HPHR Editorial: Racism Is a Public Health Problem

HPHR Journal ◽  
2014 ◽  
Vol 2014 (3) ◽  
Author(s):  

The killings of Rumain Brisbon, Tamir Rice, Akai Gurley, Dante Parker, Michael Brown, Eric Garner, and many other Black Americans, have brought global attention to racial inequities involving police brutality in the United States. The subsequent non-indictments resulting from the grand juries in Ferguson and Staten Island as well as the bombing outside a NAACP chapter in Colorado have left many Americans outraged. The Editorial Board of the Harvard Public Health Review recognizes that racism has driven health inequities among historically underserved and marginalized populations nationwide, evidenced not only in the extraordinarily disparate rate at which Blacks are killed at the hands of the police compared to Whites, but also through inequities in environmental exposures, limitations in access to health care, and other factors that affect optimal health and well-being. Indeed, Eric Garner died after a police officer violently compressed his neck and chest. This officer’s actions severely limited his ability to breathe, which already had been compromised by asthma, obesity, and hypertensive cardiovascular disease—diseases that occur at substantially higher rates among Blacks than Whites. As the Institute of Medicine (IOM) has noted, the role of racism in undermining Black health is undeniable.

2013 ◽  
Vol 41 (S1) ◽  
pp. 42-45 ◽  
Author(s):  
Andrea M. Garcia

According to the Institute of Medicine, chronic pain affects at least 116 million adults in the United States (U.S.), which is more than the total affected by heart disease, cancer, and diabetes combined. Pain costs the nation up to $635 billion each year in medical treatment and lost productivity. It has been conceptualized as a public health problem due to its prevalence, seriousness, disparities, vulnerable populations, the utility of population health strategies, and the importance of prevention at both the population and individual levels. For many patients, treatment of pain is inadequate due to uncertain diagnoses, societal stigma, the lack of effective treatments, and inadequate patient and clinician knowledge about the best ways to manage pain. This article explores the inadequate treatment of pain in the U.S. and the subsequent rise of prescription painkiller abuse, misuse, and overdoses. This is followed by a review of the actions taken by states to regulate the prescribing of controlled substances.


2020 ◽  
pp. 073401682095770
Author(s):  
Kate Kelly ◽  
Nai Soto ◽  
Nadi Damond Wisseh ◽  
Shaina A. Clerget

Although often left out of public health efforts and policy decisions, prisons, jails, and detention centers are integral to community health. With an average of 650,000 citizens returning home from prison each year in the United States, and thousands of correctional staff members returning home every night, there are millions of touchpoints between outside communities and carceral settings. For this reason, carceral communities should be central to planning and policy making in response to the spread of the COVID-19 illness. As social workers and clinicians, we are urgently concerned that efforts to prevent COVID-19 infections in prisons are underdeveloped and inadequate in the face of a fast-spreading virus. In this commentary, we outline a set of public health, policy, and clinical recommendations based upon the existing literature to mitigate various risks to the well-being of carceral communities.


2021 ◽  

Distracted driving is defined in the Oxford English Dictionary as “the practice of driving a motor vehicle while engaged in another activity, typically one that involves the use of a mobile phone or other electronic device.” However, other distractions not involving the use of a cell phone or texting are important as well, contributing to this burgeoning public health problem in the United States. Examples include talking to other passengers, adjusting the radio or other controls in the car, and daydreaming. Distracted driving has been linked to increased risk of motor vehicle crashes (MVCs) in the United States, representing one of the most preventable leading causes of death for youth ages 16 to 24 years. Undoubtedly, the proliferation of cell phone, global positioning system (GPS), and other in-vehicle and personal electronic device use while driving has led to this rise in distracted driving prevalence. This behavior has impacted society—including individual and commercial drivers, passengers, pedestrians—in countless numbers of ways, ranging from increased MVCs and deaths to the enactment of new driving laws. In 2016, for example, 20 percent of all US pediatric deaths (nearly 4,000 children and adolescents) were due to fatal MVCs. It has been estimated that at any given time, more than 650,000 drivers are using cell phones or manipulating electronic devices while driving. In the United States, efforts are underway to reduce this driving behavior. In the past two decades, state and federal laws have specifically targeted cell phone use and texting while driving as priority areas for legal intervention. Distracted driving laws have become “strategies of choice” for tackling this public health problem, though their enforcement has emerged as a major challenge and varies by jurisdiction and location. Multimodal interventions using models such as the “three Es” framework—Enactment of a law, Education of the public about the law and safety practices, and Enforcement of the law—have become accepted practice or viewed as necessary steps to successfully change this behavior caused by distractions while driving. This Oxford Bibliographies review introduces these and other aspects (including psychological influences and road conditions) of distracted driving through a presentation of annotated resources from peer- and non-peer-reviewed literature. This selective review aims to provide policymakers, program implementers, and researchers with a reliable source of information on the past and current state of American laws, policies, and priorities for distracted driving.


