Graduation!

I can't believe this week is final's week and this Friday is the College of Public Health graduation ceremony. The past two years have flown by. It still hasn't sunk in completely that I will be done with graduate school at the end of this week. These past few weeks have been especially exciting, with one of the highlights being that I accepted a job offer! I am going to be a Health Education Specialist. I think the job is a great fit for me and I'm looking forward to beginning in June!

Leaving the College of Public Health is certainly very bittersweet. I am excited to begin my post-graduate professional career and put what I've learned in the MPH program to use, but at the same time, I will miss being around my classmates (as well as the faculty and staff) and taking interesting classes. Although I certainly plan to continue to stay connected to the College of Public Health community, as an alum who is close by, it will be quite different from being a current student.

It's been a pleasure blogging for the College these past few months as well! If you're considering going to the University of Iowa College of Public Health and would like to ask me some questions, please don't hesitate to contact me. You can get my email address from Lexie Just by emailing lexie-just@uiowa.edu.

HIV Exposure in Iowa

Last week, I went to an event that was put on by the Sexual Health Alliance of Johnson and Linn Counties called HIV Transmission in Iowa: Criminalization and the Changing Legal Landscape. I didn't know before attending the event that Iowa had some of the strictest HIV exposure laws in the country. I also didn't know that when someone who knows they're HIV-positive exposes another person to HIV without disclosing their HIV status, it's treated more harshly than the same situation is when other communicable diseases are involved, including diseases of similar severity (such as Hepatitis B). I also didn't realize that in many states, including Iowa, it doesn't matter if the HIV-positive person wears a condom, is taking their medication to lower their viral load, or doesn't actually transmit HIV - it's just the exposure to HIV without disclosure that matters legally (with no regard to risk).

They played a clip from this documentary, which looks very powerful and interesting. Nick Rhoades, who is featured in the documentary, spoke at the event.

I'm definitely going to check out this documentary once it's available.



In other news, right now everyone is really excited about the Building Dedication, which is today. I'm really looking forward to it, especially since Thomas Frieden (director of the CDC), Harrison Spencer (president and CEO of the Association of Schools of Public Health), and Senator Tom Harkin will be there!

I also just got back from the Iowa Governor's Conference on Public Health, which was definitely a great networking experience. I met a lot of interesting people and learned about some great things that are happening across the state.

Cancer Complexity

Lately I've been reading a lot of articles complicating the idea that finding cancer early is always a good thing. For example, I just read this NPR article about a Norwegian study that found that mammography can lead to the "over-diagnosis" of breast cancer by finding a tumor "that would never have gone on to cause symptoms or death." This is somewhat similar to some of the criticisms of the P.S.A. test for prostate cancer, which caused a lot of men to get treated for prostate cancer when they likely would have died of something else before the prostate cancer caused any problems.

It seems like the critiques of these screening tests go beyond whether or not the screening tests have high enough specificity and sensitivity (both concepts I first learned about in an epidemiology class here!), and have more to do with the nature of the cancers themselves. It's an interesting idea to me that may be some types of cancers aren't as well-suited for a screening test, since finding them early doesn't lower mortality. Apparently that's the cause with testicular cancer, which, according to the Mayo Clinic, is "highly treatable at all stages, so finding testicular cancer early doesn't make a cure more likely." Judging from this new Norwegian study and from other recent studies, it sounds like with breast cancer, there may some types of breast cancer that are good to find early while there are a few types of breast cancer that might not have the same benefits to being found early.

All of this adds a lot of complexity to an already complicated health problem. The fact that even within a kind of cancer there may be some types that benefit to screening while other types don't is really complicated to communicate to patients. I think generally speaking it's still very much agreed that the mammography, the Pap test, and the various kinds of colorectal cancer screening tests are still good and important to do. One harm of these findings is that it may lead people to not get screening tests done, since they figure "What's the point?", when in reality these screening tests still save lives.

Anyway, that's just been on my brain lately!

I should also note that April is Sexual Assault Awareness Month and there are a lot of great events coming up if you're in the Iowa City area. I know I'll definitely be going to the Take Back the Night rally and the Clothesline Project.

And this is an article my friend showed me that I read recently that was interesting: White Until Proven Black: Imagining Race in the Hunger Games - Anna Holmes, The New Yorker
This doesn't have to do with health; it's about race in books (specifically the Hunger Games but it branches out from there). I'm a fan of the Hunger Games and was really disturbed by some of the racist responses to the casting in the movie and I thought this article explored what those responses mean.

