Features

BC Global Public Health and the Common Good faculty aspire to engage conversations about public health at every level. The posts archived below were orignially featured in the BC Global Public Health Newsletter. Read more about conversations surrounding public health that were inspired by current events this past year.

 

Nadia Abuelezam

Can a TV Show or Movie Cause a Change in Health Outcomes in the Population?

Nadia Abuelezam, Assistant Professor, Connell School of Nursing

May 3, 2019

Can a TV show or movie cause a change in a health outcome in the population?

This question has been asked in the past:

And most recently:

Is Netflix’s show 13 Reasons Why associated with an increase in suicide among young people?

In the month after the release of the Netflix show, the rate of suicide among 10-17 year old boys increased by 29% (no association was found among young girls or older age groups). The authors of the article can’t claim causation – that the shows CAUSED more suicides – but they talk about association and the patterns in suicide rates observed after the show aired. They conclude that caution should be taken in exposing young children and adolescents to the show.

Suicide is the 10th most common cause of death in the United States and the second most common cause among teenagers and young adults. Recent evidence shows that more young girls (ages 10-12) are using poison to attempt or complete suicide. Another major risk factor for suicide is screen use and screen time, which scientists know leads to changes in mood, sleep, and suicide risk.

The third season of 13 Reasons Why is in production, should it be stopped? Is there enough evidence to stop production? What is the media’s role in assuring the public’s health? We know that the media’s primary concerns are ratings and income. What would it take to stop the show’s production? Or are there counter-acting strategies that the public health community can use to educate young people who watch the show?

Do you think that production should be stopped for 13 Reasons Why?
Share your thoughts with us by using this link! (Survey has concluded) 

Tam Nguyen

Early Exposure to Allergens and the Risk of Allergies

Tam Nguyen, Assistant Professor, Connell School of Nursing

April 26, 2019

With the trees and flowers blooming, many people may experience seasonal allergies.  While seasonal allergies can be annoying, allergies in general exist in many different forms, and are a major cause of illness in the United States.  As many as 50 million people - about one in five - have allergies from one or more of the following things: food, dust, mold, cockroaches, insects, drugs, and materials such as latex.

For a moment, let’s turn our attention to the latest research related to the prevention of food allergies, especially peanut and egg allergies. Up until 2017, the American Academy of Pediatrics recommended that babies not eat peanuts and eggs until 1 year of age.  From 1997 - 2017, peanut allergies tripled in prevalence in the United States. Initially, strategies to address this problem focused on allergen avoidance, but a key observation, a 10-fold higher rate of peanut allergy among Jewish children in the United Kingdom compared with Israeli children of similar ancestry, suggested an alternative approach and prompted a large body of research to examine the benefits of introducing allergenic foods earlier in life.  For example, a systematic review and meta-analysis showed an association between early introduction of peanuts and eggs and a lower risk of peanut and egg allergies in infants.

Now turning our attention back to seasonal allergies, there is also a growing body of research suggesting that early childhood exposure to a “good microbiome” can help other types of allergies, especially seasonal allergies.  A combination of strategies are recommended to get exposed to the “good microbes,” including natural childbirth, breast feeding, increased social exposure through sport, other outdoor activities, less time spent indoors, eating a diverse diet, and appropriate antibiotic use.  For those of us who are no longer children- it might not be too late for some of these strategies. So, go out and enjoy the blooming flowers and trees, and feel free to take some allergy meds if it will help, I know I will probably need to!

Nadia Abuelezam

What is the most dangerous animal in the world?

Nadia Abuelezam, Assistant Professor, Connell School of Nursing

April 12, 2019

What is the most dangerous animal in the world?
(And what does loud electronic dance music have to do with it?)

If you answered shark, lion, or elephant you’d be wrong! It’s actually the mosquito! Mosquitos are responsible for the transmission of a large number of dangerous viruses and parasites globally including malaria, dengue, lymphatic filariasis, Chikungunya, Zika, yellow fever, West Nile virus, and Japanese encephalitis. These diseases were responsible for over half a million deaths in the year 2017. Mosquitos are not only a nuisance in hot Northeastern summer months, but they are actually quite dangerous to the health of populations globally.

