All posts by victorianorinev

Glossary 4

Socioeconomic Gradient–A phenomenon describing the hierarchical differences in health outcomes among a population based on the value that society places on certain characteristics, whether it be income, job, educational attainment, etc. This can be viewed as a ladder in that moving down the social ladder, more ill health and shorter life expectancy are experienced at each rung.

Feedback Loops–In systems analysis, the impact of changes in one influence or factor on other influences or factors in a positive or negative direction.

Health Disparity–a type of difference in health that is closely linked with social or economic disadvantage. Health disparities negatively affect groups of people who have systematically experienced greater social or economic obstacles to health. These obstacles stem from characteristics historically linked to discrimination or exclusion, such as race or ethnicity, religion, socioeconomic status, gender, mental health, sexual orientation, or geographical location. Other characteristics include cognitive, sensory, or physical disability.

In every course I have taken, I see how poverty is a major factor in the quality of mental and physical health of individuals. Sure, there can be people who have more than enough money, and they can be abused, abuse, have cancer that runs in their families, etc.. But the rates of mental and physical illness are higher with those who live in poverty, and I would argue the rates of mental illness are much greater as well. We know that poverty is a public health crisis in Seattle and all over the world. And secondary to poverty are toxic living environments, lack of health care esp. mental health care, and a general lack of information regarding financial security, vaccines, and other public health community initiatives. I guess, my point is that in all my studying, I see that poverty needs to be addressed, so we can move on, otherwise we will continue to Band-Aid issues, and create new generations who live ill and ill-informed.  I see poverty as a primary issue, and health as secondary, and off of each of those branches tertiary issues, but I believe that poverty and health go hand in had–and they have for all of human history!

 

 

Riegelman, R., & Kirkwood, B. (2015). Public Health 101: Healthy People–Healthy Populations. Second edition. Burlington, MA: Jones & Bartlett Learning.

Reflection

I absolutely love Public Health–the application of sociological philosophies! If I do make it into a graduate program, I’ll be considering public health in addition to clinical psychology! I learned a lot of why the ACA is so important; making it illegal to discriminate against pre-existing conditions when applying for medical insurance, the expansion of mental health services through Medicare, and I recently learned about this website: https://openpaymentsdata.cms.gov. I also discovered a lot of information about 401k fees, and my personal finances. I learned that public health has been the driving force behind many consumer protection laws, like; seatbelts, the distracted driver laws, baby back to bed, making lead and asbestos in consumer products illegal, and of course regulations for our food, pharmaceuticals and cosmetics. I have learned that even with all of these laws, we still need more. And to reiterate yet again, information and regulation brings autonomy. Thank you so much, I have learned a lot about public health this quarter!

Pharmaceutical Prompt 1

Direct to consumer adds are particularly troubling when they are for products that require expert knowledge—like pharmaceutical drugs. When DTC ads are reinforced with pharmaceutical payments to doctors who are pushing them, I believe this is a question of ethics. Unapproved drugs continue to be marketed to consumers, including OTC, and even H1N1 products that have no efficacy whatsoever. These three talking points do demonstrate why we should think about changing DTC ads, or any type of aggressive marketing of pharmaceuticals. All drugs should be approved prior to marketing, and full-disclosure should be made to physician, and consumer alike. I do disagree with ‘off label’ uses, as I think this is a source of ethical compromise. Instead, if there is a legitimate ‘off label’ use, then the drug should be put through the same testing as it was for the primary use of the drug. I was able to visit https://openpaymentsdata.cms.gov and I found out that one of my Grandmother’s doctors has been receiving over 10k every year, except last year, when he received over 17k. This is contrasted to one of my doctors, who received $24.01 for the year of 2016. I would highly recommend everyone use this website to search for their doctor. Getting rid of the ACA would also remove this resource in addition to many others, and this website provides accountability for our doctors. Accountability and information are the first steps we can take as a public health solution. Perhaps in addition to this website, doctors must post how much they have received from pharmaceutical companies right next to their diploma. Finally, I don’t think DTC pharmaceutical ads should be legal, especially when many aren’t approved.

