EARTHQUAKES and Public Health

By Mara Constantine

In light of the large number of earthquakes in Berkeley this past Fall, as well the fairly large one in Oklahoma, we may be thinking seriously for the first time about an earthquake plan.  When living in more or less temporary housing, as students often do, it’s easy to tell yourself the “Big One” won’t come while you’re living there and to put off taking appropriate precautions.  According to the USGS, there is a 63% probability of a magnitude 6.7 or greater earthquake striking the greater San Francisco Bay Region in the next 30 years.  In other words, there is a chance that a strong earthquake could hit this year.  

While it’s impossible to know the exact probability of an earthquake occurring during a more specific time range, there are simple and easy steps we can all take to help us prepare for the aftermath of an earthquake.  The first step is awareness – it is important to know what risks you face in the event of a strong trembler.  Do you live in a soft story apartment building?  A soft story building is typically a several-story apartment building located over a parking garage or a series of retail businesses (with large windows).  The consequences of the soft story design were dramatically illustrated in the 1994 Northridge, CA earthquake: “Upper floors were suspended above long, open areas instead of rigid walls. The spindly posts often propping up the lower floors proved to be no match against heavy, swaying upper stories.”  According to the City of Berkeley, soft story buildings “have performed poorly in recent earthquakes with some buildings collapsing and causing serious injury and death.”  So, if you live in this type of building it is important to be aware of the risk.  Since 2005, the City of Berkeley has required landlords to notify tenants if they live in a soft story building, the second phase of the Soft Story Program requires landlords to retrofit their buildings to improve their safety.  As of October, however, “only 66 out of the 269 landlords who own soft story buildings in the city have retrofitted.”  If you feel comfortable discussing this and taking a bit of a stand, talking to your landlord about your concerns about building safety may help encourage him or her to begin retrofits.  Because retrofits have been so slow, it is important to consider whether a building is soft story when looking for your next place to live.  

Building safety issues are also present on campus.  Please visit website of UC Berkeley’s Seismic Action Plan for Facilities Enhancement and Renewal to see if the buildings where you spend time are seismically fit: http://berkeley.edu/administration/facilities/safer/rating.html/.  Despite years of retrofit and in some cases seismically unfit buildings being knocked down and entirely rebuilt, there are still an alarmingly large number of buildings on campus that are rated seismically poor.  While efforts to remedy this continue, such as the upcoming demolition of Campbell Hall, progress is frustrating slow because of lack of funding.  

In case of an earthquake, the US government recommends to keep in mind the mantra DROP, COVER, AND HOLD:  “DROP to the ground; take COVER by getting under a sturdy table or other piece of furniture; and HOLD ON until the shaking stops. If there isn’t a table or desk near you, cover your face and head with your arms and crouch in an inside corner of the building.”  The website ready.gov, published by the Federal Agency for Emergency Management, has information about what to do before, during, and after an earthquake in order to best stay safe.  Check out the website here: http://www.ready.gov/earthquakes!  

I’d like to leave you all with a few tips that are easy enough for even the busiest college student.  First, because fires are the most common hazard after an earthquake, make sure you have a fire extinguisher, know where it is, and know how to use it.  Second, have a supply of bottled water at all times.  During an earthquake, water pipes may rupture and local stores could quickly run out of water.  It is also recommended to keep a supply of canned food (with a can opener) in case an earthquake of very large magnitude has long lasting effects making it impossible to cook or to buy supplies.  Finally, phone service is known not to function properly when many people are making calls or sending texts at the same time, as would happen in the event of an earthquake.  Therefore, it’s a good idea to make a plan with your best friend or significant other of where to meet in case you cannot contact each other after an earthquake.  

About the Author: Mara Constantine is a 4th year sociology major and California native. She is currently a research assistant for Professor Kristin Luker. In addition to writing for the Public Health Advocate blog, Mara is also an active member of the Cal Cooking Club and a tutor in the YWCA’s English-in-Action program. Her public health interests include maternal and child health, health of immigrant populations, and health disparities.Ab

Starting a New Semester? Watch Your Sleep Cycle!

