Category Archives: Health behaviors

Healthy Intersections Podcast: October 2023

By | February 17, 2024

This month’s topic focuses on suicide and social determinants of health (SDoH) Welcome to the Healthy Intersections podcast for October, 2023. Today’s podcast focuses on the links between suicide and social determinants of health in the United States. Suicide is one of the causes of deaths of despair, along with deaths from drugs and alcohol.… Read More »

Health effects of tech overload: Can public health see it?

By | August 31, 2023

What if there was a public health problem so big that even public health leaders were too enmeshed in its grip to be able to warn against its perils? I worry that we are in that very conundrum with regard to our relationship with technology. It has accelerated from being part of our world to… Read More »

Using data-driven quality measurement and analytics to build health equity

By | April 27, 2023

The disproportionate impact of COVID-19 on underserved communities underscored the need for systemic change and renewed efforts to reduce health disparities in people with social risks.  This post describes a partnership between Inovalon and Humana to develop a new health equity composite quality measure to identify disadvantaged populations with the largest care disparities and determine… Read More »

Healthy Intersections Podcast: April 2023

By | April 24, 2023

Originally published April 6, 2023; updated April 24, 2023 to add audio links. Welcome! April 2023 marks a new milestone for the Healthy Intersections Podcast (HIP), sponsored by the American Public Health Association’s Medical Care Section. I’m taking on the role of the main producer of HIP. We’re also moving to a video AND audio… Read More »

Social Fitnessing as a Pandemic Health Strategy

By | February 23, 2023

Public health has preached a lot of things in the three years of the COVID-19 pandemic. It has promoted social distancing, masks, vaccines, and quarantine to help prevent the spread. And it has helped spread awareness about antivirals for people infected with COVID-19. But what about “social fitnessing”?   This is the premise that the… Read More »

A Renewed Outlook on Substance Use Prevention

An Opportunity to Get Ahead of the Overdose Crisis For many Americans, drug use ‘prevention’ conjures memories of early public health campaigns using fearsome imagery and catchy slogans to deter substance use. Campaigns implored youth to “just say no” to drugs, and the public received stark warnings: “this is your brain on drugs.”

Long-acting reversible contraception in the era of abortion bans

It is more important than ever to expand access to a broad range of safe and effective contraceptives that includes long-acting reversible contraception (LARC) methods. We are living in a new era in the US. As of early November, 2022, abortions are banned from the point of conception in 12 states and severely restricted in… Read More »

Improving treatment adherence with evidence-based approaches

Over the last 25 years, researchers have documented the broad impact of behavioral interventions on a range of psychological and physical health outcomes. Despite the promise of evidence-based treatments, a common challenge for practitioners is ensuring treatment adherence to maximize benefits. This is especially challenging for most chronic conditions. Integrating research and recommendations from medication… Read More »

SDoH in Same-Sex Couple Hotspots and Coldspots

By | June 24, 2022

Happy Pride month! In this post, I’d like to share about a research project in progress that is relevant to the LGTBQIA+ community. This post may also be interesting to those of you who care ok about health equity and the social determinants of health (SDoH). I am a member of the queer community myself.… Read More »

Diabetes Cure or Diabetes Management?

By | May 26, 2022

Reuter’s announced in January that diabetes deaths in the United States continue to surge well above pre-pandemic levels with over 100,000 Americans dying from diabetes in 2021. Given COVID-19’s relationship to diabetes, we may see this trend continue. Increasing deaths from diabetes is a clear call to action for new solutions. Historically, diabetes has been… Read More »

Parent Perspectives on Birth Equity – Birth Equity Series Part 3

In the United States, 700 women die every year from often preventable pregnancy or childbirth complications. An additional 60,000 more experience highly preventable birth injuries. Black women are three times more likely to die from those complications than white women. According to the CDC, the maternal mortality rate in the U.S. is roughly 17.4 maternal… Read More »

Words Matter in Creating Birth Equity – Birth Equity Series Part 2

While some health outcomes improve in the United States, racial and ethnic disparities in pregnancy-related outcomes persist. In the United States, Black women are three times more likely to die from a pregnancy-related complication than white women. In Kansas, Black women are more than three times as likely to die of pregnancy-related complications compared to… Read More »

Defining Birth Equity in Kansas – Birth Equity Series Part 1

The pace of progress is never fast enough for those who stand to suffer the biggest losses. Nowhere is this more apparent than in the glaring health inequities impacting Black mothers and babies in Kansas. Among the multitude of injustices Black Kansans face today, the disproportionate rates of death and devastating health complications for Black… Read More »