Photovoice: “Moderate Drinker”

What are healthy drinking habits? Where is the line between moderate and excessive drinking? Do we know what we need to in order to make healthy choices when it comes to drinking alcohol? What is socially acceptable vs. the recommended dietary limit of alcohol? What’s the typical discourse? I don’t believe most consumers know exactly what the limits of drinking are in order to make informed and healthy choices. I think the common knowledge and typical discourse is that one drink is equal to one serving, no matter the ABV content, what it’s been mixed with, or how big the glass is. This is incorrect, and many people might be drinking excessively without even being aware. In this post, I hope to give you the information you need in order to make healthier drinking decisions. And in doing so, we can change this discourse regarding healthy drinking habits when we celebrate with our friends and family.

This photo is of a beer sample my mom had while we were out to eat. The beer was 4.5%, she had one, and I drove us all home since I had none. She did not drink anything else for the rest of her evening. “Moderate drinking.”

KIMG0851

According to the Dietary Guidelines for Americans, moderate drinking is considered 1 drink per day for women, and up to 2 drinks per day for men. “In comparison to moderate alcohol consumption, high-risk drinking is the consumption of 4 or more drinks on any day or 8 or more drinks per week for women and 5 or more drinks on any day or 15 or more drinks per week for men. Binge drinking is the consumption within about 2 hours of 4 or more drinks for women and 5 or more drinks for men” (https://health.gov/dietaryguidelines/2015/guidelines/appendix-9/). I believe there is a huge disconnect between what is considered healthy moderate drinking, and what is socially acceptable, and what is marketed to us.
Now let’s define what 1 drink is according to the CDC:
• 12 ounces of beer (5% alcohol content).
• 8 ounces of malt liquor (7% alcohol content).
• 5 ounces of wine (12% alcohol content).
• 1.5 ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey). (https://www.cdc.gov/alcohol/faqs.htm)

One of these beers is 8% and the other is 8.6%. These were from my fridge.

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The alcohol content in these beers proves the disconnect between what we’re being sold, and what is actually a healthy amount of alcohol. And the discourse about this, is not healthy. We want the higher ABV, we think we’re getting more bang for our buck, and we don’t consider the health effects. If I were to have one of the beers from my fridge every night, that’s too many since they are over 8%. And if I were to drink one of those a night, that would be more like 1 ½ beers a night, which would be 10 ½ drinks per week. And that’s “high risk” drinking for a woman. I honestly believed that if I had one I was okay, and I never considered the ABV content of my drinks. My husband, and close friends all buy the higher ABV drinks, because our habits are unhealthy, and we have no real concept of moderate drinking. Our discourse about what healthy drinking is, is non-existent. And I think it’s safe to say that American’s have a portion control problem when it comes to their alcoholic beverages—in addition to everything else we consume. More information brings greater autonomy. I hope I have provided the facts in a simple manner so that you can apply them to your life, and make healthier decisions about drinking.

Glossary Post 3

ex·ces·sive
ikˈsesiv/
adjective
adjective: excessive
  1. more than is necessary, normal, or desirable; immoderate.
    “he was drinking excessive amounts of brand
mod·er·a·tion
ˌmädəˈrāSH(ə)n/
noun
noun: moderation
  1. 1.
    the avoidance of excess or extremes, especially in one’s behavior or political opinions.
    “he urged the police to show moderation
binge drink·ing
ˈbin(d)ZH ˌdriNGkiNG/
noun
noun: binge drinking; plural noun: binge drinkings
  1. the consumption of an excessive amount of alcohol in a short period of time.
    “teenagers as young as 16 admit to binge drinking”

Since, I’m doing my photovoice on millennial alcohol consumption, I thought these terms would be relevant, though already recognizable. The issue is distinguishing between the first two; excess, and moderation. For women the line is between 1 drink and 2. The CDC recommends no more than one a day for women, and 2 for men. Is it okay though for me to have none one day, and two the next? Or is that binge drinking since it’s in excess of one? Or is that heavy drinking if it adds up to eight a week for a woman?

 

https://www.cdc.gov/alcohol/faqs.htm

Death & Dying Prompt 1

On the morning of December 23, 2010 I went into labor with my first child. I arrived at our local birthing center in more pain than I anticipated for this event. It was a busy night, and I felt neglected by the different nurse mid-wives coming in and out of the room. My daughter was in a funny side-ways position, which was causing ‘back labor’ and the pain I mentioned that I wasn’t anticipating. Early the next morning our daughter’s heartbeat had dropped to 40 bpm, and she had passed her first stool. We rushed to the hospital where I had an emergency c-section. They cut my bladder. I wore a catheter for the first month of motherhood. I was filled with anger toward every practitioner involved, as well as the shame that my body had failed me. I became depressed.