The World Health Organization published an analysis in 2016 indicating that nearly 21 countries could eliminate malaria by the year 2020. Namibia, one of the countries on the WHO list, is currently working to move towards malaria elimination through a multi-pronged approach including evidence-based and environmentally sound disease vector control interventions. Malaria incidence has decreased in Namibia by 97% from 2000-2012, but incidence has been on the rise since the year 2013.

Many scientists and researchers are coming up with creative ways to prevent mosquito transmitted infections, and some of these solutions are really out there! A recent study suggested that if you blast Skillrex’s song “Scary Monsters and Nice Sprites” Aedes aegypti mosquitos were much less likely to reporduce and bite humans. This is because mosquitos rely on sound for reproduction and feeding. Who knew that electronic dance music was so powerful!

Sanaria, a biotech company, is trying to produce a vaccine to prevent malaria acquisition. They’ve worked with robotics teams at Johns Hopkins to invent a guillotine for mosquitos. This tiny guillotine decapitates and dissects the salivary gland of the mosquito so they can extract the malaria-causing parasite that is an important component of their vaccine. But even with enough extracted parasite, the vaccine may not be effective at preventing malaria transmission because the immune response that needs to be elicited by a malaria vaccine is much higher than that for other diseases for which vaccines are readily available. This takes “the war against mosquitos” to another level!

While there are many challenges that remain to malaria elimination globally, creative solutions that may help reduce the malaria burden in resource-poor settings are being developed by teams worldwide.

Nadia Abuelezam

When a Picture is Worth a Thousand Words

Nelson Portillo, Assistant Professor, Applied Developmental & Educational Psychology

March 1, 2019

We like to say, ‘a picture is worth a thousand words’ when an image communicates a message effortlessly and better than written or spoken words. In the field of Public Health, we can visually represent and communicate our understanding of complex problems with data visualization techniques that summarize large amounts of information. Perhaps the best examples of images that are worth “a thousand words” in public health are those of maps created with Geographic Information Systems (GIS) applications in which we can represent and analyze spatial (geocoded) data. Besides being visually appealing, maps can communicate meaningful information without the need of understanding complicated forms of analysis, which makes them accessible to virtually everyone.

Historically, maps have been the primary source for storing and communicating spatial information. According to Koch (2005), medical mapping emerged as an attempt to understand the relationship between place and health. The earliest application took place in Italy, in the 17th century, with Filippo Arrieta (1694) as a means of administering health protection policies against the outbreak of plague in the province of Bari. In the 18th century, Valentine Seaman (1796) used maps as a tool for disease topography in New York for Yellow Fever. In 1878, the Boston Board of Health identified the smelliest places in the city in a map titled Showing the Sources of Some of the Offensive Odors Perceived in Boston. Below you can admire this early data visualization application (Image source: City of Boston Archives).


In the course “Public Health Practice in the Community,” students are introduced to the world of GIS and data visualization techniques to understand complex geographical patterns of relevant public health issues such as the opioid crisis, chronic diseases, and social determinants of health, among others. Students learn how to produce maps that convey information based on big data using a suite of tools that include PolicyMap and ArcMap. Although the course is not just about data visualization and GIS, students spend a significant amount of time learning the main concepts and techniques of this exciting application of public health. If you want to learn more about some of the most commonly used data visualization techniques for maps, check the blog of Vasavi Ayalasomayajula at socialcops.

Perhaps the most exciting part of the course is the creation of a digital poster in which students are free to explore fascinating research questions related to public health issues in spatial contexts. The learning curve is steep and students work hard to produce compelling visual representations, but they find this challenging process very rewarding. The fruit of their labor is entered into a cross-campus GIS competition sponsored by the main library and coordinated by Barbara Mento, our wonderful health librarian and Data/GIS Manager Senior at O’Neill Library. This friendly competition receives a healthy number of submissions every year and the work of numerous students is recognized with prizes. The winning entries are printed and displayed in large format at the library. Digital copies of all winning posters are available on the library’s website. You can see one of winning entries for 2018, by Emily Janin, which explored the health barriers and limitations that Palestinians face in East Jerusalem and the West Bank. Another example from 2018 is the work of Gabrielle Bouchard who examined the leading chronic diseases in Allston-Brighton community based on data from the Centers for Disease Control and Prevention’s 500 Cities Project.

