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Author: Anonymous

The World Health Organization (WHO) was founded on April 7th, 1948. More than 7,000 people from 150 countries work for this organization. Their goal is to provide good healthcare services to people globally. Their aims are to improve health, support the vulnerable, and maintain order and safety. However, not all is as it seems with the WHO. In recent years, it has been facing a number of problems such as corruption, racism, and an ineffective bureaucratic structure.

In the field of global health, corruption can be defined as “misappropriation of authority, resources, trust or power for private or institutional gain that has adverse effects on regional, local or international health systems and/or that negatively impacts individual patient and/ or population health outcomes” (Tim K Mackey, 2018, p. 1 ). According to the Guardian, a senior WHO official misused the funding set aside for the prevention of Ebola in West Africa that began in 2013 as well as an outbreak in the Democratic Republic of the Congo (Ratcliffe, 2019). The staff fabricated a mission so that a senior employee’s girlfriend, a junior professional, could be with him during the Ebola outbreak (Ratcliffe, 2019). The senior employee abused his power and authority for his own benefit, negatively impacting the international health systems. This sets a bad example for his colleagues who might follow his lead. This negative trend will only disrupt the efficiency of international health systems.

Despite the director of the senior management team in WHO, Dr. Tedros Adhanom, claiming that the WHO management team is the most diverse and gender balanced of any United Nations agency, racism and sexism still pervade (Ratcliffe, 2019). The anonymous email to senior management of WHO alleged that “there were crooked recruitment and selection processes that were tantamount to fraud, corruption and abuse of authority” (Keaten, 2019). For example, the senior official who misused Ebola cash might have not obtained his position if not for the flawed hiring process in WHO’s emergencies department (Cheng, 2019). This email contradicted what Dr. Tedros advertised to the world, ruining WHO’s credibility. This contradiction also illustrated Dr. Tedros’s lack of knowledge or willingness to overlook the flaws of WHO’s administrative system and further demonstrated the corruption from the top to the bottom in WHO.

In addition to corruption, racism is rampant in WHO. According to AP, three emails complained about the “systematic racism” against African staffers. They were being “abused, sworn at and shown contempt to” by their Geneva-based colleagues (Keaten, 2019). Nevertheless, two additional emails addressed to WHO directors revealed that the officials being reported for racism were trying to stop the investigation into racism (Cheng, 2019). Oyewale Tomori, a Nigerian virologist who previously worked at WHO, was not surprised by the email and believes there will be more complaints regarding corruption and other misconduct in WHO (Cheng, 2019). WHO is supposed to advocate for racial equality, and yet this reality demonstrates WHO’s utter failure in this regard.

While WHO strives to serve the world better, its inefficient and unregulated administration causes corruption and creates unfriendly working environments for people of color. “WHO is the leading technical agency in global health, assisting states with surveillance, strengthening and preparing grant applications” (Pillinger, 2017). The inherent reasons behind the collapsing system are a lack of international scrutiny and transparency towards the usage of large amounts of government funding. A single mistake WHO makes has dire consequences on the wellbeing of the world since it sets the ultimate guidelines and sets an example for countries. Therefore, higher regulation of the WHO and more visible processes will minimize the rate of making a mistake.

Additionally, “Like most parts of the United Nations, it (WHO) is infamously, inevitably, tangled in bureaucracy. It has a tendency to freeze in the face of controversy” (Kidder, 2009, p. 172). Tracy Kidder criticized the bureaucracy that prevents WHO from giving an immediate response in crisis situations. For example, WHO’s slow response to the Ebola outbreak in 2013 contributed to more than 11,000 deaths (BBC News, 2015). To improve the efficiency of the administration, WHO should downsize their large bureaucratic staff and create a merit-based hiring process that is visible to the public. With a smaller and more qualified staff, WHO will be more flexible when a crisis requires immediate actions.

Issues of corruption, racism and bureaucracy in WHO must be addressed immediately if WHO wishes to maintain its status as a renowned international organization and continue doing good in the world. Corruption and racism should be addressed through intensified international surveillance and transparent utilization of government funding. Improved administration through downsizing staff and a merit-based hiring process will enable the WHO to give immediate response.

