The effect of conflict on the mental health of children and adolescents

As we have been studying the cumulative effects of environmental stressors on population health, PHS Student Zeeshan Yacoob brings our attention to an article about the effects of the Israeli-Palestinian conflict on mental health through the experience of an 11-year-old boy. Zeeshan writes:

Zeeshan writes:

This article is about an 11-year-old Palestinian boy who suffers from PTSD after witnessing his brother die. After reading this article I began to wonder how these children will grow up and what type of society they will establish in the future. Furthermore, I also began to wonder about all of the health conditions they would have to face even if their situation would change overnight (for example if they were taken in as refugees to the U.S.). I’m sure that many of these children due to their stress will suffer from conditions like hypertension, cardiovascular disease and depression. As a result, their productivity as a society will decrease and also the societies educational attainment will also undoubtedly decrease. All in all, not only do I feel frustration and anger for the situation that these children have been exposed too but I also worry what their health future will look like not only for themselves but also for the next generation after them.

Zeeshan also points us to a systematic review on the effects of conflict on mental health of children in the Middle East:

Image result for salwa massadPopulation Health graduate, Salwa Massad, PhD has done significant work in this area. She is currently a research manager in the World Health Organization’s Palestinian National Institute of Public Health and adjunct faculty at Columbia. Here is a link to a presentation of her brave and powerful work on the health of children living in chronic war zones:


Questions of non-binary gender and population health

PHS 795 Student Rissa Lane writes:

This article was published in CNN on Wednesday, September 20th, and refers to The Global Early Adolescent Study: An Exploration of the Factors that Shape Adolescence, an article published in the Journal of Adolescent Health volume for October 2017 and came from researchers from Johns Hopkins Bloomberg School of Public Health and the World Health Organization. The study draws connections between binary gender roles imposed on people from a very young age and the health implications that result. The article suggests that gender role expectations are the result of bias from group to group and the norms that exist in a community, because gender roles exist in nearly every culture across the globe, but the expectations for each gender are not necessarily synonymous across different populations. This study is particularly relevant to the content covered in this course as we have started to look at health of populations and social-ecological determinants of health. Typically, controls are imposed on study participants to regulate the effects of varying income, education level, age, and gender on the representation of results of evaluation. With this study, it becomes evident that the binary gender system may actually have health implications in and of itself.

We’re Waiting for the Paperwork

By PHS 795 student, Gabrielle Waclawik

A few weeks ago, President Trump proclaimed he considered the opioid epidemic a national emergency. Our nation’s opioid crisis has been brewing over many years, really since the 1990’s when pain gained recognition as the fifth vital sign and opioids, the ‘wonder drug’ were utilized in response. But it really was not until the problem began to infiltrate and make noise in the more white and affluent communities in the last 5-10 years, that the opioid epidemic began to gain traction in the mainstream and popular media. Now, this is no longer an issue that we, as a society, can ignore, as non-prescription opioid use, addiction, overdoses, and preventable deaths have increased at such a dramatic and exponential rate over the last decade. Most importantly, we must not forget that much of this illicit drug use started as a routine prescription for opioids from a licensed health provider. In fact, according to the CDC, people who are addicted to prescription opioid painkillers are 40 times more likely to be addicted to heroin.

However, some still argue against the use of their tax dollars towards funding free needle exchange programs, or easier public access to a readily available antidote (Naloxone), claiming that this only propagates a message that illicit drug use is tolerated by our society. Others, perhaps, believe this is an isolated problem among the drug user community, that does not affect them, thus how can it be a public health issue of national concern requiring collective action? But in reality, beyond the addiction, the overdoses, and the preventable deaths, downstream effects have now become extremely evident, with increasing numbers of new Hepatitis C and HIV cases on the rise. According to the CDC, new Hepatitis C cases in the U.S. grew nearly 300 percent between 2010 and 2015. In 2015, the state of Indiana’s new Hepatitis C cases were increasing as such a rapid rate that the state declared it a public health emergency, immediately making syringe exchange programs legal for the first time ever in its state. Furthermore, the access to medication alone for Hepatitis C treatment has been a greatly debated topic due to its high costs, and whether state and federal medical programming should be bearing this burden. This does not even begin to include the preventable drain of numerous other resources such as hospital costs or decreased work force productivity.

The degree of complexity the opioid epidemic presents requires multi-disciplinary action on many levels, and has, more recently, finally forced a government response.  On a state level, Wisconsin has led the charge with republican Representative Nygren, whose own daughter experienced heroin overdose and continues to battle drug addiction. Rep. Nygren brought forth the HOPE Act, which was initially signed in 2014 but continues to have addendums up for vote. On a national level, while President Trump may have made a public verbal statement acknowledging the issue, weeks later he still has yet to officially sign the paperwork to formally declare the opioid crisis a national emergency. In fact, the Atlantic article points out that despite Trump’s efforts to repeal the Affordable Care Act, the failure to repeal avoided a dramatic cut to Medicaid and thus maintained states’ ability to respond to the opioid crisis through the broader coverage of treatment and substance abuse programs. By signing the declaration, it will allow us easier access to federal disaster funds and waiving of certain federal program regulations. So that we can more quickly and robustly respond to this growing opioid epidemic, please sign the paperwork, President Trump.