The Florida Keys usually conjures up images of sunshine, ocean breezes, and copious cocktails. But beyond the vacationers paradise, there is the reality of life in the Keys – and needing access to health care.
Across the 137 square mile archipelago, there are only 266 health care providers for 74,000 residents (and 2.25 million annual visitors). The Florida Keys has a serious shortage of health care providers and services.
There are two main types of shortage designations, as determined by the Health Resources & Services Administration (HRSA).
I spent this rainy morning shadowing a pediatric nephrologist, the specialists for kidney function in kids. The number of conditions they see is vast, but each has a unique course and some can progress to renal failure, even with medical intervention.
Chronic renal failure is the result of slowly progressive kidney diseases (and it not often reversible). 1 in 3 American adults is at risk for kidney disease — the two main causes of CKD in the adult population are diabetes and high blood pressure. In kids, CKD is often associated with inherited disorders, malformations present at birth, and autoimmune diseases, to name just a few.
We’re well into the 2020 presidential election cycle and there are a lot of health care proposals floating around. Most of them want to increase access to insurance and some have a plan to reduce the cost of care. But unfortunately, universal access to health insurance does not equate to health equity or better health outcomes. Health care systems are designed to handle individual medical needs, not the most critical causes of poor health – socioeconomic factors. In the United States, the development and provision of health care has fundamentally misunderstood what health is and what it requires.
A 2017 study in Health Affairs conveyed that the U.S. has one of the largest income-based health disparities in the world. Among the poorest third of Americans in the study, 38.2 percent reported being in “fair or poor health,” compared with 12.3 percent of the richest third. Most of the nations studied had an income-based health disparity, with the exception of Japan and Switzerland.
I love Monday’s – time to make a new weekly to-do list and the possibilities for what I can accomplish during the week seem endless. (Although I don’t love Monday mornings with an exam as much as Monday’s without exams). Over on Instagram, I’ve been sharing about public health and health policy on Monday’s. I’m trying to make #MPHMonday happen! And I thought it was finally time to migrate some of that fun over to the blog!
I typically listen to podcasts for news or current affairs analysis but I also love them as an opportunity to learn about new topics or fun trends.
Fun fact about me: I actually used to edit two podcasts as part of my job in graduate school! One focused on innovations in emergency medicine and the other centered on improving the quality and value of health care.
I wanted to share some of my public health, health policy, and medicine favorites!
Happy Friday! I hope you’ve had a great week. Since I got back from Europe on Wednesday night, I’ve been getting my life back in order (so much laundry) and studying for an exam this afternoon. I’ll have a recap of my days in Barcelona up soon, but in the meantime, here are just a few things I’ve been loving lately!
Sara Bareilles’ new album Amidst the Chaos was released this week and I’ve probably already listened to it 40 times. Since her last album, she wrote the music and lyrics for Waitress on Broadway and even starred in the production! I was lucky enough to see her as Jenna and it was magical. Everything she writes is gold and this is no exception. She was the musical guest on SNL last weekend and no lie she sounds the same live as on the recording. That takes serious talent. Go listen now!
DISCLAIMER: I am not a doctor (yet!) or physical trainer. Please always consult your doctor before trying anything you may read on my blog.
The other day, I did a quick workout to try and rid myself of the post-conference and end of Daylight Savings funk that I’ve been in all week. It worked well enough — I got some good studying in before bed and woke up feeling rested for the first time in over a week. It actually made me start reminiscing about my own journey from not caring for daily physical exercise to using exercise to alter my mood and make me more productive. I tried out plenty of sports as a kid, but spent most of the time picking weeds during rec soccer games or hating that I had to be outside. I just wanted to sit inside and read. Yeah, I’ve been interested in learning forever. I’m still bitter over a summer reading contest I lost…the winner was the librarian’s daughter, which I thought should be disqualifying…
During my senior year of college, I took a class called Man’s Food, which was a basic nutrition course and it made me question everything I knew about healthy eating. I became a bit too regimented in what I ate for a few months — oatmeal or eggs for breakfast; a sandwich, carrots, and an apple for lunch; and then it was up in the air for dinner– but I lost a good, and needed, 10 pounds. Then I started walking on the treadmill every other day and eventually, ran my first half marathon. It was an incredible accomplishment and also some of the worst physical pain and exhaustion I have ever felt.