 

References

Cheng, M. (2019, January 17). AP Exclusive: UN health chief orders probe into misconduct. Retrieved March 28, 2019, from https://apnews.com/           0309500d252b4d63aab359d4c4e1965f

Ebola global response was ‘too slow’, say health experts. (2015, November 23). Retrieved from https://www.bbc.com/news/health-34877787

Keaten, J. (2019, January 18). UN health agency: Rising misconduct reports are ‘positive’.    Retrieved from https://www.apnews.com/8230c79f64084a3cb3a88e0d7e1b36b6

Mackey, T. K., Vian, T., & Kohler, J. (2018). The sustainable development goals as a framework to combat health-sector corruption. Bulletin of the World Health Organization, 96(9), 634-643. doi:10.2471/blt.18.209502

Pillinger, M. (2017, June 22). The World Health Organization spends more on travel than on key diseases. That’s actually okay. Retrieved from https://www.washingtonpost.com/news/monkey-cage/wp/2017/06/22/the-world-health-organization-spends-more-on-travel-than-on-key-diseases-thats-actually-okay/?noredirect=on&utm_term=.01cf10204e83

Ratcliffe, R. (2019, January 18). “Senior WHO official accused of using Ebola cash to pay for girlfriend’s flight”. Retrieved March 28, 2019, from https://www.theguardian.com/global-development/2019/jan/18/senior-world-health-organization-official-accused-of-using-ebola-cash-to-pay-for-girlfriends-flight-corruption-racism-sexism

Kidder, T. (2009). Mountains beyond mountains: The quest of Dr. Paul Farmer, a man who would cure the world. New York, NY: Random House.

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By: Eva Rondon

One Sunday afternoon, my friends and I found ourselves at a favorite spot in Lowell, Wham’s Café. It’s a small Kenyan spot known for authentic food. When the aromatic food arrived on our server’s tray, I got to thinking about Kenya and more broadly about Sub-Saharan Africa, their amazing food, and how this region might go about keeping their food safe. I turned to Google, as the kids do, and gathered some helpful information. Now I want to share my new knowledge on Sub-Saharan Africa’s burden of foodborne illness and what steps can be taken to reduce the burden.

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The infographic above shows the burden of foodborne illness in Sub-Saharan Africa (World Health Organization). You can see that salmonella and other diarrheal diseases are responsible for approximately 70 percent of the burden. Chemical hazards, such as aflatoxin and cyanide, are responsible for approximately 25 percent of foodborne-related deaths (NPR). Because these toxins pose a stronger threat than diarrheal diseases, they get a lot of attention and funding from the global health community, representing $140 million in spending by multilateral development agencies, such as the US Agency for International Development (USAID) and the Bill and Melinda Gates Foundation (McDonnell). Additionally, the Standards and Trade Development Facility has spearheaded an ongoing project called the Sub-Saharan African Total Diet Study, in which researchers are studying the diets of individuals in Benin, Cameroon, Mali, and Nigeria. This is based on a similar study conducted on Americans by the FDA. The increased funding and availability of projects surrounding food safety in the Sub-Saharan region are vital first steps to reducing the burden of food borne illnesses.

 

2 Ways to Reduce the Burden

 

Erastus Kang’ethe, a professor of public health at the University of Nairobi says, “Governments didn’t put much importance on [food] safety. The question was, can our people be fed?” (McDonnell). Access to safe foods and the burden of foodborne illness is closely intertwined. With strides being made in regards to access, here are three potential approaches to reducing foodborne illness in Sub-Saharan Africa:

 

  1. Education

I propose that a system should be implemented to educate mothers in different towns and villages about food safety. Numerous studies have found that mothers are the most committed to learning opportunities for the sake of their families (Amarok). Time and space could be allotted in different villages so that mothers and their young children could attend a short series of courses about food safety, and learn what actions they can take to increase the odds that their families are being safely nourished.

This is a more effective alternative to food safety being taught in schools. It is not guaranteed that teachers are properly trained in the material, and it would be difficult to pinpoint an age group where this topic is most appropriate. Studies in Kenya, Egypt, India, and Ghana indicate that educating mothers is a good step for developing countries, leading to a higher likelihood their children will be educated and eventually escaping poverty (Francis). Applying this knowledge to the realm of foodborne illnesses, mothers’ children will be more educated.

  1. Continent-wide food safety authority

The African Union is already working on a continent-wide food safety authority, with plans to publish a report by the end of 2019 that will include strategies for reducing the burden of foodborne illness (Amarok). This organization will presumably run comparably to its American counterpart, the FDA. This is an exciting time with the possibility of food safety being prioritized in their respective countries, but of course, this will not be enough.

This is because before the African Union commits fully to food safety, it needs to commit to food access. Right now, approximately 20% of individuals residing in Sub-Saharan Africa are undernourished (Our World in Data). As the world develops overall, this number decreases. It will be interesting to see, however, what strides will be taken in this region to address this problem with more depth and with a sense of urgency. Like all things in public health, a problem is multi-faceted and complicated. For now, food access trumps food safety.

