The Global Goals From a Public Health Perspective

There is an interconnectedness between Public Health Principles and the recently agreed upon/adopted UN Global Goals. These, are also known as Sustainable Development Goals (SDGs). 

This prompted me to think that most of our actions (governance, leadership, housing, exercise, nutrition, health-care..) as being processes that ensure quality livelihoods for all people whether in homes, schools, hospitals, dormitories, cities, trains, ship and airplanes. There are definitions I want to first refer to:

Public health refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases (WHO).

Public health is the science of protecting and improving the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases. Overall, public health is concerned with protecting the health of entire populations (CDC).

Public health is the health of people in general; the science of caring for the people of a community by giving them basic health-care and health information geared at improving living ( MERRIAM-WEBSTER).

On 19 July 2014, the UN General Assembly's Open Working Group on Sustainable Development Goals (OWG) forwarded a proposal for the SDGs to the Assembly. The proposal contained 17 goals with 169 targets covering a broad range of sustainable development issues. These included ending poverty andhunger, improving health and education, making cities more sustainable, combating climate change, and protecting oceans and forests.^[1] On 4 December 2014, the UN General Assembly accepted the Secretary-General's Synthesis Report which stated that the agenda for the post-2015 SDG process would be based on the OWG proposals.^[2]

The Intergovernmental Negotiations on the Post 2015 Development Agenda (IGN) began in January 2015 and ended in August 2015. Following the negotiations, a final document was adopted at the UN Sustainable Development Summit September 25–27, 2015 in New York, USA.^[3] The title of the agenda isTransforming our world: the 2030 Agenda for Sustainable Development^[4][5]

The Sustainable Development Goals (SDGs), also called Global Goals,^[6] and Agenda 2030 ^[7] are an inter-governmentally agreed set of targets relating tointernational development. They will follow on from the Millennium Development Goals once those expire at the end of 2015.^[8] The SDGs were first formally discussed at the United Nations Conference on Sustainable Development held in Rio de Janeiro in June 2012 (Rio+20).

The definition "Public health refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases," makes me contemplate on the following 17 measures as aspirations I want to pursue as a Public Health Practitioner:

1. End poverty in all its forms everywhere.

2. End hunger, achieve food security and improved nutrition, and promote sustainable agriculture.

3. Ensure healthy lives and promote well-being for all at all ages.

4. Ensure inclusive and quality education for all and promote lifelong learning.

5. Achieve gender equality and empower all women and girls.

6. Ensure access to water and sanitation for all.

7. Ensure access to affordable, reliable, sustainable and modernenergy for all.

8. Promote inclusive and sustainable economic growth, employment and decent work for all.

9. Build resilient infrastructure, promote sustainableindustrialization and foster innovation.

10. Reduce inequality within and among countries.

11. Make cities inclusive, safe, resilient and sustainable.

12. Ensure sustainable consumption and production patterns.

13. Take urgent action to combat climate change and its impacts.

14. Conserve and sustainably use the oceans, seas and marine resources.

15. Sustainably manage forests, combat desertification, halt and reverse land degradation, halt biodiversity loss.

16. Promote just, peaceful and inclusive societies.

17. Revitalize the global partnership for sustainable development.

CONCLUSION:

The knowledge of, owning the right set of Public Health skills as well as a continued cognizance of the interconnectedness and intersectionality between the 17 measures will go a long way to make me a more effective Public Health Practitioner.

REFERENCES:

1.  Press release - UN General Assembly’s Open Working Group proposes sustainable development goals, 19. July 2014

2.  Synthesis report of the Secretary-General on the post-2015 sustainable development agenda

3.  World leaders adopt Sustainable Development Goals". United Nations Development Programme. Retrieved25 September 2015.

4. Transforming our world: the 2030 Agenda for Sustainable Development".United Nations - Sustainable Development knowledge platform. Retrieved 10/04/2015.

5. "Breakdown of U.N. Sustainable Development Goals". Retrieved 10/04/2015.

6.  The Global Goals: Resource and Media Kits for the Sustainable Development Goals

7. Harris, Gardiner (27 September 2015). "Obama Tackles Poverty and Sexism in U.N. Speech". New York Times. Retrieved 29 September 2015.

8. Breakdown of U.N. Sustainable Development Goals". Retrieved 10/4/2015.

Table Salt From a Public Health Perspective

Jane is someone who has never had her barbecued and roast beef without salt. She would use all sorts of expletives or profanities loudly enough if you dare hide salt. She asks in her husky whisky scarred voice out loud: "what would we be without salt?"

