Friday Five: withdrawal, Amanda Bynes, gluten-free labels, vaccine rates, urgentrx

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Pulling out is surprisingly popular

A study that will be published in the September issue of Obstetrics & Gynecology shows that 31% of women aged 15-24 used withdrawal as the primary form of contraceptive at least once. The study also found that 21% of those women became pregnant, compared to 13% of women who used other methods. I was pretty outraged to learn that so many young women rely on their partners to pull out, so I consulted the Kinsey Institute site Kinsey Confidential to compare different forms of contraceptives:

Method Typical Effectiveness Theoretical Effectiveness
Withdrawal 81% 94%
Male condoms 85% 98%
Oral contraceptives 92% 99.9%
Intrauterine Device (IUD) 99% 99%
Implant 99.01% 99.01%

Whelp, turns out the much-touted condoms don’t fare much better in preventing pregnancy than withdrawal, but IUDs and implants are far better. Advocating for more extensive use of IUDs and implants would help more women learn about their effectiveness and safety, and could play a major role in reducing the number of unplanned pregnancies. (FYI: condoms protect against some STIs, so keep using them, okay?)

Now we know what’s ailing Amanda Bynes

After publicly unraveling, actress Amanda Bynes has been placed on psychiatric hold and reportedly diagnosed with schizophrenia. Schizophrenia is a debilitating yet treatable disease that can lead to delusions, hallucinations (including hearing voices and smelling odors that don’t exist), and cognitive issues, among other symptoms. I sincerely hope that her family and doctors help her find the right treatment so she can find relief from her suffering. This story is playing out all over the gossip mills, and we can learn from this: erratic behavior requires intervention. In an open letter, her former co-star Nick Cannon also taught us an important lesson about how provide compassion:

So I say to my sister Amanda Bynes you’re not alone. I’m here for you. I understand. I care and I appreciate you, because that’s what family does and that’s what family is for. I also extend this to anyone else in my life, past or present that may find themselves in hard times. I’m here! Call me! Because I truly believe, the hand you’re helping up today may be the one you’re reaching for tomorrow.

Side note: take a look at this fantastic Atlantic article with Dr. Christine Montross titled “How well do we really understand mental illness?” for more insight into the hows and whys of treating severe mental illness.

Gluten-free labels, now with accuracy!

People with celiac disease, those with gluten sensitivity/intolerance, and dieters can all rejoice because this week, the FDA standardized the label “gluten-free.” The limit is 20 ppm, the lowest amount of gluten detectable in a food product. Foods such as fresh fruit and eggs can carry the label “gluten free” because they naturally contain no gluten. Regulations like this help consumers make informed choices. Considering more than two million Americans cannot digest gluten, having consistent, effective labels is the right thing to do for their health.

State-by-state vaccine rates tell us about exemptions

Each year, the CDC analyzes vaccine rates among the 50 states, Washington DC, five cities, and eight other US jurisdictions that receive federal funding for immunizations. This year, Mississippi topped the list, with 99.9% of kindergarteners receiving full doses of MMR, DTaP, and varicella (chicken pox). Overall, median exemption rate for the country was 1.8%; Oregon had the highest, with 6.5% of kindergarteners not meeting the vaccine standards. Interestingly, Mississippi does not allow religious or philosophical exemptions for immunizations. Removing religious and philosophical exemptions altogether wouldn’t be appropriate, but perhaps the success Mississippi has with getting children vaccinated will spark a conversation about strengthening the requirements for getting an exemption.

UrgentRx: alleviating upset stomachs, potentially saving lives

Forbes just published its list of what it deems the 25 most innovative consumer and retail brands of the year. An over-the-counter medication company, UrgentRx, made the cut. The company produces powders of common treatments for headaches, allergies, and digestive issues, along with plain aspirin intended for use during a heart attack. UrgentRx powders can be taken without water, meaning that you can give yourself a hit of heartburn medicines whenever you need it. The implication for potentially life-saving doses of aspirin are immense: a study in the American Journal of Cardiology, as reported by Harvard Medical School, showed that chewed aspirin worked faster against heart attacks than swallowing it whole or taking a liquid version. For a person with heart disease, carrying around a powdered dose eliminates the need to chew and provides the benefits of aspirin as quickly as possible.

Health Communicators should be Podcasting!

