Adjusting to the quarantine efforts and stay-at-home order has been difficult. There has been a lot of change in a very short amount of time. Taking care of physical health is important in the face of COVID-19, and now taking care of mental health must be a focus in the face of social isolation due to quarantine efforts.
The American Psychological Association and SAMHSA have some guides about how to look after your mental health, and some of their suggestions are presented here.
People serving prison sentences have much higher rates of HIV, Hepatitis C, and tuberculosis than the general population. Unfortunately, competent HIV screening and care is inconsistently available. They also have higher rates of substance abuse and mental health concerns. Once released, health care can continue to be inconsistent or inaccessible with all the life activities involved in transitioning back into the community. The health effects of individual people involved in the criminal justice system affect their families and communities as well. Managing chronic conditions of loved ones adds to the stress and cost of supporting someone returning from prison, and the costs of health care can result in untreated conditions that can be unintentionally transmitted to others. With the massive increases in prison populations, these health problems are an example of how mass incarceration is a public health issue as well as one of justice.
Join us next Friday for a webinar about Mass Incarceration and who it is affecting. Register here: http://bit.ly/chtawmi
Center for Prisoner Health and Human Rights
White text over background picture of barbed wire fences
The prevalence of HIV/AIDS is 4-5 times higher among inmates than in the community.
Hepatitis C is 9-10 times more prevalent in correctional facilities than in the community.
Tuberculosis is up to 17 times more prevalent in prisons and jails than among the general population.
Justice-involved individuals like prisoners also suffer higher rates of hypertension, asthma, arthritis, and cervical cancer compared to the general population.
Inmates also age faster, demonstrating the physical health of individuals 10-15 years older in the community.
Being healthy is expensive. There are the clearly established barriers in a lack of resources (access to nutritious food, treatment and medication costs, inconsistent insurance, etc) and lack of preventative services (dental, health, etc) which can result in more costly after-the-fact treatment. These expenses resulting in poor health and lack of treatment are crucial when discussing poverty and health, but these clearly established effects of poverty are not the only ones. There is growing research to indicate that there are effects of poverty on health that are not directly related to access to healthcare. Some examples include living in a more polluted environment and the constant stress of making ends meet contributing to health deterioration and complication.
It is also the case that some people are pushed into poverty by medical expenses, and living in poverty further negatively effects health in what becomes a feedback loop for many. Public health initiatives in the United States are gathering research on what policies and programs can help to address these complicated factors like poverty that affect so many parts of a person’s life and health. Federal initiatives like Healthy People 2020 have had social determinants of health as leading health indicators. The complexity of how each determinant affects the others means that more collaborative and innovative policies and programs are needed to support people to have every opportunity to be healthy.
Join us for a webinar all about poverty, anti-blackness and gender next Friday, 3/13/20 at 12. Register here: http://bit.ly/abpchta
Infographic titled Social Determinants: factors that Influence Your Health
Income: Your income can determine how healthy you are. How much you earn can influence both your well-being and how long you are expected to live.
Income is linked to:
Mortality: 500+ infant deaths and 2.8 thousand low-weight births could have been prevented if all states had raised their minimum wage by $1 in 2014.
Disparities: Wage gaps persist by gender, race, and ethnicity. Men’s wages per hour in 2015: Hispanics $14, Blacks $15, Whites $21, Asians $24. Women’s wages lag behind men’s across the board.
Inequalities: The richest 1% of Americans can expect to live as many as 14 years longer than the poorest 1% of Americans.
Child Death: In 2014, 44% of U.S. Youth- more than 31 million kids and teens- lived below or just above the poverty level.
