Agnes Scott College PH 101 SU2019

This is Public Health

Page 3 of 5

Mapping Social Determinants

https://drive.google.com/open?id=1OyK56VMHqJfyvANPXeujeBJK16ibo_HT&usp=sharing

On my walk through downtown Decatur to the Decatur cemetery starting at Avery Glenn Apartments. During my walk I noticed how the start of downtown Decatur, just across the railroad tracks was significantly nicer, and as I moved further away the difference in care level was obvious. Also as I moved further I moved away from a Emory Primary care clinic and more towards the Emory hospital. The fire department however was right next the Arlo a fancy apartment building. Nicer housing options were closer to the train tracks and further away the housing was less nice. Obviously the convince of nice living in downtown Decatur is still very localized by how close to the square a place is, the farther away one moves the less nice the options are. This is probably due to the popularity of the square which holds many restaurants, boutiques, and nearby a fancy market place while a cheap shopping option would require a longer walk and or mode of transportation. Those that are wealthier want to live in convince and can afford the restaurant and marketplace prices so the prices of housing rises to keep out those who could not afford the shops of downtown Decatur.

Mapping of Social Determinants of Health

Carlie Charles

https://drive.google.com/open?id=1F0zI0SJj7CaiY1v928y3goEdcJm6J1-k&usp=sharing

Carlie’s Walk in Downtown Decatur

On my walk from Avery Glen to Downtown Decatur, I decided to take the route of the square starting at my apartment. I walked to the courthouse, the Wells Fargo on Ponce, and then took a different direction back home. What I noticed the most was how the sidewalks in the inside of the perimeter of Downtown were all nicely kept and wide enough to possibly fit three people shoulder to shoulder. Yet, when I took the backroad back to my apartment, I noticed that the sidewalks were very narrow and there were cracks from where the weeds split through. It was strange to me because there were nice houses on that street and it was obvious that there were families who had children in their homes so the fact that it wasn’t necessarily safe for children to walk those sidewalks was daunting. It made me think that Decatur puts a lot of effort into maintaining the square because it is Downtown and there is a lot of money invested as there is a multitude of restaurants and other stores all centralized there. The trashcans scattered across the square further supported that as once you reached into the outskirts of the square, there were no fancy trashcans to be seen.

Social Determinants Map

https://www.google.com/maps/d/u/0/edit?mid=1n7QQMbv-BoVp_nvJ9I6PfyyHSh0FvPhN&ll=34.238237710290676%2C-84.491720397329&z=17

I walked around historic downtown Canton. Canton is the county seat of Cherokee County, Georgia. There were sidewalks and crosswalks all over the city which made it safe and easy to walk around. There were several different social determinants of health in just a mile long walk: government buildings, medical establishments, parks, restaurants, businesses, housing and places of worship. I found that a lot of the housing and buildings were old, but it makes sense because it is a historic city that is preserving older buildings. The buildings and housing did not seem unsafe even though they were old. There was accessible healthcare in Canton but not everyone who lives there can afford it. The majority of the workforce in Canton does not have a high education which brings down their incomes affecting what healthcare they can access. Poverty rates in Canton range from 13.3% – 20.1% of the population.

The New York Times. (2014). [Newsgraphic of poverty rate in Canton, Georgia] Mapping Poverty in America. Retrieved from http://www.nytimes.com/newsgraphics/2014/01/05/poverty-map/index.html

United States Census Bureau. (2019). [Map of employment in Canton, Georgia in 2015]. On The Map (Employment). Retrieved from https://onthemap.ces.census.gov/

