Category Archives: Public Health

Research Journal: “Attention to Local Health Burden and the Global Disparity of Health Research”

Posted on by

Evans, J. A., Shim, J., & Ioannidis, J. A. (2014). Attention to Local Health Burden and the Global Disparity of Health Research. Plos ONE, 9(4), 1-9. doi:10.1371/journal.pone.0090147

In this peer-reviewed journal article, two main factors, i.e. global burden of disease and global market for treatment, are analyzed for a correlation with medical research. With the reasoning that biomedical research can be measured using the total number and type of research articles – systematic reviews, randomized controlled trials, and research on animals subject – published in a well-known database called MEDLINE, researchers sought to understand how disease burden and treatment drives research in poor and developed countries. Global burden of disease was measured in disability-adjusted life years (DALYs) for 111 conditions. The global market for treatment was measured as follows:

In the above equation, GNI stands for gross national income per capita.

The findings concluded that despite the fact that poor populations have the highest burden of disease and disability, the least medical research is carried for them. Furthermore, the global market for the same condition in developed country is significantly higher than that for a poor country. It is important to address global inequality in health research because policies based on evidenced-based research can be implemented only when enough research is conducted.

 

Video Journal Entry on “Paul Farmer: Rethinking Health and Human Rights”

Posted on by

UC Berkeley Events. (2009, March 31). Paul Farmer: Rethinking Health and Human Rights. [Video File]. Retrieved from https://www.youtube.com/watch?v=lwy22pXrig8

In this online Distinguished Health Leadership Lecture Series organized by the University of California, Berkeley, Dr. Paul Farmer discusses community-based health care in poor countries and what strategies can be taken to ensure basic human rights. One of the things that was not always apparent to me was that public health policies are designed with cost-effective approach. (He described cost-effectiveness as the religion of public health.) This plays a significant role in how medical care is delivered in countries with meager public infrastructure. The argument against using expensive medication for poor is that these drugs can be used in other important cases. It is simply not cost-effective to treat drug-resistant cases. That seems very wrong, especially considering that drug-resistant cases arise from mismanagement of medical services, i.e. when patients are moved from one trial to another without properly completing their treatments.

One of the things that I really admire about Dr. Farmer’s philosophy is the idea that standard of care should be uniform and not dependent on a person’s wealth. Therefore, setting low standard of care with the label that that is cost-effective is not right. Instead, policy makers should aim at providing high quality of medical care and work with pharmaceutical industry to bring down drug prices.

Dr. Farmer shared some valuable strategies that potential public health workers can adopt and benefit from. He mentioned that when NGOs from foreign countries work with the public sector, they are able to accomplish far-reaching goals. (I have to research this idea more thoroughly and find out what he meant by “scale” and “rights” as the two main reasons to collaborate with public sector.) He also suggested cutting down consulting fee, which is heavily applied by international agencies.

It was surprising to see that universities that are known for public health research and training have no more than 2% of actual service contributed to real-world work. The lack of implementing research that is conducted in universities is troubling.

Research Journal: Mountains Beyond Mountains

Posted on by

Kidder, Tracy. (2003) Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World. New York: Random House.

In this work of nonfiction, Tracy Kidder chronicles the life of Paul Farmer, a dedicated doctor, anthropologist, and infectious-disease specialist, who brings quality health care to an impoverished region in Haiti. Later his organization, Partners in Health (PIH), expands their work in Peru and Russia to fight multidrug-resistant (MDR) TB. Farmer’s fundamental premise for all his efforts is that the poor deserve access to health care just as much as anybody else and that the world should not deny this birthright of basic care, especially when modern medicine has answers to most of the health problems of people in poor countries.

I found this book inspiring because here was a true story that showed how a single person brought about change in neglected places like the prisons in Russia and the villages in Haiti. It is easy to sit back and blame corruption, penury, and lack of democracy as the main obstacles to a stable health care system in third world countries, but we can either turn our backs on the issues or take action. Farmer’s drive to act was laudable. The book also touches on the themes of medical anthropology and explores the importance of incorporating local view of health with modern medical tools. One of my favorite quotes from the book is by an old Haitian woman, who is being treated for TB and who still adheres to believe in voodoo after she has been cured. She says, “Are you incapable of complexity?” At times, it might seem people have contradictory beliefs, but it is best if medical professionals understand them rather than dismiss them.

