The Built Environment, Environmental Justice and Ferguson/Mike Brown Case

December 10, 2014 by

A few weeks have passed since a jury decided that there should be no indictment of Darren Wilson, the cop who repeatedly shot and killed Mike Brown, a teen in Ferguson Missouri. Following the decision, I found myself explaining the term and real phenomena of environmental justice to my colleagues. After which I went to a class, which focused on the built environment.

These three events that seem so unrelated actually have a lot of overlap and point to a real structural problem in this country. For better understanding I will begin by explaining a few terms.

Environmental Justice is a movement that began in the 1980’s when a predominately black community protested the siting of a PCB(very harmful chemical) landfill in their community. The field evolved as Robert Bullard conducted research noting that most of the landfills (very harmful, toxic places) in the United States were located in primarily black communities. Environmental Justice is defined as the fair treatment and meaningful involvement for all people with regards to planning and polices related to the environment. The goal is to ensure that people live in environments that they feel are safe, nurturing, and productive.

However, environmental injustice, exist in many places in this country. In a community or city with environmental injustice a specific population like poor people or people of color may have an overwhelming burden to environmental pollutants like chemicals in the air water and soil. They may not have access to healthy food. They may not have access to health care and may have features of the community environment which make it unsafe. This compiled burden makes the situation unjust because other communities like predominately white communities may not have this same problem.

From the environmental justice movement came the term the “built environment.” The built environment refers to anything that is man-made– so the buildings we live in, parks in our neighborhoods, the way we design cities, transportation, the types of stores we have in our community, where sidewalks are located and so much more. In poorer and minority communities the built environment is not always conducive for healthy living. Much of this problem, research has shown, is structural, which means that a certain population has been oppressed to the point that it becomes difficult to get out of this hole.

Alongside this burden is administrative oppression, this is where Ferguson comes in. Ferguson is a  primarily black community with primarily white cops—somewhat misplaced representation between the people who “protect” and the civilian population. This is a problem, one which is linked with an unjust environment and with a unconducive built environment.

As a public health professional I hope to bring awareness and change to the barriers that significantly affect specific groups of people. That is what public health is about—helping people have healthier, happier lives, which are not ended by others who suffer no consequence!

#JusticeforMikeBrown #JusticeforALL #PublicHealth #BlackLivesMatter

#Turning a National Negative Into a Personal Positive

University of Michigan students protest against police gun violence

University of Michigan students protest against police gun violence

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University of Michigan Students Stand Against Police Violence

University of Michigan Students Stand Against Police Violence

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University of Michigan Students participate in Die In

“Hello, World!”

December 8, 2014 by

Hi guys! I’m Anita, a first year Master’s student in the Biostatistics program. I completed my Bachelor’s in Statistics-Mathematics at Rutgers University this past May and came straight here! (Personally, I’m really glad I didn’t take a break after undergrad – it definitely works for some people, but not me – I’d get distracted!) I can’t believe my first semester is almost over. It really does feel like I got here yesterday. And it certainly doesn’t feel like I have to start studying for finals (!!!) soon…

Speaking of school, it’s going well. Classes are challenging, but in a refreshing sort of way and not too much more so than I expected. I honestly feel like I’ve learned more in this first semester than I did during my entire undergraduate career (sorry RU!). There are also lots of schmantastic things about SPH that I love, like some really great places to study in natural light, the Reflection Room for anyone who wants a quiet place to meditate/pray, and the Biostat-kids-only computer lab. I’m sure all three will come in handy during FINALS (!!!!!!!) next week!

But let’s ignore finals for now… I’m super excited to be blogging for SPH! There’s just so much excitement in talking about oneself ;D Already I foresee myself blogging about my mess of hobbies (which includes extreme crafting, my love affair with yoga, marathoning Avatar, crying over the Starks and cooking unnecessarily extravagant meals for myself while dancing), and how I’m trying to balance everything with a full course load, a GSI position, applying for internships and oh yeah, sleep.