Author(s):  
Thomas Simon ◽  
Kimberly Hurvitz

Violence, including child maltreatment, youth violence, intimate partner violence, and sexual violence, is a significant public health problem in the United States. A public health approach can help providers understand the health burden from violence, evaluate evidence for prevention strategies, and learn where to turn for information about planning and implementing prevention strategies for this preventable problem. For the past three decades, the U.S. Department of Health and Human Services has published “Healthy People” objectives for the next decade. The Healthy People 2020 initiative includes 13 measurable objectives related to violence prevention, one of which was selected as a Healthy People 2020 Leading Health Indicator. Progress to achieve these objectives can save thousands of lives, reduce the suffering of victims and their families, and decrease financial cost to the law enforcement and healthcare systems. The role that nurses can and do play in violence prevention is critical and extends beyond just caring for victims to also include preventing violence before it happens. This article summarizes the violence prevention objectives in Healthy People 2020 and the resources for prevention available to support nurses and others as they move prevention efforts forward in communities to stop violence before it starts.


Author(s):  
V. B. Zamkevich ◽  
M. D. Diachuk ◽  
T. S. Gruzieva

Introduction. The development of the public health system provides for the solution of the basic operational functions of public health, including surveillance and assessment of the state of health and well-being of the population, taking into account risks to public health.Given the importance of alcohol as a risk factor for the development of diseases, the study of its prevalence in the population, consumption patterns and health effects is an important public health problem. The aim of the study. To identify current trends in alcohol consumption and the associated risk factor for health damage in Ukraine and countries of the WHO European Region.Materials and methods. Bibliographic, medical, statistical and information-analytical methods were used in the study. The key  scientific base were the European Health for All Database, the Global Information System on Alcohol and Health (GISAH) and the European Information System on Alcohol and Health (EISAH). Results. Significant differences were found in the prevalence of alcohol consumption by population in different regions of the world per capita per year, up to 16 times, with the highest rates in the WHO ER. Ukraine is characterized by high levels of alcohol consumption (8.6 liters) and negative tendencies for their growth during 1991-2016 by 45.8%. At the same time, in Ukraine the consumption of strong alcoholic drinks predominates, while in the countries of the European Union - wine and beer. The increase in alcohol consumption in Ukraine and the prevalence of strong drinks in the structure of consumed products (51.5%) is an unfavorable prognostic indicator and requires the adoption of preventive measures. The negative consequences of alcohol consumption are the prevalence of alcohol dependence (2.2%), alcohol-related disorders (6%), a significant proportion of deaths (20.5%) due to this risk factor in the overall structure of all deaths, etc. Significant is the contribution of alcohol to the formation of indicators of road traffic injuries, including those with a fatal outcome, crime rates, etc. Conclusions. Surveillance of the prevalence of alcohol use, patterns of consumption and assessment of alcohol-related public health problems is an important basis for determining directions, justification and taking countermeasures.


Author(s):  
Butool Hisam ◽  
Mohammad Nadir Haider ◽  
Ghazala Saleem ◽  
Admin

We are observing with great concern the global spread of the COVID19 Pandemic. What is equally alarming is a less visible, albeit serious Public health issue; one that the United Nations has dubbed as the ‘Shadow Pandemic’ [1]. This is none other than the globally prevalent issue of violence against women, particularly Intimate Partner Violence. Intimate Partner Violence (IPV) is a serious, possibly preventable public health problem globally. Pakistan ranks among the countries with the highest IPV rates [2]. On 11th March 2020, the World Health Organization declared the highly infectious and lethal Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) to be a pandemic [3]. Drastic measures were enforced universally to curb the spread of COVID-19. Countries issued strict nationwide lockdowns to isolate the population and implemented social distancing. The economy was impacted tremendously, and many people experienced financial and emotional hardship during this mandatory confinement. While everyone was affected, one population was in a far worse situation than others. Survivors of IPV were trapped alongside their perpetrators and faced difficulty/less freedom to escape threatening situations compared to the past. It is not surprising given that historical periods of uncertainty such as war or economic crisis have resulted in increased interpersonal violence, including violence against women [4].  The Hubei province of China, the first region to undergo a lockdown, saw nearly a doubling of their rates of IPV with the start of COVID19 Pandemic.  Similarly, tragic stories gained nationwide coverage in the United States. IPV may also have risen in Pakistan, even if it is not being covered as extensively. During pandemics, fear causes us to minimize our personal needs and make sacrifices we would not normally make. This could be a reasonable approach for most but should not be for survivors of IPV. IPV survivors live in constant fear for themselves and their children; they are now devoid of their only means of mitigation; avoidance. Local woman’s support groups in Pakistan should act and spread awareness about this grim reality hiding underneath the Pandemic. Resources/funding should be made available for survivors to be able to reach out for support without having to leave the watchful eyes of their perpetrators. Public health officials ought to investigate and document the rise in IPV to help identify the leading causes of the increase. These steps will assist in developing crisis-specific guidelines to provide adequate resources for the future. Continuous....