Cited from the Nation’s Health,: A Publication of the American Public Health Association
We have presented some statistics on several health disparities faced by Black Americans this month. The people working to reduce these disparities are working towards health equity. Health equity, according to the American Public Health Association, is the opportunity for all people to achieve their best health. In order to do this, some factors that can create barriers to or facilitate best health have been identified. Though terminology sometimes varies, they are generally quality affordable healthcare, educational opportunities, housing, discrimination or Minority stressors, food security and access to healthy foods, stable income and job security, environmental quality, and neighborhood conditions. These factors are complicated, and often related to one another. Having a stable and healthy environment, accessing continuous and quality services, and being free of an unhealthy environment are thought to be the building blocks for health equity. Working to increase access and stability, and reduce the harm of an unhealthy environment is the current path away from disparities and toward equity.
For those interested in how we can use the health disparity data to move towards equity, the CDC has many resources here: http://bit.ly/36F6VoJ
Infographic titled The Path to Achieving Health Equity
What social and economic factors must be addressed on the path to achieving Health Equity?
A central bubble has the words ”HEALTH is affected by” inside. Connected to the central bubble are 8 other bubbles with attached words: discrimination/minority stressors, food security and access to healthy foods, stable income and job security, environmental quality, neighborhood conditions, quality affordable healthcare, educational opportunities, and housing.
Health equity aims to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives.
This infographic was created by the Health Equity Institute for Research, Practice and Poli
The CDC keeps track of many different health data sets. One of these is called potentially preventable deaths. This is something of a confusing public health term. The number of these potentially preventable deaths can be thought of as a public health goal. If all people received appropriate and timely treatment or effective public health intervention, the potentially preventable deaths would equal zero. To complicate this term even more, there are certain risk factors that are considered modifiable or controllable as a way to potentially prevent a death from things like heart disease and stroke by lowering the risk of a cardiac event or a stroke. Those risk factors are: high blood pressure, high cholesterol, cigarette smoking, diabetes, unhealthy diet and physical inactivity. This is one of the current public health prevention strategies for the outcome disparities like Black men being over-represented in potentially preventable death from heart disease and stroke. As we discussed last week, disparities are complex problems with many factors, and public health workers know that effective prevention efforts must be combined with increased access to quality treatment to address them.
Interested in information about health disparities in Philadelphia? Join us next Friday for a webinar about lower limb amputations presented by Dr. Marcelin. Register here: http://bit.ly/rgdple
Title: Black men are at highest risk of dying early from heart disease and stroke
Two bar charts are shown, one for men and one for women. The X-axis is labeled with different racialized categories, and the Y-axis is labeled preventable deaths per 100,000 people.
For the “men” bar chart, the numbers (or preventable deaths) are as follows:
American Indian/Alaska Native: 90
Asian Pacific Islander: 47
For the “Women” bar chart, the numbers are:
American Indian/Alaska Native: 46
Asian Pacific Islander: 22
Source: the national vital statistics system, US Census Bureau, 2010
Health Disparity was our Word Wednesday this week. When a group of people is more impacted by illness than another, it is called a health disparity. This can look differently depending on the specific illness. The number of people affected, the quality of life impact, and the access to treatment are all factors to consider when describing how one group is more affected than other by the same disease. National Black HIV/AIDS Awareness Day is February 7th, and we want to recognize that a health disparity exists for Black Americans in regards to HIV. In 2016 and 2017, Black Americans were 13 % of the total population. However, they were 42% of people living with HIV, and 44% of new HIV diagnoses. In particular, Black men who have sex with other men account for the highest rate of new HIV cases in 2017. However, Black women having sex with men are the highest rate of transmission through heterosexual contact. Targeted programs to reach groups with the largest health disparities are working to reduce and eliminate this disparity along with working to treat and eliminate HIV/AIDS across the population.
If you are someone looking to connect with other Black advocates and learn about the people creating programs, the Black AIDS Institute is honoring some important people this month (https://blackaids.org/).
Taking breaks is an important part of being healthy! Briefly disengaging from your work, whether it is physically strenuous, mentally intense or simply continuous, is a way to keep your brain and body active and able to perform what you need it to. From 20 seconds to 5 minutes, breaks can help reboot your brain and prevent pain. Take time to rest your eyes and stretch!