 

Works Cited

Francis, Taylor. “Female Education in Sub-Saharan Africa.” Comparative Educationhttps://www.researchgate.net/publication/44815283_Female_Education_in_Sub-Saharan_Africa_the_key_to_development

McDonnell, Tim. “A Fatal Public Health Problem In Africa That Flies Under The Radar.” NPR, NPR, 21 Feb. 2019, www.npr.org/sections/goatsandsoda/2019/02/21/696385246/a-fatal-public-health-problem-in-africa-that-flies-under-the-radar.

STDF. “How Safe Is Africa’s Food?” YouTube, SDTF, 19 Nov. 2018,       www.youtube.com/watch?v=J3-QEN0YpZE.

“Why We Teach Mothers : Amarok Society.” Amarok Society RSS,          amaroksociety.org/wordpress/what-we-do/why-we-teach-mothers/.

World Health Organization. “Foodborne Diseases in Sub-Saharan Africa.” who.int. https://www.who.int/foodsafety/areas_work/foodbornediseases/infographics_afro_en.pdf

By: Kaylee Smith

In 2017, Nature reported that gonorrhea is becoming “as incurable as it was in the 1920s, before the first drugs to treat it were used” (Maxmen, 2017). I find this statement alarming. As a US citizen, gonorrhea has never struck me as a major threat to public health. Sex education in the US isn’t as effective as it could be and this means 2.3 million people became infected with gonorrhea and other sexually transmitted infections (STIs) in 2018 despite sex education in schools. There are antibiotics which cure gonorrhea so why is prevention of this specific STI so important?  It’s important because gonorrhea is becoming increasingly difficult to treat due to a rise in antibiotic resistance and is tied to increased cases of HIV.

Resistance is a troubling occurrence globally warranting the World Health Organization (WHO) to include it in their list of top ten threats to global health in 2019 (Who.int, 2019). Infections including pneumonia, tuberculosis, salmonellosis, and gonorrhea have all had cases of resistance. However, I think there are several aspects of gonorrhea which make it a particularly alarming infection to see on this list including, its high rate of incidence, the nature of transmission, and the disease’s connection to HIV. Drug-resistant gonorrhea poses a unique threat to US public health but what really concerns me is that it poses an even greater threat to global health.

The following video created by the Center for Disease Control and Prevention gives a general overview of the emerging issue of drug resistant gonorrhea (Cdc.gov, 2018). https://www.youtube.com/watch?time_continue=211&v=iFwlnljV2Go

In the US, gonorrhea is the second most commonly reported notifiable disease (Cdc.gov, 2018). This translates to about 170 cases per 100,000 population, a number that has been on the rise since 2009. In low income countries even higher rates of infection have been observed with about 1,000 cases per 100,000 population (Who.int, 2017). Gonorrhea can be treated successfully with antibiotics so the high incidence alone is not enough to make the STI a global health priority. However, imagining a near future in which gonorrhea becomes fully resistant to known antibiotics, the high incidence of the disease will become much more alarming as prevalence could begin to increase just as rapidly as incidence.

Gonorrhea is unique compared to pneumonia or tuberculosis because it is an STI. Incredibly successful methods of prevention exist for STIs but difficulty in implementing these methods significantly decrease their success as sexual health is a relatively taboo topic globally. The WHO notes “consistent and correct condom use” is a particularly important way in which individuals can protect themselves against spread of the disease (Who.int, 2017). However, globally, condom use is trending down (Who.int, 2017). In a world where gonorrhea is becoming more difficult to treat, countries should prioritize public health campaigns which make condoms more accessible as well as promote their consistent and correct use. Addressing the issue of resistance will require medical advances, such as new antibiotics, but maybe just as important is comprehensive sexual health education. Prevention is possible, the solution already exists, but implementing prevention methods are not always socially palatable and this issue cannot be underestimated or ignored. If full resistance occurs and new antibiotics have not been discovered, prevention efforts will be the only defense against gonorrhea.

Another reason that increased condom use is especially important in the context of antibiotic resistant gonorrhea is because of an increased risk of HIV infection associated with gonorrhea. Research suggests that individuals coinfected with gonorrhea and HIV are at an increased risk for infecting partners with HIV and individuals infected with gonorrhea alone are at a higher risk of getting HIV (Who.int, 2017). The number of individuals infected with HIV has been decreasing due to prevention efforts, as well as increase accessibility to antiretroviral therapy, made all around the world but antibacterial resistant gonorrhea poses a serious threat to this success. The high incidence of gonorrhea in the US suggests the massive impact resistance could have but, as with many global health issues, low income countries will bear an even greater burden than those with high income. High income countries will have the resources to protect their citizens but lower income countries already burdened with various other infectious diseases will feel the greatest impact. If new antibiotics are not developed to treat gonorrhea, then it will once again become an incurable disease which will lead to consequences on an already incurable disease, HIV.