2020 ◽  
Vol 110 (9) ◽  
pp. 1300-1303
Author(s):  
David R. Buys ◽  
Roger Rennekamp

Cooperative Extension (Extension), part of the land-grant university system, has been engaged in rural communities for more than a century. While the focus of Extension’s efforts has largely centered on agriculture, there is an important thread of work that has similarities to public health. As Extension settles into its second century, we are working to be even more engaged in efforts that improve the health and well-being of rural communities in particular. Extension faculty and staff are accomplishing this through direct-to-the-population education and through partnerships with more classically oriented public health organizations able to leverage Extension’s networks and positive reputation in communities to engage them and improve their health. A component of these partnerships includes Extension faculty and staff increasingly engaging in policy, systems, and environment work and other initiatives that help ensure longer-term, systemic changes more likely to improve health outcomes. In short, Extension clearly changed the agricultural system of the United States, and because of its reach into rural communities, it has the capacity to do for health in rural communities in this second century what it did for agriculture in the first century.


Author(s):  
Charley E. Willison

Homelessness is a public health problem. From rising housing costs to discriminatory lending and leasing, natural disasters, and mental illness, homelessness has many different causes and many similar effects: serious adverse consequences for physical and mental health across the life course. This chapter makes the case for homelessness as a public health problem, with chronic homelessness as scope of focus for this book. This chapter then introduces the main question of the book: If municipalities are the site of the U.S. homeless epidemic, what are municipal governments doing to address homelessness, and why? This chapter then outlines the role of governance structures in shaping municipal approaches to chronic homelessness, describes the governance system responsible for designing and delivering solutions to homelessness and chronic homelessness in the United States, and the history of homeless policy in America. Finally, this chapter lays the roadmap for the book and subsequent chapters.


2020 ◽  
Vol 41 (1) ◽  
pp. 347-361 ◽  
Author(s):  
Jonathan M. Samet ◽  
Thomas A. Burke

The quality of the environment is a major determinant of the health and well-being of a population. The role of scientific evidence is central in the network of laws addressing environmental pollution in the United States and has been critical in addressing the myriad sources of environmental pollution and the burden of disease attributable to environmental factors. We address the shift away from reasoned action and science to a reliance on belief and document the efforts to separate regulation from science and to remove science-based regulations and policies intended to protect public health. We outline the general steps for moving from research to policy, show how each has been undermined, offer specific examples, and point to resources that document the enormity of the current efforts to set aside scientific evidence.


Author(s):  
Eduardo Cazap

In the next few decades, breast cancer will become a leading global public health problem as it increases disproportionately in low- and middle-income countries. Disparities are clear when comparisons are made with rates in Europe and the United States, but they also exist between the countries of the region or even within the same country in Latin America. Large cities or urban areas have better access and resource availability than small towns or remote zones. This article presents the status of the disease across 12 years with data obtained through three studies performed in 2006, 2010, and 2013 and based on surveys, reviews of literature, patient organizations, and public databases. The first study provided a general picture of breast cancer control in the region (Latin America); the second compared expert perceptions with medical care standards; and the third was a review of literature and public databases together with surveys of breast cancer experts and patient organizations. We conclude that breast cancer is the most frequent cancer and kills more women than any other cancer; we also suggest that aging is the principal risk factor, which will drive the incidence to epidemic levels as a result of demographic transition in Latin America. The economic burden also is large and can be clearly observed: in countries that today allocate insufficient resources, women go undiagnosed or uncared for or receive treatment with suboptimal therapies, all of which results in high morbidity and the associated societal costs. The vast inequities in access to health care in countries translates into unequal results in outcomes. National cancer control plans are the fundamental building block to an organized governance, financing, and delivery of health care for breast cancer.


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