Recently in Social Infrastructure Category

Your immune system is a tremendously sustainable system! But we can exercise it with a dose of... laughter.

John Cleese takes us on a tour of a laughter therapy practice in India.

Laughter promotes stress reduction, community bonding, stronger immune system... and joy. What a simple solution!

A NEW WINDOW INTO THE DISCUSSION ON HEALTH CARE POLICY
by Dan Weintraub

After more than 25 years covering public policy and politics for California newspapers, Dan Weintraub begins a new online journalism initiative that promises to report on California's government and its communities in new ways.

HealthyCal.org, a nonprofit web site I'm creating with initial funding from the California Endowment, will cover public health policy from inside the Capitol and from communities across California. The goal is to connect the two in a conversation that will inform both.

Nearly two dozen medical schools that have recently opened or might open across the country, the most at any time since the 1960s and '70s.

These new medical schools are seeking to address an imbalance in American medicine that has been growing for a quarter century.

Many bright students were fleeing to offshore medical schools, or giving up hope entirely, when they could not get into domestic schools. 

In a weird aberration of "outsourcing", the medical field was outsourcing medical education to foreign countries, and then hiring foreign nationals to work in our American healthcare system, presumably at lower rates and longer hours.

During the 1980s and '90s only one new medical school was established.

"Huge numbers of qualified American kids were not getting into American medical schools or going abroad to study," Dr. Lawrence G. Smith, dean of the proposed Hofstra University School of Medicine, in Hempstead, N.Y., which is not yet recruiting students, said last week. "I think it was a kind of wake-up call."

The proliferation of new schools is also a market response to a rare convergence of forces:

• a growing population;
  
• the aging of the health-conscious baby-boom generation;
  
• the impending retirement of, by some counts, as many as a third of current doctors;
  
• the expectation that, the present political climate notwithstanding, changes in health care policy will eventually bring a tide of newly insured patients into the American health care system.

Colleges serve a "Gatekeeping Function" as well as education of new practitioners.  By carefully limiting the number of trained professionals, those with established careers have less competition -- and that can be important to personal care services that must maintain a full staff even when they have a light load of patients.  Under-staffing also causes long delays in getting an appointment, and has healthcare consequences when care is delayed.

If all the schools being proposed actually opened, they would amount to an 18 percent increase in the 131 medical schools across the country.

Read more at the REFERENCE SOURCE:  New York Times

Heavy backpacks place a measurable strain on the spines of children, with heavier loads causing greater spinal strain and increased back pain, reports a study in Spine, January 2010 

My husband and I started getting concerned about heavy backpacks when our son was required to carry a very heavy backpack weighted down with a year's worth of books when he was in gradeschool.  It just didn't make sense.  It's taken a long time to get the research to prove the problems.  But it's here now, and solutions need to be found -- such as eBook readers.

The next step in convincing schools to "lighten the load" is to show how expensive back pain and back care is to our society.  Maybe business and government can prevent that long term impact on healthcare costs by providing children is an alternative to heavy books.

Test Results for Children's Back Health 

Magnetic resonance imaging (MRI) scans show compression of the spinal discs and spinal curvature caused by typical school backpack loads in children, according to Dr. Timothy Neuschwander of University of California, San Diego, and colleagues.

Backpacks' Effects on Disc Height and Spinal Curve Linked to Back Pain

The study included eight children, mean age 11 years. A special upright MRI scanner was used to image the children's spines in standing position--first with an empty backpack, then with increasing weights of 9, 18, and 26 lb. These weights represented about 10, 20, and 30 percent of the children's body weight.

Two key spinal measurements changed as the backpack load increased.

• Heavier weights caused compression of the intervertebral discs, which act as a cushion between the vertebrae (bones of the spine).
  
• Especially in the lower spine, the disc height became smaller (reflecting greater disc compression) at heavier backpack weights.
• Heavier loads were also associated with increased curvature of the lower spine, either to the right or the left.
  

Half of the children had a significant spinal curve even with the 18 lb weight. Most of the children had to adjust their posture to bear the 26 lb backpack load.

As backpack weight increased, so did the amount of pain reported by the children. At the heaviest load, the average pain score was nearly five (on a ten-point scale).

