This was one of our first entries defining prevention in the public health context and we were asked to make a submission by the Kathleen Show as a part of their Prevention not Prescriptions new weekly program. So, as we dig back into the root causes of our work, here's prevention for you:

The first issue I'd like to discuss is about Prevention. Public Health in its core aspects involves assessing, planning and developing infrastructure, resources and materials to improve the health of a population.


As professionals we are not primarily clinicians, we are in many ways administrators, organizers and educators. Given this, in order to accomplish our goals we must utilize this role effectively by focusing primarily on prevention. As a public health professional I ask: what is the problem, the extent of the problem, it's nature and how can it be resolved, prevented or it's negative impacts reduced?

This is what I believe defines prevention. However, it's not that simple, prevention isn't just about investigating a problem and either eliminating it or reducing it's impact. In the context of health and infrastructure it is about environmental change. This may mean changes in systems, methods of delivery, increased access to essential resources and more efficient service delivery. Thus, it requires change on many levels.

I decided to discuss this issue, because as an alcohol prevention specialist I often run into many different interpretations of this type of prevention. As I mentioned earlier we are not primarily clinicians, however the disease of alcoholism like many other health indicators is clinical and can be treated. Yet, just as prevention is not education only, treatment is not the only way to solve the problem. For those in education, prevention is the primary vehicle for delivering health messages in their setting, treatment's contextualization is in providing resources to resolve, subside or reduce negative health impacts.

The point here is that prevention involves both education and treatment in terms of increasing access and efficiency of health resources. So, when we explain the concept of a comprehensive approach, this is what we mean. I'm the coordinator and collaborator, educators are my partners to explain the problem and provide instruction for prevention, clincians are my partners for delivery of accessible and effective care. The institutional structure is the basis for bringing these two entities together and the population itself are the vehicles of change. Given this, I prefer not to tell people what prevention is, instead I'd like to work with people to see what it is, their role, and how their work with others put together the pieces of the puzzle.

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This week we're talking about immigration, the real issues, while discussing facts and potential solutions. In the past we've talked about the health, political and cultural context of US Mexico border issues and the Israeli Palestinian conflict. Our discussions have centered around the political and economic impact and perspectives from these situations while maintaining an emphasis on prevention, politics and today's culture. Our last presidential campaign, the War in Iraq or WWIII and ongoing issues on this topic provide a platform for discussion. However, we must remind ourselves that this issue has been in existence throughout human history and our ability to engage in honest debate, often depends on the political climate. Now is the time. Yet, we shall not forget yesterday when we speak of today and we should do our best to recognize others when we look towards the future.

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This week we're talking about prevention and our goal is to have a better sense of how others define it and in what context do they feel it is a necessary or essential tool. We'll start with a quote from an original entry that we wrote in February on prevention:

"We must examine why some communities have greater access to resources than others and how our political and geographical landscape can address these gaps. In order to achieve our goal of improving health we must look towards the future by examining where we need to change the present."

You can find this and other original blog entries on prevention here: http://blog.spicersconsulting.com/page/4.aspx

Take a listen to this new entry, look back at others related to the American culture, food, health, healthcare, economy, drugs and other issues, all discussed with an emphasis on prevention.

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This week we're talking about human rights. It's a relevant issue given that President Obama spoke at the Human Rights Campaign National Dinner this past Satruday, October 12th and much attention has been brought to the issue of marriage equality over the past few years. However, we must consider the context within the nations and communities that we are discussing these issues. Marriage equality and gay rights brings up a moral debate over religious and social beliefs. Yet, human rights emphasizes the importancy of acknowledging that people should have equal access to resources regardless of who they are and in order to live safely and comfortably. Issues that are most paramount in other countries relate to someone's ability to live, work or thrive in their community regardless of who they are and we often think about death, starvation and persecution that need attention. In the US we are afforded many rights and because of this we should consider how all citizens should have equal access given that we all want to live happy and healthy lives for ourselves, our family and for future generations.