Even though I can’t wait to go home to New Jersey for winter break, I think I really do have a big crush on Ann Arbor. It’s a great, energetic city with so many fun, quirky stores that I love (has anyone been to the Robot Repair Store??). Plus, there are so many amazing restaurants, and that makes me happy. I live near Kerrytown, which is close to Central Campus and is less than a 15-minute walk from SPH. There’s also a great Farmer’s Market down the road every Wednesday and Saturday, although I think they’ve stopped doing that now that the weather is so cold. Regardless, I LOVE, LOVE, LOVE our little corner of property. I give it an A+++, highly recommend, would live here again (and I plan to!). Mostly because food, and also I don’t want to move again so soon in general. (But also because it’s awesome.)

Welp, that’s it for now! GOOD LUCK to everyone who is currently studying for exams, writing papers and finishing up final projects! I’ll be sending good vibes and best wishes your way :)

It’s Already December?!

December 4, 2014 by

aparnaCan’t believe that it’s been three months since I started my MPH journey….and can’t believe that I’m almost a quarter of the way through! It’s amazing how time goes by so quickly…

I’ve been away from the blogging world for a bit…it’s been a whirlwind of classes, exams, illness, and of course figuring out The Internship.

Michigan’s internship requirement is one of the reasons that I decided to study International Health Epidemiology. The 16 other students in my cohort and I will be traveling all over the world next summer for our required 10-12 weeks, immersing ourselves in data, data, and more data. Still finalizing the details on my own internship, but it’s been really exciting to hear about all my friends’ plans! It’s going to be a summer of adventure for sure, and I’ll most likely be in India! It’ll have been 6 years since I’ve been back to India and I’m pretty nervous – I’ve never spent time (outside of 2 weeks to volunteer) doing anything besides hanging out with my family there…I haven’t even seen the Taj Mahal yet! Nor have I ever stayed anywhere for more than 7 weeks….so I feel as though it’ll be an exciting journey.

I’ll be back post finals, but if you have any questions at all about Epidemiology, or International Health specifically, feel free to reach out!! Otherwise your thoughts may end up something like this….

epid blog  Source here

Happy Finals Season…err, Happy Holidays? :)

Skittles and toxic chemicals

November 26, 2014 by

charles-zhouBefore you draw any conclusions based on the title, no, there isn’t anything that harmful in Skittles (unless you consider the fact that eating a pack a day may lead to diabetes).

I really like Skittles. Picking a favorite flavor is almost like picking a favorite child, as the saying goes. I don’t remember much else from kindergarten besides showing up to class on time and being rewarded with Skittles.

Unfortunately, Wrigley (the gum company that makes Skittles) decided to change green Skittles from lime to green apple last year. I just bought Skittles for the first time since the change and I’m not impressed.

Now, put yourself in my shoes and pretend you really don’t like apple-flavored candy. Imagine buying three packs of Skittles from the supermarket checkout lane, opening them up, and seeing all green apple Skittles (or whatever flavor you like the least) except for one. You would be mortified and probably writing the Wrigley Company or calling their customer service line.

The scary thing is that a situation like this exists in the United States, and it’s a lot worse than 3 bags of green apple Skittles. Our main toxic chemicals regulation, the Toxic Substances Control Act of 1976, or TSCA (pronounced “tosca” like the opera), is extremely weak and in most cases, simply ignored. Out of the approximately 85,000 chemicals available on the market and used in the United States, we only have good information on about 500 of them. One in 170. That’s one Skittle you like and would be willing to eat, and 169 green apples.

There is the equivalent of about 9 bags (2.17 oz) of Skittles in this bowl, meaning you can eat 3 of them.

There is the equivalent of about nine 2.17 oz bags of Skittles in this bowl, meaning you can eat 3 of them.

This is not to say that the chemicals we don’t know about are all bad. Chemistry has made the conveniences of modern life possible and society has benefitted immensely from the 85,000 chemicals that it uses. Many are probably harmless, and many employers protect their workers from exposure to potentially dangerous ones. Despite this, it is unsettling to know that there are 84,500 chemicals that we know virtually nothing about with respect to health effects. And while many are harmless, there are also quite a few that are probably pretty nasty and can cause some serious damage. We should appreciate the green apples, at least a little, but by no means should we accept a bowl full of them.