In humans, the craving for salt can be traced to the taste buds. Yes, you read right. The sweet, sour, bitter,salty taste buds.

But, what is this salt (table salt)?

Salt is Sodium Chloride [NaCl]. Sodium'schemical symbol comes from the Latin word for sodiumcarbonate, natrium. Discovery: Sodium was first isolated by Sir Humphry Davy in 1807 using electrolysis of caustic soda, although it had been long recognized in compounds. Sodium is a soft, bright, silvery metal that floats on water ( for more see: Google).

First and foremost, a person needs from 1,500mg-2,500mg of salt daily (31-41% of a teaspoon). "People need about one and one-half teaspoons of salt per day. Anything less triggers a cascade of hormones to recuperate sodium from the waste stream, hormones that make people vulnerable to heart disease and kidney problems" (Sally Fallon Morell, president of the Weston A. Price Foundation ¹, 1991).

In one study by Harvard researchers, a low-salt diet lead to an increase in insulin resistance, which is a risk factor for type 2 diabetes -- and the change occurred in just seven days!http://articles.mercola.com/sites/articles/archive/2012/02/17/dangers-of-salt-restriction.aspx#_ednvihttp://articles.mercola.com/sites/articles/archive/2012/02/17/dangers-of-salt-restriction.aspx#_ednvivi Other research has found salt restriction may play a role in:

• Increased death rates among people with type 1 or type 2 diabetes
• Increased falls and broken hips, and decreased cognitive abilities, among the elderly
• Giving birth to babies of low birth weight
• Poor neurodevelopmental function in infants

There is also a condition in which you have too little sodium is known as hyponatremia, where your body's fluid levels rise and your cells begin to swell. This swelling can cause a number of health problems, from mild to severe. At its worst, hyponatremia can be life threatening, leading to brain swelling, coma and death. But mild to moderate hyponatremia has more subtle effects that you or your health-care provider may not even connect with a sodium-deficiency problem, including some or all the following:

1. Nausea

2. Loss of appetite

3. vomiting

4. Loss of energy

5. Muscle weakness

6. Spasms

7. Headaches

8. Fatigue

9. Confusion

10. Incontinence

11. Mood changes

12. Poor clotting of exposed wounds/ulcers

We do need this salt in the right quantities.

A high salt intake and high blood pressure can cause too much calcium to be excreted by the kidneys into the urine, leading to a buildup of calcium and therefore kidney stones. They can be very painful and in some cases can lead to kidney disease.

The Dietary Guidelines for Americans recommend limiting sodium to less than 2,300 mg a day — or 1,500 mg if you're age 51 or older, or if you are black, or if you have high blood pressure, diabetes or chronic kidney disease.

Salt helps maintain the fluid in our blood cells and is used to transmit information in our nerves and muscles. It is also used in the uptake of certain nutrients from our small intestines. The body cannot make salt and so we are reliant on food to ensure that we get the required intake.

Jane has a point in as far as appetite goes. But perhaps appetite is a motivation for us not to deprive the body of the other uses of salt. Salt in the right amounts, helps in metabolism. However, in very low or high amounts it can be a risk.

REFERENCES:

1. FDA Warned on Dangers of Salt Restriction
2.http://www.answers.com/Q/Where_on_your_tongue_are_taste_buds_located.
3.http://www.cnn.com/2010/HEALTH/05/15/america.salt.addiction/

Sickle Cell Disease from a Public Health Perspective: Lessons from the National Heart,Lung and Blood Institute (NHLBI)

This is a second topic I am sure many have heard about. Yes, we are talking about Sickle Cell Disease ( SCD). Sickle Cell Disease is caused by a genetic abnormality in the gene for hemoglobin, which results in the production of sickle haemoglobin. Hemoglobin is a protein that carries oxygen. Once oxygen is released from a sickle hemoglobin it sticks together and forms long rods which damage the shape of the red blood cells (WebMD). Abnormal hemoglobin is called haemoglobin S, this causes sickle cell disease (SCD).

SCD, is passed on from parents to children, it is not contagious and no one can catch like they catch a cold or an infection. People with SCD inherit one abnormal gene from both parents. When the person has inherited one abnormal gene then they are said to have an abnormal hemoglobin S. When they inherit both genes they are then said to have hemoglobin SS. Hemoglobin SS is called Sickle Cell Anemia. This is the most severe and most common SCD.

