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PhotoVoice Project

Coffee is the life blood of the modern world, and probably has been seen the birth of civilization. Coffee’s heritage can even be traced back to the ancient plateaus of Ethiopia (NCAUSA.org, 2017). The actual cultivation and trade of coffee began in the Arabian Peninsula in the 15th-16th century, coffee became was known as the Wine of Arabia (NCAUSA.org, 2017). Coffee arrived in Europe in the 17th century and quickly gained popularity across the continent (NCAUSA.org, 2017). In England, coffee houses were referred to as Penny Universities, because of the low cost of the beverage and the interesting conversation that could always be found there (NCAUSA.org, 2017). Finally, once coffee had reached the British colonies that later became the United States and the events of the Boston Tea Party took place, coffee quickly became the American drink of choice (NCAUSA.org, 2017).

“Coffee – the favorite drink of the civilized world.” – Thomas Jefferson


Processed with VSCO with a9 preset

To answer my first question, “What choices do I have?” Well, the answer is both simple and complicated. There are lots of companies to buy from, and many sources of coffee beans (Businessinsider.com, 2011). Conversely, despite all the different flavors of coffee that is advertised, there are actually only two types of coffee (Businessinsider.com, 2011). The two types of coffee bean are Arabica and Robusta. Arabica makes up about 70% of all coffee beans sold and Robusta, which is cheaper, is typically used in instant coffee (Businessinsider.com, 2011).



My second question is “Who’s selling me what?” In the US, there is really only five top brands that dominate the market: Keurig, Folgers, Starbucks, Maxwell House and Dunkin’ Donuts (Fortune.com, 2015). Of course, there are many independent coffee brands in the market, but none of them come close to the leading five. Besides that, they most likely buy their coffee from the same distributors or producers. Here is a list of top 10 coffee producing countries (WorldAtlas.com, 2016).:

Rank                           Country                                           Coffee Produced in Kilograms

10                                Guatemala                                                    224,871 US tons

9                                  Mexico                                                           257,940 US tons

8                                  Uganda                                                          314,489 US tons

7                                  Honduras                                                      380,296 US tons

6                                  India                                                               385,786 US tons

5                                  Ethiopia                                                         432,287 US tons

4                                  Indonesia                                                      814,629 US tons

3                                  Colombia                                                       892,871 US tons

2                                  Vietnam                                                         1,818,811 US tons

1                                  Brazil                                                              2,859,502 US tons



Coffee is a $100 billion industry, second only to oil (Businessinsider.com, 2011). I found it interesting to learn that there are only two kinds of coffee bean, even though coffee is made out to be more diverse by coffee companies. Per the National Association of Coffee USA, Arabica beans are grown at very high altitudes, between 3600-6300 feet above sea level, and are the best beans to be used in coffee beverages.


As a consumer and a coffee enthusiast, it is good to know that Brazilian Arabica coffee beans are the best on the market. Thankfully, Brazilian Arabica coffee is also the most common, which means that it all comes down to how the beans are roasted, which I’m sure is considered some form of a trade secret because I could not find any information on how exactly it is that so many companies, like Starbucks and D&M, can have so much variation in flavor.

The photos used for this project were more artistic in nature, rather than informative. However, they server their purpose since coffee is more artistic than anything else. In a lot of ways coffee’s trade craft resembles that of the beer industry, and it seems to carry a similar narrative with it as well. These photos help to illustrate the majestic beauty of coffee; they capture the exquisite light as it is reflects off the many forms of coffee, unleashing feelings of bliss and happiness. I can accredit these photos to pexels.com, which is a free license, open source, online photo data base.