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To start off this week's topic of global health we decided to do a weekly blog entry with a newly initiated pod cast to go along with it. This podcast is an introduction to global health as an emerging field in the professional arena. In this written entry I'll talk about some of the current events and emerging issues that are relevant here. Many have seen coverage of President Obama hosting a UN convocation where the long time Libyan leader Moammar Gadhafi spoke for the first time in about 40 years, going on for nearly 1.5 hrs. of which many interpreted as an odd and perplexing speech. Gadhafi even had trouble finding a place where he would be allowed to set up his traditional tent, near UN headquarters in New York. Iranian President Ahmadinejad spoke as well in his usual fashion and we watched assembly members walk out during his time at the podium. Obama and Secretary General Ban Ki Moon lead the way with their collegial, clear and focused efforts to host this event and address some of the key challenges our nations currenlty face. Following this was the G20 summit, hosted in Philidelphia which brought much coverage on how this City has shifted from an industrial town with significant environmental hazards to a green economy. A few current events in brief and we welcome your votes on this post, commentary and additional insights. Check our Facebook fan page for more global health insights throughout the week: http://www.facebook.com/pages/edit/?id=243685945234#/pages/Spicers-Consulting/243685945234

Much has happened in the weeks since my last entry. We continued to memorialize Michael Jackson after I wrote about this case of a another celebrity succumbing to the price of fame. The push for healthcare then dominated the political news and now this week, we focus on the issue of race. I have dedicated much time in my community over the past 8 months, engaging in efforts to advocate for social justice and inclusion. In doing work professionally on prevention and public health issues, I know that our communities do not really begin to focus on many serious issues until a tragedy or controversial event reaches the public's attention. In this case we are now focusing on racial profiling among law enforcement and the impact it has had on communities of color. After the arrest of African American Harvard Professor Henry Louis Gates at his home in Cambridge Masschussets, the continued friction between law enforcement and communities of color ensued. Obama was compelled to clarify his remark  saying that the Cambridge Police acted stupidly by calling it a "teachable moment." What does this mean? I feel it emphasizes the need to learn from our history and acknowledge that problems exist, contributing to both parties on either side to over react; highlighting that this still remains a systemic issue.   

                                                                                   

What do we do from here? My hope is that once this issue dies down in the media, we will not just return back to how things were. In the fight for policy reform, advocates can take advantage of situations like this to mobilize the community and facilitate action. How can we do this? We must engage in dialogue. On the local level, law enforcement and their constituents should come together to share view points and make reccomendations for action. These reccomendations must then go to local leaders and produce a proposal for institutional change. Continued acknowledgement that this is a subject of concern and we must examine how the past has impacted the present, is the basis for a need to do something.

Obama was criticized for commenting on what was said to be a local issue. However, what he shed light on is that a local issue allowed this country to reflect on a national problem. Thus in moving forward, we must bring the work back to the local level and continue to share within and between communities, the change that we are implementing in our own back yards. Systemic and institutional change will take much time, yet we can use the strategies mentioned above over the long term. A community forum and recommendations for action are starting points that will transfer this work into our existing structures on the local level. This topic of interest can become a priority on our boards, councils, city governments and grass roots organizing movements. As we all learned from the eight years past, unless we exercise our freedom to speak and act, we cannot see the change we know we want that is based upon problems from yesterday persisting today.

Just when I thought I've ran out of things to blog about, the news reports start rolling in. Not only in my life but on the national and international spotlight. In a short span we lost three American icons: Farah Fawcett, Ed McMan and Michael Jackson. On the international front, the uprising in Iran faded as the Obama administration made it's first declaration of war i.e. combat troupes in Afghanistan. In this post I'd like to write more specifically about what happened to Michael Jackson having died after being administered a drug that was only meant for operating rooms and how I connect with the pressure to succeed in this country. Many speak of the price of fame and I think in many ways this expectation and its potential harm is a common thread in our culture. 