The introduction to data visualization techniques and mapping helps students to think about public health issues and their visual representation in new ways. Try it and discover the fascinating ways in which GIS can help you create pictures that are worth a thousand words.

Nadia Abuelezam

The Importance of Rest and Relaxation

Nadia Abuelezam, Assistant Professor, Connell School of Nursing

March 1, 2019

Spring break could not come fast enough! We're (professors and students alike) sick of the winter weather and tired from all of our course work and exams. So we hope you're able to get away from campus and enjoy a bit of rest and relaxation next week. And perhaps, using our public health oriented minds, we could actually view spring vacation as a public health intervention for college students. There has been some research suggesting that vacation time reduces risks for cardiovascular disease and reduce stress and improves well-being. That doesn't mean you'll be able to return to a state of perfect health when you return, some evidence suggests that a vacation may be more beneficial for people in certain jobs and fields

Perhaps while on break you can start thinking about ways that you can bring rest into your daily routine on campus. That do you do on break that calms you or creates a sense of well-being? Is there any way for you to incorporate that into your daily routine on campus? Maybe making some time for exercise, increasing the amount of sleep you get, or spending time with family and friends rejuvenates you - how can you make these possible when you return for spring break? Planning is key! Creating sustained behavior change requires diligent effort and significant planning. Spending some time over spring break planning for the remainder of the semester may put you more at ease for your return. 

Remember to look out for public health all around you - no matter where you may be!

Phil Landrigan

A Major Victory for Public Health: Industrial Accountablity for Environmental Pollution

Phil Landrigan, Director, Schiller Institute

February 22, 2019

The February issue of the American Journal of Public Health contained a must-read article entitled An Enormous Victory for Public Health in California: Industries Are Responsible for Cleaning Up the Environments They Polluted.

This piece describes the successful outcome of a lawsuit that the state of California brought against three major manufacturers of lead-based paint on the grounds that these companies had knowingly sold a hazardous product poisoning thousands of children. The suit was based on the legal theory that lead is a “public nuisance”. The amount the judgement fined the paint companies was $400 million. The money will go to clear lead pain in thousands of older homes and apartments.

This was a sweet and long-awaited victory. Previous efforts in the states of Massachusetts and Rhode Island and in the city of Milwaukee to hold the paint companies accountable failed either because courts rejected the cases (RI and MA) or a jury ruled in favor of the paint companies (Milwaukee). Full disclosure: I served as an expert witness for the State of Rhode Island and the city of Milwaukee and I testified against the lead paint companies and their lawyers. So I feel a personal of sense of vindication here.

The California court’s endorsement of the “public nuisance” theory which has previously been used by health departments to stop people from dumping hazardous waste in rivers or piling up garbage in their backyard is a huge break-through. We can expect other states to follow. The article concluded by reminding us that even in times when the federal government chooses not to safeguard public health or protect the environment, state and city governments are powerful actors who can advocate public health and the common good.

Tam Nguyen

Celebrating Public Health Leaders in Honor of Black History Month 

Tam Nguyen, Assistant Professor, Connell School of Nursing

February 8, 2019

February is Black History Month. The US began celebrating it in 1926 as a way to remember important people and events in the history of the African diaspora. In honor of Black History Month, three notable Black Public Health leaders are highlighted. 

Dr. Michelle A Williams, Dean of the Harvard T.H. Chan School of Public Health:

Dean Williams is an internationally renowned epidemiologist whose work focuses on reproductive, perinatal, pediatric, and molecular epidemiology. She has published over 450 scientific articles, and was elected to the National Academy of Medicine in 2016. Before becoming Dean, she was a Professor and Chair of the Department of Epidemiology at the Harvard Chan School of Public Health, and Program Leader for the Population Health and Health Disparities Research Programs at Harvard’s Clinical and Translational Sciences Center. Additionally, Dean Williams previously had a distinguished career at the University of Washington School of Public Health. During her tenure at the University of Washington, Dean Williams received a Presidential Award for Excellence in Science, Mathematics and Engineering Mentoring from the National Science Foundation for her work in developing the Multidisciplinary International Research Training (MIRT) Program, which was designed to encourage underrepresented students to pursue careers in biomedical and behavioral science research careers.
 