 

Work Cited

Maxmen, A. (2017). Untreatable gonorrhoea on the rise worldwide. [online] Nature. Available at: https://www.nature.com/news/untreatable-gonorrhoea-on-the-rise-worldwide-1.22270 [Accessed 22 Feb. 2019].

Cdc.gov. (2018). Gonorrhea – 2017 Sexually Transmitted Diseases Surveillance. [online] Available at: https://www.cdc.gov/std/stats17/gonorrhea.htm [Accessed 22 Feb. 2019].

Cdc.gov. (2018). Antibiotic Resistant Gonorrhea – STD information from CDC. [online] Available at: https://www.cdc.gov/std/gonorrhea/arg/default.htm [Accessed 22 Feb. 2019].

Who.int. (2017). Antibiotic-resistant gonorrhoea on the rise, new drugs needed. [online] Available at: https://www.who.int/news-room/detail/07-07-2017-antibiotic-resistant-gonorrhoea-on-the-rise-new-drugs-needed [Accessed 22 Feb. 2019].

Who.int. (2019). Ten health issues WHO will tackle this year. [online] Available at: https://www.who.int/emergencies/ten-threats-to-global-health-in-2019 [Accessed 22 Feb. 2019].

 

 

 

By: Azanta Thakur

I was born and raised in Florida. My parents immigrated from Bangladesh over thirty years ago and settled in a place that mirrored Bangladesh’s climate: hot year-round, a lot of rain, and near the ocean. I have my feet in two worlds that are starkly different from each other in every single way imaginable except for one: climate change. Bangladesh and Florida, among other low-lying countries and islands, are two of the most susceptible areas on Earth to sea-level rise and changing climates. You may be able to imagine that the stake I have in the fight against climate change is personal. When I read a New York Times article, “Study Warns of Cascading Health Risks From the Changing Climate”, it drew me in. It briefly discusses the 2018 report of the Lancet Countdown on health and climate change, shaping nations’ health for centuries to come. It is a brief yet telling read that analyzes the Lancet article, dividing it into categories based on how it will affect community and public health. It is a very good read, albeit alarming, and I highly recommend it if you are interested in the intersectionality of climate change and public health. But while it covers a lot — extreme heat, lost labor, infectious diseases, droughts and floods, and food production — I wanted to discuss one thing the article does not: pollution and single-use plastics.

In 2018, a gruesome video from 2015 of a marine biologist pulling a plastic straw out of a turtle’s nose went viral. It was this single video that sparked the movement against straws to explode. But the virality of ditching the straw was certainly not a movement. For all intents and purposes, it was a moment in the face of a much, much larger problem: plastics. In my opinion, the war on straws is like “thoughts and prayers” for climate change. There are gruesome realities that stretch far beyond straws under the ocean. According to a paper published by Science, several million metric tons of plastic enter the oceans every year with straws making up just a tiny fraction of this total (Lebreton et al., 2018). And while yes, that equates to 7.5 million straws on U.S. beaches and in the oceans, they are not the holy grail that will solve our plastic issues. Straws are just a poster child for the bigger issue of the use of plastics.

According to the EPA, less than 10% of all plastic in the U.S. are recycled. Most of it is not recyclable and is sent to the landfill — or sent to the oceans through sewers, storm drains, and runoff (Jambeck et al., 2015). Once the plastics enter the oceans, they become stuck in current systems and create the giant patches of plastic floating away — like the Great Pacific Garbage Patch.

azanta

Source: Phys.org. Pacific plastic dump far larger than feared: study

These patches are not only getting bigger, but also beginning to sink down to the bottom of sea beds where they are starting to break down. Scientists have only recently started to study the breakdown of plastics into tiny microscopic pieces, called microplastics. Driven by UV radiation, the sun’s rays can break up the chemical bonds in plastic layer by layer, creating microplastics (Lebreton et al., 2017). Two years ago, they found that microplastics can be created in as little as eight weeks, blowing the misconception that plastics take years to disintegrate quite literally out of the water (Andrady, 2017). Now we’re finding plastic in environments that have just emerged due to glacial melting, like in Antarctica — the places you would believe to be the most pristine places on the planet (Greenpeace, 2018).