Goldschein, E. (2011, November 14). 11 Incredible Facts About The Global Coffee Industry. Retrieved July 26, 2017, from http://www.businessinsider.com/facts-about-the-coffee-industry-2011-11#after-crude-oil-coffee-is-the-most-sought-commodity-in-the-world-1

The History of Coffee. (n.d.). Retrieved July 26, 2017, from http://www.ncausa.org/About-Coffee/History-of-Coffee

Szenthe, A. (2015, March 08). Top Coffee Producing Countries. Retrieved July 26, 2017, from http://www.worldatlas.com/articles/top-coffee-producing-countries.html

Groden, C. (2015, September 29). Here Are the 5 Top-selling Coffee Brands. Retrieved July 26, 2017, from http://fortune.com/2015/09/29/top-coffee-brands-keurig/

Free high quality photos · Pexels. (n.d.). Retrieved July 26, 2017, from https://www.pexels.com/

Welcome to Week Six – Winding down and taking stock….

As you focus on catching up, and producing a powerful photovoice assignment, take a moment to reflect on the PUBH 209 course objectives outlined in the syllabus. Please review them.

Course Objectives Reflective Prompt – due PW Friday July 28 or LC Sunday July 30
By the LC deadline of next Sunday July 30 at 10pm, post a reflective statement about your progress in consumer health, how meaningful you believe it is for most public health students (or even others) to be able to do the things on the list, and other thoughts about the course objectives, especially as they relate to improving personal and societal health and other outcomes. Use your username and Course Objectives as tags and Reflection as the category. I’ve copied the course objectives here below for your convenience.

Course Objectives: By the end of the course, students will be able to:

  • describe the impact of recent health care legislation on consumers;
  • describe U.S. consumer protection laws, agencies, and strategies;
  • find and use credible information about health-related services & products;‎
  • describe industry influence, fraud, quackery & unscientific claims
  • collect and share qualitative data regarding consumer health
  • outline key historical events that affect people’s choices and outcomes in a given realm of consumer decisions
  • provide and analyze examples of credible, accessible consumer-relevant information and sources, with an emphasis on helping others to distinguish between sources that help and hinder healthy decision making.
  • compare health-related policy and societal decision making in the United States and other locations, as well as across regions of the United States; as a result of comparing these contexts, they will be able to emphasize any apparent links to health behavior, choices, and outcomes.

It is my hope that you find that, through the materials provided to you and the requirements for you to read, think, explore, and write about consumer health-relevant issues and strategies, you can do at least 5 of the listed items very well, at least one other on the list fairly well, and at least one other adequately.

(Keep in mind that at THIS point we still have 1/6 of the class to go, so if there is an item you believe you can not do at all or can only do marginally at best, you still have a week to work on that skill! You may perhaps decide to address that intention in your reflective statement….)

Pharmaceutical Industry Prompt 1, Post 5

If I were asked what my top three reasons are for why we need to rethinking how Direct to Consumer advertisements are regulated I would first deliberate on the statistic involved with DTC ads. Which we all have access to the information at this point so I’m not going to rattle on about it. However, it is important to point out the growth that comes from the DTC ads and the increase of drug consumption.

The first reason we should rethink how DTC ads are regulated is as pointed out by the FDA, there is minimal oversight of how accurately the drugs are advertised (Health Affairs, 2003). Essentially, drug companies that falsely advertise their products are served little more than a slap on the wrist from the FDA (Health Affairs, 2003). There needs to be a better way for the FDA to penalize companies for misleading the public.

Second, there is a notable increase in consumers being prescribed drugs by their physicians that are DTC advertised (Health Affairs, 2003). Which isn’t necessarily bad for the consumers, but if the drug companies are falsely reporting facts about the effects and side effects of the product. Then there can be less than desirable consequences to the consumers, all the while the drug companies continue to profit (Health Affairs, 2003).

Third, allowing drug companies to directly advertise to consumers enables them to do what is called branding. Meaning that they can inflate drug prices because of the brand name the product carries with it once it has become available in the market. One of the effects of branding is consumers being misinformed about what their options are in regards to treatment. Often enough, even after the drug patent has expired, consumers will choose the more expensive brand name drugs over the lower costing generic drug simply because of the established brand recognition. And in some cases, the pharmaceutical companies are producers of both the brand and generic products allowing the companies to have near or total control of a particular market for that drug. Basically, they can double dip into consumers’ pockets with little to no competition. This is referred to as a monopoly and can mean much higher prices for consumers, as well as a lack of potentially lifesaving drugs, since a single company can only produce a certain number of units regardless of how much of the market they control.