Dr. Regina Benjamin, former U.S. Surgeon General:

Dr. Benjamin served a four-year term as the 18th U.S. Surgeon General (2009-2013). During her tenure she shifted the national focus on health from a treatment-based to a prevention-based perspective; highlighting the importance of lifestyle factors such as nutrition, physical activity, and stress management in the prevention of chronic disease. Additionally, during Dr. Benjamin’s term she advocated for breastfeeding and baby-friendly hospitals, tobacco use prevention among youth and young adults, healthy housing conditions, and suicide prevention. Before serving as the Surgeon General, Dr. Benjamin established the Bayou La Batre Rural Health Clinic on the Gulf Coast of Louisiana, where she provided care for patients on a sliding payment scale and even covering some medical expenses out of her own pocket. Dr. Benjamin has been widely recognized for her determination and commitment to social justice.
 
Dr. Camara Jones, former president of the American Public Health Association:

During her tenure as the president of the American Public Health Association, Dr. Camara Jones brought the impact of racism on health and well-being to the forefront of the public health agenda. She spearheaded a National Campaign Against Racism, with three specific goals: (1) naming racism as a driver of social determinants of health, (2) identifying the ways in which racism drives current and past policies and practices, and (3) facilitating conversation, research, and interventions to address racism and improve population health. Dr. Jones has published various frameworks and parables, most notably Levels of Racism: A Theoretic Framework and a Gardener’s Tale, to help facilitate an understanding of the nuances and layers of racism across the populations.
 
Let’s applaud their contributions and use it as inspiration for our on-going work, and ambitions, in public health!

Nadia Abuelezam

An Upsurge in Measels in the United States

Nadia Abuelezam, Assistant Professor, Connell School of Nursing

February 1, 2019

Measles, a highly contagious virus whose elimination was declared in the United States in 2000, has been circulating more regularly in the United States in recent years.

As of Wednesday, 39 cases of measles were confirmed in Washington State (in both Clark and King County). The majority of these measles cases have occurred in unvaccinated children.

So why are we seeing measles cases in Washington? Washington is one of the most permissive vaccination opt-out states. In Clark County, Washington almost 8% of all children have received exemptions for vaccines for entry into kindergarten (2017-2018 school year).

The national average is 2%. All 50 states require vaccinations for students, but almost every state allows for exemptions based on religious belief. In addition, 18 states grant philosophical objections (personal or moral beliefs opposing vaccinations). The county with the highest nonmedical vaccine exemption rate is Camas County, Idaho where 27% of the children have received exemptions for vaccinations. The measles vaccine is a highly effective primary prevention measure providing 93% immunity with one dose (and 97% with two). Increasing vaccination exemptions have been found to be directly correlated with increasing measles outbreaks.

Unfortunately, after they’ve started, measles outbreaks are very hard to contain. Measles has a very long incubation period - the time period between infection and the onset of symptoms. This means that people are likely spreading the disease before they even know they have it. Additionally, the measles virus is unique in that it can survive for hours outside of the body increasing the number of opportunities for infection. In an unvaccinated population one person with measles can infect between 12 and 18 others – that’s really infectious!

While the United States is believed to have (epidemiologically) transitioned from a state of high infectious disease burden to one of high chronic disease burden, the threat of measles remains a concern in the United States. Health educators, clinicians, and public health practitioners are tasked with increasing vaccination rates in order to maintain herd immunity and protect immunocompromised individuals (who cannot receive vaccinations). There are many challenges to this call to action, including the need for more effective scientific communication/education and stronger community partnerships to increase vaccination rates. Are we up for the task?

Nadia Abuelezam

The Global Cesarean Epidemic 

Joyce Edmonds, Associate Professor, Connell School of Nursing

January 25, 2019

As the United States government shutdown enters its second month, the risks to public health continue to rise. A key responsibility of government is to protect and promote the health of its citizens and so when the government does not function there are far reaching effects to individual and population health. What exactly happens to public health during a government shutdown? Employees and duties within key government health agencies are categorized as essential or nonessential. Nonessential personnel are furloughed and services cease. Essential personnel must work without pay during the shutdown, they may be given retroactive pay once the shutdown ends, that is only if Congress passes legislation authorizing such payments, which are not otherwise guaranteed.

Three examples from the recent shutdown show how the core functions of public health at federal agencies are negatively impacted.

