Health Benefits of Pet Ownership

            When talking to people before heading home for break, I discovered that most students were really excited to see their pets at home.  This got me thinking about what having pets does for us.  The health benefits of pet ownership have been shown as contradictory in previous studies (Utz, 2014).  These studies have used inconsistent methods and biased samples, so the results have been inconclusive.  Utz reported on a study done to address the previous studies problems (2014).  This recent study showed that pet ownership does appear to have a positive effect on health.  Owners of pets are less likely to be diagnosed with congestive heart failure, report arthritis, or be obese.  People with pets also report and are physician assessed to have excellent or very good health ratings.  This is true for overall health except for allergies and asthma.  Pet owners have been documented to having more prevalence of allergies and asthma than non-pet owners.  This could be an artificial increase because pet owners have more contact with animals and are more likely to be aware of asthma and allergies (Utz, 2014).

            A further study done in China proved that dogs have some benefits on their owner’s health.  Owning a dog is positively associated with feeling healthier.  Dog owners in this Chinese demographic are also less likely to miss work and have fewer nights of bad sleep.  This means that it is possible for pet dogs to contribute to considerable health care savings (Headey et al., 2008).  Other studies have also been done in the United States, Australia, and Great Britain on pet cat and dog ownership and health benefits.  The results of these studies showed that having a cat or dog relieves feelings of loneliness.  The presence of a pet in home is also good for a friendly atmosphere and putting people at ease.  The results of these studies make me happy and appreciate my pets even more.

·         Headey, B. (1999). Health benefits and health cost savings due to pets: Preliminary

estimates from an australian national survey. Social Indicators Research, 47(2), 233-243. Retrieved from http://search.proquest.com.ezproxy.lib.purdue.edu/docview/197667607?accountid=13360

·         Headey, B., Na, F., & Zheng, R. (2008). Pet dogs benefit owners' health: A 'natural

experiment' in china. Social Indicators Research, 87(3), 481-493. doi:http://dx.doi.org.ezproxy.lib.purdue.edu/10.1007/s11205-007-9142-2

·         Utz, R. L. (2014). Walking the dog: The effect of pet ownership on human health and

health behaviors. Social Indicators Research, 116(2), 327-339.

doi:http://dx.doi.org.ezproxy.lib.purdue.edu/10.1007/s11205-013-0299-6

The year was 1621

Thanksgiving 1621

The year was 1621 when many believe the first thanksgiving meal was celebrated with the abundant harvest that had ended the famine that resulted in many deaths across the pilgrim population. This is what Americans have been celebrating this weekend! Not being American myself, I was curious as to why such a holiday was celebrated more so here than in Canada. The history of how this holiday was a triumph over an epidemic of famine among a population brings hopeful light onto many global health concerns we have today of food insecurity and diseases associated with such. It is each year that we are given this rebirth of hope needing to be cherished as well as reflected upon in how we can use this new-found hope to address our current health situations across the world. By learning through historical events, we can identify ways to reduce food insecurity, create bountiful harvests and agricultural practices.

There is a much needed movement needing to be had to detach ourselves from the marketing holiday that it has come to be towards one of humbleness, a moment to reflect on what the history books would say about the year 2016 and thanksgiving. Perhaps it is time to create a new holiday that celebrates a new day of health, a new solution to a problem we currently have. For example, as we sit in traffic jams this weekend to reach many different destinations for that thanksgiving feast, the stress thousands of vehicles have on our climate that impact our current health concern of warming temperatures. Or even perhaps once we finally get to our destination, reflecting on where our food has come from and the trickling down effect on the small scale farmers of where the brussel sprouts, potatoes, and ingredients in the pumpkin pie have come from. How can we address these issues? How can we create a movement away from such a heavily market-created holiday towards one of reflection and inspiration in order to address many global health concerns we have today? 