Parents are increasingly concerned about the heavy backpacks their children have to carry. The new study is the first to use imaging techniques to see how backpacks affect children's spines.

More than 90 percent of U.S. children carry backpacks, typically with weights equal to 10 to 22 percent of their body weight.

Carry Backpacks on One Shoulder or Two?

The results suggest that heavy backpacks cause compression of the spinal disks and increased spinal curvature, both of which are related to back pain reported by the children. Although the children were wearing the backpack straps over both shoulders when the MRI scans were performed, the researchers note that spinal curvature could be even greater if the backpack was carried over one shoulder--as many children do.

Lower Back Pain for Children -- Through Adulthood

"Low back pain in children may be worsened by discogenic [disc-related] or postural changes," Dr. Neuschwander and colleagues write. This could have long-term implications, as children with back pain are at increased risk of having back pain as adults. The researchers call for similar studies to examine the effects of heavy backpacks in children with existing back pain.

About Spine
Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. According to the latest ISI Science Citation Impact Factor, Spine ranks highest among subspecialty orthopedic titles. Visit the journal website at www.spinejournal.com

Surgeon General Declares Thanksgiving as "Family Health History Day"

Surgeon General Regina M. Benjamin, today declared Thanksgiving Day 2009 to be the nation's sixth annual "Family Health History Day," when families can make plans for gathering their health history, with the aid of the My Family Health Portrait Web site.

"An important first step in preventing illness is learning about health conditions in our families that may put us at risk for inheriting diseases such as diabetes, heart disease, cancer, Alzheimer's, mental illness, and many others," said Dr. Benjamin.  "Discussing family health information with each other can often uncover things you never knew, simply because no one ever asked."

Your family health history can help direct your doctor, physician assistant, or nurse practitioner to specific tests or treatment plans you may need to take to prevent or delay disease.  For example, you can be tested for a heart condition or cancer because it's in your family history.

You can find the Office of the Surgeon General's
My Family Health Portrait Web site at
https://familyhistory.hhs.gov.

Once you have entered family health information, the on-line portal assembles the information into a medical "family tree" format that is useful for health care clinicians. This tool is free for anyone to use.

Filling out the "My Family Health Portrait" usually takes about 20 minutes.  You can share the Web portal with your family members to help fill in missing information. The portal also allows relatives to create their own family health history by adding to information already entered by another family member.

After filling in the information, you can save the information to your computer and -- if you want to -- share it with your doctor.  The Surgeon General's Web site does not retain the information once the tool has been used to assemble it.

"On this Thanksgiving holiday, I hope you and your family will take a few minutes to create a family health portrait," Dr. Benjamin said.   "Learning your family's health history is a valuable investment to make in your health and your family's health."

Obesity and its cardiovascular complications affect many African Americans, according to background information in the October 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Standard behavioral treatments for obesity appear to be less successful in African Americans than in whites. Cultural modifications to these standard programs--such as the inclusion of family members and support networks--may enhance their effectiveness.

Enrolling in a weight loss program with a family member or friend appears to enhance weight loss among African Americans, but only if the involved partner attends sessions frequently or also loses weight, according to the report.

The goal of a University of Pennsylvania School of Medicine  study was to achieve and maintain a 5 percent to 10 percent weight loss.

Components of the program included counseling that encouraged self-monitoring of food intake and physical activity, distribution of pedometers, group sessions involving weight and activity checks and skill building, and community-based field workshops such as cooking demonstrations and gym visits.

Weight Loss Results

After 24 months, main participants had lost an average of 5.3 pounds. Participants in the two family groups initially had better attendance and greater weight loss than those in the individual group, but these changes were not statistically significant and decreased over time.

TIP: Personally tailored counseling sessions

However, participants whose partners attended more personally tailored counseling sessions had lost more weight at six months in the high-support group and at six, 12 and 24 months in the low-support group. 

TIP: Choose your partner carefully

In addition, those in both family groups whose partner lost at least 5 percent of their body weight had greater weight loss at six months than those whose partner lost less than 5 percent.

This study was funded by a grant from the National Heart, Lung, and Blood Institute. Laboratory analyses were provided through a General Clinical Research Center Grant from the National Institutes of Health/National Center for Research Resources.