Later, I was able to see past the anger and realize this was nobody’s fault, not even my own. What occurred was not negligent, rather it was an adverse unintentional outcome of a very difficult birth. “It is important to understand one fundamental concept – there is a difference between adverse events and negligence. An adverse event is an injury occurring during the course of medical management” (Sohn, 2013). The doctors and midwives did everything they could to manage a difficult situation, and to keep my daughter alive. And in that regard, they succeed. Managing post-partum OCD and depression, they did not. “Negligence is the failure to provide a standard level of care or, in other words, the delivery of substandard care”(Sohn, 2013). At this point I would highly encourage anyone who reads this to please read this following link, and consider which of these scenarios are negligent or adverse: https://www.propublica.org/article/lost-mothers-maternal-health-died-childbirth-pregnancy. I think many of these maternal deaths are adverse, some are uniformed on the part of patients themselves, and I believe others are truly negligent.“According to researchers in Georgia, Michigan and other states, mental health disorders have become a leading contributor to maternal deaths among white women in the months after childbirth” (Cillekens, Freitas, Martin, 2017) are therefore, preventable deaths, and negligent on the part of all health care providers involved. When mental health disorders are the leading contributor of death, there is negligence occurring without a doubt. Again, “negligence is the failure to provide a standard level of care…” (Sohn, 2013).

I don’t know if it’s immediately helpful to know how many women suffer pregnancy related health complications, or that I am one of many women who lives with a mental health disorder. I certainly feel less alone, but I also wonder why, why is this all so commonplace? It was, however, helpful to find the definitions and differences between negligence, and adverse. The high occurrences of adverse health effects does lead to more questions. Why aren’t consumers being educated more on the signs and signals of their possible adverse health outcomes due to medical treatments and conditions? I am again (for the second time so far) reminded of something our professor said in the first week, “ in order to have autonomy, you need to have more information, and in order to have more information, you need more consumer regulation.” I think more than anything I would encourage people to look into the adverse health effects of their medical conditions, and treatments. I would encourage them to ask their doctors in detail about the signs and signals of life threatening conditions related to their conditions and treatments.

Martin, N., Cillekens, E., & Frietas, A. (2017, July 17). Lost Mothers. Retrieved July 17, 2017, from https://www.propublica.org/article/lost-mothers-maternal-health-died-childbirth-pregnancy

Sohn, D. (2013, February 15). Negligence, genuine error, and litigation. Retrieved June 23, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576054/

Glossary Post 2

de·ple·tion

 

dəˈplēSH(ə)n/
noun
reduction in the number or quantity of something.
“the depletion of the ozone layer”
scar·ci·ty
ˈskersədē/
noun
the state of being scarce or in short supply; shortage.
“a time of scarcity”
supply and demand
phrase of supply
  1. the amount of a commodity, product, or service available and the desire of buyers for it, considered as factors regulating its price.
    “by the law of supply and demand the cost of health care will plummet”

I don’t know that I fully understand depletion in the context of consumer public health. But since it’s a question for our final, I thought I’d try and figure it out. So, when I think of depletion I think of a reduction in goods and services. Maybe a scarcity of doctors in rural areas, or a scarcity of jobs. But it’s hard to think beyond that, I mean in our society there is no shortage of food, of healthy food, junk food, diabetes, overweight Americans, violence, mental and physical illnesses. So, what does depletion have to do with it? Really? Are we lacking information? I don’t think so since we have adequate access to information, we just have to filter it. Are we lacking human services, like health care, and mental health facilities–yes! Maybe depletion isn’t the question–maybe it’s the answer?  Maybe reducing the supply of sugar, and alcohol could be a solution to some of our present health epidemics? Maybe reducing the supply for harmful goods, services, and entertainment would reduce their demand? Or maybe I missed the mark. All definitions were pulled from a simple Google search.

Photovoice: “Craft Beer”

I would like to discuss alcohol, and how much of it my generation consumes. I’ll answer: how healthy is it, and what do we need to know in order to make healthier choices. I think there’s a fine, undefined line between moderation and excess, and when you ask people what they consider to be healthy–responses differ.  I may change which questions I decide to answer, and I would really like to try and use my own photos.