Complementary Feeding, Globalization and Child Health

Per the WHO, Complementary feeding is defined as the process starting when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore other foods and liquids are needed, along with breast milk. The transition from exclusive breastfeeding to family foods is referred to as complementary feeding. Formerly, the ideal age of this transition was at the age of 4 months. However; recently, based on the new WHO recommendations, exclusive breastfeeding is found to be of maximum benefit to the child health when it continues till the age 6 months. Starting from 6 – 24 months of age, complimentary feeding should continue side by side with breastfeeding which should continue through this period. This period is critical for child growth during which, nutrient and micro-nutrient deficiencies contribute globally to higher rates of child malnutrition which is the underlying cause for multiple diseases that account for high child mortality rates of children under five worldwide. Apart from timing, adequacy, appropriateness, and cleanliness are crucial with the transition to complimentary food.

In the developing countries, the problem is complicated. Women in the era of globalization are forced to go to labor market to afford money for themselves, babies, and families. The work conditions are not suitable to maintain the exclusive breastfeeding till the age of 6 months and mothers tend to either shift to formula and/or complimentary feeding earlier. In most of the developing countries this carries disastrous influences on child health. These countries mostly lack access to clean and safe water and/or refrigeration. Hence; the risk of illness dramatically increases when babies start solids and/or formula especially that they did not get their sufficient immunity from their mothers’ breast milk. With introducing solid foods and or/formula to babies, potential exposure to pathogens from contaminated food, water, or utensils will significantly increase. Additionally, the solid food introduced to the child is mostly dependent on availability of food in households rather than adequacy and appropriateness to the child age which could expose the child health to further complications.

Tackling the problems of exclusive breastfeeding and complimentary feeding practices is crucial due to their global influence on child health and mortality rates. However; interventions in the developing world is very complicated. Although lack of knowledge is a major factor, I believe that it is neither enough nor successful in such communities. In my opinion, these problems should be tackled from multi-perspectives, taking into consideration the individual level along with the structural barriers and the social suffering of the mothers in the globalized world.

Reference:

http://www.who.int/nutrition/topics/complementary_feeding/en/

What if the World went Vegan?

What if the World went Vegan?

Vegetarianism and Veganism have been discussed in our class a minimal amount in terms of global health; however, rising popularity of this lifestyle in North America has flourished with numerous research studies and documentaries on its impact on health (i.e.: Before the Flood) and its relation to climate change (also a topic of concern on how it too can impact the global health environment). Recently, I came across an article hypothesising the effects of a scenario in which the world went vegan.  

Researchers at the University of Oxford used a data set from the UN Food and Agriculture Association and WHO and compared the effects across global health.

Fact:

ü  Greenhouse gas emissions would fall by 50% by 2050

ü  Health costs due to the decrease in noncommunicable diseases world wide per year= $735 billion US (following international guidelines of a healthy diet), $973 billion (vegetarian diet), $1 trillion (vegan diet)

ü  Decrease in deaths= 5.1 million (healthy diet), 7.3 million (vegetarian), 8.1 million (vegan)

ü  75% of these benefits occurring in developing countries

Developing countries are in deed where many of the global health concerns we have discussed are present and a lot of these benefits would be seen there. Many pro meat consumption arguments include the livestock’s capacity to generate business for small and local farmers, being a way of life, health benefits, as well as the cultural symbolism that meat consumption is often associated with. However, these concerns have supporting counterarguments mentioned above including the health benefits. It is also interesting to note that “the world’s agricultural system would need to produce 25% more fruits and vegetables, and 56% less red meat” (DeWeerdt, 2016). This production can be shifted towards local farmers who would otherwise be farming for meat consumption with strategic processes in place to identify which crops can be best grown in certain countries due to their climate.

I certainly am not suggesting everyone goes vegan, simply considering the alternative of even reducing meat consumption to the international dietary standards would be a desirable change. Presenting the evidence in this light that is supported by data is worthy of consideration. Perhaps efforts should be weighed more heavily on adopting a global lens towards diet and food consumption (including increased donor funding towards planning and implementation) that a significant impact on many global health concerns we have today will be addressed.