Source: Newswise, Inc

Health underlies everything we do.  Not "health care" but health. 

Our well being.  Think safety and joy and comfort food.

Our environment.  Remember Love Canal?

Our behaviors.  Think "exercise".

Our food and exercise and social connections.  Our community resiliency and survival network.

But politics and economics soon enter the health equation.

Here's a health idea that Democrats and Republicans agree on: when given information on the genetic factors that cause diabetes, both parties equally supported public health policies to prevent the disease.

But a study designed by the University of Michigan showed Republicans were less supportive of such policies after reading news reports that people with diabetes got their illness because of social or economic factors in which they live, such as lack of neighborhood grocery stores or safe places to exercise. The social factors increased Democrats' support.

"When people are given the same information they can come away with very different opinions," says Sarah E. Gollust, Ph.D., a Robert Wood Johnson Foundation Health and Society Scholar at the University of Pennsylvania who worked on the study during her doctoral work at U-M.

Increasing public awareness of social factors that impact health may not uniformly increase public support for action because some groups simply do not believe they are credible, authors write.

Social Values Influence Policy...surprised?

"Policymakers and journalists should be aware that social values influence people's opinions about health policy, and certain messages in the media might trigger these values," she says.

The findings contribute to evidence that Americans' opinions about health policy are polarized by political party lines, according to the study.

Gollust designed the study with Paula Lantz, Ph.D., a social epidemiologist and chair of the Department of Health Management and Policy at the U-M School of Public Health and Peter A. Ubel, M.D., professor of internal medicine at the University of Michigan and director of the U-M Center for Behavioral and Decision Sciences in Medicine.

Diabetes News and Policy Research

Study participants viewed news articles about type 2 diabetes on the Internet and then answered questions about their opinions on health policy and their attitudes about people with diabetes.

When each viewed an article on the links between social and neighborhood factors and diabetes, 32 percent of Democrats agreed with social factors' role on health compared to 16 percent of Republicans.

Polarizing Information

"If you are more liberally minded the 'neighborhood explanation' can be motivating, but for people who are more conservative politically, that message can backfire and make them even less interested," says Ubel. "The same information can polarize people."

Diabetes was merely used as an example of a common health issue.

Social and Economic Factors ... and Health

While type 2 diabetes is associated with health behaviors, such as poor diet, lack of physical activity and obesity, these behavioral factors can be influenced by social and economic factors such as living in an unhealthy neighborhood.

Genetic Factors... and Health

Scientists have also identified numerous genetic variants that increase susceptibility to type 2 diabetes.

Non-medical Strategies for Health Care

So why focus on social factors? The goal of framing health matters according to social factors is increasingly used to shift attention to non-medical strategies to improve health. The media also commonly discuss the prevalence of social factors when describing health issues, but few studies have been devoted to whether it shifts public opinion.

Messages in the Media

"The problem is these messages aren't going to have the same effect on all people," Ubel says.

The authors do not suggest that news media avoid reporting on social factors. Rather, advocates who want to mobilize the public to support public health policies might consider disseminating information to the media about both social factors and individual behavioral causes to avoid triggering resistance. 

Messaging Options

• Social factors
• Individual behavioral causes
• Physical science
• Economic data
  

Tailored Messages for Audiences?

Isn't tailoring messages close to manipulation?  Writers and message makers all have to pick and choose what is included and excluded from our final message products ... but blatant manipulation to affect advocacy goals is not in our shared best interest. 

"Advocacy groups need to be very careful in thinking about who their audience is and what framing will work best for that audience," Ubel says. "Media should do a richer job of helping people understand each of these different causes."

Authors: Sarah E. Gollust, Ph.D., Paula M. Lantz, Ph.D., and Peter A. Ubel, M.D.

Citation: American Journal of Public Health, Vol. 99, No. 12, December 2009

Funding: Robert Wood Johnson Foundation Health and Society Scholars Program at the University of Michigan and at the University of Pennsylvania, the U-M Center for Behavioral and Decision Sciences in Medicine, and the University of Michigan Rackham Predoctoral Fellowship.

Resources:
U-M Center for Behavioral and Decision Sciences
http://www.cbdsm.org/

U-M School of Public Health
Department of Health Management and Policy
http://www.sph.umich.edu/hmp/

Source:  Newswise, Inc.