Breast Health Summit

I'm sorry it's been so long since my last post! Between spending time on my practicum event, keeping up with school, working my two jobs, and job hunting, my blogging has gone by the way-side. Things have calmed down a little though now that my practicum event is basically complete! My practicum has been organizing, implementing, and evaluating a Breast Health Summit. The Summit itself happened on March 10th in Cedar Rapids. The event was a day-long and focused on African American women, although health care providers and public health professionals were welcome to attend as well. 78 people ended up attending and it went really well.

Here's the save the date I made for the event

One of the biggest take-home lessons I got from the whole experience was a reminder on the importance of working with members of the targeted community in all stages of planning, implementing, and evaluating the event. Women who are leaders in the Cedar Rapids African American faith community were involved right from day one in planning this event. Without their involvement and all the time they dedicated to this project, the event would have been a lot less well attended and not nearly as effective.

The Gazette wrote a great piece about breast cancer in African American women and the Summit before it happened. Some members of the planning committee and two speakers at the Summit are interviewed in it. That article is available here.


In other news, I am planning on following the Affordable Care Act supreme court case closely these next few days! NPR has had some great articles about the case recently, including this one.

Semi-Formal & Ghostbusters

Last night was the College of Public Health Student Association semi-formal, which was a blast and a nice break from school, work, and job hunting. It was great to see people from all five departments there! I think the new building has already helped a lot in unifying the different departments, but this event was a fun way to bring different groups together.

After the semi-formal, I went out and saw a midnight showing of Ghostbusters, which was great as always, although I had forgotten that an EPA agent is portrayed as a bad guy! That was a bit of a bummer. Apparently at least one person actually has used Ghostbusters to illustrate why they think the EPA is bad. I mean, honestly though, even within Ghostbusters, it's not like the EPA wasn't somewhat justified in trying to stop them. In the movie, Dr. Peter Venkman calls the proton packs they use "unlicensed nuclear accelerators" - I can understand why there might be some environmental health concerns with that!

Anyway, not much else is new with me. There are some new pictures of the College of Public Health building, so if you haven't gotten a chance to see if for yourself - check these out!

Here are some articles I've read recently that were interesting:

Latest Drug Shortage Threatens Children with Leukemia - Richard Knox, NPR

What Obama's Budget Proposal Means for Disease Prevention - Betsy McKay, Wall Street Journal

In Women, Heart Attacks Often Strike Without Chest Pain - Scott Hensley, NPR

Trip to the State Capitol!

Yesterday I traveled with a social worker and a group of nurses from the Oncology Nursing Society to Des Moines to talk to state senators about cancer issues. On the way up, I gave an overview of the Iowa Cancer Consortium and the ICC’s legislative priorities for the year. It was really interesting to hear about what the nurses wanted to talk to legislators about.

A lot of them expressed frustration over the current medical home system, which was created to help people under the IowaCare plan. IowaCare covers low-income people who don’t qualify for Medicaid but aren’t insured, but unfortunately if they have cancer, they have to go to the UIHC in Iowa City to get their treatment, even if they live on the other side of the state. Many of these patients have difficulty paying for transportation to get to Iowa City and don’t have a place to stay once they get here. A medical home model had been created to allow IowaCare patients to get their primary care needs met closer to home at certain clinics, but this has caused many of its own problems, as there is no standardization for what the clinics can provide for these patients. Fortunately, a lot of this will change once the Affordable Care Act is implemented, since the majority of people in IowaCare will qualify for Medicaid once it’s been expanded (and then won't be required to go to Iowa City for specialty care), but until that happens, these patients still need help.

We were able to meet with four senators, including the senator from my hometown (Sen. Hogg of Cedar Rapids, who high-fived me when he found out I went to high school where his kids go) and my own senator Joe Bolkcom. Both Hogg and Bolkcom and another senator we met with, Sen. Dvorsky, are already really involved in cancer prevention and control efforts, which is wonderful. We were only able to talk with each of them for about ten minutes, but we left them each a folder filled with information about our legislative priorities and a copy of the Iowa Cancer Plan. It was a good trip!

Pandemic! (the board game)

Last night I played the board game Pandemic with some friends. I've been wanting to play this board game for a while (I'm a big fan of board games) and this one was really fun, and definitely the most public health-related board game I've ever played.

One of the neatest characteristics of this game is that it's cooperative. Although everyone is a unique professional with different skills, they all work together to try to contain four different diseases that are quickly spreading across the globe. You win if you find the cures for the four diseases before too many outbreaks occur or you run out of cards to draw. Unfortunately last night we were not able to beat the spread of the diseases and ended up losing, but I'm looking forward to playing it again soon! Hopefully our loss doesn't reflect my real-life public health skills!