I have the honor of co-organizing (with the wonderful Nathan Kuruna) the first ever Philadelphia Podcast Festival, happening August 1-3 at PhilaMOCA and PhillyCAM. As a talkative kind of gal, I’ve been doing a few interviews to promote the Festival. This means I’ve been thinking a lot about the power of independent media to give voice to anyone who wants to tell a story. And then it hit me: public health professionals should be podcasting. First, let’s define a podcast. From the Philadelphia Podcast Festival’s site:

A podcast is a bit like a radio show that you download from the internet. A lot of podcasters use them purely to entertain people but any business, organization or individual can use a podcast to share information. This keeps their fans, customers, members or friends updated on what they’re up to. You can use it to broadcast any message you want into the world. Audio is recorded, posted online and retrieved on demand by listeners. Some listen to podcasts at their computers, others put them on an mp3 player and listen to them while doing other things (jogging, driving, etc.).

Podcasters generally release new episodes on weekly or monthly basis. A listener can manually download each episode or subscribe to a podcast and have it automatically download to a computer or device as new episodes are released.

People really do listen to podcasts. As of 2011, there were 91,000 podcasts. In 2012, Edison Research found that 29% of Americans polled had listened to a podcast at least once, and 26% had viewed a video podcast (sometimes called a vodcast) at least once. This shows a shift from early adopters of the medium into a more general audience. Not to mention, iTunes just reached 1 billion subscriptions.

Since jumping into the public health world, I’ve learned that this field is learning to love social media. We’re learning how to use Twitter, Instagram, Facebook, and the like for public health messaging. (Shout out to Jim Garrow’s social media for public health twitter chat #sm4ph for teaching me about all kinds of social media I never would have tried on my own!) However, there’s a steep learning curve for health departments and organizations to get used to making content specifically for networks like Vine or Pinterest. We're still learning how to increase the efficacy and reach of that content.

But podcasting is simple: just hit record and start talking. Public health communicators should be doing what they do best—communicating—by taking advantage of podcasting’s unique qualities:

  • Anyone can make a podcast.
  • Anyone can listen to a podcast.
  • Podcasts are portable so you don’t have to be in front of a screen to enjoy them.
  • People without home internet access can download episodes at the library or Keyspot, load it onto a smart phone or iPod and listen any time.
  • Sensitive issues like sexual health or mental illness are perfect topics for podcasts because listening to them is usually a private activity.
  • Podcast listeners often develop a relationship with podcasters through repeated exposure to their ideas and information. Regularly scheduling frequent episodes helps build trust between listener and podcaster, which is especially important for health topics.
  • Podcasts don’t have to be just informative. The medium does best with a casual tone and a steady infusion of humor and lightheartedness.

I poked around a little and found that there are some active public health podcasts. I made this handy chart of the ones I found that are still active (there are plenty of defunct podcasts—looking at you, WHO and EPA), so you can check them out. I deliberately excluded anything called a podcast simply made non-internet-based audio or video available online, such as NPR stories or recordings of lectures. There’s also a great listing of additional podcasts from academic journals at the University of Wisconsin-Madison Ebling Library.

 

Organization

Name

Latest Episode Topic

Sample Topics

Approximate Episode Length

American Public Health Association Get Ready Report July 11, 2013: Travel Safety Preparedness: hurricanes, flu, pets & disasters, healthy stockpiling 3-21 minutes
Centers for Disease Control

 

CDC Podcast July 17, 2013: Healthy Corner Store Initiative HPV vaccine, foodborne illness, zoonotic disease, history 1-20 minutes
Department of Health and Human Services HHS HealthBeat July 29, 2013: Kid Jitters and Emergencies Daily tips on asthma, preparedness, smoking, kidney stones 59 seconds
Helen Osborne Health Literacy Out Loud July 30, 2013: Stages of Change and Health Communication Poetry and health, communicating screening test results, jargon 15-25 minutes
Jigsaw PSPH I’m a Public Health Professional Get Me Out of Here! July 26, 2013: The royal baby Air quality, bogus health inspectors, local health departments 8-10 minutes
Johns Hopkins School of Public Health Public Health: On the Inside July 2013: The Consumer’s Scientist Flu, trauma, injury prevention 10-13 minutes
Harvard School of Public Health HSPH Podcast July 25, 2013: Breakfast and Heart Disease Risk Health disparities, history, new research, ACA 5-10 minutes
National Institutes of Health NIH Research Radio July 26, 2013: Evening chronotype and eating behavior Diabetes, heat safety, depression, hypnosis and sleep 15 minutes
Nina Martin Public Health United July 3, 2010: What does mosquito season mean for you? Interviews, BRCA genes, health communication 40 minutes-1 hour

I hope that as the field learns more about social and new media, we can start to embrace podcasting. Do you listen to podcasts? Have you considered starting one for public health or in another field? (If you are, be sure to come to our FREE panel discussion with podcasting experts on August 2 at 2pm at PhillyCAM.)

