Sunday, April 29, 2012
If you were unable to attend the Sujal Parikh Memorial Symposium on Health and Social Justice, or loved it so much you would like to watch the presentations again, you are in luck. The presentations from the symposium have been made available at http://sujalsymposium.org/blog-and-news/. Please feel free to share the videos with anyone you feel would enjoy them!
Tuesday, April 3, 2012
Gandhi’s Public Health Proposal: Children After an inspirational, educational, and motivational conference this past weekend, I wanted to further explore the utility of public health research, when it should be conducted, and whom should be the focus. We have a vast sea of knowledge on certain pandemics, but are sickly deprived in other important areas. Research must be purposeful towards improving the health of individuals. How do we do that...? "If we are to teach real peace in this world, and if we are to carry on a real war against war, we shall have to begin with the children" -- Mohandas Gandhi. Who is going to argue with one of the most influential men of our time and his infallible statement? However, this aphorism, although accepted by many, is implemented by few. Specifically in the field of public health, campaigns are often targeted towards children, but the research exploring the roots of these causes is often an inadequate amount. Academic research relating to health behaviors of children in much of the world is not at a caliber conducive for adequate policy change and program development to improve public health. How can we fix a problem if we do not understand it? Wars against non-communicable diseases, substance abuse, and other public health fights related to health behaviors must begin with understanding the causes of the causes: why are children motivated towards certain actions which put them at risk for certain diseases? When this is understood, progress in public health can be made. A prime example of where further research of children’s health behaviors could be beneficial--the diabetes pandemic of Belize. As the leading cause of death in Belize, diabetes is a major public health concern (The Epidemiology Unit, 2009). The overall national prevalence for this non-communicable disease is 13.1% (Gough E et al., 2008). However, the incidence of diabetes is increasing (The Epidemiology Unit, 2008; The Epidemiology Unit, 2009): from 2000-2030, the region of Latin America and the Caribbean is expected to see a 40% increase of people with diabetes in their total population (Wild et al., 2004). In a study conducted by the Ministry of Health, Belize and PAHO/WHO, statistically significant associations were found between diabetes mellitus and age, hypertension, BMI, total cholesterol, LDL, HDL, triglyceride, and waist circumference (Gough E et al., 2008). Conclusions of the study stated that these findings provide justification for the development of national policies and programs to address these public health issues and furthermore, a need to emphasis diabetes prevention (Gough E et al., 2008). But what comprise beneficial prevention strategies? Gandhi might suggest focusing on children. Behind Gandhi’s aphorism, several studies have supported that investments in early childhood development are powerful means to reduce the escalating chronic disease burden in adults, reduce costs for judicial and prison systems, and enable more children to become healthy adults who can positively contribute to society, socially and economically (ECDKN, 2007a; Engle et al., 2007; Schweinhart, Barnes & Weikart, 1993; Schweinhart, 2004; Lynch, 2004). This is because many challenges in adult society have their roots in the early years of life, including major public health problems such as obesity, heart disease, and mental health problems (CDSH, 2008). Therefore, exploring these roots could lead to answers that could develop policies that could potentially prevent future generations from the predicted prevalence of 32,959,000 cases (Wild et al., 2004) of diabetes in Latin American and the Caribbean by the year 2030. The causes of the causes should be explored: What causes certain health behaviors, which subsequently cause certain diseases? Researchers in Europe have already signed onto to Gandhi’s public health proposal. The Health Behaviors of School-Aged Children (HBSC) is an ongoing international study carried out in collaboration with WHO/EURO investigating ‘causes of the causes’. The perspective of the study is one in which adolescent health related behavior is seen as part of young people’s broader lifestyle, viewing health in a social context. With developments in scientific management and theoretical perspectives, HBSC has made a substantial contribution to the area of youth health (Currie et al, 2009). Unfortunately, the HBSC study has been limited to Europe and North America. However, evidenced by its success, international health could be greatly improved by its expansion. Similar studies should be conducted in Latin America, the Caribbean, Asia, Central America…around the globe! What could happen if Gandhi’s public health proposal was adopted in Belize? What if we better understood what was motivating children towards certain health behaviors, specifically when it came to food consumption? The onset of diabetes mellitus is largely influenced by diet, and such habits are largely developed in childhood (CDSH, 2008). During childhood, a significant amount of time is spent at school. Children are exposed to various factors influencing health behaviors during the school day, including personal factors such as peer-pressure, and environmental factors such as what food is available for purchase at the school store and what is served for lunch (if the school serves lunch). Therefore, similar to studies conducted by the HBSC should be conducted in the Latin America and Caribbean region, exploring the ‘causes of the causes’ in order to further understand the complex situation of health behaviors and lead to improved prevention strategies. What impact would Gandhi’s public health proposal have in Sub-Saharan Africa? The Appalachia region of the United States? Southeast Asia? We must further explore and understand before we can make sustainable improvements in public health. And we can begin with children... -Rebeccah