Running 13.1 miles in Orlando in October can be brutal — it was still so hot and humid and my longest training runs had been during D.C.’s lovely crisp fall. But I did it, recovered, and then wanted more. I even convinced a group of colleagues to run a half marathon with me! [Yes, we’re still friends!] I eventually reached a point where I started running less and joined a the gym so I could try out Bodypump class, which I learned about years ago from Julie of Peanut Butter Fingers. I went to that class twice a week until I moved to Philadelphia — the first time I took it, I was so sore I couldn’t walk without pain for nearly a week!
Welcome to the first edition of “This Week in Health Policy!” I used to send a weekly roundup of health policy and public health news to one of our student interest groups in graduate school, so I thought it would be a great way to share the interesting articles, research papers, podcasts, and more that I come across each week with all of you! I wanted to pop in yesterday to share but studying had to take priority.
I spent yesterday at my desk, aside from attending our exam review, and did some meal prep to get me though some of the weekend with healthier food. I planned to make pasta with lots of veggies and chicken sausage but ended up having at last three times as many veggies than pasta, so it’s more of a veggie sauté with pasta. Oh well, it tasted great and more veggies is always a good thing! But this exam must be getting to me because I definitely forgot to strain all of the water out of the pasta and put my new dry erase markers away in the silverware drawer…?
Quick note: I’m not here to debate vaccines — I am a medical student and public health practitioner and I have read a good deal of scientific evidence on this topic. I firmly believe in the safety, efficacy, and public good of vaccination. My goal with this post is to provide you with some of the legal fundamentals that influence vaccination and the impact of pockets of low immunity on individual and public health.
It’s Wednesday and I’m one day closer to my cardio midterm and to my family visiting for my medical school pinning ceremony next week! For those wondering what a pinning ceremony is, it’s my medical schools’ alternative to a white coat ceremony, which are usually held at medical schools in the fall. I’ll report back after mine, but I assume it will be similar to all the others that occurred around the country back in August– a formal ceremony to officially “coat” us with the white coat we wear for clinical experiences.
Before I dive in to a full day in the library, I wanted to spend a little time on the current measles outbreak in the Pacific Northwest. As medical students, we learn how vaccines work and the recommended vaccine schedules for different populations but it’s also important to know the legal and public health issues that influence why state laws vary regarding compulsory vaccination. Let’s use the current measles outbreak as our springboard into this issue.
Nutrition education is lacking in most health professions education — either isn’t incorporated, exists in the context of specific disease-related diets, or glosses over the concept of nutrition and diet. Honestly, it’s understandable considering how much knowledge needs to be conveyed and learned — especially in medical school, the only health profession I can speak to personally. But, just as I’ve written before about the need to incorporate more health policy education, it’s time to also offer more discussions about nutrition and the vast impact of society and policy on the “what” and “where” people eat. [Also just as important is proper education on eating disorders. This post from my friend Clare of Fitting it All In is a great overview about caring for individuals with eating disorders.]
Obesity is common, costly, and poses serious health risks. So let’s start with some numbers to get our bearings about why this topic warrants our attention:
On a short study break, a classmate and I were discussing how the public health and health policy courses we took in graduate school influence our view of the healthcare system as medical students. It was the most productive form of procrastination (nerding out about public health and health policy) but it was also supremely frustrating to talk about all the problems in the healthcare system. The ACA was such a monumental step forward and now it seems like we’ve taken many steps back–only 34 states have expanded Medicaid, states are implementing work requirements for Medicaid, and Congressional Republicans have tried to repeal the ACA dozens of times with no real replacement or effort to fix the provisions that aren’t working well.