  1. The Indian Health Service, an already strained system that provides health care to tribal communities, is out of funding in the shutdown, and only providing services that meet “immediate needs of the patients, medical staff, and medical facilities.” Clinicians see a systematic breakdown in a system that’s already very strapped for resources. The agency has also suspended grants that support tribal health programs, as well as preventive health clinics.
  2. The Food and Drug Administration routine inspections have ceased and food safety and nutrition programming is on hold. While food surveillance of high-risk products continue, operations are compromised. The FDA has also ceased monitoring of imports, notification programs, and the majority of laboratory research necessary to inform public health decision-making. Further, the FDA will not accept new drug and device applications for review, delaying acceptance of potentially life-saving innovations.
  3. The Environmental Protection Agency has furloughed 13,000 employees, with just 794 people deemed essential undertaking the agency’s responsibilities. Environmental testing and inspections have ceased meaning the public’s water, air, and soil are left untested for dangerous contaminants (e.g. lead, mercury). For example, testing to ensure toxic chemicals aren’t leaking into the lower Cape Fear river in North Carolina has been halted.

Health advocacy and civil rights organizations including the American Public Health Association have called for an immediate end to the shutdown. Lawmakers and the Trump administration must work together, for the health of the public.

Note: As a result of the current Federal government funding situation, the information on federal government websites may not be up to date or acted upon. result of the current Federal government funding situation, the information on this website may not be up to date or acted upon.

Nadia Abuelezam

Racism, Hate Crimes and Public Health in America

Nadia Abuelezam, Assistant Professor, Connell School of Nursing

December 14, 2018

Racism is a public health issue because it has impacts on a person’s and population’s health at multiple time points. Immediately, racism can cause violence, physical injury, and mental health issues (including anxiety, depression, PTSD). In society, we’ve seen that racism can also lead to disparities in educational and employment attainment and segregated and substandard housing in many part of the United States, including Boston. Long term exposure to racism can also cause dysregulation of the endocrine and cardiometabolic systems eventually leading to chronic health conditions like heart disease and diabetes.

Racism can also have intergenerational health impacts as well. For those who have taken Course 1 in the public health sequence, you know that stress and hypervigilance (consequences of racism) are strongly associated with preterm birth rates among highly educated Black women (when compared to less educated White women). The health impacts of racism are numerous and it is important to remember that this is not just a social justice issue but a public health issue as well. If you’re interested in understanding more about the connection between racism and health, we suggest reading this article.

Racism and hate crimes are social determinants of health. The Global Public Health Program at Boston College stands with Black students and students of color on campus - especially after the anti-Black hate crimes that occurred early Sunday morning. We condemn any and all forms/acts/types of racism at Boston College and beyond.

To quote Nancy Krieger’s work on hate crimes and public health: “To melt the iceberg of injustice, we, as health professionals, must not only tally the population health burdens due to social and economic injustice and show that equity leads to health equity, but we must also work with others in all sectors of society to expose and challenge the ideologies, agendas, and actions of individuals, organizations, and political parties who directly benefit from hate and inequity.”

Nadia Abuelezam

The Impact of Media Portrayal on Public Discourse and Public Health

Nadia Abuelezam, Assistant Professor, Connell School of Nursing

December 7, 2018

It’s the holiday season! That often means we are thinking about giving gifts and donations to organizations and people in need. It’s also the time of year where we see numerous advertisements and commercials for organizations asking for donations to help those in other countries. These commercials often feature pictures of young children or families from Africa looking sad, hungry, or impoverished (like the one below). Have you ever thought about what people in Africa think about these advertisements? 


recent study took to understanding how these images are viewed in the countries receiving the most aid from these organizations (Ethiopia, Ghana, Malawi, South Africa, Uganda, and Zambia). They asked focus group participants to examine advertisements from some of the largest and most well respected NGOs and to give their feedback on the use of particular photos and messages. Most of the respondents reported feeling sad that the images portrayed Africa as an inferior continent in need. Additionally, respondents felt that all advertisements should emphasize the dignity and respect underlying the missions of many of the NGOs these ads are serving. 