Artificial light during sleep puts women at risk of obesity

  1. The article describes that there is a positive association between weight gain and light exposure during sleep for women. The article claims lights turned on during sleep are risk factors for women.
  2. 43,722 women who took part in Sister Study, a study aimed at discovering environmental risk factors that breast cancer were each asked how much they are exposed to artificial light at night (ALAN). This allowed the women to be split up into four groups: 1. no light, 2. small night-light in the room, 3. light outside the room, and 4. light or television on in the room. The participants also reported their weight, height, and hip/weight circumference at the start of the study. They were then followed up after on average about 5.7 years, and it was discovered that women who slept with light or television in the room had 17% more risk of gaining 5 kg (11 lbs) or more compared to women who slept with no lights. They also had a 13% higher risk of their BMI increasing 10%, and overall the risk of being obese was 22 to 33% higher for them.
  3. I can say that I am quite susceptible to this risk because I am guilty of sleeping with the lights on (I forget to turn them off when I am tired) and when I do turn off the lights, I often am on my phone in the dark until I get sleepy. When I wake up, I don’t feel refreshed at all- I am always tired.I knew there are other risks associated with scrolling through your phone before you sleep, but I did not know that it is linked to obesity as well. Diabetes runs in my family (both of grandmothers had it), so gaining weight can significantly increase the risk. The other thing that I thought about when I read the article was about the social determinants of health. The article mentions that people who live near cities may not have control over the amount of light they are exposed at night. It made me think about the possible disparities between the wealthier and poor areas- in poor areas, people may not be able to afford high quality curtains that block the lights from outside, which increases the risk of obesity and they have very little control over it. I don’t have to worry about this problem, but it makes me think about how social status affects health in different ways.
  4. I drew from my personal experience and what happened to my family members to determine the risk. I mentioned that I wake up tired, and I have noticed myself resorting to sugary drinks or foods to try to get that boost of energy. As we all know, sugar consumption is linked to diabetes. I also binge on caffeine, which creates a downward spiral of poor sleep. My grandmother used to be overweight, and developed type 2 diabetes. She did not live for very long after that. My other grandmother has been bedridden for about a decade now, and before every meal she has to inject insulin/get her blood taken by punching a hole in her finger. I could never directly look at the process because it looked painful.
  5. Slovic’s work applies to my perception when he mentions the idea that we become extremely frightened by things we perceive as uncontrollable or catastrophic (such as a nuclear power plant and the risks of radiation) but we are rarely scared of risks we think we can control but are actually riskier (driving cars). I thought the same at first; I thought that lights are such a trivial thing and that is not a big issue. But as I thought about it more, I realized that the “trivial” effect can be detrimental if it is done repeatedly. Slovic concludes by mentioning that policy makers should improve their interaction with the public, but it made me feel like I have to be the one searching for the right information rather than wait for people to change for me, especially regarding health.

References

Hewings-Martin, Y. (2019, June 13). Artificial light during sleep puts women at risk of obesity. Retrieved June 17, 2019, from https://www.medicalnewstoday.com/articles/325450.php


Drinking Alcohol Increases Risk of Breast Cancer

BBC News (June 19, 2019) Women not aware enough of breast cancer link to alcohol. BBC News. Available at https://www.bbc.com/news/health-48677953 (Accessed June 19, 2019).

Consumption of alcohol is a risk factor for developing breast cancer. Women who drink 2 units of alcohol a day increase their risk of developing breast cancer from 8% to 11%. Because I am a woman with a family history of breast cancer but I only drink minimal amounts of alcohol at social events, my perceived susceptibility of developing breast cancer is still only based on my family history. However, my perceived severity of breast cancer is high because I could get very sick and/or die from it. This information about alcohol increasing the risk of breast cancer affects my thoughts by making me think I should continue to drink minimal amounts of alcohol, as it is a risk factor I can control. I did not have any background knowledge that drinking alcohol increased the risk of breast cancer. Comparing my knowledge that drinking alcohol may affect heart health and can affect liver health helped me realize that it can affect other parts of the body as well. This led me to understand that it increases the risk of breast cancer. I interpreted the number of units of alcohol that increases the risk of breast cancer (2) as far lower than the recommended alcohol limits for men and women per day (14). Slovic’s work described how if a risk is familiar one might not think of it as risky as an unknown risk. Slovic’s work does not apply to my own perceptions of the risks of breast cancer. Even though drinking alcohol is a familiar risk like driving a car as opposed to an unknown risk like nuclear weapons and genetically modified food I took this into account in my perceptions. Although 14 units of alcohol is the recommended limit to drink a day and a familiar risk I perceived that to lower my risk for breast cancer I would need to drink a much lower amount, less than 2 units of alcohol a day.