Anyway, I could talk about board games forever, but here are some articles I read recently that you may also find interesting:

Cancer is just as deadly as it was 50 years ago. Here's why that's about to change. - Charlie Jane Anders, io9


Child abuse experts call for U.S. campaign - Frederik Joelving, Rueters

Researchers say malaria deaths are twice the official count - Richard Knox, NPR

New Semester, New Building!

My last semester has started, and one of the most exciting things about it is that the College of Public Health is officially in the new building! The building is awesome - very beautiful with lots of natural light. It's great to have a building of our own. I think having all the different departments closer together will help with College unity as well. There are already a lot of fun events lined up that will take place in the building, including a cultural potluck on Wednesday and showing Contagion this Thursday.

I'm taking two classes this semester, in addition to doing my practicum and working. I'm really excited for both of my classes: Maternal, Child and Family Health and Health Communication Campaigns. I'm interesting in both of these classes and my practicum is already in full swing, so it should be an interesting and fun semester!

Goodbye 2011!

It's hard to believe that 2011 is almost over. 2011 was a very good year for me, although I'm looking forward to 2012. 2012 is both exciting and kind of scary to me, since it will be a major transition year. I'll be getting my MPH in the spring and (hopefully!) starting a new job in public health.

I hope that you had a good 2011 and are excited about 2012 as well. Before I head off, here is a great little video about one of the best things you can do for your health.

Have a happy and safe new year!

The Way We Get By

Even though it's finals week, I still find time to take an occasional break. Recently, I watched The Way We Get By, a 2009 documentary about three troop greeters in Bangor, Maine. (I'm a big fan of documentaries and have Netflix, which is a little dangerous because there are so many great documentaries, like this one, on there.)

This was an incredible documentary, although be prepared to cry about eight separate times if you watch it. The documentary provides a window into the lives of three elderly people who multiple times a week, often in the middle of the night, go to the Bangor International Airport to greet US troops either going to or returning from Iraq or Afghanistan. Although these three people greet the troops for a variety of reasons, one profound reason is that it helps create a sense of meaning and purposefulness for their lives.

I couldn't help viewing this film from a public health prospective. What I mean by that is that since this film documents the lives of three elderly people, it illustrates some unique issues that affect them. Each have their own health problems, including some more serious conditions like severe depression and heart problems, and cancer. I thought about the Health Communication class I took last summer (especially the lecture about health literacy) as I watched one of the main characters try to describe the treatment he receives for his prostate cancer or as another main character explained the pills she takes daily. In addition to health problems, one of the main characters also had a substantial amount of debt and struggled with loneliness and isolation. It definitely provides some perspective on many of the struggles elderly people face today.

Food deserts

I recently did a group presentation on Food Deserts for my Environmental Health class. According to the CDC, food deserts are "areas that lack access to affordable fruits, vegetables, whole grains, low-fat milk, and other foods that make up the full range of a healthy diet." One thing we learned while researching food deserts is that there's even one in Iowa City. There's a great online tool available that was developed by the USDA that allows you to search by address and see if there's a food desert in your area. The food desert in Iowa City included the very place where we were giving our presentation (which was in the University of Iowa medical school building, part of the health sciences campus).

Even though I had known some about food deserts before this presentation, this USDA report to Congress about food deserts was very interesting and had a lot I didn't know before. One of their major findings was that access to food actually isn't an issue for the majority of people - the bigger issues may be easy access to unhealthy foods and the cost of food. They also outline a lot of neat potential solutions to food access issues, including community food projects, and some of the major gaps in the research.

Anyway, next week is the last week of classes and I have two big papers due on the same day and then two big tests on the same day (it seems like it always works out like that, doesn't it?), so I should probably get back to work!

Here are some articles I thought were interesting:

Emergency Room Closures Hit Minorities, Poor Hardest - Kristopher Husted, NPR
Depressing.

Xeni Jardin Live-Tweets Her First Mammogram, Is Diagnosed With Breast Cancer - Dodai Stewart, Jezebel
I've been reading BoingBoing for years - a blog that Xeni Jardin helped found - so when I read this, it almost felt like it had happened to someone I know. I thought this article had some good points about the fact that she live-tweeted her experience getting her first mammogram and her results is a "sign of How We Live Now." Stewart also notes that "Jardin's decision to update her followers as she went for her breast exam highlights a positive aspect of public sharing: The ability to reach out of a community, and have that community embrace you, in turn."