June 19th of every year, is set aside as the National Sickle Cell Day.  This year ( 2015) Dr. Gary H. Gibbons of the  National Heart, Lung and Blood Institute (NHLBI), shared the story of  Afia Donkor who is one of a handful of people to have undergone a successful bone marrow transplant to cure her disease.

The NHLBI also set the stage for an opportunity at the campus of the National Institutes of Health in Bethesda, Md., that will brought together diverse members of the sickle cell disease community, including patients and their families, advocates, health care professionals, professional societies, government agencies, and others.  As a community, we will discuss and strategize about the future of sickle cell disease research.  The forum will include panel sessions and discussions that focus on issues affecting those living with sickle cell disease, including sickle cell research, pain management, disease treatment, and other timely topics.

According to the NHLBI Website, in the United States, most people with sickle cell disease (SCD) are of African ancestry or identify themselves as black.

• About 1 in 13 African American babies is born with sickle cell trait.
• About 1 in every 365 black children is born with sickle cell disease.

There are also many people with this disease who come from Hispanic, southern European, Middle Eastern, or Asian Indian backgrounds. Approximately 100,000 Americans have SCD.

SCD can manifest in many forms: blockage of blood vessels, known as vaso-occlusive crisis; obstruction of smaller vessels by sickled red blood cells; pain crisis; injury to internal organs due to blockage of blood flowing to them which can cause ischemic injury. There are 6- more episodes per person annually. Other forms of pain and complication are :  malaria exacerbates effects of SCD; dactylitis; avascular necrosis; acute joint necrosis; abdominal pain; liver infarction; papillary necrosis; inability to concentrate urine ( isosthenuria); deep bone pain; fevers; acidosis; dehydration and chirped lips.  What does this inform us?

Some suggestions to make life better:

1. Improve on reception services for those in acute pain or crisis.

2. Establishing community and national awareness drives addressing SCD.

3. Anti-malaria drives such as universal practices ensuring no mosquito bites.

4. Provision of mosquito repellants and insecticides.
5. Provision of Folic Acid Supplements.
6. Translating literature on SCD in format that is understandable.
7. Providing education on partner testing for abnormal genes.
8. Training resource persons to provide care, management and interventions.
9. Establishing cultures fr testimony giving following Bone Marrow Transplants.
10. Provide opportunities for community engagement

SOURCES:

1. NHLBI

2. WebMD

3. NIH

Diesel from a Public Health Perspective: Lessons from California

I am sure you are a writer or someone who enjoys discussions about matters of everyday or not so everyday concern. In this series called "from a Public health Perspective," I hope to bring to the forefront themes, subjects and materials that have not been common in the dialogue or ethos of our realm of everyday life.

This will be part of doctoral and postdoctoral level works combining research, community health education, immunology, health and public health.

In the series I shall write a short narrative geared at provoking deeper understanding and critiquing. I hope you join in and help make this an educative platform. We need to bring more subjects into the conversational arena if we want to contribute to a critical mass of practices that engender care for others and the Earth.

This is the first of the series: Diesel from a Public Health Perspective!

Diesel is a product of Crude Oil, a mineral occurring naturally. When crude oil is processed at refineries, it can be separated into several different kinds of fuels, including gasoline, jet fuel, kerosene ( paraffin), grease, vaseline and diesel. A scientist called Rudolf Diesel contributed to the science of separating these fuels. Hence the name diesel. Diesel is heavier, corrosive, evaporates more slowly and has a higher boiling point than water. it is a popular product in that it has a higher energy density than gasoline (petrol).

Imagine, 1 gallon ( 3.8L) of diesel fuel contains about 155X10,000,000 joules. 1 gallon of gasoline contains 132X10,000,000 joules. Diesel engines get better mileage than equivalent gasoline engines.

Diesel engines are around us:  freight ship, vehicles, construction, generators, trucks, school buses, city buses, trains, cranes, farming equipments and emergency response vehicles. We rely on diesel to ship bulk goods.

Diesel emits very small amounts of carbon monoxide, hydrocarbons and carbon dioxide. These emissions lead to global warming. From this observation, we see it does not contribute to global warming. However, it produces very high amounts of nitrogen compounds and matter in particle form for example soot and sulphur. These lead to acid rain, smog and health hazards. According to the office of Environmental Health Hazard Assessment  (OEHHA) of California, exhaust from diesel engines contains substances that can pose a risk to human health. Diesel, is a complex mixture of thousands of gases and fine particles that contain over 40 toxic air contaminants some of which are suspected to cause cancer. These substances are:  nickel, benzene, arsenic, formaldehyde and harmful pollutants such as nitrogen.

