, life balance, public health history, and everything in between. Among other topics, we talked about the role of social media and mainstream media in the vaccine debate.
So I thought of that conversation as I watched last night's re-run of PBS Frontline's special "The Vaccine War" (originally aired April 27, 2010). I highly encourage advocates on both sides of the issue to check it out.
The piece was quite balanced with interviews on all sides. For example, we heard from vaccine advocate Dr. Paul Offit, bioethicist Dr. Arthur Caplan, anti-vaccine advocate parents in Ashland, OR (with one of the lowest vaccine rates in the country), Jenny McCarthy and her colleagues at Generation Rescue who continue to argue for evidence of the link between vaccines and autism, and from parents of a girl who almost died at 6 weeks from whooping cough.
It explored possible contributors to the fear of vaccines and/or the lowering vaccination rates:
So I thought of that conversation as I watched last night's re-run of PBS Frontline's special "The Vaccine War" (originally aired April 27, 2010). I highly encourage advocates on both sides of the issue to check it out.
The piece was quite balanced with interviews on all sides. For example, we heard from vaccine advocate Dr. Paul Offit, bioethicist Dr. Arthur Caplan, anti-vaccine advocate parents in Ashland, OR (with one of the lowest vaccine rates in the country), Jenny McCarthy and her colleagues at Generation Rescue who continue to argue for evidence of the link between vaccines and autism, and from parents of a girl who almost died at 6 weeks from whooping cough.
It explored possible contributors to the fear of vaccines and/or the lowering vaccination rates:
- 1998 Lancet article by Dr. Andrew Wakefield that linked autism to childhood vaccines (*This article has since been retracted and MANY U.S. and International epidemiological studies have found no scientific evidence of a causal link)
- A new generation of parents that are too young to know the devastating effects of vaccine-preventable diseases like polio. One interviewee used a term that I really like- "Community Recollection". As Community Recollection of these diseases disappears, we can become complacent.
- A false sense of security because many of these diseases are not seen frequently in the United States. However, we forget that with the ease of air travel, borders are almost non-existent. For example, the piece followed an outbreak of measles in San Diego that started when a non-vaccinated 7 year old from the US contracted it while vacationing in Switzerland and brought it home to classmates.
- The Internet. While it also offers many positive benefits regarding healthcare (e.g., access to information/publications; online support groups and connections with a "community" of individuals with similar diagnoses)- it also has its potential downfalls.
- It can keep controversy alive- even after it has been disproven (e.g., the Wakefield article)
- False or unproven information can go viral and it is hard to retract! They use the example of the youtube video of Desiree Jennings (a 25 year-old Washington Redskins cheerleader) that claimed that a flu shot caused her debilitating muscle disorder.
So how can Public Health compete with the Media and the Internet?
- Let's not compete. Let's collaborate. Let's learn (either through our own capacity or collaboration) to effectively communicate public health information online. Our biggest audience (the public) is not usually reading our peer reviewed journals or attending our annual conferences. This is already starting to happen. Public health organizations have active Facebook and twitter accounts, blogs, videos. Let's keep going. And let's train our public health colleagues/students in health communication.
- Let's remember to share the spotlight with celebrities and other spokespeople that have influence over the public. Like it or not, the way people get their health information and make decisions is changing. They do not just agree with doctors or scientists. I almost always see these debates featuring Public Health (scientist speaking in jargon) vs. Celebrity/Parent with moving emotional story about their child being injured by a vaccine. That is hard to compete with! Believe it or not (because we seem to only hear from Jenny McCarthy), there are also pro-vaccine celebrities. Jennifer Garner and Kristi Yamaguchi have been flu vaccine advocates. Jennifer Lopez and Keri Russell have been pertussis vaccine advocates. Let's make sure the public knows that.
- Let's think about the framing and marketing of vaccination messages. When the HPV vaccine is framed as a Cancer Vaccine for both boys and girls...versus an STD Vaccine for just girls/young women it is perceived very differently by the public.
Tell me what you think:
- What can we do to change the current "Community Recollection" about vaccinations?
- Other suggestions regarding how public health can collaborate with the media/internet sites to communicate more effectively with the public?
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