Think about it. We don’t have adequate information on 99.4% of the chemicals we use. If you’d be willing to contact the makers of Skittles about something so egregious, it’s time we started putting pressure on Congress to reform TSCA and demand its enforcement.

And Wrigley, please stop making me buy a special pack of Skittles just for the lime ones.

Also published on my personal blog—you can check it out here.

Vaccines: Calling the Shots

November 24, 2014 by

One of my favorite aspects of being an SPH student is my expanded knowledge of interesting goings on at the University. It can be hard to decide which ones to make time for, but when I got the email about the screening of this NOVA episode, I knew I had to go.  I have been fascinated by the phenomenon of parents forgoing child vaccinations in the developed world ever since I watched the Frontline documentary called The Vaccine War.

The screening of the NOVA episode  “Vaccines: Calling the Shots” took place on Sept 26th. Professor Zikmund-Fisher who is in the Health Behavior and Health Education department , Dr. Andrew Maynard from the Risk Science Center, and Assistant Professor Sonya Dal Cin of Communication Studies in the College of Literature, Arts and Sciences were there to lead discussion at the end of the episode screening. Professor Zikmund-Fisher is actually featured in the episode and  collaborated with the director of the episode, Sonya Pemberton.

This episode attempts to take a middle of the road approach. By that I mean, “The Vaccine War” shows two extreme camps in the vaccine discussion- those who adamantly support vaccines and an exact immunization schedule, and those who do not believe in vaccinations at all- while Vaccines Calling the Shots presents parents who are  confused on the topic, and  more nuanced look at the topic. It is also highly informational- it discusses the science of how vaccines work, the history of vaccines themselves, as well as the creation of the Polio vaccine. There are a lot of firsthand accounts by parents whose children have been negatively effected by diseases that were once thought to be eliminated by vaccinations, and a firsthand account of doctors caring for those patients. Interestingly, there was also an account of two different parents and one (grown) child who discussed negative impact of vaccines on their lives. This is what made the episode fairly neutral- its portrayal of the good and the bad.  After the episode the instructors led a very engaging discussion of our thoughts surrounding the episode. We  discussed the humanization of the doctors’ first hand accounts through their expressions of frustration and sadness at the sickness of young un-vaccinated children with highly preventable diseases. We discussed the portrayal of parents as well. The thing that has stuck with me from our discussion is that, on a spectrum, most parents views on vaccination fall in the middle category on the spectrum of- “I will vaccinate my child and I know exactly why I will vaccinate them”  to “I will not vaccinate my child because I feel I understand them and I am not willing to do that” . These parents in the middle tend to be those who are most influenced by others and need to be reached by  this NOVA episode. In our conversation with them  we have to acknowledge that they have concerns, that being a parent can mean making scary decisions, but if they are given good information and fully educated, they will make the healthy decision for their child. I think this episode accomplishes exactly what it set out to do. You can watch the full episode here.

Health insurance and information costs

November 22, 2014 by

tanya

When I first moved to the U.S. for work, I had to initially buy my own health insurance. I started to do research, call insurance companies, and ask co-workers to try to choose the best fit for me. I found a plan that, in my view, balanced costs and quality with accessible premiums and coinsurance rates. When I went to the doctor for the first time and got the bill, I thought someone had made a mistake. It seemed like I didn’t have health coverage at all because I was responsible for most of the costs. After I called my insurance company and inquired for details, I learned the bills didn’t met the deductible because I had a high-deductible health plan. I asked why the doctor didn’t warn me those expensive tests would probably be covered by me? the insurance agent replied, “It is your responsibility to know…”

unexpected bill

I remembered that funny story twice this semester. First, in my Health Services System class while we were discussing about health insurance marketplaces/exchanges under the Affordable Care Act (ACA). The marketplaces are online platforms where individuals and employees of small firms can purchase private insurance plans. There are four tiers of qualifying health plans with different actuarial values: Bronze, Silver, Gold, and Platinum that range from lower premiums with higher deductibles and less benefits, to more expensive plans with higher quality. It is certainly not the same as shopping for holiday gifts online…

online-holiday-shopping

But, it is definitely more practical than what I did when I was buying my own health insurance. Instead of consulting multiple sources, consumers can have all the information centralized in their state marketplace. Complete information is crucial and, therefore, the role of state navigators will be important to help people know exactly which services will be covered or paid out of their pockets.