The best solutions to these problems would be to limit drug companies to only being able to advertise in less popular mediums, like magazines, or only in doctor offices. An alternative solution in congruence with limiting advertising mediums would be to require drug companies to only advertise directly to medical service providers. So that way only the medically informed individuals are making the decisions in regards to patient treatment, not consumers that normally don’t have a medical background. This could make drug companies more competitive and more accountable by giving them a more well educated audience to appease. Most importantly, regulations need to be changed which would allow the FDA to be able to better hold drug companies accountable as mentioned in the above paragraph. Additionally, the government needs to be able to reduce the number of pharmaceutical monopolies and lower the barriers to entry so there can be more drug producers in the market. By doing this drug prices will be reduced and there will be more drugs available. Furthermore, an increase in competition should lead to more innovation and better drugs for consumers. In conclusion, besides making conditions better for consumers, these afore mentioned solutions would also result in a major blow to big pharma. Which would have even larger implications than just helping consumers, it could affect everything from politics to the war on drugs and the opioid crisis. But that is where I am going to leave this post because otherwise it will surpass the assignment threshold.


Health Affairs. (2003). Retrieved July 21, 2017, from http://content.healthaffairs.org/content/suppl/2003/12/05/hlthaff.w3.120v1.DC1

Finance Prompt, Prompt 2, Post 4

The fiduciary rule is a regulation put in place by the department of labor that will require financial advisers to act in their client’s best interest rather than in their or their firms interest (True Measure, 2016). The rule will also cause the industry to change how financial advisers are payed by changing it to a fees based system rather than commission based (True Measure, 2016). This will help to eliminate any conflict of interest and disincentives the sale of bad retirement plans to retirement investors (True Measure, 2016).

Out of the two resources, the John Oliver show did the best job explaining the fiduciary rule and the state of the current retirement investment market. John Oliver speaks the language of the people and knows how to use a comedic light that makes the otherwise boring financial information more palatable for the average American consumer. The True Measure website does a good job debunking common myths surrounding the fiduciary rule. However, the information was not presented in an interesting way, and I do not believe the average person would understand it much less want to take read the information.



4 Arguments Against the Fiduciary Rule Debunked. (n.d.). Retrieved July 16, 2017, from http://www.truemeasure.com/blog/2016/4/14/5-argument-against-the-fiduciary-rule-debunked

Blog. (2016, June 14). Retrieved July 16, 2017, from http://www.uspirg.org/blogs/blog/usp/last-week-tonight-john-oliver-retirement-industry-minefield-here%E2%80%99s-answer

Consumer Protection and Regulation: School Meals

Whether or not the law is always on our side, it is the hope of Americans that the law is there to protect all people. When we look at driving laws, gun laws, drinking age laws, etc., the peoples’ best interest is in mind. For many years however, it seemed that regulations in school lunches did not necessarily have the best interest of America’s children at heart. Along with the inauguration of Barak Obama as President in 2009, came First Lady Michelle Obama, and with her, a passion to get America’s youth active and healthy. According to the USDA, with Mrs. Obama’s help, new standards came into affect for healthier school meals to enable healthier children. For the first time in fifteen years, school meals were being criticized and forced to improve.

Standards required by law include: Proper portions and caloric intake amounts, daily fruits and vegetables, reduced amounts of saturated fat, sodium, etc., offering low-fat options. This is one instance where the law is helping teach America’s youth the importance of nutrition and helping gear toward a healthier generation overall. Scientists and nutritionists helped develop these standards, expanding them outside of the cafeteria and into the vending machines on campuses. Increased funding for public schools across the nation was also promoted due to these new standards. Regulating school lunches directly affects the consumer (the children of the schools) and is allowing them proper education on nutrition as well as easy and affordable access to it.