The public health implications have not yet been studied of just how far plastics will reach and how much they will affect us because of how new microplastics are to us. Still, it’s easy to imagine that they can’t be good. There are no concrete answers it seems, but we know that microplastics are getting into fish (and we’re are eating those fish) (Foley et al., 2018). Some studies suggest that microplastics are causing harm in organisms, yet other studies are finding that they are benign, for both fish and humans. The research is inconclusive, but none of the science says everything is normal. It’s a matter of whether we should be worried, or very, very worried.

The fact remains that the problems are growing faster than our knowledge, and we could be very well poisoning our oceans to permanent ends; the oceans that affect our very climate, environment, and consequentially, human health.

 

References

Andrady, A. (2017). The plastic in microplastics: A review. Marine Pollution Bulletin,      119(2017), 12-22. doi: 10.1016/j.marpolbul.2017.01.082.

Foley, C.J., Feiner, Z.S., Malinich, T.D., & Höök, T.O. (2018). A meta-analysis of the effects of exposure to microplastics on fish and aquatic invertebrates. Science of the Total Environment, 631-632, 550-559. doi: 10.1016/j.scitotenc.2018.03.046.

Greenpeace. (2018). Microplastics and persistent fluorinated chemicals in the Antarctic. Retrieved February 21, 2019 from https://storage.googleapis.com/planet4-international-stateless/2018/06/4f99ea57-microplastic-antarctic-report-final.pdf.

Lebreton, L., van der Zwet, J., Damsteeg, J., Slat, B., Andrady, A., & Reisser, J. River plastic emissions to the world’s oceans. Nature, 8(15611). doi: 10.1038/ncomms15611.

Lebreton, L., Slat, B., Ferrari, F., et al. (2018). Evidence that the Great Pacific Garbage Patch is rapidly accumulating plastic. Nature, 8(4666). doi: 10.1038/s41598-018-22939-w.

Rustagi, N., Pradhan, S.K., and Singh, R. (2011). Public health impact of plastics: An overview. Indian Journal of Occupational & Environmental Medicine, 15(3), 100-103. doi: 10.4103/0019-5278.93198.

Sengupta, S. & Pierre-Louis, K. (2018). Study warns of cascading health risks from the changing climate. New York Times. Retrieved February 15, 2019, from https://www.nytimes.com/2018/11/28/climate/climate-change-health.html.

 

What the Measles?

By: Tayun Park

When you think of measles, what do you think of? You’re probably not sure of the symptoms but maybe you’re envisioning red rashes like chicken pox. Or coughing, high fevers, stuffed or runny sinuses, symptoms akin to the flu. Or maybe you have no idea!

Measles is a viral disease with symptoms akin to both the chicken pox and the flu. Living in a high-income country, measles is not high on my radar; it’s a disease of the past. Why should I worry about it when vaccines are readily available, and vaccination is a requirement for public school attendance?

If we live in a country where all able children are vaccinated, why are we seeing an outbreak of measles across the country? By mid-March 2019 there were 268 confirmed cases of measles within the United States. But this isn’t the only outbreak in a high-income country in recent years. There were 14,451 cases across Europe in 2017, three times the amount reported in 2016. Most of these cases are being reported in children under the age of 12 months. Based on vaccine schedules, the first measles, mumps, and rubella (MMR) vaccine is scheduled to be during 12-15 months of age. The increase in the number of children diagnosed means that herd immunity is failing.

Herd immunity is the idea that if a certain percentage of the population is unable to contract an illness, AKA vaccinated, then the people who are unable to receive vaccinations, due to lack of access, autoimmune disease, allergic reaction, or too young to have received the vaccine, will be protected against the illness as well. Of course, this isn’t a failproof method as there are many confounds that can work against this in part due to our globalized world.

Understandably, the MMR vaccine has been a victim to false propaganda spreading an unproven correlation to autism faster than people have looked for facts. A recent reintroduction to the Wakefield paper, a product of research fraud and bribery, has caused a lot of this MMR vaccine drama. This paper was written only because “[Wakefield] had been paid by attorneys seeking to file lawsuits against vaccine manufacturers”.

Some anti-vaxxers base their facts on specific but rare cases of severe allergic reactions to vaccines. The anti-vaxxers in a video posted by Jubilee Media bring up the idea of informed consent about the risks of vaccines and I agree that that is an important aspect of any medical procedure.

Vaccines are NOT entire living viruses or bacteria that will be realized in your body as a full-fledged illness, but parts of a virus/bacteria or dead/weakened viruses/bacteria that have been tested to not cause disease. The Center for Disease Control (CDC) acknowledges that “any medication can cause a severe allergic reaction. Such reactions to a vaccine are estimated at about 1 in a million doses.” The CDC also prefaces this with the reminder “vaccines are continually monitored for safety, and like any medication, vaccines can cause side effects. However, a decision not to immunize a child also involves risk and could put the child and others who come into contact with him or her at risk of contracting a potentially deadly disease.” For more information, you can read this paper about Vaccine Allergies.