Drawing of an upper body with the arms extended and stretching the wrists.
The first diagram has the hand bent with the palm facing out and the fingers upwards, creating a 90 degree angle at the wrist. The other hand is gently pulling back on the hand to stretch the wrist.
The second diagram has the hand bent with the fingers downwards and the palm facing the torso, with the other hand gently pushing on the back of the hand to stretch the wrist.
The third diagram has the palm facing outwards again, but with the fingers pointed down towards the floor, and the other hand gently pulling to stretch the wrist.
A separate diagram has the hand closed in a fist, palm facing the torso and bent down at the wrist, with the other hand pulling it towards the body to stretch the wrist.
Another diagram is both hands, palms facing each other and touching with the fingers pointed upwards says: push your palms together and slowly lower your hands
A different diagram has a hand with the fingers slightly spread and facing downwards with the palm out says: with your wrist facing up, press your palm against a wall. A second hand drawing has an arrow pointing up from the thumb and says: for a deeper stretch, use your other hand to gently lift your thumb.
The final diagram shows hands, loosely bent at the wrists moving up and down and says: shake it out!
Chronic pain is usually defined as pain that lasts longer than 3 months, or that lasts past the expected time for healing. Chronic pain occurs for many reasons. Sometimes the pain is because of an underlying condition that does not heal, like arthritis pain that is caused by inflammation repeatedly. This pain serves the function of letting us know something is damaged, even if the damage cannot be entirely repaired. However, chronic pain can also be due to nerve damage that lasts after an initial injury has healed. This type of pain, over time, can alter pain responses in the body and result in increased pain even without stimulus. This pain does not serve a functional purpose, and can be frustrating and difficult to treat. Chronic pain is a description of experience, not a diagnosis. The different causes of pain require different treatments and management systems. An accurate diagnosis can help clarify treatment options that are specific to the causes of an individual’s chronic pain. It is also important to realize that living with chronic pain often causes mental health struggles in addition to physical pain. Depression is common, and treatment for mental and physical health are important.
To learn more about individual chronic pain management, and how phone apps can help, The Critical Path Learning Center is hosting a workshop on Jan 30 2-4pm. You can register here: http://bit.ly/39SGoHh or by calling 267-428-7352.
Infographic titled What is chronic pain?
Chronic, persistent or long-term pain is pain that continues for longer than 3 months. It is usually defined as pain that persists beyond the normal time that tissues take to heal following an injury.
Chronic pain is a significant global health burden.
Across the globe low back pain causes more disability than any other condition.
Main causes and conditions of chronic pain: low back pain, cervical and thoracic pain, rheumatoid arthritis, osteoarthritis, shoulder pain, headache disorders, cancer, fibromyalgia.
New section titled Facts about pain
Acute pain alarms us about potential tissue damage and typically comes on suddenly as a result of a specific incident such as surgery, childbirth, a fracture, or trauma.
Chronic pain serves no biologic purpose as it is not related to the threat of tissue damage. Chronic pain can be considered a disease state and can persist for months or years.
Pain persists in response to being overly sensitive to a perceived threat of harm to your body, despite the absence of tissue damage
New section titled How Physical Therapy Helps
Physical therapy helps people with chronic pain develop the skills they need to manage and take control of their condition, increase their activity and improve their quality of life.