Scooby-Doo and Secular Humanism - Chris Sims, Comics Alliance
This has nothing to do with public health, I just thought it was a really good read. My partner Tim, who is a major Scooby-Doo fan, showed it to me, because I am not a big fan of the show (I've just always found out pretty boring and formulaic.) This article does make a compelling case for why Scooby-Doo is awesome. As a person who values rationalism, I was somewhat moved (although I still don't have an urge to watch Scooby-Doo).

Pizza is a Vegetable: Another Example of Corporate Influence on US Politics

You've probably already heard that Congress reclassified the tomato sauce on pizza as a vegetable for school lunches. The phrase "pizza is a vegetable" has even already become an internet meme.

In case you don't know what I'm talking about: basically, Congress blocked proposed changes by the USDA to make school lunches healthier.

As the New York Times reported, "Food companies including ConAgra, Coca-Cola, Del Monte Foods and makers of frozen pizza like Schwan argued that the proposed rules would raise the cost of meals and require food that many children would throw away... The companies called the Congressional response reasonable, adding that the Agriculture Department went too far in trying to improve nutrition in school lunches."

This is a perfect example of the control large companies have over our political system. These big food companies basically bought out Congress to not allow healthier changes to be made - "practical, science-based standards" supported by nutrition experts.

I read the politics section of reddit occasionally, and Tarkaan, a reddit user, wrote something I really agree with: "See, the reason this is offensive and that you should be outraged by it is because nutritionists and scientists guided public policy to improve health and nutrition in children. ConAgra came in and spent a bunch of money, and erased the work that science has done." Tarkaan relates this decision back to Occupy Wall Street and one of the major things the movement is about: protesting the corporate influence on our democratic process.

The Occupy movement has been getting a lot more attention lately, especially after the videos of the police officers pepper spraying UC Davis protesters went viral. Although the videos showing police brutality are disturbing and important, the Occupy movement is about much more than reforming our enforcement practices. Corporate influence and lobbying affect so much, including public health.

Back from DC!

I got back from the American Public Health Association conference yesterday, which was held in DC this year. The trip was really fun! I still can't get over how great it is that the MPH program and CBH department basically paid for the whole trip (airfare/travel, registration, and hotel); it's definitely pretty wonderful to get the opportunity to DC for free and be around public health leaders.

Like last year's conference (and most conferences in general, I think), some of the sessions were excellent while others were more so-so. I've found that it seems like most of the sessions are very focused on researching health problems, which, while obviously very important, can be a little frustrating if you're working in an implementation/practitioner capacity. It's always great to learn new things though, and it was fun hanging out with other MPH students and one of my coworkers. It was also nice to see DC again (I hadn't been there since I was in elementary school). One of the highlights of the trip was going to Sprinkles, a cupcake shop that has ridiculously good cupcakes! It was also kind of cool to see Occupy DC (which was set up very close to my hotel).

One of the most amusing things at the conference - an exhibit had ties for sale with disease patterns.

Here are some articles I've read recently that I've thought were interesting:

Native Foster Care: Lost Children, Shatter Families - Laura Sullivan and Amy Walters (NPR)
Absolutely heartbreaking story about how Native American children are disproportionately taken from their homes and put into foster care.

Her Name is Jahessye Shockley. - Francie Latour (The Hyphenated Life) 
A sad and well-written article about how missing white children get way more media attention (and donations) than missing children of color.

The Birth Control Solution - Nicholas D. Kristof (NYT Op-ed)
A simple case for increased birth control. It's hard to argue with this logic, even if you are pro-life.

What's Luck Got To Do With It? - Jim Collins and Morten T. Hansen (NYT essay)
An interesting article on luck and "return on luck."

Informed Patient: A New Push to Prevent Infections in Cancer Patients - WSJ Health Blog 
About the CDC's new campaign and website.

Mammogram's Role of Savior is Tested - Tara Parker-Pope (NYT Well)
Interesting article about mammograms. It seems that recently there's been more discussion on the potential downsides of various cancer screening tests. Even though this article was interesting, I have to say I'm still a big supporter of mammography - it still has been proven to save lives.

Fat Talk Free Week!

This week is Fat Talk Free Week. This article in the Huffington Post really captures what the week is all about. Dr. Rosenberg describes "fat talk" as "comments like 'I feel so fat in these clothes,' or 'do I look fat?' It can also be saying to someone else, 'You look great, did you lose weight?' This implies that lost weight is the metric of looking good."