There is also a lack of fear regarding the diseases which high income countries have been immunized to. They do not realize the risks and potential deaths that could follow contracting a preventable disease. It also comes to our negligence of world news. As of today, Madagascar has seen over 900 dead in their measles epidemic. Measles is not a different disease in Madagascar compared to Europe. Better sanitation and proper hygiene does not change the mortality rate of a disease, it just changes the rate of occurrence.

The best way to fight against disease is vaccination. Yes, there are side effects. Now, it’s become part of a larger, better conversation. But remember that when choosing to not immunize yourself or your child, it’s not just a decision you’ve made for yourself. You’re affecting everyone you come in contact with as well, and that’s not a decision you can make on your own.

As I wrap this up, The New York Times is releasing an article about Japan’s worst measles outbreak in years. Why? It’s due to people from a Valentine’s Day gift fair interacting with a religious group that does not vaccinate.

  

For more fun sources you can watch:

The Thing About Vaccines… | Vaccine Controversies | Doctor Mike here

Or

Doctor Reacts to Middle Ground: Pro-Vaccine vs Anti-Vaccine here.

 

 

            Works Referenced

Do Vaccines Cause Autism?. The History of Vaccines. https://www.historyofvaccines.org/content/articles/do-vaccines-cause-autism. Published January 25, 2018. Accessed February 22, 2019. 2, 2019.

By: Jenice Ko

Growing up, I was taught that a 65 out of 100 was a passing grade, but a 90 or more was ideal. Numbers meant everything to me as I looked at prices or phone numbers, and I placed a value on them with the assumption that the larger number was a better one. If I scored a 47% on a test now, let alone back then, I’d be absolutely crushed. Simply put, I failed. Now let’s take that 47% and put it in terms of flu shot effectiveness. The shot isn’t effective over half of the time – why does it deserve praise? The truth is that 47% is great. Not everything is about high marks from the start, but rather improvement.

According to Joshua Doyle’s “Interim Estimates of 2018-2019 Seasonal Influenza Vaccine Effectiveness”, the flu shot for the 2018-2019 season is 47% effective (Doyle, 2019). In comparison, for the 2017-2018 season, the shot was only 40% effective, with 185 child deaths linked to the flu (Doyle, 2019). Now on a broader scale, in the United States, 79,000 people died, 959,000 people were hospitalized, and 48.8 million people suffered from the flu just in 2018. Given the 7% increase, the current projection shows a decrease in the number of deaths, people hospitalized, and people sick with the flu.

I understand why college students are reluctant to get flu shots: cost, time, or disbelief. However, just like that common adage says “your body is a temple,” so it’s time that you start treating it like one. With insurance, flu shots are reasonably priced around $20 (CDC, 2019). Without insurance, you still have the option to go to clinics or even CVS and pay for a shot out of pocket for $25.I realize that $25 is a lot, especially from a college student’s or retiree’s wallet, but $25 is much cheaper than spending upwards of $50 trying to buy medicine to help you feel better once you have the flu, and it can even save your life. You may not feel this way, but your body deserves the investment. In addition, the actual administration of the flu shot doesn’t take very long. If time was the biggest concern, then scheduling an appointment at your primary care physician, clinic, or urgent care for a shot can help you plan your day around this appointment. The reluctance to get a flu shot because of its ever-changing nature shouldn’t be a reason to not get one. Things are constantly changing and evolving, and if you aren’t smart enough to adapt, you fit Charles Darwin’s standard for survival of the fittest – except you won’t be the one surviving.

Right now, the flu shot isn’t much of a hot topic because of the resurgence of measles in the last year, but that doesn’t mean it should be forgotten (Scutti, 2019). Just like how everyone should be getting the Measles, Mumps, and Rubella (MMR) vaccine instead of hoping for herd immunity to save their lives, people should also be taking the flu shot seriously. I’m a big fan of herd immunity. Germs are constantly traveling through communities, but the idea that 95% of the population being vaccinated to prevent the spread of disease and possibly eradicate it altogether feels like a surreal dream when it’s actually a reality (Oxford Vaccine Group, 2016). Unfortunately, herd immunity isn’t the answer to everything. Given that only 43% of Americans received a flu shot in the 2017-2018 flu season, herd immunity doesn’t work as well in this instance (Young, 2018).