 

Syllabus

Posted on by

Macaulay Springboard 2014 – 2015

I. Rationale:

This course constitutes of a capstone project that will explore themes of disparities in public health, social medicine, and preventive interventions. With both a reflective and critical component, the one-year plan will tie what I have learnt from service learning projects previously and integrate it with evidenced-based research.

II. Course Aims and Outcomes:

Aims

The goal of this project is to build a thoughtful and well-structured eportfolio, which will serve to spread awareness on public health issues.

Specific Learning Outcomes:

By the end of this course, student will be able to:

  1. Understand the main components of public health, that is, population-based health programs, surveillance, and social justice.
  2. Master research skills by using various modes, ranging from social media to peer-reviewed journals.
  3. Undergo critical analysis of tobacco use and its adverse effects on public health with statistics.
  4. Identify factors affecting health disparities and explore intervention programs.

III. Format and Procedures:

Class meetings constitute of presenting assigned material/ research journal entry and providing constructive criticism.

IV. Tentative Course Schedule (Documentaries, additional readings etc. will be added as I go along)

August 29 (Introductions) – Overview of the springboard class.

September 5 – Discuss timelines, most influential texts, syllabi, research methods, and critique last year’s capstone projects.

September 12 (What is public health? What are the principles, practices, and policies of contemporary public health?) –

1. An Evaluation of the GlobalNetwork of Field Epidemiology and Laboratory Training Programmes: A Resource for Improving PublicHealth Capacity and Increasing the Number of Public Health Professionals Worldwide. (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=91261331&site=ehost-live)

2. Attention to Local HealthBurden and the GlobalDisparity of Health (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=95817714&site=ehost-live)

3. Global Health in the 21st Century. (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=94991298&site=ehost-live

September 19 (What are some of the top health issues and leading causes of death?) –

1.  The top 10 causes of death (http://www.who.int/mediacentre/factsheets/fs310/en/)

2.  The 10 leading causes of death by country income group (2012) (http://www.who.int/mediacentre/factsheets/fs310/en/index1.html)

3. Explore fact sheets on WHO websites.

September 23 (Understand the tobacco epidemic and find out data and analysis on tobacco control.) –

1. WHO report on the global tobacco epidemic 2013. (http://www.who.int/tobacco/global_report/2013/en/)

2. Find out about successful intervention programs such as Tobacco Free Initiative (TFI).

October 10 (Explore the role of tobacco in increasing risk factors such as pulmonary diseases, coronary heart diseases etc.) –

1. Prevalence of oral mucosal lesions in dental patients with tobacco smoking, chewing, and mixed habits: A cross-sectional study in South India. (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=89621040&site=ehost-live)

2. Is There Any Association between Use of Smokeless Tobacco Products and Coronary Heart Disease in Bangladesh? (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=79911691&site=ehost-live)

October 17 (How do policies on tobacco control effect the use?) –

1. Sweden SimSmoke: the effect of tobaccocontrol policies on smoking and snus prevalence and attributable deaths. (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=96236555&site=ehost-live)

October 24 – 

Bayesian Approach to Zero-Inflated Bivariate Ordered Probit Regression Model, with an Application to Tobacco Use. http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=87045747&site=ehost-live

October 31 (What are some interventions taken to lower rates of tobacco use?)

1. “I would do anything for my child, even quit tobacco”: Bonus effects from an intervention that targets adolescent tobacco use. (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=43112606&site=ehost-live)

2. Preventing TobaccoUse Among Young People in India: Project MYTRI. (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=39655718&site=ehost-live)

November 7 (What are some interventions taken to lower rates of tobacco use?) –

1. Pilot evaluation of a population-based health intervention for reducing use of smokeless tobacco. (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=6366367&site=ehost-live

2. Community-based model for preventing tobacco use among disadvantaged adolescents in urban slums of India. (http://ccny-proxy1.libr.ccny.cuny.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=50985787&site=ehost-live)

November 14 – TBA

November 21 – TBA

December 5 – TBA

December 12 – TBA