Great weekend!

This weekend was very needed after last week, which was filled with a larger-than-normal load of readings, writing assignments and even a test. Some friends and I went to the Kalona Fall Festival on Saturday, which I had never been to before. They had a ton of great (and ridiculously unhealthy) food, including fried PB&J (pictured below), and it was fun to see the crafts and the historical side of Kalona as well. Also, Stringtown Grocery is an awesome little grocery store just outside Kalona where you can get things like spices in bulk, freshly made pastries, or other random local items. My partner, Tim, got some sweet habanero pickles from there and they are deliciously sweet and spicy!

I also tried out some new recipes this weekend, including this curried sweet potato and lentil soup (which is one of the best soups I think I've ever made; I doubled the lentils and used low fat coconut milk) and these roasted rosemary tofu cubes (which were pretty good but needed a bit more flavor, so I dipped them in BBQ sauce, which tasted great!).

I hope you had a good weekend too! I'm looking forward to this week - tomorrow is the College of Public Health Student Mentor-Mentee Program kickoff event at The Mill restaurant and then this weekend is Oktoberfest in the Amanas, which is always fun.

Here are some recent articles you might find interesting:

Officials, churches join fight against sexual diseases - Anna Gorman, LA Times
Seems like an innovative idea for an intervention (providing free tests through a computer kiosk and mobile van) and it's awesome that churches are supportive of it as well.

Growth of children's hospitals raises adult-size questions - John Fairhall, NPR
The fact that children's hospitals (like the majority of hospitals in general in the US) are classified private nonprofit, yet often they make a substantial profit and have very high-paid CEOs, is very interesting. It does bring up some ethical questions as to whether or not they should qualify as nonprofit.

The effects of hourly differences in air pollution on the risk of myocardial infarction: case crossover analysis of the MINAP databse - Bhaskara et al.
This study found that for every 10 µg/m³ increase in traffic-related pollutant level, the risk of heart attack increased during the period of 1-6 hours after exposure.

Iowa's Colorectal Cancer Dialogue

Last Friday, I went to Iowa's first Colorectal Cancer Dialogue, which was organized by the Iowa Cancer Consortium, the American Cancer Society, and the Iowa Get Screened Program. The day-long conference was all about colorectal cancer (CRC) - a type of cancer I didn't realize was as common as it is until I started working for the ICC. This may sound ridiculous, but I didn't even know until recently that one of my grandparents was a CRC survivor. (I found out when I was asking one of my parents about our family medical history; my grandparent had been diagnosed and treated for CRC long before I was born and died when I was in elementary school.)

Colorectal cancer is the second leading cause of cancer-related mortality (lung cancer is the leading cause). The fact that it causes so much mortality is especially upsetting considering that its one of the few cancers for which there are screening tests available and if its found early, the chance of 5-year survival after diagnosis is 90%.

Much of the discussions at the Dialogue focused on how to increase CRC screening rates, either by targeting physicians and other health care providers to recommend screening or by educating adults about the various screening options/providing the tests themselves. When people think of CRC screening, they usually only think of colonoscopy, but there are actually three different kinds of screening tests that have been shown to be effective for average-risk adults aged 50 to 75, including getting an annual fecal immunochemical test (FIT). The speakers included Dr. Durado Brooks (national director of the CRC and prostate cancer division of the American Cancer Society), the University's own Dr. Charles Lynch and Dr. Barcey Levy, and ACS's Lorrie Graaf. Many materials from the Dialogue, including presentations, are available to everyone on the ICC website.

Here are some random public health articles you might be interested in:

Conservatives Step Up Attacks On Public Funding For Birth Control - Julie Rovner
Rep. Steve King from Iowa apparently doesn't realize that women can be on birth control and still have children some other time in their lives.

Time to Revive Home Ec -Helen Zoe Viet
"Too many Americans simply don’t know how to cook. Our diets, consisting of highly processed foods made cheaply outside the home thanks to subsidized corn and soy, have contributed to an enormous health crisis."

Med Schools Fall Short on LGBT Education - Eliza Barclay

And here's a picture of my cat, Alley, sitting on my lap while I tried to work on a literature review paper yesterday:

Weight and health

I’m very interested in the relationship between weight and health, although I hold some unconventional views. I think that weight alone should not be used as an indicator of health and that focusing on weight loss as a goal in health interventions can have some unintended negative outcomes.

First, I will preface this by saying that I am not denying that the US population, on average, eats worse and is less active than it was in previous generations, and that this has led to poorer health outcomes. As a person interested in public health, I think there should be efforts (on multiple levels, not just individual) to improve our nation’s health. I also realize that we have, on average, gained weight.