I would love to hear your thoughts on this as I know many of you do consume meat and animal products and are public health professionals! 

Reference

DeWeerdt (2016). What if the Whole World Went Vegan? Conservation. University of Washington. http://conservationmagazine.org/2016/03/can-vegans-really-save-planet/

At the Mercy of our Environment: Epigenetic Influences Have Complex Impact

Last week I attended a talk by Dr. Valerie Knopik, a genetic biologist, entitled "Genes + Environment = behavior?" The concept of nature and nurture both coming together to affect our biology and behavior is nothing new, but Knopik challenged the assumption that some sort of linear model could sufficiently describe the relationship.  Rather than genes and environment each contributing separately to our behavior, she eloquently displayed the complex web of factors relating the two.  Not only do nature and nurture influence us, but they also influence each other in complex ways, sometimes even before they affect us.  What does this mean for international health?  I feel we often talk about how cultural, political, historic, and geographic factors have effects on people's health to no fault of their own, and that not everyone has equal access to health.  However, Knopik's talk shows how this can go beyond social factors to influence our actual biology in serious and lasting ways.

Dr. Knopik discussed her work with smoking during pregnancy (SDP) and how that relates to ADHD in children.  First she described some of the variables that can predict for smoking during pregnancy, most notable of which is, as could be expected, chronic smoking abuse.  However, this behavior is also linked to a variety of other circumstances, such as social phobia and depression, and church attendance actually had a protective effect against it.  Ultimately this research into related variables to smoking during pregnancy found that this behavior was also a proxy for other behaviors, and that it was also genetically influenced.  When we turn our attention to children who faced SDP in utero, children are at highest risk for developing ADHD when they have genetically inherited the risky allele for the nicotinic receptor AND are exposed to SDP.  If the children ONLY have the risky allele OR are exposed to SDP, but not both, risk of ADHD is much lower.  

This information has obvious application in the field of public health, and international health.  When we seek to promote healthy behavior change, or even just to understand the root causes of a health problem in a given community, it is vital to remember that there is more at play than the choices people make.  I think it is quite common for public health professionals to understand that environmental limitations such as socioeconomic status and education can negatively impact health behaviors, but biology must not be counted out.  The unfortunate thing is that this can be hard to change; as epigenetics research shows, we are not entirely in control of our gene expression but are at the mercy of environmental exposure, prenatal care, and even behavior of the generations that came before us.  Ideally, we need to be able to communicate to people that their behaviors are not only affecting them but also their descendants for generations to come.  More realistically, we can recognize that genetics and environment do not only independently impact our health but also influence each other, so any particular health concern we seek to attend to as international health officials requires careful analysis and deep understanding of all contributing factors.

Perceived Barriers and Facilitators to Mental Health Help-Seeking

I am pleasantly surprised at how exposed I have been to mental health issues in public health this semester; it is a topic that we have discussed almost every class, Lala’s point of interest, my group’s final paper project, and an area I will soon be working in.  I think a large part of why we discuss mental health in public health is because there are a lot of perceived barriers to seeking mental health care due to stigma that varies from country to country and even town to town. 

Gulliver, Griffiths, and Christensen (2010) looked at perceived barrier and facilitators to mental health help-seeking in young people globally.  The statistics they found are not surprising to what we already know: only 18% of 12-17 year olds in Germany with diagnosable anxiety disorders utilized mental health care; only 34% of 15-16 year olds in Norway with high levels of depression and anxiety symptoms sought professional mental health care in the previous year; and only 25% of children 4-17 with a diagnosable mental disorder had utilized mental health services six months prior to the survey.  Key barriers that they found in their review included the following: stigma surrounding mental illness (10 studies); confidentiality/trust (6); unable to identify symptoms of mental illness (5); concerns about the mental health provider (5); and reliance on self/do not want help (5); among others (see Table 1 of reference).  I have included a picture of the top rated barriers they found in quantitative studies (Table 3).  Curiously, they also looked at key facilitator themes to seeking mental health services: positive past experiences with help-seeking, social support/help from others, confidentiality/trust in mental health provider, among others (see Table 2 in reference).