Personally, I think about how I need to make a name for myself, get a good paying job and raise a family. However, as I've begun my career I've realized a lot of things. In today's society havig a bachelor's degree is not enough for a good paying job, yet having worked since you were 16 isn't evidence enough of quality work experience. When I consider how hard I've worked and how on either side of me, those with more money get further and those with much less money are stuck. Often we talk about street smarts vs. book smarts, and ultimately in many ways money is the underlying factor. However, when we talk about health it becomes clear that what's on the surface is in most cases not a predictor of an invidual's ability to live healthy. Everyone is different yet, we all share very similar genetic make up.

                            

What's my point? The point is that as an individual with a unique experience and outlook on life, you have the power to decide how you use the resources you are given to make what you want and keep what you've earned. Yet, we live in a country where those with power, money and fame are reverred. This is an unrealistic tenant to think that most Americans or even humans should strive for this. In our nation's history, we have chosen to measure power and success by what's on the surface and we are now paying the price. The choice-in the context of our three most recent celebrity deaths- is to use power as a tool to educate, use it as a tool to entertain or allow it to get the best of us. Thus we must recognized that many do not have the power to choose, but everyone has the power to be and in that simple term there is a lot of room for interpretation.

I facilitated a meeting today just after finding out that my University did not get a large federal grant which I had worked hard to lead the process of submitting. As we moved forward with identifying how we would find additional resources to provide our students with support to reinforce healthy behavior choices-thus improving their academic, individual and personal success- one of the folks at the meeting said: "We just need to communicate to the administration that the importance of investing in this is based on an unmet need" I responded by saying "can you say that to our Vice President for me?" In addition to that,I  sat in on a conference call among Universities across Michigan to consider applying for another similar federal grant to form a statewide coalition. Later in the day I went with a student to local bars and liquor stores to provide information and resources on responsible alcohol sales and service.

This is just one day in my life, where the work I do as a health educator and youth advocate reinforces what our society, American citizens and our institutions should, are and will think about every day: Unmet needs. So, how are they met? Well, maybe it depends on who you ask, how you ask or what your needs are. That's what we all want to know: what is the need? How do we address it? Will our way of doing so be effective? Finally and most importantly now in the world of grants, program management and development: How can we evaluate it?



Saturday, June 27th will mark National Healthcare Day of Service. http://my.barackobama.com/page/content/hcserviceattend
Individuals involved with Organizing for America will be participating in events across the country to bring attention to the need for national healthcare reform. Four events are happening in the City where I live and I had a chance to attend the meeting where we talked about planning for this event. Everyone has an agenda, thinks particular needs are important based on their personal and professional experience, but what does this event do? It brings people together to focus on one goal we can all relate to: healthcare.

Let me conclude by going back to what I started out with. We can work together to identify a common goal, but as we all know resources- human and fiscal- put it into place. At the end of my day I sat with 3 other healthcare professionals where we spoke to high school students of color, and emphasized that whatever you do, don't give up. The unmet need to live as in continuing life's journey, can hopefully drive many and encourage most to keep on giving.

In a prior posting I talked about the quick fix culture that has evolved into our 'it's all about me' and 'want it now' way of living. Which brings up a continued question as to how this will affect our future generations. As someone working on a college campus, my job is to understand the health trends amongst our students and find ways to provide meaningful and effective programs and services to educate, empower and engage. The environment our youth grow up in is increasingly complex, high stakes and filled with a multitude of choices. As I focus specifically on alcohol prevention, I've found that the college experience has changed for our young people. A college degree today is a requirement and not necessarily an advantage, thus just going to any college doesn't guarantee a job. However, the transition to college life is still viewed as the time to let loose and experiment in social decision making. Students have increasing pressure to excel amidst an environment that is set up to guarantee success among a small sub set of the population; how will they be able to let loose while facing the pressure to be perfect?