While I recognize this relationship between our increasingly unhealthy environments/lifestyles and our increasing size, I don’t think that it’s as clear-cut as many in our society make it out to be. I believe that someone can have a technically unhealthy BMI (over 25) but still be healthy while someone who has a normal BMI can be unhealthy. Now, clearly there are countless credible studies that have found that people with higher BMIs tend to be at risk for an assortment of health problems that are less common among people with lower BMIs, but there are also a number of studies that complicate this apparently obvious relationship (for example: here, here, and here). And while perhaps on average someone with a BMI of 30 is more likely to have certain health issues than someone with a BMI of 20, this does not mean that all people with a BMI of 30 are unhealthy and that all people with a BMI of 20 are healthy.

I believe that our focus on weight as the primary sign of health and our obsession with weight loss as the way to gain health has lead to some unintended negative consequences: 

1. There are many very unhealthy ways to lose weight. If weight loss is the focus instead of adopting healthy behaviors regardless of weight loss, people may try to lose weight at any cost, even if it means actually being less healthy. 

2. People who have a normal BMI may think they’re healthy even if they aren’t eating well or getting enough physical activity, while people with higher BMIs who adopt healthy behaviors may become discouraged and think they aren’t healthier if they don’t lose weight. 

3. By conflating weight with health, people who do not have a normal BMI are automatically judged as being unhealthy, even if they actually are healthy/do have a healthy diet and exercise regularly.

As a society, we are very focused on losing weight as the key to being healthy, but I think there may be a different way to approach it. What about being healthy simply for the sake of health, not weight loss? This is what I like about Health at Every Size (HAES). I find this approach to health very interesting and others have argued that we should have a paradigm shift away from focusing on weight loss to HAES. Here, here and here are some published articles on the benefits of HAES.

Of course, it should go without saying that even someone who does have a high BMI and actually is very unhealthy (for whatever reasons) should still be treated as a human being and not discriminated against. Here’s an example of weight discrimination: this study found that the higher your BMI, the less your doctor respects you.

It should also be noted that the degree of agency people have in controlling their weight (and health in general) is greatly debated. Our society tends to put the blame largely on individual-level factors (usually focused on behaviors, but sometimes genetics are mentioned too). Public health professionals and some other experts have done an excellent job of pointing out other factors, including environmental and social.

I am not the first person to say these things, and many other people have written much more eloquently than me on these issues. I know many people feel passionately about this topic and may disagree with me. I love to discuss this issue, so feel free to voice your opinion!

Working for a Non-profit

I love working for a non-profit. I've worked at Iowa Cancer Consortium (ICC), a state-wide cancer control non-profit, since June 2010 and it's been a really wonderful experience. While I know there's a lot of variation within the non-profit sector, generally speaking I think many non-profits can provide unique opportunities for students interested in public health. Since non-profits are often (unfortunately) working on a very tight budget and have activity-packed staff, students can often take on more responsibility than they may otherwise be able to in jobs in other areas.

Through working at the ICC, I've been able to work on a range of projects and expand my skills and knowledge considerably. My boss and coworkers have taught me a lot and continually provide me with guidance. I've been able to help plan conferences (like the upcoming Iowa Cancer Summit, which is open to anyone interested in cancer control efforts!), design materials, write grants, edit web pages, conduct literature reviews, contribute to revising the state cancer plan, facilitate membership meetings, learn a lot more about cancer control methods and cancer itself, and meet some cancer control leaders from across the state.

Granted, there are some downsides to working in the non-profit world: the disappointment when a proposed project doesn't get funded, the uncertainty when the fiscal year ends. But all in all, it's been an invaluable experience and I'm looking forward to working with them for the rest of the school year.

The Rape Victim Advocacy Program in Iowa City is another great non-profit I love being a part of. I don't work there, I'm just a volunteer advocate, but the women that work there are incredible and they do many very important things, like provide free counseling for survivors and conduct sexual assault prevention education.

Anyway, enough about non-profits! Here are some articles you might find interesting:

Women could be given the right to choose Caesarean Birth - James Gallagher
I've been interested in birth and its medicalization for a few years now. I feel a little conflicted about the right to choose to have a C-section. On the one hand, I could see how it may be empowering to have women be able to control their childbirth to this degree, but on the other hand, a C-section is a pretty major operation. Plus, childbirth is a natural process that sometimes becomes a medical emergency, but certainly isn't always. I lean towards the view that it's best to avoid getting a C-section unless it's absolutely necessary, but I can understand why some women may feel differently.

Obama Administration Abandons Stricter Air-Quality Rules - John M. Broder
Depressing, but on the bright side - at least Obama isn't actively trying to dismantle the EPA.

Fewer Americans Are Smoking, And Those Who Do Puff Less - Timothy W. Martin
Some good news and bad news in this article. Especially relevant to Iowans since we just lost millions in state anti-tobacco funding.

Texas wildfires destroy more than 700 homes in two days - CNN Wire Staff
Really terrifying stuff. I have some friends in Austin; hopefully the fires stop soon. I'm a little surprised about how long its taken for these fires to get national attention (although the Southern drought in general didn't get very much national attention this summer either, I thought).

And to end this post: I thought this youtube video was pretty funny.