People, animals, fish, birds and plants are exposed to toxic gases. It is more severe for organisms near or around objects that produce the exhaust. In humans, this particle pollution causes: emphysema, asthma, chronic heart and lung diseases, childhood illnesses and allergies.

So, we see that diesel is good in that it has been behind the development boom and increase in built infrastructure which is so central to our life. But, we have also seen the risky side of it to our life. What does this inform us?

Some suggestions to make life better:

1. Improve engines to reduce emissions.

2. Retrofitting  cars with particle-trapping filters.

3. Vigilance in tracking defaulters.

4. Use of alternative fuels ( propane, electricity, natural gas
5. Reduce idling time of engines.
6. Street cleaning.
7. Providing education to people about risk factors.
8. Putting up notices for the public as well as alerts.
9. Establishing Walking and cycling zones in cities or built urban areas
10. Pollution taxes/penalties.

SOURCES:

1. California Air Resources Board ( ARB) 

2. Energy Information Administration 

3. EUROPA

4. OEHHA (oehha.ca.gov)

5. The American Lung Association of California ( ALAC)

A Positive Attitude: Survive, Keep a cool head and Be productive

One does not buy positive attitude from a pharmacy nor can one order it online. But it is both a prescription and a character that is indispensable. It is as important a subject as medicine, engineering or law.

Jane works as Muni-Train driver and she plies the longest routes from one end of San Francisco to another. One end is North Beach and the other is South Beach. She is used to being asked questions about the Bart (Bart is another transport form in the Bay Area), about which cab to take, how much fare to pay and where to get off if one is in Oakland ( Jane is a San Francisco Muni employee). She tries her best. On top of everything, sometimes the train has a fare who just wants to sleep! All this is taken up by Jane with equanimity and suave. At the end of it all, Jane is still smiling. “It is part of the job, “she says with a dismissive shrug.

Tom, is a new immigrant from Mexico and he lost his house after 3 months following his arrival in San Francisco. He had to look for a job and housing at the same time. He did this and after two weeks got a job as a security guard at a construction site on Howard Street. He worked at night and during day he volunteered as a store keeper for half a day. He slept in a corner of this store for two months and managed to save enough to get a shared apartment. He also enrolled at a college and he is about to complete his Medical Transcription and Filing Course. These two examples show what positive attitude means.

Positive attitude is one of the greatest assets. Progress and success, whether in the classroom, at home, in life, during recreation, on the job, or at home, are affected largely by it. One’s personality also reveals one’s readiness to assume the responsibilities involved in day to day life’s activities, one’s job, social life. There are universes of responsibilities such as those that are: work-related, parenthood-related, filial-related, social-related, road-user-related, host-related, guest-related, professional-related, conduct-related and individual-related. Jane and Tom understood and had a grasp of their different universes and the mechanics involved. They knew what it takes to survive, to keep a cool head and be productive. This is what matters at the end of the day.

At the individual level, one has to examine one’s inner self critically to ensure that no negative tendencies intrude. Gauge your environment, engage in virtuous activities however pressing matters may be, avoid feelings of inferiority, don’t make excuse for poor work or too little done. These are negative traits cause depression, tension, irritation, and intolerance. One’s attitude toward one’s fellow classmates or workers, toward supervision and toward responsibility is as important as one’s attitude about oneself. Great motivators like John Maxwell Company or Key-note speakers talk about this. This becomes your way of doing things and it eventually becomes an enduring structure of beliefs that will make you persist even when many seem to be giving up. A positive attitude builds a positive mental concept of our ability and worth. This is extremely important in striving toward a goal. Conversely, it is impossible to progress satisfactorily in work or live a meaningful life if one is filled with negative perceptions. Perception of yourself is a powerful force that influences and guides you. If you perceive yourself as becoming successful, you will see yourself as responsible for your progress and you will pinpoint what you do. You will reinforce your attainments and correct your errors. You know that you guide your destiny; and since you perceive that you are competent, you will invest your time, energy, and talents in full measure today so you may reap the benefits of a superior typing tomorrow. Jane has worked with Muni for 15 years and she says she will be around for another 10 years. Tom is committed to making it as well. He sees his life getting better every day and he has overcome his fears. You need to cultivate a positive attitude. It is your own way of watering your own garden of life. Do not give up.