By Umair Jamal

Insomnia is the most common sleep disorder in the general population. Patients with this disorder have trouble initiating and maintaining sleep, as well as having impaired waking function. There are two types of insomnia which are short term (acute) insomnia and long term (chronic) insomnia. Acute insomnia could last from one night to a few weeks. Chronic insomnia is when the individual has insomnia for at least three nights a week for one month or longer. About 30-40% of the population is affected by insomnia, 10% of which have chronic insomnia. Insomnia is associated with a reduced quality of life, disorders that are affective, and more health service use. The direct medical costs have been estimated to be $13.9 billion annually. Despite all this, a majority of people who have chronic insomnia remain untreated and lack knowledge about treatment options. 

Some of the causes of acute insomnia include stress (such as job loss, death of a loved one, divorce, an upcoming exam), illness, and certain medications. Chronic insomnia is caused by behavioral factors, or the effects of chronic mental or medical disorders.  

The symptoms of insomnia include having difficulty falling asleep most nights, tiredness during the day, sleepiness during the day, not feeling refreshed after waking up, and waking up several times during the night. Symptoms of insomnia are symptoms of other medical or mental conditions as well. 

Individuals who are at a higher risk of developing insomnia include those who have concurrent depressive symptoms, comorbid medical disorders, or comorbid psychiatric disorders. Insomnia is also common for lower socioeconomic groups and lower income individuals. Insomnia can occur at any age, but the incidence tends to increase with age. There is an association between black race and the prevalence of insomnia. Insomnia also tends to affect women more so than men.      

Psychological-behavioral and pharmacologic treatments have been proven to treat chronic insomnia. By curing or treating a mild form of insomnia, it is important to practice good sleeping habits which can give you a good night’s sleep. 

The following may help improve sleep:

• Try going to sleep and waking up at the same time each day.
• Avoid caffeine, nicotine, and alcohol late in the day. 
• Get regular exercise, but not right before sleep.
• Do not eat a heavy meal late in the day. 
• Keep comfortable sleeping conditions.
• Follow a relaxing routine to help you sleep such as reading a book or taking a bath. 
• Do not use your bed for anything except for sleep and sex.
• If you are lying in bed unable to fall asleep, get up and do something until you feel sleepy. 
• By preventing worries, keep a journal before going to bed, and list issues that are worrying you.

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About the Author: Umair Jamal graduated from UC Berkeley in 2011 with a major in Public Health. His interests in Public Health include Global Health, Community Health, and Biostatistics. As an undergraduate, he was also a member of the International Health Committee in the CalUPHC. As of now, Umair is doing a post-bac at Berkeley in the Pre-Health professions program. He plans on pursuing medicine in the future.

Stress and College

by Kevin Yuan


Stress is simply a fact of nature, forces from inside or outside the world affecting an individual. The individual responds to stress in ways that affect not only the person himself but also the world around him. Because of the large amount of stress in our modern lives, we usually think of stress as a negative experience. This phenomenon is accompanied especially with students starting out in college, whether it is social stress, academic stress or other stresses. Studies done by several entities such as ABC news, The Bullet, and several college campuses have revealed a possible new phenomenon revealing that the Class of 2014 are more stressed than older peers. According to a survey conducted by the University of California, Los Angeles reported that “this year’s freshman class rated themselves as having the lowest emotional health in the past 25 years.” The survey included the responses of over 200,000 incoming freshman at four-year universities. Tevya Zukor, director of Counseling and Psychological Services at the University of Mary Washington, states herself that “the research being conducted on college and stress does tend to indicate that students are entering college with greater levels of stress…” Noting the clear rise in stress levels of those entering college, we must explore the facets contributing to this phenomenon.

The two most common stresses encountered by college student include academic stress and social stress. Obviously, the workload of college is exponentially more involved than that in high school and it comes with less help and hand-holding from parents and teachers. With challenging classes, scheduling events and issues to handle, and the necessity for a more independent nature of the learning, college requires entering students to adjust in an ephemeral amount of time. Coupled with the academic stress encountered by an entering college student, stresses involved with leaving one’s support structure, creating a new network of friends and dealing with being away from home make adjusting to the college life quite difficult.