The Future of Telemedicine Depends on Applying Lessons From The Pandemic

By | October 28, 2021

During the pandemic, telemedicine demonstrated it’s power. As we begin to make the shift back to in-person clinical care in a post-pandemic world, it’s important to look at the lessons learned during the pandemic. This will help guide us in how to move forward and improve telemedicine delivery. The History The use of telemedicine is… Read More »

The Uncertainty of Black Pregnant Women and COVID-19 Vaccines

In March 2020, the Centers for Disease Control and Prevention (CDC) confirmed COVID-19 as a pandemic. More than 18 months later, the nation has yet to return to ‘normal’. Hope for normalcy increased with the rollout of COVID-19 vaccines in the months that followed. Reluctance and resistance to vaccination, however, have made it difficult to… Read More »

Unconscious Bias in Health Care

By | June 30, 2021

The global Covid-19 pandemic came with financial, emotional, and physical health implications for just about everyone worldwide. Along with those burdens, a significant strain was placed on resources, people, and systems. Issues that were lingering just beneath the surface bubbled up, inequities became highlighted, and urgent outcries and demands for swift solutions became harder to… Read More »

Admitting Defeat in the Fight Against Obesity

By | March 26, 2021

As we are overcoming the COVID-19 pandemic, the obesity pandemic is worsening. The United States is the most obese country in the world. Is it time to admit defeat in this 30-year battle against obesity?  Only 1 in 122 mildly obese people with a primary care physician will achieve a normal weight, according to a… Read More »

Toward Vaccine Equity

By | March 23, 2021

The pandemic has consistently exposed the underlying inequities and effects of systemic racism on American Indian (AI) and other marginalized communities. The health equity challenge of 2021 is around COVID-19 vaccine equity. Over the first months since the vaccine has become available, communities of color are not getting shots in the arm at the same… Read More »

Treating the Opioid Crisis: Current Trends and What’s Next, Part 2

Last week, we discussed three noteworthy trends from the past decade in treating the opioid crisis. The first was recognizing medication for opioid use disorder (MOUD) as the standard of care. The second was formalizing an addiction medicine specialty. And the third was expanding the availability of MOUD. This week, we’ll consider three additional trends in… Read More »

Treating the Opioid Crisis: Current Trends and What’s Next

Throughout the past decade, the U.S. has seen a dramatic shift in addiction medicine research, clinical practice, and related stigma in seeking care. In a pair of blog posts, we will explore the top six trends related to treating the opioid crisis. And we’ll consider what may be next. The Opioid Epidemic Opioid addiction has… Read More »

Public Health and Medicine Are Essential Partners in Advancing Health

By | November 30, 2020

Historically, public health has served the nation through sanitation, immunization, and other disease-prevention activities (e.g., disease tracking and quarantine). For example, public health developed wastewater treatment programs to help fight typhoid fever during the industrial revolution. It also helped educate the public (and the food industry) on safely preparing and preserving foods. As a result,… Read More »

Is Sleep Driving Up Your Medical Costs?

By | October 22, 2020

  Millions are losing sleep due to anxiety, fear, and the difficulty of maintaining a schedule during this pandemic. Research suggests that those who get insufficient sleep may be at risk for health conditions such as obesity and heart disease. Yet, too much sleep may increase the risk of other health conditions such as diabetes and… Read More »

Potential effects of COVID-19 on health care utilization and quality measures

What are the potential impacts of COVID-19 on health care utilization? How will changes in healthcare use impact quality measures? Researchers are asking many key questions to understand the impacts of COVID-19. It is clear that trends in healthcare use are changing. These changes will likely affect quality measure scores in the future. This is… Read More »

Options for Universal Coverage: Part 3 – Increasing Medicare Benefits

In this series on options for universal coverage, we explore elements of various reform proposals and evaluate their potential impact. Rather than examining complete proposals, we highlight specific policy elements that appear in one or more such proposals. The three we focus on in this series are: Eliminating Medicare Advantage (May 14, 2020) Expanding Medicare… Read More »

Pandemic PPE Waste: An Environmental Health Educational Opportunity

By | September 2, 2020

In our battle against COVID-19, one of our unique challenges is the use of face-coverings. Despite evidence that supports wearing face coverings, this has become a polarizing issue in a highly politically-divided climate. After shifting mask guidance in the early days of the pandemic, the WHO and the CDC issued formal guidelines on wearing face… Read More »