Let me clarify something – you cannot get the flu from getting the flu shot. Most likely you get sick in coincidence with the flu shot for a variety of reasons: you were sick when you got the shot, you caught the flu during the two-week window before the shot takes full effect, or you’re reacting negatively to the vaccine (Mayo Clinic Staff, 2018). If you don’t believe me or Mayo Clinic, maybe hearing Dr. Ken Jeong say it will help you. This urban myth has stirred up enough bad publicity for something so valuable in our lives. It’s time to actively work to promote an old but forgotten truth: flu shots save lives.

As a 20-year-old student, numbers still dictate a large part of my life. It affects whether I have enough money to pay for groceries or if I’m able to apply to the graduate school of my dreams. There are so many opportunities to become a statistic, but I know that one statistic I don’t want to be a part of is one of the many who have the flu. I may not always get As, let alone Bs, but I do know that it’s essential to be kind to myself. After all, if I held myself to the standard of flu shots, then 47% isn’t that bad.

 

Works Cited

 

Blanton, L., Dugan, V.G., et al. (2019). Update: Influenza Activity – United States, September 30, 2018-February 2, Morbidity and Mortality Weekly Report (MMWR), 68(6), 125-134. http://dx.doi.org/10.15585/mmwr.mm6806a1.

Center for Disease Control. (2019, March 1). CDC Vaccine Price List. Center for Disease Control. Retrieved from https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/index.html

Doyle, J. D., Chung, J. R., et al. (2019). Interim Estimates of 2018-2019 Seasonal Influenza Vaccine Effectiveness – United States, February 2019. Morbidity and Mortality Weekly Report (MMWR), 68(6), 135-139.  http://dx.doi.org/10.15585/mmwr.mm6806a2

Mayo Clinic Staff. (2018, September 11). Flu shot: Your best bet for avoiding influenza. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/flu/in-depth/flu-shots/art-20048000

Oxford Vaccine Group. (2016, April 26). Herd Immunity: How does it work? University of OXford Department of Paediatrics. Retrieved from https://www.ovg.ox.ac.uk/news/herd-immunity-how-does-it-work

Scutti, S. (2019, January 29). Measles: At least 107 measles cases confirmed across 21 states. CNN. Retrieved from https://www.cnn.com/2018/08/15/health/us-measles-cases-cdc/index.html

Wired. (2019, February 18). Ken Jeong Answers More Medical Questions From Twitter [Video file]. Retrieved from https://www.youtube.com/watch?v=3obig1XeOlw&feature=youtu.be&t=102

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By: Corrina Salas

The term “loneliness” often brings about images of an unattended party, few people at a large celebration, or generally speaking, short bouts of isolation. Seldom does this word conjecture thoughts such as “global health epidemic” or a significant indicator of life expectancy. If someone is feeling lonely, the typical advice I have heard is to simply “get out there” or to pick up a hobby that could bring them closer to others. This has been the socially acceptable way of dealing with loneliness. After findings by U.S. health insurance company Cigna and UCLA, both reports estimate that ~50% of Americans feel lonely at the time they were surveyed (Polack). Both studies used similar tests to give individuals a “loneliness” score, involving questions related to how the respondent feels about their relationships and if they believe they have fulfilling companionships (Polack). Though this may be viewed as only a mental health issue, other studies have shown that physical ailments begin to arise when someone feels perpetually lonely (Cleveland Clinic).

Nations across the globe are beginning to address the effects loneliness is having on their residents. The United Kingdom (UK) recently appointed a Minister for Loneliness to address and remediate the epidemic that is currently sweeping throughout the country. According to the “loneliness commission” in partnership with the Red Cross of the UK, approximately 18% of the UK’s population feels “mostly/always lonely” (“The Co-Operative”). Countries such as Japan and Sweden have done preliminary research on how loneliness is affecting their citizens (Mullins). This is an interesting time where we are seeing a common human experience being highlighted by governments as a health issue through research and public recognition. A small handful of states will hopefully create the initiative for other countries to consider the loneliness of their own citizens.

Though the U.S. currently leads countries in its research regarding loneliness, the UK’s officiated  Minister for Loneliness, Tracey Crouch, hopes to initiate studies that help estimate the number of Britons who are lonely, as well as program to help alleviate this epidemic (Prime Minister’s Office). She hopes to implement an initiative where postal workers would check up on their clients, as well an investment in more community spaces. In addition, with the help of Prime Minister May, Crouch hopes to make loneliness an easier topic to discuss in schools/workplaces. Though other European countries are dealing with the ramifications of widespread loneliness, Japan is also facing a similar issue amongst its citizens. Though elderly people in Japan experience loneliness on a grand scale (15% of elderly men that live alone have fewer than 1 conversation/week), 15% of Japanese citizens surveyed say they have no social interactions outside of their families (Hoffman). Japan currently does not have any government interventions intended to address this problem, but it may be necessary in the near future.