The facets mentioned thus far explore the typical stresses an entering college student faces upon attending school but linked with these common stresses include the weak economy and the limited market of jobs for college graduates. Because of the bad economy, students are indirectly affected by its negative percussions. Professor Steven Greenlaw of the economics department at the University of Mary Washington reports that he has “students whose parents have been laid off because of the recession… they have serious problems going to school and staying in school.” Because of this, more and more college students are holding temporary jobs now in order to pay tuition and survive financially while in school. Many students share the same concern as Romen Borsellino, a junior at Amherst College in Massachusetts who claims that ‘I am torn in three different directions…I have to do something to make money, got to build a resume and find something I like to do. That alone is terrifying, especially during a busy school year.’ Many college students also say that pressure rises significantly after freshman year as they move closer to graduation in which they must eventually seek jobs in a weak economy. 

The decrease in job opportunities and the deflating economy has undoubtly affected entering college students in a significant way. Not only do entering college students have to worry about academics and social aspects of college but they have to worry about finding a job in the next four year.

Occupy! A Public Health Perspective

By Cecilia Bonaduce


I can't help but view the Occupy movement through the eyes of a Public Health major.  The media focuses almost exclusively on the myriad of goals and opinions promoted by the movement and on the actions taken by protestors in cities around the country.  Though I find this interesting, I find most of my attention captured by the Public Health efforts taken by the movement.  


With such a large scale movement, incorporating both marching and camping out, what actions can the government or private organizations take to protect public health during these times?  What actions are necessary, during times of protest, to promote public safety and health?


Though a seemingly innocent and procedural, the question of how to promote public health and safety with the Occupy movement is particularly contentious because this debate has been used, traditionally, to limit the scope of actions protected by the First Amendment.  Nevertheless, taking actions to protect public health is important and should not be cast aside simply because it is politically uncomfortable.  


Injury

Rubber-bullet Injury

As the movement heats up across the country, encampments are finding a need for first aid stations.  Oakland demonstrates the evolution of this need very well: what started out as a small and nonviolent demonstration has now both expanded and experienced police brutality during the past few weeks.  The media has reported many cases of protestors being shot with rubber bullets, attacked with tear gas and pushed around by police.  In addition to physical confrontations with police, there is serious risk of injury during marches and during police raids of the camps.  Protestors can trip and get trampled by crowds, they can hurt their ankles while running etc. etc.. The media seems to exclusively report negative and unethical examples of police action; however,  there are proven risks associated with large groups of demonstrators camping out in the streets.

  

Occupy LA First Aid Station

Occupy Oakland - Tear Gas

Hygiene

Tents do not come with plumbing.  Though this may seem painfully obvious, think about the implications.  Tent-towns are forming and growing across the nation, mostly concentrated in large cities.  There are protestors who have been living in tents for weeks and weeks. Occupy LA realized this conundrum quickly and provided the tent-town with rows and rows of portable toilets. Without this service provided by the government what would the demonstrators do? I will leave that for the reader to consider.  


In addition to the problems associated with a lack of restrooms, there is a problem when it comes to waste disposal.  While visiting Occupy LA, I noticed a significant amount of trash, both nonorganic and organic, decaying or piling up on the sidewalk, outside of tents and next to food-preparation stations (tables, stove tops, grills etc).  The lack of proper waste disposal puts the environment at risk, makes healthy food consumption and preparation in the encampments unlikely and burdens government clean-up crews...workers...the 99% that the movement claims to protect.

Occupy Oakland

 

Occupy LA

Final Thoughts


The permutation of efforts by Occupy and by the government are slowly addressing the health and safety needs of the people.  The Medic Tents are capable of treating minor injuries, the portable toilets provided by the government represent an invaluable service and, despite their flaws, the constant police surveillance means that if a significant injury were to occur, help could be on the way rapidly.

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About the Author: Cecilia Bonaduce studies Public Health with a concentration in infectious disease at UC Berkeley. As Chief Blog Editor of PHA Blog, she enjoys contributing articles in addition to her duties as Editor. Cecilia plans to take a year off to work in the public health field before applying to medical school. Additional interests include cooking, singing and Cal Boxing Club.

Infectious Diseases and Public Health

By Alice Huang 

Infectious diseases, which are also referred to as communicable or contagious diseases are caused by germs or pathogenic microorganisms such as fungi, viruses, bacteria and parasites among others. From their name, these diseases are highly infectious or contagious, which means that their means mode of transmission is from one individual to another either directly or indirectly. The transmission of these diseases occur in a number of ways such as through physical contact, body fluids, contaminated food, transmission by vector organisms and airborne inhalation among others. Research indicates that infectious diseases are very dangerous and that they are responsible for more deaths than any other single cause (Britannica Educational Publishing, 2011).