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“Gender” From a Public Health Perspective

Gender as both a term and an aspect of socio-bio-culture, is like a vehicle.  Both women and men can drive it. To drive a vehicle one needs a permit. To get a permit or license one needs to attend driving lessons and pass testing after. Gender is such a tool too. It can be studied, analysed, synthesized and thematized.

Gender is a systematic progress towards actualization for both women and men. It should be a means to give both men and women a means to learn to negotiate with each other and explore each side's uniqueness with both given an unbiased start. It must be a socialization that highlights the unique contributions of women and men. It has to show how inequality can be addressed. Gender to be relevant to both women and men, it has to improve on accessibility, affordability, sustainability, negotiation, conservation and accountability as far as resource use goes. Gender must the desire to steer the dialogue towards how inequality can be addressed. Gender must be a means to show that all sexes can be productive and all that is required are spaces where that can be allowed to take place. Gender must allow for skills transfer to next generations both horizontally and vertically.  By horizontal means is meant the passage of skills from one generation to another. Vertical skills transfer is when it happens across sex, gender and cultural diversities. Gender is not simply an euphemism for anything to do with women. It should not be dismissed as feminization, emasculation. It is the broad sweep in which seas, mountains, forests, rivers and valleys are the vista that greets one’s view.

Women have performed well in positions and roles that have been thought to be a reserve for men. Granted there are roles that women alone can do by virtue of anatomy such as gestation, lactation and nursing. On top of these, women can engage productively in roles that men have been engaged. There has to be an infrastructural mechanism to allow this to happen. Many have used such mechanisms like: feminism, pro-active inclusion, education of the girl-child, women movement building to name but a few. True, we may need reminders, in form of women or men to sharpen our focus on the usefulness of gender as a tool. But, it should not mean men will be served after all women have. Gender is about institutionalizing mechanisms through with women and men are able to fully actualize. 

Women have proved they too can be as productive as men and contribute to the general well-being of society. This can be seen across many cultures during meal times. Women contribute so much time to feeding the world. It was a woman who is credited to have invented a first computer. During the Beijing 1995 Women Forum, Robin Abrams a senior woman leader and innovator gave an in-depth presentation on the roles women played in early years as well as now, to design products and provide tools that elicit the best in people. She was referring to a computer. But there are other examples from Architecture, Medicine and Physics (e.g, Madam Curie). So, it would be so Jurassic Age-like to even start a debate that tends to cast women as weak! The thing to do should be how we institutionalize gender to serve all sexes.

Imagine a consistent effort to make amends, re-educate ourselves and equip our minds with an ability to think towards institutions. Gender can be a systematic progress towards actualization for both women and men. Right from childhood certain stereotypes that promote denigrating power roles can be challenged. In her blog on challenging traditional gender roles, Marsha R. (2012) shows how through the gifts given to girls and boys or women and men on Mother’s and Father’s Day each May and June of every year as an example of “countless ways we perpetuate the stereotypes and biases about what women and men are supposed to like and be like.” In it she continues to say “ our media, marketing, language, and culture about these expectations and assumptions filter down to the youngest of us.”

Gender must be a socialization that highlights the unique contributions of women and men. It is this attitude and paradigm shift that is critical to cause a much needed change among men and women. This change according to Sara Delamont (2001) will provide a structure that allows for detailed exposition of studies about gender differences and for a cumulative argument about the significance of changing social institutions.

Whenever the word gender is mentioned it should trigger the desire to steer the dialogue towards how inequality can be addressed. Gender to be relevant to both women and men, it has to throw light on accessibility, affordability, sustainability, negotiation, conservation and accountability that benefits all.  Gender must be a means to show that all sexes can be productive. Gender must allow for skills transfer to next generations both horizontally and vertically.  By horizontal means is meant the passage of skills from one generation to another. Vertical skills transfer is when it happens across sex, gender and cultural diversities.

REFERENCES:

1. Linda Lee Lindsey, 2014 December 11. Gender Roles: A sociological Perspective. Routledge

2. Marsha Rakestraw, 2012 June 11. 12 Children’s Picture books that challenge traditional gender roles. Retrieved from Institute for Humane Education website

3. Robin Abrams, 1995. Looking at technology through women’s eyes. Retrieved from http://gos.sbc.edu/a/abrams.html.

4. Sara Delamont, 2001. Open University Press.