New section titled Benefits of exercise for chronic pain
Flexibility: maintain flexibility and movement
Cardiovascular: important for cardiovascular health
Strength: helps to build and keep muscle tone
Mood: improves mood and general wellbeing
Exercise therapy is included in all guidelines for the treatment of chronic pain- ask your physical therapist, the exercise expert
It’s Cervical Health Awareness Month! A 2019 CDC study showed that the HPV vaccine that has become widely available is reducing cervical pre-cancer. Women who had received the HPV vaccine had the most drastic decrease in pre-cancers, but unvaccinated women showed a decline as well. Without further study, the cause of decline in unvaccinated women cannot be explained, but a possibility is herd protection (or immunity). For those who remember our flu shot health fact from October 18, herd immunity is the protection a population gains from disease because many of the individuals are immune to it. Essentially, it is difficult for viruses to be transmitted when many people are immune, which results in those who are not immune having protection due to the immunity of those around them. Infection-based cancers, like cervical cancer that can develop due to HPV, are particularly concerning for people living with HIV/AIDS, as compromised immune systems make contraction more likely. There is also research to suggest that a small number of people living with both HIV and HPV develop cervical cancer more rapidly. Unfortunately, the reason for this is not yet well understood, and more research is needed. Regular gynecological visits are important to maintain cervical health and prevent infection!
Nutrition and teeth go hand in hand. We often hear about the foods to avoid for healthy teeth: sugary and sticky foods. Avoiding these foods, and practicing oral hygiene help teeth stay functional and pain-free. It is also important to keep in mind that healthy teeth are necessary for proper nutrition. Many of the nutrient rich foods require healthy, strong teeth to eat. For people with chronic diseases that have oral effects, it is important to pay attention to oral hygiene, including visiting dental professionals. FIGHT Family Dentistry offers many dental care services (http://bit.ly/35CfBeT), particularly for people with anxiety around dental visits and those who do not have regular dental appointments.
For Dos and Don’ts of oral care, you can visit our blog for the complete infographic at http://bit.ly/2uw1A5D.
For more nutrition info, join us on January 24 for a webinar all about nutrition!
This infographic is from the Academy of Nutrition and Dietetics. Visit eatright.org for more information on healthful eating or to find a registered dietitian nutritionist.
Infographic titled Nutrition and Oral Health: the Root of It All
Registered dieticians at the Academy of Nutrition and Dieticians recognize a link between mouth health and nutrition. Oral infectious diseases, as well as acute, chronic and terminal illnesses with oral symptoms can impact not only our ability to consume food properly, but also our health and nutrition status.
For many, an annual dental exam is a luxury. The top 10 stated with the highest percentage of dental visits: Utah, Minnesota, Wisconsin, Hawai’i, New York, New Hampshire, Massachusetts, Rhode Island, Connecticut, and New Jersey. 72% on average have health insurance. Bottom 10 states with the lowest % of dental visits: Texas, Missouri, Oklahoma, Arkansas, Mississippi, Louisiana, Alabama, Tennessee, West Virginia, and Kentucky. 56% on average have health insurance.
New section titled Oral Health Issues in Older Adults (65+ years)
1 in 3 have untreated dental issues
40% have periodontal (gum) disease.
2 times more likely to be toothless if living in poverty.
25% have no natural teeth and instead use dentures or implants.
New section titled Oral Health Issues in children (2-4 years)
Tooth decay has increased, with significantly more reported among non-hispanic black and Mexican American children. 18 % in 1988-1994 and 24% in 1995-2004.
Don’t regularly sip on sugar-sweetened or carbonated drinks.
don’t overly consume sticky foods or slow-dissolving candies.
Don’t frequently eat desserts or other sugary foods.
Do maintain a healthy diet of fruits and vegetables, lean protein, low-fat dairy products and whole grains that provide essential nutrients.
Do practice good oral hygiene (i.e. brushing your teeth with fluoridated toothpaste twice a day; drinking fluoridated water; and seeking regular oral health care).
Oral health care and nutrition is about education, but the collaboration between patients, dentists and registered dietitians can prevent and alleviate a lot of common dental problems- and offer better health to boot!