Chronic Mood Disorders Post-Heart Attack Increases the Likelihood of Premature Death

https://www.businessinsider.com/chronic-depression-after-heart-attack-tied-to-increased-risk-of-death-2019-6

Rapaport, Lisa. (June 12, 2019) Chronic depression after heart attack tied to increased risk of death. Business Insider. Available at https://www.businessinsider.com/chronic-depression-after-heart-attack-tied-to-increased-risk-of-death-2019-6 (Accessed June 18, 2019)

a and b. This article discusses the findings of a study that assessed the risk of premature death in patients who suffered from (a) chronic mood disorder(s) following a heart attack. Researchers evaluated the emotional distress of about 58,000 patients who had just suffered from a heart attack over a period of time. Patients were evaluated two months post heart attack, again one-year post heart attack, and then followed for at least four years post heart attack. 21% of patients reported psychological distress during both evaluation periods (after two months and a year post heart attack). The study showed that those who reported emotional distress during both evaluation periods were 46% more likely to die due to a cardiovascular cause and 54% more likely to die from other causes compared to those who did not show signs of emotional distress. 15% of patients experienced emotional distress after two months but reported no emotional distress after one year. The study found these people didn’t have a higher risk of mortality compared to those who reported no emotional distress during either evaluation periods. 11% of people reported no emotional distress after two months but did report emotional distress after a year. This group had a 46% greater risk of dying from causes other than cardiovascular.

c. For my age range, the likelihood of me suffering from a heart attack is slim. I have no previous history of cardiovascular issues and my doctor hasn’t voiced any concerns about my cardiovascular system. If I did suffer a heart attack I would be slightly alarmed because I do have anxiety. But I know that there are resources to control anxious thoughts. Consequently, suffering from a heart attack would not cause me to panic about mortality. The article states that there is some evidence supporting that treating depression and anxiety would improve survival rates but more research needs to be done. I’m not severely impacted by this health risk so I’m not overly concerned about its effects. Furthermore, heart attack aside I still wish to reduce anxiety levels.

d. While I don’t plan on having any cardiovascular issues in the near future, it does put into perspective how my mental health impacts my physiological health. My reasons for reducing anxiety was primarily to improve my mental wellness. I didn’t think mental thoughts could pose a long term effect on other biological processes. I thought once the anxiety is gone, that is it; there are no other biological impacts other than those experienced in that moment of anxiety. After reading this article and I realize anxiety can have long-lasting effects on my physical and mental health. Anxiety can be difficult to manage but is important to manage. To interpret the numbers I mentally grouped people into the categories the article described and thought about how mental illness affects people’s choices. For example, those with chronic mood disorders post-heart attack may have died because their mood disorder perpetuated poor lifestyle choices that increased their risk of cardiovascular disease (i.e. not wanting to cook a meal and instead opting for a fast food meal).

e. Slovic’s work does apply to my own perceptions of the risks that I read in the story. As I stated previously, I feel I have some control over my anxiety levels. I know that there are multiple resources available to help me cope with and reduce anxiety. Furthermore, society has made improvements towards destigmatizing mental illness; mental illness isn’t a foreign concept that people are scared to talk about. With this information, I am less worried about being affected by this condition. If I suffer from a heart attack, my solution would be to work towards reducing anxiety levels, something I am in control of.

School Start Times Intervention

Mammoser, Gigen. (June 13, 2019). Starting School Later in the Morning Helps Teens Get Their Homework Done. Heathline. Available at https://www.healthline.com/health-news/pushing-back-school-help-teens-get-homework-done (Acessed June 17, 2019).