The history or background of infectious diseases can be traced back to many centuries ago and it is believed that most of them such as malaria, may have originated from the tropical forests of Africa. This is also one of the reasons why these diseases such as malaria and tuberculosis are referred to as tropical diseases. Over the years, a lot of research has been dedicated into the cures and sustainable solutions for eradicating communicable diseases, most of which have borne fruits through major developments (Britannica Educational Publishing, 2011). The research has helped in coming up with ways to control, treat, eradicate and prevent the diseases. Without doubt, these researches have helped in solving millions of people across the globe.

For instance, small pox, which is regarded as one of the most dangerous infectious diseases, was completely eradicated in 1979, after the discovery of the small pox vaccine. Infectious diseases are often classified in accordance to their causes. For instance, as indicated earlier, the major causes of infectious diseases include bacteria, viruses, fungi, protozoa and parasites among others. Some of the major infectious diseases in the world include tuberculosis, malaria, various types of flu such as swine flu and avian flu, small pox, chicken pox, typhoid meningitis, tetanus, Hepatitis B, Syphilis and Measles among others. 

Majority of these infectious diseases are life threatening and they therefore have a major impact on the lifestyles of people. For instance, it some of them are very expensive to treat once contracted especially in terms of finances and time needed for patient management. They also affect the daily lives of people such that whenever there is an outbreak, people have to stay very alert to avoid infections especially for those transmitted through the air (Britannica Educational Publishing, 2011).

 Majority of these infectious diseases are preventable through vaccines and medication after consultation with medical professionals. However, one of the basic and most effective ways of preventing the spread of communicable diseases is by observing hygiene in all aspects of our daily lives. Community awareness is also another way to prevent communicable diseases, in this way the government and some NGO’s are actively involved in educating the communities on ways and measures to curb spread and diseases. In most cases vaccines and medication for such diseases is offered for free. In addition, other cures and solutions for prevention of infectious diseases include immunization, especially for newly-borns which should be kept up to date, eat healthy and hygienically foods, use antibiotics as per the prescription of the doctors, seeking medical attention if infection persists even after medication, being cautious around al, wild animals as well as unfamiliar domestic animals, avoiding unprotected sex, staying alert especially when visiting undeveloped and high risk disease areas as well as areas of insect infestation. 

Some of the major infectious diseases in the world including tuberculosis, malaria, various types of flu such as swine flu and avian flu, small pox, chicken pox, typhoid meningitis, tetanus, Hepatitis B, Syphilis and Measles among others attract major scrutiny from the governments and organizations.

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About the Author: Alice Huang is  a sophomore at UC Berkeley, with a major in Molecular and Cellular Biology. She loves to write and writing has become her way of expression for the occurrences in her daily life! She is interested in public health primarily because she likes learning about nutrition and thinks that maintaining a healthy body is more important than trying to find cures to the variety of diseases out there in the world. 

Vinegar and Cervical Cancer?

I’d heard from the Turkish manager of my apartment that drinking a tablespoon of vinegar could cure any cold or flu, but I was not aware that it could also detect cervical cancer.  Better yet, it’s actually true!  The New York Times article “Fighting Cervical Cancer with Vinegar and Ingenuity” explains how the acetic acid in common household vinegar turns cancerous lesions in the cervix white, allowing them to be frozen off.  The whole procedure, both detection and removal, can be accomplished by a nurse in just one visit.  For women in developing countries, who may be hindered by both distance and finance from larger medical centers, this technology is an important and effective way to reduce deaths cervical cancer.  http://www.nytimes.com/2011/09/27/health/27cancer.html 

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About the Author: Mara Constantine is a 4th year sociology major and California native. She is currently a research assistant for Professor Kristin Luker. In addition to writing for the Public Health Advocate blog, Mara is also an active member of the Cal Cooking Club and a tutor in the YWCA’s English-in-Action program. Her public health interests include maternal and child health, health of immigrant populations, and health disparities.Abou