December 3rd is the International Day for People with Disabilities. 61 million adults in the United States live with disabilities, which is 1 in 4 people. Adults older than 65, non-Hispanic Native Americans/Alaskan Natives, and women are more likely to have at least one disability. Americans with disabilities are more likely to smoke, have heart disease, and diabetes than non-disabled Americans. 1 in 3 of those 61 million people with disabilities do not have a regular healthcare provider and have unmet medical needs due to cost of treatment. Access to healthcare is an important part of having a good quality of life, and Americans with disabilities can be vulnerable to the consequences of barriers to healthcare access. More information can be found at the CDC website: http://bit.ly/34vttI0
Infographic titled Disability Impacts All of Us
61 million adults in the United States live with a disability
26% (1 in 4) of the adults in the United States have some type of disability, the percentage of people living with disabilities is the highest in the South
Percentage of adults with functional disability types:
13.7% mobility: serious difficulty walking or climbing stairs
10.8% cognition: serious difficulty concentrating, remembering, or making decisions
5.9% hearing: deafness or serious difficulty hearing
4.6% vision: blindness or serious difficulty seeing
3.7% self-care: difficulty dressing or bathing
Disability and Communities
Disability is especially common in these groups:
2 in 5 adults age 65 years and older have a disability
1 in 4 women have a disability
2 in 5 Non-Hispanic American Indians/Alaskan Natives have a disability
Section titled Disability and Health
Adults living with disabilities are more likely to have obesity (38.2% for people with disabilities compared to 26.2% of people without), smoke (28.2% compared to 13.4%), have heart disease (11.5% compared to 3.8%), and have diabetes (16.3% compared to 7.2%)
Section titled Disability and Healthcare Access
Healthcare access barriers for working-age adults include
1 in 3 do not have a usual healthcare provider
1 in 3 have an unmet healthcare need because of cost in the past year
1 in 4 did not have a routine check-up in the past year
Section titled Making a Difference
Public Health is for all of us. Join the CDC and its partners as we work together to improve the health of people living with disabilities. Promotion of healthy living, monitoring public health data, researching and reducing health disparities, building inclusive health programs, and improving access to health care.]
Some exciting developments in HIV prevention were presented this past July at the IAS Conference on HIV Science. Initially, prevention of HIV transmission was only safe sex practices. Then in 2012 the drugs we know as PrEP and PEP were approved to prevent the transmission of HIV. PrEP is a prevention drug that can be taken daily the prevent transmission for people who are more likely to come into contact with HIV, like someone whose sexual partner is HIV positive. The NIAID is funding research into new ways to administer PrEP that do not require daily pills. This infographic describes the current research!
Infographic titled Long-Acting Forms of HIV Prevention
For some people, long-acting forms of HIV prevention may be more desirable than a daily pill
Section titled HIV Prevention today- and in the future
Taking an oral dose of the medication Truvado once a day, every day can prevent HIV infection.
NIAID-funded researchers are developing and testing alternative HIV prevention products that could be inserted, injected, infused, or implanted from once a month (monthly)… to once a year (yearly) in people who commit to using the products on an ongoing basis.
New section titled NIAID is funding research on 4 types of long-acting HIV prevention
Intravaginal Ring (IVR): Polymer ring inserted into the vagina releases antiretroviral drug over time
Implant: Device implanted in the body releases antiretroviral drug over time
Injectable: Long-acting antiretroviral drug is injected into the body
Antibody: Antibody is infused or injected into the body
New Heading titled At What Stage Is This Research
Implant is in design and development and manufacturing and safety study stages
Ring and antibody are in manufacturing and safety study and human study stages, and injectable is in human study stage.
Karam Mounzer, MD
Dr. Mounzer identified two major gaps in the care of patients with HIV/hepatitis C (HCV) co-infection, and the complexity of multidrug-resistant HIV treatment. He is involved with many clinical trials focusing on drug development and better understanding of HIV immunopathogenesis with the Wistar Institute. He is involved in teaching and mentoring.
Dr. Cruz is a board certified pediatrician who serves as the Medical Director for our Pediatrics and Adolescent Health Center. He has presented and/or published in the fields of community violence and domestic violence prevention, quality improvement, behavioral health, curriculum development and mentorship. In 2019 he received the Greater Philadelphia Social Innovation Award for Innovations in Healthcare.