A.) Because kids’ and teens’ sleep cycles change over the course of puberty, they tend to wake up later at around eight or nine in the morning. But unfortunately, school usually starts way before then, distrubing their sleep cycles and making them more tired and unfocused during school hours and thereafter. To find a way to make teens more energized and focused throughout the school day, a study was done where a school district volunteered to start the school day about an hour later at or after 8:30 am.

B.) Over the course of the school year starting from the fall of 2017 until the spring of 2018, the study took place at Cherry Creek School District, where more than 15,000 students in the grades 6-11 participated in the study by taking surveys on their condition in response to the new time change. The intervenion was incredibly effective as students had more sufficient sleep and on the weekends lessened oversleeping by 38 minutes. Fewer students reported being too sleepy to do homework and there was a signifigant increase of academic engament during school hours.

C.) While I can’t think of anything to be seen as confounding, as sleeping-in leading to more energization throughout the day seems to be pretty striaght-forward. Speakig from personal experience, I definately felt more energized throughout the school day when I woke up at around eight am instead of the usual five am. However, the study design could be improved upon. For example, whose to say that the students who reported their conditions didn’t just lie so that they could sleep in more instead; having to go to school later doesn’t necessarily mean that they will go to bed around an apporpriate time. I think that the teachers and parents should have also had a survey distributed to see if the students claims really are true, and thus have more consistent findings.

D.) I think it’s very possible for this to catch on again, as this has happened before in the past. I myself used to go to school that started at around 9:00 am when I was in elementary, however, for some reason my school district set the start time earlier and earlier from middle school to high school to the point where I would wake up at around 5:00 am. In theory, I think if this study was proposed to my school district for instance, as being more healthy for the students, they would be willing to consider changing it back to 9:00 am. Though I think the reason it was set earlier is because of the fact that parents need to get to work on time and can’t do that if their kids need a ride to school. Though a way to solve that would be to reinstate school buses again, and maybe possibly change the starting time of workplaces themselves. It could possibly be marketed as “new” and “innovative” since now there are studies that prove what is the most effective for sleep cycles and class focus. This study could also be interpreted to the sleep cycles of employees and wanting to monopolize their time and energy to their work. Essentially, this will only be changed if it benefits adults as well, as adults are the ones who would make a decision on this implementation.

LGBTQ Youth and Substance Abuse

https://www.thenewsguard.com/news/study-shows-lgbt-youth-at-increased-risked-of-substance-use/article_f145d240-88b0-11e9-8b3f-1b81f3c9b03a.html

Klampe, Michelle. (June 9, 2019). Study shows LGBT youth at increased risked of substance use. The News Guard. Available at https://www.thenewsguard.com/news/study-shows-lgbt-youth-at-increased-risked-of-substance-use/article_f145d240-88b0-11e9-8b3f-1b81f3c9b03a.html (Accessed June 19, 2019).

This article discusses the increased usage of substances by LGBTQ identifying young women. Klampe says that the “odds of substance use among females who identify as sexual minorities… is 400 percent higher than their heterosexual female peers” (2019). This difference in substance use starts as young as 13 years old and can increase as these women enter their 20s. In general, research has shown that LGBTQ youth may appear to use substances almost three times more than their counterparts (Klampe, 2019). Although I am a bit out of the age group that they ran their initial study on, I am still within the range of interest. It is likely that if I am not aware of my actions, I can become susceptible to this issue, especially depending on the people that I am surrounded by and their relationship with substances. In my opinion, substance use is a pretty severe problem because it affects a person’s entire lifestyle – from physical health to mental health to work performance. It can be very detrimental to someone’s overall life. I think it is really important for young people to be aware of their relationship with alcohol, nicotine, and/or marijuana because it can escalate out of control as people begin to depend on these substances as coping mechanisms for the hardships in their lives. LGBTQ youth deal with higher rates of discrimination, depression, and violence, so it makes sense that they may abuse substances. However, these statistics say more about how much help the community needs because substances only further add to the issues people may face. In my experience, I have seen my LGBTQ friends use substances more, and at a younger age, than my heterosexual peers, because my LGBTQ friends dealt with more mental health issues and family instability. It is important to address substance abuse because it can impact the entire community, much like HIV/AIDs. Substance use is a disease that many people do not acknowledge, but it can drastically change people’s health outcomes. To interpret the numbers, I broke down 400% to about 4x more in order to conceptualize it with people.