            Studies like this are crucial because they help health care professionals fix the right problems: the first step to solving an issue is to (1) talk with the people your intervention affects and (2) ask questions ask questions ask questions.  I also think that Lala’s article on reflexivity that we read a few weeks could come into play perfectly with this topic.  Stigma has unfortunately portrayed mental illnesses harshly and creates judgements in all of us.  With mental health especially it is important to address your own judgements and thoughts, put them aside, and focus on the issue and people.  On a global scale, these judgements can vary widely.  Again, before we plan an intervention it is important to talk with the people of the area we are working in, and realize that what worked for one country/town may not work for another.  Slowly but surely, I think we can defeat the barriers to mental health help-seeking.

Reference

Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BioMed Central Psychiatry, 10(1), 1.

Personality Traits and Health

Personality traits and health have long had an interesting and complex relationship.  Physicians and researchers have looked at how one influences the other.  The most common study is how personalities affect health.  It could be argued that health status can change personality as well, but there is little to no research done on this yet.  Shifren and Bauserman make the connection between personality traits leading to lifestyle choices (1996).  Individuals who have high scores in expressive and instrumental traits are more likely to have better health behaviors.  These include the use of more safety precautions and are less likely to smoke tobacco products.  It has also been shown that people who do not ask for medical assistance during ailments or injury are more likely to be susceptible to preventable illness and death.

In a more recent article, Bogg and Roberts evaluated personality traits as a psychological construct (2013).  Much of their research showed conscientiousness as an influential personality trait on health.  Conscientiousness is the personality trait related to being vigilant or careful.  People ranked with more conscientiousness personalities lived longer and had less disease risk.  These include indicators of pathology for diabetes, ulcers, strokes, high blood pressure, tuberculosis, and skin problems.  The most recent studies have been focusing on conscientiousness personalities and the handling of stress (Bogg & Roberts, 2013).  As we have discussed in previous conversations, stress can cause a tremendous number of health problems.  More conscientiousness leads to better coping and adaptive strategies for stress.  Because this is a fairly recent line of research, the correlation between health-related outcomes and conscientiousness for stress is lacking.  This being said, the initial findings warrant further attention.

The future of health and personality traits, at least according to Bogg and Roberts, is to co-develop health behaviors and conscientiousness.  The researchers believe that this will reduce the amount of morbidity and eventually mortality experienced by populations.

References:

• Bogg, T., & Roberts, B. W. (2013). The case for conscientiousness: Evidence and implications for a personality trait marker of health and longevity. Annals of Behavioral Medicine, 45(3), 278-88. doi:http://dx.doi.org.ezproxy.lib.purdue.edu/10.1007/s12160-012-9454-6
• Shifren, K., & Bauserman, R. L. (1996). The relationship between instrumental and expressive traits, health behaviors, and perceived physical health. Sex Roles, 34(11-12), 841-864. Retrieved from http://search.proquest.com.ezproxy.lib.purdue.edu/docview/225375107?accountid=13360

Cognitive Dissonance and Mental Health

Frantz Fannon, a psychiatrist and philosopher from the island of Martinique regarding cognitive dissonance said, "Sometimes people hold a core belief that is very strong. When they are presented with evidence that works against that belief, the new evidence cannot be accepted.  It would create a feeling that is extremely uncomfortable called cognitive dissonance. And because it is so important to protect the core belief, they will rationalize, ignore and even deny anything that doesn't fit in with the core belief."

In “Suicide note” by Langston Hughes, he writes, “The calm, cool face of the river asked me for a kiss.” Apart from the literary significance of the poet and poem itself, there is a cognitive dissonance implied in the simple statement that strikes at the heart of the young. According to psychologist cognitive dissonance is a theory where there is a tendency for individuals to seek consistency among their beliefs and opinions, their cognition.  Dissonance increases with the importance of the subject to the person, how strongly the dissonant thought conflict and the ability of the individual to rationalize and explain away the conflict. Dissonance is most powerful when it is about self-image. When there is an inconsistency between attitudes or behaviors or dissonance, something must change to eliminate the dissonance.