Gender Inequalities in Health Care

By Umair Jamal

Gender differences and inequalities have resulted in differences in health status and health care between men and women. In our society, women tend to have less access to health care than men. Socio-cultural factors often prevent women from accessing certain health care resources that are easily available to men. Women are also more prone to develop a variety of diseases and disorders including mental health problems, which are expensive to treat. According to World Health Organization, examples of such disorders can be anxiety, depression, or eating disorders.  Social factors such as violence and discrimination against women can have a negative effect on their health. In general, men have greater access to health care than women because men are more likely to have more resources, their disease and mental disorder rates are lower, and they face less violence and discrimination as compared to women. For women, exposure to more violence is associated with greater health problems. As an attempt to solve these issues, there are health agencies and organizations raising awareness of women’s health and are taking action to improving the quality of health for women. .

Throughout the world, on average, women are receiving less cash income than men, so men are more likely to afford healthcare . More women than men tend to have unpaid employment, economic dependency, and child-care responsibilities. They tend to have better education, better jobs, and are out at work all throughout the day so they partake less than women in child-care responsibility. 

In addition to these social factors, which are associated with less access to health care for women, another major factor is mental disorders. According to WHO, females have a higher prevalence than males in developing anxiety, depression, eating disorders, or other mental health conditions. If these are left untreated, additional physical health problems may arise. Co-pays and deductibles can be highly expensive for these services, and costs add up which results as a problem not only for women without health insurance, but also for those who do have it. Many health insurance plans do not include mental health services, and it becomes difficult for women to seek the treatment they need. 

Women have a greater chance of heart attack. Women are less likely to survive a heart attack than men, and are more likely to have atypical symptoms from the attack. Those females who survive a heart attack have a higher rate of a second myocardial infarction as well as higher rates of congestive heart failures than men. Since women have a higher possibility of being diagnosed with such diseases, they are charged more for health insurance, and the cost may be to high for them to afford.. 

Violence and discrimination can also have negative health consequences for women. Violence against women has serious health consequences which can result in physical injuries and health problems related to mental health and HIV/AIDS,. Women who experience violence are more exposed to HIV/AIDS and STDs. Violence can also have negative outcomes to mental health. Women who fear violence may be prevented from learning or sharing their HIV status and from receiving treatment. 

In addition, violence and discrimination against female infants results in a high rate of infanticide and neglect. These infants face malnutrition and the illness is not addressed in young girls. There are higher rates of  malnutrition because of the low social status of women, and, it contributes to higher mortality rates for women and infants. With neglect, low status for women, as well as these negative health consequences, it would not be easy to obtain access to health care. It is becoming a serious problem that women are not having access, that major initiatives are needed in order to increase awareness on the health issues of women and solve the problem. 

The American Heart Association launched the “Go Red Campaign,” which had people to wear the color red and decorated national monuments in red which brought attention to women and heart disease. In addition to this campaign, a program in Florida, called “Take It To Heart,” was a collaboration between companies, organizations, and the media in order to convey the message of gender inequalities to health care. “Take It To Heart,” has attracted a lot of people. Large amounts of crowds have attended health fairs and conventions centered on women’s issues. In addition to these awareness campaigns, more can be done to improve health and health care access for women.

The National Council of Women’s Organizations believe that it is important to improve programs and policies to address female’s physical wellbeing throughout their life. The organization’s agenda is to eliminate    inequalities and discrimination that affects many women. In terms of women’s health, they support universally accessible health care in mental health, long-term care, and HIV/AIDS services.  

In order for women to utilize more health care services, women have to overcome barriers set by gender inequality. One  strategy is to reduce the cost of health care. Another strategy includes improving and expanding services. This is intended to make health services more available in the community to reach the poorest and most remote areas. Another strategy is to reduce inequality and empower women. Some of the ways to empower women is for them to receive education, employment, mobility, and social networks. Decreasing discrimination is an example of reducing inequality. 

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About the Author: Umair Jamal graduated from UC Berkeley in 2011 with a major in Public Health. His interests in Public Health include Global Health, Community Health, and Biostatistics. As an undergraduate, he was also a member of the International Health Committee in the CalUPHC. As of now, Umair is doing a post-bac at Berkeley in the Pre-Health professions program. He plans on pursuing medicine in the future.