Also, during one of my Health Economics classes I learned about the so-called “consumer-driven health plans”(CDHPs), that combine high-deductible health insurance with a tax-advantaged account. Employers started to offer CDHPs in 2001, and by 2012 the plans represented about 15% of the privately insured market (EBRI survey, 2013). One of the main goals of CDHPs is to reduce health care costs by requiring consumers to take charge of their health care decisions, e.g. controlling the demand, not the supply of care. The survey did not find clear evidence about individuals becoming more cost conscious after enrolling in CDHPs; however, some studies have estimated that enrollees in CDHPs spend approximately 5-7% less than enrollees in traditional health plans. Again, asymmetry of information is an important factor to take into account when implementing these plans, so that people avoid having to pay for unexpected medical bills and do not delay needed care!

Behind Virus: Social Factors that Makes Ebola Treating More Challenging

November 20, 2014 by

I remember at the first class of Introduction to Public Health class, Dr. Scott invited Dr. Gilsdorf from medical school to give us a lecture about current spot topic: Ebola. Before attending the lecture, I prepared several questions to ask Dr. Gilsdorf and one of them is since American government can take infectious American doctors back to States and successfully cure him at Emory University, why can’t we share success tips with African people or take some badly ill patients to Emory? Due to limited lecture time, I didn’t get the chance to ask those question and that bothers me a lot. I even feel disappointed and a little bit of anger because this is one typical health care disparity and inequality. However, after went to the “Ebola and Public Health” panel discussion last Thursday, I have to admit that my original views are too naïve to consider all possible of other factors that limit Ebola treating.

One of the most essential factor is based on the economic status of most Ebola affected countries: Guinea, Sierra Leone and Liberia. Dr. Snow from population studies center presented us the average health care cost per capital before Ebola break in these countries, which ranges from $67 to $171, compared to $ 8233 in the United States. They have way higher maternal death and premature death also. Both data indicates these three countries do not have advanced health system; the health of women and children cannot be well protected especially. Unfortunately, as we all know, women and children are the most risky population to get Ebola since they have weaker immunity system and children are easily get infected by their mothers.

Then the other speaker guide us to do a math about the amount of money cost to treat a single Ebola patient. Ebola patient must be isolated so he/she will need his/her own area and one single lab to run possible infectious sample for him/her. The patient will need 2 to 3 24/7 health care providers to monitor and record data, at least 2 lab analysts, and more doctors and research team members. Hospital might have to vacate the floor for this Ebola patients since normal people are too afraid to share the same floor with him/her, which decrease hospital’s income. Adding all possible costs, it is estimated that treating a single Ebola patient with Ebola costs roughly $500,000 in total and around $14,000 per day for two weeks. For now, only 50% hospitals in the States have the equipment and personal to admit no more than 1 Ebola patient, in worst case scenario.

Based on these two points I just mentioned, it is not hard to understand why it is almost impossible to cure Ebola in those three countries currently due to their economic status.

Moreover, urbanization of Guinea, Sierra Leone and Liberia highly increase the interpersonal contact rate, which is another reason why this Ebola break have impacted huge amount of people. Unfortunately, this social change cannot be modified in very short amount of time and it becomes another obstacle of Ebola treating. Other factors including trust issues to health care providers sent from the States, their beliefs to Voodoo curing (normally needs to draw blood from sick people), their limited epidemiology knowledge and cultural habits of inhumation as well as high adaptation of Ebola virus all make Ebola treating more challenging.

Introduction: where I’m from, where I am, and where I’m going

November 12, 2014 by

amy Hello! My name is Amy and I’m a second-year biostatistics M.S. student here at the University of Michigan School of Public Health. I’m going to be blogging about my shenanigans as a student and relatively new resident in the Mitten State.