I know I used to make self-depreciating comments in high school and early in college - it's just such a part of our culture and I think in many circles it's an expected way for women to talk. Starting in college, I began to stop saying things like that, because I started to realize that making those comments isn't just dissing yourself - it sends a message to others as well. I can't count the number of times friends of mine (many of whom are much smaller than me) have commented negatively on some aspect of their body ("My arms are so gross," "I feel like a cow"), and I've thought - what does that say about my body and how it looks? Obviously, their intention is just to remark on their own body/express their opinions about themselves - not to insult anyone else, but I think people often forget that their negative comments send a message to others about what's acceptable and what's not acceptable in terms of body size.

Here are some articles I've read this week that you might find interesting:

Interview: James Hansen on the Tar Sands Pipeline protest, the Obama administration, and intergenerational justice - Jerry Cope, Huffington Post
I've become really interested in the Tar Sands pipeline - which, if you don't know about it, is basically a proposed project to have a large oil pipeline go through the United States to link crude oil from Canada to refineries in Illinois, Oklahoma and the Gulf Coast. Leading climate scientists like James Hansen (a UI grad and Iowa native who heads the NASA Goddard Institute) and environmentalists (such as Bill McKibben) have said this pipeline would be "game over" for the environment and have gotten arrested for protesting it. I really hope Obama rejects the proposal.


Pedestrians on streets designed for cars - Lisa Wade, Sociological Images
Features some great examples of problems in the built environment

Men with disabilities face increased risk of sexual violence - Whitney Blair Wyckoff, NPR

Can the 14th amendment defend itself? - Linda Kerber, CNN Opinion
I just saw Linda Kerber speak this morning at the law school and it was very interesting (my friend who attends law school told me about the lecture and invited me to come with her). Ms. Kerber talks a lot about the importance of historical context in understanding the constitution. The 14th amendment is not something I had thought a lot about, but I think her take on why it is important in terms of immigration is fascinating.

Film Underscores Koreans' Growing Anger Over Sex Crimes - Choe Sang-Hun, NYT
A recent South Korean film about the sexual assaults of a number of deaf students in a school and the lax punishments the perpetrators got has "tapped into the widespread anger of official reluctance to take sex crimes seriously, and over how justice is served." Nearly a 10th of the country's population has seen the film.

Early Detection

My friends joke that all I do is talk about cancer, and here I am - talking about cancer again. But big things have just happened in the cancer world! The United States Preventive Services Task Force (USPSTF) recently decided to not recommend using the P.S.A. test on healthy men to screen for prostate cancer. This decision came after the USPSTF reviewed five clinical trials that showed that the P.S.A. test often results in tests that cause needless complications and that it does not lower mortality. This is a controversial decision for some, especially since there are many men who believe the P.S.A. test saved their life and there are a number of groups who advocate for increased use of the P.S.A. test.

I think this article, the Shortfalls of Early Cancer Detection, brings up some very interesting points, in light of this new decision. Harris states that "scientists had found cancer cells in the blood of patients with seemingly tiny, localized cancers, suggesting that cancer cells could spread silently early in the course of disease. In that case, so-called early detection might not really be early, or of much value. Researchers coined the term 'biological predeterminism' to underscore how the cellular makeup of a given cancer — rather than when it was found — was most important in determining survival." (emphasis mine).

Early detection is a central part of cancer control, and I think it should continue be, especially for the cancers we have effective and proven-beneficial screening tests for (breast, cervical, and colorectal). With these three caners, early detection does make an impact on mortality, and increasing the use of the evidence-based screening tests is an important way to control cancer. But I think Harris makes a good point that maybe for some cancers, finding it early doesn't lead to decreased mortality, and that needs to be taken into account when considering which best course of action to take in terms of research. Although I think for some cancers, like lung especially, the development of an effective screening test would be very beneficial and could lower mortality, maybe there are other cancers where finding it early wouldn't necessarily lower mortality. Maybe for those cancers, a different route needs to be taken, like developing alternative treatments that are more effective.

Anyway, enough about cancer. I'm looking forward to this weekend. I'll be going to see the Old Capitol City Roller Girls play their last bout of the season, the Monster's Brawl. The Roller Girls and some people attending will be wearing costumes, so that should be fun!

Here are some other articles I've read recently that you might be interested in:

Domestic Violence Law Repealed by Lawmakers in Topeka, Kansas - John Hanna, Huffington Post
Pretty upsetting.