It seems to me that Slovic is claiming that the unknown and uncontrollable factors frighten people more than familiar causes, such as automobile incidents. In this case, I think Slovic’s work would apply. Although the media discusses celebrities’ overdoses and fatal endings due to substances, there is not much discussion on how substances affect everyone else. People also are unaware of what is considered substance abuse, so they do not always know when their usage is becoming excessive or harmful. Substance use has become normalized in our society, so it is becoming harder for people to understand the gravity of its consequences.

Red Meat and Death Risk

Sandoiu, Ana. (June 13, 2019). Red meat and death risk: Study offers new insights. Medical News Today. Available at https://www.medicalnewstoday.com/articles/325456.php (Accessed June 16, 2019).

A. and B.) The article details that people who increase their intake of red meat in their diet had a higher risk percentage of death than people who decreased their intake. It all stems from an eight-year study conducted by Professor Yan Zeng of Shanghai University, and Frank Hu and Fredick J. of Harvard University. They studied about 53, 553 women and 27, 916 men without any cardiovascular diseases and cancer at the start of the study (Sandoiu 2019). From years of observation and research, they found that an increase of red meat by half a serving per day increased the mortality rate by 10%, and for half a serving of both processed and unprocessed red meat, it increased the mortality rate by 13%. “Prof. Zheng and team found that people who increased their total amount of daily processed meat intake by half a serving or more were 13% more likely to die from any cause. Increasing unprocessed meat by the same amount daily led to a 9% rise in all-cause mortality risk” (Sandoiu 2019). In comparison to the groups that decreased their red meat consumption, their mortality rate did not change. They also found that this effect did not change no matter the subgroup of age, physical activity, dietary quality, smoking status, and alcohol consumption. The mortality rate lowered when subjects decreased their red meat intake and instead ate alternatives such as nuts, fish, skinless poultry, dairy, eggs, vegetables over the course of the study (Sandoiu 2019). The conclusion of this study was that if you eat less red meat and instead used other means of protien, you’ll lower your chances of premature death.

C.) I feel like I have a high chance to be affected by this health revelation because red meat is in my diet, and while I’m not consistent in what I eat, I do have brief periods of eating red meat in a discernable amount that could possibly raise my risk of mortality. I think it would be pretty bad if I managed to gain an illness because of this as I have a potential risk of a lot of dieseases due to my genetic history. Examples being, type 2 diabetes, cancer, stroke, alzheimers, etc; Some of them, more closer to me than others. This article has made me more cautious of how much red meat I should consume from now on when I choose dishes for my next meal.

D.) While I can’t say I have a deeply emotional response to this article, my mental process was more along the line of what I need to do in oder to prevent my mortality rate going up in terms of monitoring my diet, and my family members’ diet. There’s nothing really specific I can draw upon besides the fact that I know that red meat is not all that good for the body prior to reading this article. Knowing how much red meat should be consumed is similar to the food pyramid that we are all taught in elementary school. Less than a serving of meat (3-5 oz), and 5 to 13 servings of fruits and vegetables everyday. This also reminds me of counting clories that people typically do in order to burn off the right amount each day. I didn’t really use much in terms of processing the numbers, as I feel what the article was conveying to me was simple enough to process.

E.) I can relate to Slovik’s assessment of risk because while I am concerned about development of diseases due to unsavory red meat consumption, I am not particulary panicky about it as it is something I am vaguely familiar with, or something I’ve heard about my enitre life whether the numbers are correct or incorrect. Talking about diet is one of the most common topics in regards to health, and this extra bonus doesn’t necessarily shake me up as finding out about some unkown disease or an upcoming pandemic. Even if heart disease is the number one killer in the U.S, knowing how to tackle it brings ease to my mind regardless of the fact that I have a high chance of dying from it.