Find out more about the Philadelphia Podcast Festival by following us on Twitter and check us out on Facebook. You can also get the schedule of events and purchase tickets.

Why we can't let Jenny McCarthy join The View

Jenny McCarthy’s dangerous vaccines-cause-autism message has been well catalogued and critiqued by writers across the Internet (you can start here, here, and here). But I hadn’t ventured far into her world until hearing the news that she was “in serious talks” to join the popular daytime talk show The View. Vaguely knowing that she advocates for some batty autism cures, I stuck my toe into the world that literally made her its president, Generation Rescue. My conclusion? If ABC makes the mistake of hiring her, and she brings her anti-doctor, anti-science rhetoric to The View, all of us concerned with spreading evidence-based information better be ready every day to combat her misinformation. McCarthy's book chronicling how she "cured" her son of autism.

A note about sources: finding balanced sources on vaccine safety is a tough task, and I found myself questioning both the Generation Rescue folks and the people criticizing them. Many of the sources I found are very biased and a link to them does not mean I endorse their message. As you find yourself going down the rabbit hole, remember to read everything skeptically. However, the best resource I found for anyone interested in the actual science regarding this issue is the Children’s Hospital of Philadelphia’s Vaccine Education Center.

I learned about the “Biomedical” approach to “curing” autism through a video McCarthy made a few years ago. Generation Rescue no longer has on its site, but YouTube squirreled it away for our viewing pleasure—Part 1 Part 2.  She goes into detail about how and why “Biomedical” is the only thing that makes sense for healing children with autism. I suggest you carve out fifteen minutes to watch it so you know what’s coming if she makes it onto The View.  Warning: the video may cause bouts of rage.

The two most important parts of the video are direct quotations from McCarthy that summarize the danger she poses to public health:

  1. After listing brand name supplements and referring viewers to Kirkman Laboratories to purchase them, McCarthy encourages parents to give supplements to children in order to “detox” them from yeast and toxins, and says, “If you’re unsure about dosage, ask your pediatrician.” Then she rolls her eyes. “Or, most of the time, they don’t know anything. So I would say, um, ask someone at Kirkman Laboratories.”

So here we have McCarthy herself telling us not to trust pediatricians. Rather, we should call up a company that sells allergen free supplements and ask them how much to give to children. She encourages us to trust salespeople over trained professionals, simply because she believes in what they’re selling. In her view, doctors are useless and possibly malicious.

2. Attesting to the power of positive thoughts, she invokes the book “The Secret” and says, “Whatever you think becomes your reality.”

This is some serious magical thinking. McCarthy believes that her wishes will come true. She imagined her own son being healed of autism, and lo and behold, he was! When all a person has to do is believe something is true, she has no need for scientific facts. Give that person a microphone, and she may be able to convince others that whatever they believe is the truth, too.

By lending her face and considerable charisma to the cause, McCarthy has already done serious damage to immunization levels across the country by raising the profile of misguided vaccine fears. Many states are below the necessary vaccination level to maintain herd immunity for pertussis, measles, and diphtheria. Herd immunity means that there is a certain percentage of the population that needs to be vaccinated against a disease in order to keep the unvaccinated safe. Vaccination keeps infectious diseases from spreading by containing the possibility of an outbreak. For example, in order to protect those who cannot be vaccinated—infants, pregnant women, etc. from measles, 92-94% of the population needs to be vaccinated against it. When immunization levels drop below 92%, the population is at risk for an outbreak and the same people who could not get the vaccine are now at risk for the disease.

The View is a daily show. If she’s hired, I’m sure McCarthy will talk about anything from insomnia to hair color to shoe insoles, if her Twitter feed is any indication. But it will only be a matter of time until the issue for which she is best known becomes part of the conversation. When it does, we must be ready to talk openly about the results of research and the reliability of doctors to give sound, proven advice. Though talking about it over and over may seem redundant or boring, the truth is that vaccine levels are declining and we must speak on behalf of public health.

In the meantime, tell ABC what you think about McCarthy joining The View. Phil Plait at Slate has an excellent example of the polite note he wrote and inspired me to write to them and make my note public. Here is what I wrote to them. Feel free to use some version of my letter if you’d like:

I strongly urge you not to hire Jenny McCarthy as a new co-host. She is the president of the group Operation Rescue, which advocates for practices that harm the public's health, especially avoiding vaccines. If she is hired by The View, she will have a daily opportunity to influence the health decisions of viewers. Please do not add to the ease with which bad and potentially dangerous health information is spread.

For more information, please see http://bit.ly/12pTOyW  

Sincerely,

Teagan Keating

Please take the time to write to ABC before they hire her. Because if she does make it onto the show, we’ll have to do a lot more than that.