I'm very concerned about health options.  My own, my family's and our society's obsession with extreme health measures.  I was pleased to find this creative list of innovations and have selected to highlight  a few of these innovative health options that might also apply to American solutions for practical, affordable health care.

Grameen Health in conjunction with the 6th Annual World Health Care Congress put out a request for a poster session on extremely affordable global health solutions: "The poster Session will promote such innovations that seek to meet demands for low-cost, high-quality health care through a bottom-up understanding of unmet health needs and display a culture for continuous, incremental improvement of existing services to meet needs better... This session is intended as a platform for extremely affordable solutions in health care delivery using innovative enabling technologies and business models."

Mobile Solutions for Nutrition Monitoring
Childrens' Health Monitoring using mobile phones:
Open source, mobile phone based monitoring platform to address critical gaps in Malawian health care provision. Working with the Ministry of Health in Malawi, we are revamping their early warning famine surveillance system, employing affordable and readily available mobile technologies to empower local stakeholders with the tools necessary to effectively monitor nutrition conditions in their region. In addition, our project will enable the Government of Malawi, UNICEF Malawi, and their partners to geographically map and track child malnutrition trends accurately and in real time.

Maybe we need something like this for monitoring the hunger, safety and educational wellbeing of our children in America.


Women-Owned Franchises: Diagnostics
Throughout rural India, a scarcity of medical professionals has triggered a crisis - skyrocketing the opportunity costs to attain health care in urban areas. Without viable alternatives, the rural populace turns to unregistered practitioners - resulting in a low quality of care.   By supporting the entrepreneurial spirit of women-owned franchises, this growing network addresses health needs at the village. Drishtee drives each unit to break-even within a year. Qualified women applied to become DHF entrepreneurs; successful candidates received low-cost medical and business training. Medical equipments are financed as a loan. At training completion, DHFs are capable of conducting basic diagnostics, first-aid, eye screenings, and retailing OTC medicines and hygiene products. Drishtee partners with local private hospitals to provide physicians and specialists for weekly and monthly village clinics. Prices are scaled according to community needs.

Home-based or small business health screenings with transmission to your doctor.  That makes sense!


 Mobile Games for Healthcare
Freedom HIV/AIDS is first ever initiatives on HIV/AIDS awareness using mobile phone games, and it is also the largest ever-social initiative on the mobile devices.). The initiative has effectively been able to reach out to over 27 millions people in providing HIV/AIDS awareness and health communication through mobile phones. Mobile devices are the most prevalent tools in the hands of a common man all specially in the developing world. The number of mobile phone users in India reached 347 million at the end of 2008 (according to data released by the Telecom Regulatory Authority of India). In addition, more people in India have access to mobile phones than landline telephones or PCs, which makes mobile phones an extremely powerful medium for communication in India. Mobile is the device of the future, whether it is communication, education, health care, e-governance or information. In India, 24% of mobile users live in small towns and villages. Seeing the success of the launch of first four games in India, Freedom HIV/AIDS worked towards scaling the program, with rolling out of new games for regional consumption.

Wow...mobile phone information delivery is the way of the future!


WaterHealth International: Clean Water Solutions
Access to clean, safe water is one of the world's most urgent health crises. WaterHealth International's mission is to achieve unprecedented scale in providing affordable, clean, and safe water worldwide in order to save lives and enhance economic development. WaterHealth's unique combination of break-through technology and innovative business models enables the delivery of highly affordable, clean water to even the most remote, low-income rural communities. WaterHealth's business approach to this challenge includes partnerships for implementation with commercial institutions, international agencies, local and central government bodies, and non-governmental organizations. WaterHealth's modular community-owned water "micro-utilities" are designed especially for rural and peri-urban communities. Each facility, known as a WaterHealth Centre, utilizes a multi-stage filtration system in conjunction with the company's proprietary, breakthrough ultra violet light disinfection technology, UVWaterworks™. The technology is highly efficacious against a broad spectrum of microbial pathogens, and the integrated system purifies and disinfects water with high microbial contamination, to produce safe, potable that meets or exceeds WHO guidelines.

There are American communities that don't have access to clean, fresh water, too.

SOURCE: Zyozy.org