LGBT Self-harm Rates versus Heterosexual Peers.

https://www.usnews.com/news/health-news/articles/2019-06-03/lesbian-gay-youth-at-higher-risk-for-self-harm

Mozes, Alan. (June 3, 2019) Lesbian, Gay Youth at Higher Risk for Self-Harm. U.S. News. Available at https://www.usnews.com/news/health-news/articles/2019-06-03/lesbian-gay-youth-at-higher-risk-for-self-harm (Accessed at June 3, 2019).

The behavior discussed in the article is of non-suicidal self-harm and how it is higher for those in the LGBT community versus the Heterosexual community. According to the article LGBT teens self-harm rate was between 38%-53% while the self-harm rate from heterosexual teens was much lower 10%-20%. This makes the relative risk rate between 2.65-3.8. So LGBT teens are 3.8 times more likely to self-harm than straight people. Since I am finishing up my teen years as a member of the LGBT community I feel like I am less susceptible now, however I did fall susceptible to self-harm as a teenager. Being older means that I have a stronger support system and better understanding of the impact of therapy. Developing the issue was very bad and took a long time to overcome and be able to talk about it. While the article clarifies that the self-harm studies was specifically non-suicidal, once starting to self-harm it can easily lead to suicidal idealization. Not only can it lead to suicidal thoughts, once one begins self-harming it can lead to higher risk of infection from open wounds not properly taken care of, as well as worsening depression as it becomes an unhealthy coping mechanism that becomes difficult to replace with a healthy one. This article affected my thoughts about self-harm for LGBT teens because while it discusses most of the direct causes are isolation and bullying, it can also develop because of the higher risk of mental illness such as depression and anxiety LGBT teens face. A lot of emphasis is put on the higher rates of suicide in the LGBT community but I feel that now with these statistics and the fact that it is not on a decline, that we need to focus also on prevention or information about self-harm.

This story meant a lot for someone who is LGBT and who has dealt with self-harm and mental illness and realizing that while my mental illness was not brought on due to me being LGBT as I had a supportive group of friends and family, I know that being a lesbian added to my anxiety and stress. Even when one has a better childhood it still does not mean that the outside factors of not knowing who will be accepting and who won’t, if it is safe to be myself in public or not can add a lot of stress. Combine the stress of an already hate filled world with the confusing time of being a teen and questioning ones sexuality will of course lead to mental health issues and self-harm issues. For this article I drew on personal experiences as well as those shared by in person friends or online friends who also struggled with self-harm and being LGBT. I considered that all teens face extreme stress during that time of their life, and that it can only be exacerbated when there is something else about you that is deemed different and therefore a reason to hate. Since the numbers were in a range I assumed it had to do with different parts of the LGBT facing their own levels of self-harm based on acceptability. For example Trans members probably have a higher percentage of self-harm than gay men because gay men are slightly more accepted in our society.

Slovic’s work on risk and the public perception of risks do not really relate to self-harm. However similar mindset can be applied to figure out why LGBT are at a higher risk of self-harm having to do with public perception. Slovic talks about how it is important how the public are introduced to something in relation to how big of a risk they will see it as. The public’s perception of the LGBT community is still one of fear and misunderstanding, some accept some only tolerate but in order for the self-harm rate to drop LGBT teens must feel accepted and loved for who they are. While public perception is slowly changing it needs to change quicker and better for the risk of self-harm to go down. LGBT teens still feel isolated, taught they are dirty and wrong by evangelists and current political stances. Some of the so called LGBT representation on tv can hurt teens even more and make them feel more isolated. We are the ones for comedic relief, or the ones who die, or the ones who even in fiction are discriminated against it only serves to isolate them further. I feel to help lower the self-harm rate then first public perception of us must change.

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