Sexy Breast Cancer Ads: Provocative or Patronizing? - Kate Dailey, Daily Beast
I am not a big fan of sexy breast cancer ads and I think Dailey does a nice job of summing up some reasons why - the main one being that it can detract people from the fact that breast cancer affects real people, and the reason we should care isn't to "save second base," but rather to save people.

First Lady Targets World Record for Jumping Jacks - AP
Gotta love Michelle Obama. I think this is pretty fun.

The Mammotives Project Begins!

--------------------------------------

The Iowa Cancer Summit just launched their social media campaign project, which is funded by the American Cancer Society, to help understand why women decide to get - or not get - screened for breast cancer. The project is call Mammotives. In addition to Mammotives.org, Mammotives is on Facebook and Twitter. All Iowa women, ages 40+, are welcome to join the conversation. Please spread the word too! We want to reach as many Iowa women age 40 and older as possible. For more information about the project in general, click here.   


I'm really excited for this project, which has been planned by my coworker Kelly Sittig, fellow MPH student Megan Lessard, and people at the American Cancer Society, along with other partners at the Iowa Department of Public Health and the Care For Yourself Program. Although I haven't been very involved in this project, my one claim to fame is that I helped come up with the name! Full disclosure: this awesome website, Wordriod, helped. Wordriod creates a bunch of natural-sounding new words based on what you type in and checks to see if they already exist on the internet. It's really fun!

Iowa Cancer Summit

The Iowa Cancer Summit was Monday and yesterday, and fortunately I was able to go yesterday. The Summit is an annual statewide event that brings together over 100 people involved in cancer control practices. A major theme at this year's Summit was the unveiling of the newly revised Iowa Cancer Plan, which is available to download online here. The plan is meant to guide cancer control practices across the state for the next 6 years and is separated into four major sections: Prevention, Screening, Treatment, and Quality of Life.

The keynote speaker this year was Dr. Laura Seeff, the Comprehensive Cancer Control Branch Chief for the CDC. Her talk was great; one of the take home messages was about the importance of policy and systems-level change, and that we should be sure to include efforts to change those instead of focusing only (or even primarily) on individuals. She also talked about the importance of working together with other chronic disease control efforts and groups dedicated to improving health in other ways to make sure we aren't all duplicating efforts and not being as effective as we could otherwise be.

One of my favorite parts of the Summit, however, was the Cancer Survivors Panel breakout session. Three cancer survivors spoke on the panel about their experiences. The speakers were Gail Orcutt, a radon-induced lung cancer survivor who is a tireless radon advocate and simply a wonderful person; Greg Cantwell, a stage 4 brain cancer survivor; and Gabbi DeWitt, whose mom passed away from cancer this spring. (The ICC, like the National Coalition for Cancer Survivorship, defines cancer survivors as those who have been diagnosed with cancer, those who are affected by a loved one's cancer, and caregivers). One major theme of their stories was the importance of having care coordinated. As a cancer patient, you see many different specialists, and sometimes they do not communicate with each other, meaning that major problems/complications can be overlooked and it can be very confusing. I was especially thankful for Gabbi's insights into the benefits of hospice. I think many times the focus in cancer treatment is how survivors are going to win their battle with cancer, but sometimes that is not possible, and that can be very difficult for people to accept or even want to talk about. Gabbi, who works in hospice herself, said that her mom was able to be on hospice care for 11 weeks before she passed, and that those 11 weeks were wonderful and "like a breathe of fresh air." Her mom was able to stay at home and spend time with her friends and family. For more information about hospice, here's a fact sheet from the National Cancer Institute.

This was the second Cancer Summit I've been able to go to, and it's always great to see so many great people dedicated to fighting cancer.
 
Anyway, before I got, here are some articles I've read this past week that you might find interesting:

Study Cites Increase in Throat Cancers from HPV - Denise Grady, NYT
Further support for the importance of the HPV vaccine and for the importance of vaccinating boys.


Hormonal Contraceptives May Raise HIV Risk for Men and Women - Scott Hensley, NPR Health Blog


Top 5 Unnecessary Health-care Costs - Jonathan D. Rockoff, WSJ Health Blog
"Doctors’ prescribing a brand-name statin, without first  checking to see if a lower-priced generic drug would cut a patient’s cholesterol sufficiently, results in $5.8 billion in excess health-care spending, according to the research letter published Oct. 1."


Should a Candidate's Weight be Part of the Conversation? - Katherine Hobson, WSJ Health Blog
My opinion to this question is a definite no.

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!