Here is a chart that shows school meals before and after reform, it is clear that in regulating the standards of food served in schools, children now have access to nutrient rich food; at least while on school grounds. https://www.fns.usda.gov/sites/default/files/cnr_chart.pdf

CP&R Post 3

The area I chose for this post was the consumer protection by the FDA in regards to salt. For the most part there is sufficient consumer protection, as in most consumers can make informed decisions about their sodium intake with the foods they eat. And because the FDA has done a good job educating, there are healthier options for consumers that seek it or need it. However, there is always more that can be done to protect consumers. For example, there needs to be more data gathered in respects to Himalayan pink salt and if it is healthy to use in food or not. There are claims that it can cause cancer and is worse than normal salt, but there are also arguments for the health benefits of pink salt because of the extra minerals in it. By doing a quick online search, it is clear that there is no answer to any of these questions yet.

I know that the healthy daily intake of salt can come from food, and adding salt should be avoided because too much salt in a daily diet isn’t healthy. Overtime, a high salt diet can lead to obesity, heart and other diseases. But also, too much salt can strip the gastral protective lining and allow for a Helicobacter pylori infection, which can be fatal in its self or cause stomach cancer (Gaddy et al., 2017). Part of what I don’t know is how much salt is in my personal diet, or how much is in some of the foods that I normally eat because there is not adequate labeling and information about the food. Furthermore, it would interesting to find out if other things like pink salt are actually better for consumption or if there needs to be a greater reduction in salt intake.

To find out more information about salt and diet, I will stall up to day with FDA research. I will be sure to share with fellow consumers information about the risk of too much salt in their diet. Especially, information about H. pylori bacteria and how to prevent stomach cancer.


Gaddy, J. A., Radin, J. N., Loh, J. T., Zhang, F., Washington, M. K., Peek, R. M., . . . Cover, T. L. (2013, June). High Dietary Salt Intake Exacerbates Helicobacter pylori-Induced Gastric Carcinogenesis. Retrieved July 07, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676043/

Glossary Building posts clarification!

Just had a good question: “Our own words or copy and paste?”

Short answer – Either is fine. You will of course also want to cite (and list) your sources either way.

Longer answer – Make your post meaningful by sharing some context; tell us why you find the terms important, where you ran across them, and where you looked to find a useful definition.

Looking forward to more good thinking in consumer health!  –DrP

The Monday July 3 Summary/Digest. Read here!

Hello and happy odd holiday weekend, right?

Rather than posting two separate posts leading you to responsibilities and opportunities, here’s a single post with information you should have right now.

First, if you have NOT yet been using the slides, please start. Although I haven’t specifically required you to include info from them as part of your posts, you’ll learn a great deal from them about consumer health as an area of public health. AND – bonus! – there’s a “Challenge” in one of them. Scavenger hunt!!!!! You know you want to…..

You’ll also find a third “Thinking and Discourse Prompt” up, and it specifically does invite you to make use of slides information. I look forward to seeing some of you posting to that prompt. Visit it here!

Glossary Building Posts – here’s how!

A total of five* Glossary Building posts are due by the end of the quarter. Try to post GBs every week, when new terms are hitting you, rather than rushing to post all five and having to search for terms to include. (*Note: Because I’m just getting the guidelines to you and there are only four weeks left officially, you may opt to replace one with a “challenge” or other “extra learning” post.)

Click here to see the GB guidelines at the Guidelines and Deadlines page, or keep reading.

A glossary is a specialized list of terms and definitions. You may find regular words, just like in a dictionary, but with an additional meaning or a “twist” for the context. You may find some acronyms or even concocted terms or phrases very specific to a given field, industry, or organization.

Each of your GB posts should include at least three terms that you believe are important for a glossary in consumer health, particularly if consumer health content is a chance to empower others to make the healthiest choices they want to make.

Posting on time, with attention to detail, correct citing of sources, and a readable, user-friendly approach – AND using your username as a tag and glossary as the category – will earn you the possibility of a High Pass (5/A) for your GB post.

Health Care Prompt Two

There are so many issues today, due to social media and other sources, that expose the public to “fake news” and it is truly difficult for any American citizen to decipher what is real and what is not. Fox News says one thing about the future of our health care and CNN says another, so reports such as this CBO report are crucial in understanding the reality of our situation; unbiasedly.