After COVID-19, We Must Build Back Better

By | August 17, 2020

The COVID-19 pandemic has brought to light the gross underinvestment in public health, primary care, and the social determinants of health in the United States. Yet, this experience gives us a chance to rethink our health and social service systems, as these are often siloed. We see education, employment, healthcare, housing, and other social services… Read More »

Deportation and the Traumatizing of a Generation

By | June 18, 2020

With less than five weeks to go before welcoming a second child, the patient sat in my exam room in tears. By all accounts, this was a routine appointment at the end of a routine pregnancy. Except on this particular day, clutching family photos from their recent baby shower, the patient shared with me that… Read More »

#SexEdForAll: What We Need to Prevent Intimate Partner Violence

By | June 1, 2020

We just wrapped up #SexEdForAll month in May, yet most people still believe sex education is just about sex. But it’s so much more than that! That’s why I created the Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators story map, in conjunction with the Robert Graham Center for Policy Studies in… Read More »

COVID-19 and homelessness

Our neighbors who are experiencing homelessness during this SARS-COV-2 pandemic are facing unique risks and extreme hardships. In the corner of American society almost defined by economic and racial disparities, COVID-19 has compounded and taken advantage of these long-standing vulnerabilities. An outsized burden of risk factors for COVID-19 compound the risks of crowded shelters and… Read More »

Telehealth for Addiction, Part 2 – Confidentiality: Real Concerns in Virtual Settings

As of April 17, 2020, the novel coronavirus has infected more than 2.4 million people globally and led to 170,000 deaths. The global response to the COVID-19 pandemic largely emphasizes social distancing and shelter-in-place ordinances. These policies impact everyone, also upending the lives of those not directly affected by the virus COVID-19 pandemic. Like other… Read More »

Is hydroxychloroquine ready for prime time for COVID-19? Not just yet.

By | April 17, 2020

In early April, President Trump, in his daily press briefing, told Americans to take the drug hydroxychloroquine, calling it a “game changer” for people with COVID-19: “I really think they should take it. But it’s their choice. And it’s their doctor’s choice or the doctors in the hospital. But hydroxychloroquine. Try it, if you’d like.”… Read More »

Telehealth for Addiction: Online Support Groups

The current requirements for social distancing affect support groups for people with substance use disorders, but online support groups may provide the perfect solution. This post is the first in a series of planned posts on telehealth for addiction. COVID-19, the disease caused by the novel coronavirus called SARS-CoV2, is putting tremendous strain on all… Read More »

COVID-19: health and the coming economic recession

By | April 3, 2020

The first reports of COVID-19, the name now used to describe the disease caused by a novel coronavirus, first emerged around New Year’s day of 2020. Since then, the conversation has shifted from containment efforts in Wuhan, China to social distancing and mandatory closures across the U.S., including in New York, California, Illinois [pdf], Massachusetts,… Read More »

The myth of female hysteria and women’s health disparities

By | March 5, 2020

What role might the myth of “female hysteria” play in women’s health disparities? For thousands of years, women’s health complaints were often diagnosed as “female hysteria” – a catch-all term that basically implied “it’s all in her head.” The condition was sometimes believed to be caused by a wandering uterus and/or sexual frustration. Doctors treated… Read More »

Much ado about rural health

By | February 5, 2020

As of late, rural health has been a hot topic and buzzword in the public health and health policy spheres. Health Affairs recently published an entire issue related to topics on rural health. The American Journal of Public Health recently issued a call for manuscripts for a special issue dedicated entirely to rural health. Rural… Read More »

Decriminalization of Drug Possession: Key to the Public’s Health and Health Equity

By | December 19, 2019

Research shows that decriminalization of drug possession, combined with other harm reduction efforts and treatment services, is an important component of efforts to improve public health and health equity. It was early in medical school when I encountered the first of many patients who had spent years in jail or prison for drug possession. On… Read More »

School Health Policy Series: Part 4 – The National School Lunch Program: Wasteful or Worth It?