A common way of existing that I've seen during my generation, was this idea of living a life you choose based on where you are or who you are with. Secularism has become a strong part of American society. Many catholics left the church, post holocaust Jews became more secular and a culture of sinning for 6 days and repenting for one day seemed to become more prevalent. Hyper sexuality, voyeurism and selfish indulgence have become a mainstay of self expression. This is evident in our culture of excess and the effect it is having on American's health. Could the mentality that we as inviduals are primarily accountable to ourselves- be a part of this? Is it really possible for an 18 year old to have complete responsibility over their choices in understanding their long term effects? No, and this may be why mental health problems of anxiety, depression and instability are emerging as a key health issue amongst our youth.



How might this change in the context of the hardships our society has gone through in recent years? Many young people graduating from college face the reality of not being able to get a job. This struggle has grown progressively over the last 5 years. When I graduated the challenge was about being able to translate an academic degree into a professional career. Today, many young people are going into public service. This might possibly help to build a more collective culture. The idea of community may soon become a necessity, given that we must band together to ensure our success. Questions as to whether the government is invested in our best interest hopefully become a part of daily conversations,  and may finally alleviate the apathy amongst Americans.

Yet, there's much work to do. For too long we have sufficed in leaving behind those below us and giving power to those above us. Young people endeavoring in opportunities to give back to communities they may have never stepped foot in can open this door. Americans are holding accountable those who held the power and ultimately manipulated the majority. Institutions are now being forced to restructure and find ways to appeal to and accomodate for most Americans in addition to fulfilling self interests. In this process we must continue to keep the fate of our young people in mind. This is something I constantly think about while walking within the walls of an institution, and I continue to push for our young people to be at the table. Our success depends on the future, however we cannot ensure this until we ask, listen and include. Take a minute to get to know the young people around you and you'll realize how much you have to learn.

In the past 20-30 years, along with a rise in the world's population and increased capacity in science and technology, we have been able to  further track, monitor and study the spread of human disease. These advances have allowed us to combat such epidemics as Malaria, Tuberculosis and HIV/AIDS. Yet, in recent years the human exchange of goods and services across continental borders has led to an increased susceptibility to zoonotic diseases, mutation of common viral strains and the onslaught of pandemic flu. Swine flu is on its way to becoming an epidemic and as we try to identify the scope of this public health problem, we look at the origins and causes of the disease and its spread.

I saw a report today on CNN where people in Mexico were being asked where the disease came from. Many were saying that it came from Canada or the US, and one man said that we (the US) are always finding a way to blame it on Mexico. He said something to the effect of "if there's a jalapeno in the US that causes a disease outbreak, then it must be from Mexico." This is I think where the disparity lies. While we worry about a flu epidemic, we forget that millions of people in developing countries die from preventable diseases like Malaria, acute respiratory infections and cholera. We fret over a struggling US economy while 75% of the world lives on less than a dollar a day. As a human society, we are paying the price for global exploitation of ourselves and our natural environment for the production of goods and services. Anyone could list off the many economic development principles that have been driving the ignorance and oversight that we are left to see the results of today. The reality is that in this transition, a generational shift that everyone will see at least once in their lifetime, we can easily lose sight of what brought us here.



During a disease outbreak it is important for public health officials to monitor transmission of the disease, implement strategies and controls for preventing its spread and tracking confirmed cases, treatments and associated deaths. This must be translated to the public in a way that provides enough information to understand the scope of the problem, to know how to protect ourselves, without insighting chaos or hysteria.

If you are worried about contracting the flu, remember that it is treatable, it is not life threatening and we are lucky to be in a country where your likelihood of experiencing severe consequences is minimal. However, it may also be important to consider what brought us here today. The idea that we should be helping poor countries and those suffering around the world is not one of pity. Before we feel sorry for ourselves or others, we should consider, how to take a stand, not right wrongs, but move forward towards sustainable solutions withouht forgetting what leads us to trail behind in the fight for progress.