I had already learned in previous courses how much the U.S. spends on health care and yet has some of the worst health disparities in the world, and this CBO report taught me that under this new legislation would reduce direct-spending by $1,022 billion. This seems like a great thing right? Spend less on tertiary care, put the resources into primary care and watch the country’s health flourish. But when I read on, I learned that reducing this spending is in direct relation to the fact that this legislation would cut costs in Medicaid. Medicaid helps low-incomes families all across the country receive long-term health care, and cutting budgets here would hurt many people. What I would like to know is, if spending in Medicaid is cut and this new legislation would raise insurance premiums, how are low-income and even middle-class families going to be able to afford insurance for health care? I would assume that reading the new legislation bill itself would give me the answers I am looking for. Reports such as this CBO report are quite eye-opening. I don’t often think about federal budgets, yet it affects the people of this country, especially in regards to health care; it is definitely important to consider when learning about new legislation such as this.

Healthcare Act Prompt 2

There are two things I got from the CBO report.  One thing I already knew about but hadn’t realized yet, and the other one I learned from re-reading the report. The first one is that there are subsidies or that premium adjustments are made based on income.  In saying that, and as the CBO report points out, in some regions the ACA functions well enough that people can afford payed group health plans (CBO report H.R. 1628, 2017). Of course, those regions are only successful because of the state that they are located in. Therefore, it makes sense to remove insurance trade barriers between states. This would allow for a better distribution of cost sharing under the current law. However, there shouldn’t be trade barriers between states or cost sharing. It really doesn’t make sense in the first place to have cost sharing but no market sharing. Which is part of the laws failures, such an oversight or intention socialistic implication is what led to an increase in government spending and regionally increasing premiums (CBO report H.R. 1628, 2017). As for the subsidies, not enough people know about them or they were not accessible for enough people to offset healthcare cost (CBO report H.R. 1628, 2017), meaning that either there was not enough funding, possible waste and corruption of funds or that the government failed to inform the public of a service that they helped to pay for.

The second thing I learned was that despite significant reductions in government spending on healthcare, that there would be increases in other areas that would be appropriated for reducing premiums and easing the financial burden on healthcare consumers (CBO report H.R. 1628, 2017). A lot of what went wrong with the ACA was the burden of noncontributing consumers and the lack of employer supplied health insurance. Because of the lack of jobs in the job market, employers weren’t required to provide insurance per the ACA, or employers could not provide adequate insurance plans under the ACA. Abstractly speaking, at least the government will be in some way attempting to fix the issues that now exist because of the ACA.

Now that I’ve reconsidered the question, the CBO report overall generally is not known of by most consumers. In fact, most consumers do not know what the CBO is, much less what it does, and therefore it is very unlikely that the average consumer has ever even read a Congressional Budget Office report. This is probably should be something that is taught in high schools, along with things like the constitutional law and how the American political system works, and at the very least how voting works.

What I would like to know more about is how the market will change under the new healthcare law if it does pass. For instance, the CBO report says that an estimated 22 million people will be uninsured by 2026 because of the removal of the mandated insurance under the ACA (CBO report H.R. 1628, 2017). However, it will be interesting to see what the actual number will be, especially since the government will attempt to encourage the number of low care (healthier consumers) buyers with lower premiums and better insurance coverage (CBO report H.R. 1628, 2017). I would guess that the number will be lower if not for any other reason than because of the ACA mandating that everyone buys insurance and altering societal thinking. With things as they are now, it seems like more people feel the need for health insurance or understand the issues with not having a healthcare plan. As well, one of the success of the ACA was the better regulation of insurance companies, such as eliminating the preexisting condition discrimination and standardizing the level of preventative care for healthcare consumers. All of which has become expectations for consumers and an implicit encouragement for individuals to purchase insurance. I reached this conclusion because consumers will know the general level of care that they will receive and at what cost. Only future CBO reports will tell if this analysis reigns true or not… if the new healthcare law is ever implemented, that is.