While this may not seem very relevant to public health – it certainly is! The ways in which we portray those in need or those with particular ailments and infirmities certainly impacts public perception of public health issues. The ways in which the media portrays health issues can impact participation, compliance, and public discourse around public health campaigns. For example, the water crisis in Flint, Michigan has still not been resolved and many believe it is because the residents of Flint are poor and black

This study is also important because it is one of the first that actually consults with the communities receiving aid to better understand how they would like to be portrayed. Too often public health research and aid is done without ever consulting those receiving interventions. Community-based participatory research and other types of public health methodologies that involve the communities receiving aid are so important to public health and ensuring the dignity of the "other." 

So next time you see one of these commercials (or any commercial discussing a public health campaign), ask yourself: “is this properly representing the community it means to help?”

Nadia Abuelezam

The Global Cesarean Epidemic 

Joyce Edmonds, Associate Professor, Connell School of Nursing

November 2, 2018

The October Lancet issue (Volume 392) focuses on the global cesarean epidemic and addresses the “too much, too soon” trend in our maternal healthcare systems. At the same time, the issue is recognizing that lack of access to safe and timely cesareans creates tragic consequences for women who need but are denied this life-saving procedure. The global rate of cesarean birth, has doubled in the past 15 years to 21%, and is increasing annually by 4%. In addition, there are extreme variations seen between and within countries that cannot be explained by differences in maternal age, parity, or obesity.  And contrary to popular belief most healthy women prefer to labor and give birth physiologically. While there is a lack of consensus on a single optimal level of cesarean delivery, population rates greater than 10-19% suggest overuse and are not associated with improved maternal or neonatal outcomes.  In the United States, one in three women (32%) give birth by cesarean, a major surgery that has immediate consequences for mothers and babies as well as long term health risks and increased healthcare costs. In the Dominican Republic, the overall cesarean rate is 59.3% and in Brazil the cesarean rate is 56%. 
 
The Lancet suggest that interventions to promote optimal use of cesarean include “labor companionship, midwife-led continuity of care, midwife-led units, antenatal education, training, and implementation of evidence-based guidelines at the point of care, along with mandatory second opinion and timely feedback to staff.” Addressing women’s fear of labor pain before or during pregnancy also might be effective in reducing cesarean rates. In a study, I conducted about the preferences and attitudes toward childbirth among Boston College young women, fear of vaginal birth and a desire to avoid labor pain were the main reasons for preferring a cesarean delivery. Women’s views and experiences must be included in any strategy that aims to balance the optimal use of cesarean with the risks of major surgery. I encourage you to review the Lancet Series in its entirety.

Erika Sabbath

The Public Health Hazard of Wildfires

Erika Sabbath, Assistant Professor, School of Social Work

November 16, 2018

Two major wildfires are sweeping through Northern and Southern California. The Camp Fire in northern California has become the most destructive wildfire in state history, with 125,000 acres burned, 7,600 structures (mostly homes) destroyed and, most tragically, 42 people confirmed dead and 200 more missing. The Woolsey Fire in southern California near Malibu has burned more than 96,000 acres, destroyed 435 structures, and killed at least two people. Both fires are partially contained but continue to wreak havoc.

The science is clear that climate change is partially to blame. Higher temperatures in spring and summer, coupled with reduced snowpack and earlier-than-usual spring melting, has led to reduced moisture in soil and forests. As a result, forests are tinder-dry—the perfect condition for a wildfire to burn out of control.

What are the human health impacts of these fires, in addition to the loss of life and property? The air quality in the areas surrounding the fires—which include Los Angeles and the San Francisco Bay area—is quite poor, and the particulate matter in the air is spreading as far east as Chicago. This particulate matter can exacerbate asthma and chronic respiratory disease. Children, the elderly, and pregnant women are at particular risk. Firefighters who contain these blazes are at risk of both injury and of chronic lung disease from breathing particulate matter, in addition to the safety risks associated with working in a dangerous job while exhausted.

The immediate task in California  is to contain the wildfires and rescue those in harm’s way. But the primary prevention task is to mitigate climate change and its effects, which would have the downstream effects of reducing wildfires as well as other public health hazards.

Nadia Abuelezam

Our Responsibility to Vote and Public Health

Nadia Abuelezam, Assistant Professor, Connell School of Nursing

October 26, 2018

So you’ve registered to vote, what next? VOTE!