Finance Prompt 2

In one of Dr. P’s Big Blue Button vlogs, she stated something along the lines, that in order to have autonomy, you must have access to information. This is true in all aspects of our lives, and definitely in our financial lives. I was pretty torn between writing about poverty—which is something I know very well—or writing about my present understanding of my own finances. I have struggled in poverty my entire life, and now I am beyond it…barely. I do think it’s worth mentioning before I move on, that the largest consumers of welfare are not the poor, they are corporations, and the people who can afford homes and 401k’s. So, while I discuss the potential of financial rip offs, I feel it’s necessary—like John Oliver did mention—to keep in mind many people cannot afford financial rip offs, which makes no sense at all.

I don’t feel that that the 4 standards article explained the fiduciary rule very well, I think that article assumed you already knew what the Fiduciary rule was, and so they went into greater detail. Katharine Lee’s article explained very clearly that the Fiduciary Rule is a law requiring professionals to act in the best interest of their clients, otherwise they would be creating a conflict of interest. I definitely think Oliver and Lee do a better job explaining from the consumer’s point of view, since they assume you know nothing. John Oliver’s humor also helps a lot. After I read these two sources, I immediately checked to see if I have any fees, I don’t think so, since none were on my statement—I’m hoping my employer pays them.

CP & R-Prompt 1

Synergy; “The interaction or cooperation of two or more organizations, substances, or other agents to produce a combined effect greater than the sum of their separate effects” (Google search).

I would like to view Toxic Substances in Consumer Products through both lenses; synergism, and externalities. It did come as a massive surprise to read that the vinyl lunch bags I just bought my daughters may contain lead. It also came as a surprise to learn that while the FDA does regulate cosmetics, cosmetics aren’t subject to pre-market approval—with the exception of color additives (Tickner, & Torrie, p. 6-7). I feel like that’s a bit of a contradiction, although I guess most cosmetics do have color additives, right? This seems like a loop hole, kind of….sort of, but what do I know?! So I guess, to answer the first question, I thought I was protected as a consumer, but I guess I’m not protected very well, or at least not as well as corporations are.

I know that synergy happens all day everyday in our bodies, and environments, I know that the cause of one action can have many different effects (externalities). I know that the Egyptians used lead in their totally ‘on fleek’ eyeliner. I know that the paint in our home built in 1972 most likely has lead, I know that our glittered pop-corn ceilings most likely have asbestos. I also know that the public health policies surrounding lead and asbestos exposure were put into place to protect people who worked around the stuff everyday, and that eventually affected consumers for the greater as well. A few years ago when I was doing research for an environmental studies course, I learned that the elementary school I went to had toxins spewing into it from a paint washing facility NEXT DOOR (https://yosemite.epa.gov/r9/sfund/r9sfdocw.nsf/vwsoalphabetic/Cooper+Drum+Co.?OpenDocument)! I know my family and I are surrounded by extremely toxic chemicals, though it feels as if very little is being done to protect the consumer. It is especially concerning when we consider how many different products we consume; everything from, electronic devices, tables and sofas that have toxic chemical ‘known to the state of Caliornia or something’, even our vehicles, my make-up, my daughter’s vinyl lunch box, our mattress, our laundry detergent, other cleaning items, and then there’s our food. Again, I can only imagine what kind of synergy is going on, and I often wonder what the effects will be.

I’ve been assuming organic cosmetics, cleaning products, and other personal hygiene products had better consumer protections—and it sounds like they might, since they have two agencies to answer to. “Cosmetic products labeled with organic claims must comply with both USDA regulations for the organic claim and FDA regulations for labeling and safety requirements for cosmetics” (https://www.fda.gov/cosmetics/labeling/claims/ucm203078.htm#If_a_cosmetic. I would like to learn a lot more about regulations are required for organic items vs non-organically labeled items. And I think if there’s anything I’ve learned, it’s that, the less I consume, the more safe my environment will surely be. That is, when there’s less stuff, less chemicals, less toxins known to somebody to cause birth defects (even salicylic acid is teratogenic!), then the better off we are as consumers. So, maybe the less I consume the safer I am? That doesn’t seem fair, but I do have a choice at least.