Despite the knowledge that their constituents are feeling lonely, countries might not know both how to measure this feeling and what effects loneliness can have on future health. The relative newness of recognizing loneliness as a health problem means that few comprehensive studies have been performed regarding its onset and effects. The most well-known study to date was performed by Cigna and Ipsos utilizing UCLA’s “Loneliness Scale” (Russell). This scale was developed in 1978 by D. Russell et. al., and has since been revised many times; most recently in 1996. The survey incorporates several questions regarding social connections. With a scale of 20-80, a person is deemed “lonely” if they score a 43 or higher on the test. Cigna conducted the survey amongst 20,096 Americans who were 18+ years of age, and found staggering figures regarding the state of their loneliness. 47% reported sometimes or always feeling left out and 20% rarely or never feel close to people (Polack).

Though this can be considered a mental health ordeal, somatic symptoms can arise from acute perceptions of loneliness. A paper written by Dr. Julianne Holt-Lunstead et. al claimed that increased strength in social ties is associated with up to a 50% reduced risk of premature death in adults (Holt-Lunstead).  Dr. Holt-Lunstead also claims that perpetual, deep loneliness can be comparable to smoking 15 cigarettes a day in terms of the risk factor for premature death. Levels of cortisol increase when someone perceives themselves as lonely, which can lead to coronary heart disease and disruptive sleeping patterns (Doane). In addition, perceived loneliness can have negative effects on behavior (e.g. not exercising as much), which also lead to detrimental health outcomes (“National”). In order to combat these issues, countries around the world are beginning to recognize this epidemic and plan action.

What can be perceived as a universal human experience has turned into a soon-to-be medical catastrophe if not appropriately addressed and dealt with. Now seen as a public and global health issue, extended periods of feeling lonely can be rightly viewed as what it truly is: a threat to the well-being of all humans.

 

Works Cited

Cleveland Clinic. “What Happens in Your Body When You’re Lonely?” Health Essentials from Cleveland Clinic, Health Essentials from Cleveland Clinic, 23 Feb. 2018, health.clevelandclinic.org/what-happens-in-your-body-when-youre-lonely/.

Doane, Leah D and Emma K Adam. “Loneliness and cortisol: momentary, day-to-day, and trait associations” Psychoneuroendocrinology vol. 35,3 (2009): 430-41.

Hoffman, Michael. “Solitude Appears to Have an Image Problem in Japan.” The Japan Times, The Japan Times, http://www.japantimes.co.jp/news/2018/08/11/national/media-            national/solitude-appears-image-problem-japan/#.XG3Ojs9KjfY.

Holt-Lunstad J, Smith TB, Layton JB (2010) Social Relationships and Mortality Risk: A Meta-analytic Review. PLOS Medicine 7(7): e1000316.https://doi.org/10.1371/journal.pmed.1000316

Mullins, Larry C., et al. “Loneliness and Social Isolation in Sweden: Differences in Age, Sex, Labor Force Status, Self-Rated Health, and Income Adequacy.” Journal of Applied Gerontology, vol. 10, no. 4, Dec. 1991, pp. 455–468, doi:10.1177/073346489101000407.
National Institutes of Health. “Care and Connection.” National Institutes of Health, U.S. Department of Health and Human Services, 5 Sept. 2018, newsinhealth.nih.gov/2018/08/care-connection.

Russell, D , Peplau, L. A.. & Ferguson, M. L. (1978). Developing a measure of loneliness. Journal of Personality Assessment, 42, 290-294.

Polack, Ellie. “New Cigna Study Reveals Loneliness at Epidemic Levels in America.” Cigna, a Global Health Insurance and Health Service Company, 1 May 2018, http://www.cigna.com/newsroom/news-releases/2018/new-cigna-study-reveals-loneliness-at- epidemic-levels-in-america.

Prime Minister’s Office. “PM Launches Government’s First Loneliness Strategy.” GOV.UK, Government of the United Kingdom, 15 Oct. 2018, http://www.gov.uk/government/news/pm-  launches-governments-first-loneliness-strategy#history.

The Co-Operative Group. “Loneliness Research.” Trapped in a Bubble Research, The Co-Operative Group, http://www.co-operative.coop/campaigning/loneliness.

World Health Organization. “The Determinants of Health.” World Health Organization, World Health Organization, 1 Dec. 2010, http://www.who.int/hia/evidence/doh/en/.