As I thought about ways to introduce myself to prospective students, prospective Ann Arbor residents, or any other randoms who happen to stop by on the interweb (hi!), I realized that my experiences, both academic and otherwise, can be summarized three ways:

1. Where I’m from: I was born and raised in the Bay Area. I received my bachelor’s in statistics with a minor in demography from UC Berkeley. I’ll admit that at times (read: when it’s -30 degrees), I hella miss California, but after living here a full year I could see how one would miss the seasons, to some degree (pun so intended).

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Amazingly colorful trees during the fall-to-winter transition last year on my way to school through North Campus

Actually, I’m convinced that since last winter was my first winter, my obliviousness to how weather really works helped me cope better than native Michiganders with the polar vortexes <- that’s what it’s always like, right?

winter_ecard2

2. Where I am: Namely, why U of M? I picked U of M because I felt the need after going to college 10 minutes away from my home to spend some time out of state, and because it was the most reputable biostatistics program to which I was admitted. After undergrad I felt comfortable with, and also almost an allegiance to large public research institutions, and Michigan is most assuredly a big school with all the big school activities:

It’s certainly possible to get “lost in the crowd,” and I get that that may be intimidating, but one learns to navigate the bureaucracy and join organizations or social groups in which you can make yourself heard. I myself love that there are so many people to meet!

3. Where I’m going: I don’t know! The nice thing about biostatistics is that job options are wide open. Secret: I feel that this field of study was the most decisive way I could make a non-decision. Meaning, one could work in a hospital, pharmaceutical company, government agency, consulting firm, tech start-up, or in truth at any organization with data.

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The challenge for me is doing the whole applying thang.

Hopefully I’ll have good news to report come spring 2015. Until then, I’ll fill you all in on my (mis)adventures in the charmed grad school life, so stay tuned!

Mom! I’m in Michigan!

November 5, 2014 by

Hello All,

I am Elise Tolbert. I received my bachelors degree from Tuskegee University in Environmental Sciences and I am currently a second year Environmental Quality and Health student at University of Michigan’s School of Public Health.

I am so excited to share my Michigan experience with everyone!

Here is a little video introduction with more information to follow!!!

As mentioned, this is my second year yet I am still in disbelief that I am actually here. Each day is a reminder of how privileged of an experience this is. The faculty and staff are amazing and conduct some of the most prolific research in the world.

Below are a few links to interesting things going on in the School of Public Health.

1. Here is a short clip featuring the Environmental Health Sciences (EHS) department!!

In EHS we have world class professors who work diligently to ensure that students master specific skills necessary  to evaluate critical environmental health issues and solve the worlds most pressing environmental health problems.

2. Here are 5 things you need to know about Ebola presented by the School of Public Health’s Risk Science center.

The Ebola outbreak has many concerned about their risk for exposure. Unfortunately, there is an abundance of misinformation on the infection. This clip demystifies some of the rumors about Ebola.

3.Here , the dean of the School of Public Health, Martin Philbert, gives remarks on chronic disease.

Several weeks ago the School of Public Health hosted the Public Health Symposium honoring Noreen M. Clark, former dean of the School of Public Health. The symposium focused on “Confronting the Challenges of Chronic Disease.”

The clips above provide just a glimpse to the into the excellence that is the Michigan experience. The students and faculty here are experts in all areas of public health. Additionally, there is a friendly supportive academic atmosphere here in which peers and professors are happy to share information with each other. All this is and more explains why I can not believe that I am here and find myself repeatedly saying with pure joy, “Mom, I’m in Michigan!”

Surprise Trick & Healthy Treat

November 1, 2014 by

Originally posted on jessicayuewu:

Last night, halloween came with the first snow of this coming winter. Yesterday morning, during Biochemistry class and I was trying so hard to memorize every single detail of Calvin cycle, one student walked in with a 3D dinosaur mask on his head and I have to say, that is the coolest moment on this class so far.

Being a person who is so into Halloween, I decided to give some creativity for this year’s treats. Though buying bags of candies with discounts will save a lot of time and money for me, I just assumed kids from neighborhoods might be tired to get the exactly same candies from every house, every year and will appreciate some thing new. Meanwhile, for the honor of being a Nutritional Science student, I feel I have the responsibility to try out some real desserts. After a short discussion with my friends, we decided…

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