Mental health disorders begin during youth (12-14 years of age). Poor mental health is strongly related to other health and development concerns in young people. In young people mental health issues leads to mortality in the form of suicide. I belief that young people commit suicide because of the struggle to hold two competing thoughts in the mind at the same time.  They do not know how to find, deal with or even rationalize the conflict that may arise from a belief change due to circumstances that they cannot change. Most of the dissonance that arise in young come from how they see themselves and the world around them.  Do they change their behavior and beliefs to fit the world, or how can the world be changed to fit into their beliefs.  It is how they see themselves. 

I think that if we can understand the dissonance that a young person is going through then we will be able to intervene, however in most cases the young person doesn’t even know or haven’t process the conflicting beliefs or thoughts.  Yes, the calm cool face of the water, but it asked me for my life.  Is the water then calm and cool or is this an illusion.  How do I reconcile this idea that death brings peace with the horror of DEATH itself? Suicide is a person controlling his/her faith, but what are the circumstances in which suicide became an option then was I in control, or acting because of circumstance and a change of belief?  Does a person who has cancer and chose to die excising control or being led because of the pain and the belief that they will not live pass the disease? Cognitive Dissonance…….The Calm Cool Face Of The River Asked Me For A Kiss.

Risk Factors of Preventable Mortality

            Bad habits such as smoking and over consumption of calories are becoming more and more ubiquitous among the general population. Over the decades there have been many laws attempting to reduce tobacco use, especially in public places, but obesity rates have been rising and is now more than ever being seen in the youth population. Empty calorie foods are everywhere and are usually available for much cheaper prices than healthy foods. This and the addictive amounts of sugar they contain, prompt many people to choose these foods.  How do we influence the public to make healthier choices and to avoid smoking? Tobacco use, sedentary lifestyles, and excess caloric consumption are 3 of the leading causes of mortality. These actions lead to lung and some other cancers, heart disease, stroke, and diabetes.

It is sad to see that a lot of people learn their lesson the hard way. 1 in 3 people are obese and there is an estimated 1,658,370 cases of cancer in 2015. It is the mission of public health professionals to bring about prevention of among the population to avoid disease. I believe one major problem is education, in both the parents and the children. Children are exposed to the environment and lifestyle of their parents, especially when they are too young to care for themselves. Some children have no choice but to be trapped in a tobacco filled environment and consuming second-hand smoke. Other children are being fed high calorie, in-nutritious meals at home without even knowing the effects of this food. They develop the unhealthy habits and stick to them into adolescence and adulthood. Their parents are setting them up to fail at adhering to a healthy lifestyle.

In defense of the parents, they may not be educated either. With the busy lives our generation holds, many households immediately look for the most convenient option when it comes to feeding their families, and unfortunately these are often the unhealthiest options. Fast food and frozen dinners is what our generation has come to rely on. Now that these parents are no longer in school, where should they expect to be influenced to lead a healthy life? 
        Looking at these risk factors globally, United States is not at the top of prevalence list of obesity or tobacco use. As you can see in the table below, the United States is ranked 12th of the most obese countries in the world (however it is also important to note that there are 196 countries in world).
 

As for tobacco use, you can see in the image below that the United States also does not have the highest prevalence of this risk factor. China and Eastern and Southern Europe consume the most cigarettes per person.
 

How do we combat the prevalence of these risk factors? Will the strategies be different based on location? Is this an education issue or the responsibility of the environment and policy makers? Will reductions in obesity and eating unhealthy foods result in more tobacco consumption (as a means to lose weight) and vice versa (picking up another habit). What are your opinions? What are some interventions or policies that you have seen as successful? 

http://www.tobaccoatlas.org/topic/cigarette-use-globally/
http://www.worldatlas.com/articles/29-most-obese-countries-in-the-world.html