It’s time to pay attention to the slew of topics and measures on the upcoming midterm elections related to health. Here in Massachusetts, we have one measure that is directly related to the healthcare system (although there has been quite a bit of writing about how Measure 3 is related to public health as well):

  • Massachusetts Question 1 aims to set limits on the number of patients a nurse can be assigned to during a shift. The Boston College Connell School of Nursing recently had a debate featuring two faculty members on opposite sides of Question 1. You can watch it here.

Other states have important ballot measures concerning health as well. Here are a few snapshots:

  • Montana (I-185) aims to increase taxes on tobacco and extend the Medicaid expansion to allow individuals with low income levels to qualify for Medicaid under the Affordable Care Act.  
  • Idaho (Proposition 2), Nebraska (Initiative 427), and Utah (Proposition 3) are also voting on the Medicaid expansion. Those of you who have taken Course 1 (NURS1210) will remember that this was a huge discussion point during our health policy and management lecture.
  • Voters in five states (Michigan, Missouri, North Dakota, Oklahoma, and Utah) will be voting on the legalization of medical or recreational marijuana.
  • Voters in three states (Arizona, Nevada, and Washington) will be voting on measures relating to fossil fuels and renewable energy.


No matter what you’re voting on in a couple of weeks, it’s important to vote. Read up on your state’s ballot measures and cast your vote. Voting shapes public health!

Erika Sabbath

Thinking of a Public Health Crisis on World Mental Health

Erika Sabbath, Assistant Professor, School of Social Work

October 12, 2018

Wednesday, October 10 was World Mental Health Day. On this day, we think as a public health community about how to reduce the burden of disease associated with poor mental health. In addition to the ways that depression and anxiety can decrease quality of life, they also put people at risk of suicide. Suicide is a major cause of death for people under fifty. Although the majority of suicide attempts do not involve firearms, the majority of suicide deaths do, because guns are so lethal.

While gun rights advocates and gun control advocates are often painted as being diametrically opposed, a unique partnership between the Harvard Chan School of Public Health and Utah gun-rights advocates has revealed what both sides agree is a public health problem--gun-related suicides. As a profile of this partnership in Harvard Public Health Magazine states, in the early 2000s, "There was growing data on the trend [of gun suicides], yet suicide prevention groups weren't talking about guns, and pro-gun groups weren't talking about suicide. These mutual blind spots meant that no one was taking on the issue." With that opening, an unlikely partnership was formed around an issue that was clearly a public health crisis in Utah: suicide by gun.

By working together and relying on data rather than emotion to guide their work, this unlikely partnership has achieved success in one of the most pro-gun states in the nation: the introduction of a red-flag law, which would allow law enforcement to temporarily remove firearms from the house of someone considered to be a danger to themselves or others. Data from other states show that these laws decrease suicides because suicide attempts are often fleeting impulses, and removing guns temporarily takes away the means to turn that impulse into reality. 

The issue of suicide is nuanced and requires public health interventions from many angles. But the Harvard-Utah partnership demonstrates that creative solutions to reducing suicide by gun are possible when people put aside their individual beliefs to work towards the common good.

Nadia Abuelezam

A Message on National Voter Registration Day

Nadia Abuelezam, Assistant Professor, Connell School of Nursing

September 28, 2018

This is the first of our weekly emails bringing global public health events to the greater BC community.  

It also happens to coincide with National Voter Registration Day earlier this week (September 25th). Voting is extremely important to public health in the United States. Many of the policies and laws enacted by public officials impact the health of populations directly (and indirectly). It is extremely important that as college students interested in public health, you take the time to register to vote or update your registration status in order to receive ballots and cast your vote in upcoming elections. Major public health issues have surfaced on state and national ballots in recent years including measures regarding taxation on sodataxation on plastic water bottlesthe legalization of marijuana, and increased regulation of flavored tobacco products.  

Take a few minutes to visit the National Voter Registration day website to figure out how you can update your voter registration. Make sure to stay up to date on measures and ballots happening in your home states that you can vote on through absentee ballots OR register to vote in Massachusetts. It is our responsibility as members of the public to stay informed and vote!  

For those not able to vote in the United States, you can still do your part! Read up on local measures and educate those in your communities, dorms, and classes on important measures they can take to improve the public’s health. We all have a role to play!