By | December 3, 2019

Do you recall the last time you did not have your morning cup of coffee or tea? Without it, you might be moody throughout the day and not get done what you intended. How about the last time you skipped lunch? Were you able to focus on your work with a rumbling stomach? Now imagine… Read More »

Moving from Stigmatization to Healthy Sexuality: The Vital Role of Comprehensive Sex Ed

By | August 21, 2019

As a sexual health educator at public high schools in Tennessee, teachers would consistently jump in as I approached the topic of contraception. Required by law, these teachers would “emphatically promote sexual risk avoidance through abstinence.” After this abrupt interruption, I would then proceed to talk about all forms of contraception, including abstinence. Students would… Read More »

The State of Abortion in America in 2019

By | June 19, 2019

A 14-year-old girl came to my primary care clinic with abdominal pain, similar to abdominal pain she’s had intermittently for years. As with all women of reproductive age, I checked a urine pregnancy test, and it was positive. I returned to the patient’s room to talk with her about the result, and her first question… Read More »

Health Equity Through the Lenses of Intersectionality and Allostatic Load

By | February 20, 2019

Although the term health equity is widely used, a common understanding of this term is lacking. Viewing health equity through the lenses of allostatic load and intersectionality could help. This blog post considers three case scenarios, all of which are composites of actual cases that have occurred within the United States, to explore ideas of… Read More »

The Desire to Avoid Pregnancy Scale: A new way to measure pregnancy preferences

Why do we care about unintended pregnancies? Rates of unintended pregnancy “indicate the extent to which women and couples can determine freely whether and when they have children,” as stated by Finer and Zolna. There is some evidence that women and girls who have unintended pregnancies have a higher likelihood of other risk factors, such as… Read More »

The Link Between Prescription Copayments, Contraceptive Adherence, and Unintended Pregnancy in the United States

By | December 12, 2018

There are approximately 61 million women of reproductive age (15-44 years) in the United States, and at any given time, 70% of them are at risk of unintended pregnancy—that is, they are sexually active but do not want to become pregnant. About 72% of women who currently use contraception use non-permanent methods, such as the… Read More »

Helping People with ASD Find the Right Information: Interview with Speech Pathologist Lauren Ross

By | December 4, 2018

If you have a question, how do you find the answer? Many of us do a quick Google search or search out the answer at a library.  However, people with Autism Spectrum Disorder (ASD) and their families face many challenges and barriers when trying to locate information. A recent episode of the (highly recommended) podcast… Read More »

The Health and Social Costs of Homelessness

By | September 26, 2019

The burden of homelessness on the health of those afflicted continues to be a major global public health concern. Last year, the United States recorded an increase in the number of homeless for the first time since 2010. On any given night in 2017, there were 553,742 people in the U.S. experiencing homelessness. In terms of… Read More »

A Public Health Approach to Addressing Sexually Transmitted Infections

By | August 30, 2018

Chlamydia and gonorrhea are among the most common sexually transmitted infections (STIs) in the United States, and research shows that 50% of sexually active individuals will contract an STI by 25 years old. Though chlamydia and gonorrhea are often asymptomatic in women, screening is important in order to prevent complications, such as pelvic inflammatory disease… Read More »

Medication-Assisted Treatment: A Vital Player in the Opioid Epidemic

By | August 15, 2018

For two years in a row, the United States has experienced a decrease in life expectancy, which researchers have largely attributed to the opioid epidemic. Life expectancy for the United States population was 78.6 years in 2016, a decrease of 0.1 year from 2015 [PDF]. Age-specific death rates between 2015 and 2016 increased for younger… Read More »

Do electronic pill bottles improve measurement of medication adherence?

By | August 8, 2018

Medication non-adherence can be a tricky issue for healthcare providers, patients, and pharmacists to solve. In addition to cost, there are many other factors that influence whether someone takes their medication(s) as prescribed. As discussed in the literature, side effects, confusion about medications, and the general human tendency to forget may all play a role.… Read More »

Who responds to health behavior change interventions and why?

The New York Times recently posted an article about the return on investment around public health interventions and how American life expectancy at birth increased by 30 years in the time from 1900 to 1999.  The article went on to stress that these additional years of life can largely be attributed to advances in public… Read More »

Should time management take a back seat to energy management?

Growing up we were encouraged to learn how to manage our time.  Many of us were told that time management was the key to successful careers, personal lives, and finding the balance between the two.  A cursory search online of time management brings you to a world of articles, blog posts, and books on time… Read More »

Sometimes the best medicine isn’t a medicine at all

By | March 15, 2018

Ironically, many healthcare providers–doctors, nurses, physician and medical assistants–are not trained in “health” at all but in “medicine” instead. Often, as providers, our instinct is to first reach for a pill bottle or a procedure and forget about lifestyle changes that could be safer and more financially feasible for our patients. As the burden of… Read More »