What does Covered California mean for Californians?

By Penelope Chuah

Tremendous strides towards developing more affordable, accessible, and higher quality healthcare has taken place within the past three years; this year California is about to kick-off its new health market under Covered California.

These changes to the healthcare market all began with the momentous occasion in 2010 when “President Obama with the stroke of a pen, made health care for all Americans a right not a privilege” (Nancy Pelosi, Covered California Town Hall Forum). This monumental legislation called the Patient Protection and Affordable Care Act was designed to restructure the fractured American healthcare system that has consequently ranked the nation 37th in worldwide health performance. Changes to individual premiums as well as other state insurance policies will vary from state to state. In California, Covered California will offer people an online platform to appropriately choose an affordable and high quality health plan.

So what else exactly does this legislation mean for Californians? It means ensuring that both the insured and uninsured find plans well suited to their needs; it means allowing people to choose from 13 health plans presented by the Health Benefit Exchange; it means providing premium assistance targeted by income; and it means decreasing health disparities. 5.3 million represents the number of currently uninsured Californians or those who purchase health insurance on his or her own; this number, however, will decrease tremendously this October 1, 2013 when the California health insurance marketplace opens for enrollment. In the Covered California forum hosted at UCSF, Peter Lee, Executive Director of the California Health Benefit Exchange and Berkley graduate, stated Covered California’s mission: 1. Increase the number of insured Californians and decrease health disparities, 2. Increase healthcare quality, 3. Decrease healthcare costs. The new system will provide standard benefits designed to ensure that money does not become a deterrent of access to care. Rates will be determined by age, zip code, income, and household size. How can you access this new exchange? Covered California has created an easily navigable website to facilitate new users to the options available. This online marketplace offers people a clear layout of the various health plans offered and to which ones they may qualify. For those who already have health insurance, they will be able to keep their insurance and receive the new benefits and security provided by the Affordable Care Act.

The remaining few months of 2013 and the forthcoming months of 2014 provide a bright future for the ongoing health reform process. For more information and details about Covered California and how to enroll, please follow this link: http://www.coveredca.com/

Soda Consumption

By Melanie Tina Mascarenhas

As we all know, summer typically brings us days of cloudless skies and up to fifteen hours of warm sunshine. This beautiful weather often comes with temperatures in the upper 80’s and 90’s and often times surpasses 100 degrees for a week or two. With hotter days, hydration becomes an important issue that is easily overlooked in the no-school frenzy.

Summer is the time for beach bashes and BBQs, events where sugary drinks and alcohol abound but natural beverages can be scarce. Soda consumption spikes during the summer months because, let us face it, grabbing a chilled can of Coke is convenient and refreshing in the short term. In fact, in California 62% of adolescents aged 12-17 consume at least one soda per day and, on average, soda is the top caloric source in modern teen diets. A twenty ounce soda contains sixteen teaspoons of sugar that not only fail to quench thirst, but also do nothing to satisfy hunger and lead to the familiar “crash” in energy levels mere hours after consumption. Consequently, drinking soda only serves to add to our caloric intake, which eventually contributes to unhealthy weight gain over time. In addition to increasing obesity nationwide, soda consumption also raises the risk of developing diabetes and heart disease.

Now I am not saying that we should abandon sugary drinks entirely and subsist on water and milk from here onwards (though from a nutritional standpoint, that would be ideal). After all, there are some things that just are not complete if there is no fizzy drinks involved. What is a New Year’s Eve party without apple cider? And Superbowl Sunday simply would not be the same if our beverage options were restricted to…water. The idea is to eliminate excessive soda consumption in order to lead a healthier lifestyle. This means that instead of reaching for the two liter Dr. Pepper at the grocery store, grab a watermelon that you can blend into watermelon juice or a squeeze a bunch of carrots for a boost of Vitamin A with every carrot-y sip. There are countless possibilities that can replace the sugary drinks of our time without skimping on convenience and revitalizing tastiness. Here are a few of my favorites that you can try:

1. Citrus Water
A simple alternative to flavored water, citrus water is a quick way to jazz up plain filtered water for celebratory events or everyday use.
Making this is easy if you happen to have fruit trees and an herb garden in your backyard. If not, head over to the nearest Safeway and stock up on your favorite kinds of fruit (pretty much anything will work) and a couple of herbs to add some pleasant fragrance and you are all set.

To make the citrus version, slice up a lemon, a lime, and an orange into a two quart pitcher and gently press the slices with a wooden spoon to release a bit of the juice. Fill up the pitcher with ice and add water to the top along with some more citrus slices and you are done! If you are not a citrus fan, add 2 cups of any kind of fruit (strawberry, pineapple, blackberry, etc.) along with mint, sage, or rosemary if desired and follow with ice and water for an all-natural twist on water according to your preference.

2. Lassi
My personal obsession, lassi is a traditional Indian beverage that is a staple for my summer days. There are many varieties, the most popular in the U.S. being mango. The simplest kind, however is known as plain lassi and is still as mouth-wateringly delicious as all the others.

Lassi is wholly yogurt-based so be sure to have some plain yogurt on hand if you are planning to make it. All you need to do is put 2 cups of yogurt, one cup of ice, and a little bit of salt and sugar into a blender and blend away! The final product is a frothy, white liquid that is a delight to the senses.

3. Frozen Berry Smoothie
To be honest, I’m sure berry smoothies are supposed to be made with actual berries but fresh berries can be quite pricey. Plus going to the store can be a tad out of the way. The nice thing about frozen fruit is that you can keep the little packages in your freezer, break off how much you want to use, and save the rest for the next time you have a midnight craving for a homemade Jamba Juice.

For this smoothie, use half a pack of Trader Joe’s Berry Mix (containing blueberries, raspberries, and blackberries) or any kind of frozen berry mix, really. Put the berry mix into a blender with one freshly sliced banana for thickness. If you want to shoot for the health stars or would like some added crunch, add in a dash of flaxseed or a handful of chia seeds (I hear they’re extremely nutritious). Blend until desired smoothness is achieved. Because the berries were frozen, the smoothie should be cold already so you can enjoy it right away.

4.Avocado Shake
Now I know what you’re thinking: avocados? Avocados are for salads and sandwiches! Why would I want to drink them? Trust me on this, as long as you’re not allergic to avocados, this shake is one you’ll love. Containing almost 20 essential nutrients that help with everything from lowering blood cholesterol to reducing the risk of a variety of eye diseases, avocados are a highly valuable addition to any diet.
To get your fill of this little green fruit, simply slice up one avocado and put it in your blender along with a cup of milk, ice, and a tablespoon of sugar for added sweetness. Run the blender till the shake is reasonably smooth and drink up!

Sources:
http://digitalarchive.gsu.edu/cgi/viewcontent.cgi?article=1195&context=iph_theses
http://www.kickthecan.info/soda-facts
http://www.kickthecan.info/files/documents/ktc_facts_health_consequences_R1_1.pdf
http://www.hsph.harvard.edu/nutritionsource/sugary-drinks-fact-sheet/

Media and Health: A Double-Edged Sword

By Sukhbir Kaur

Riding northbound from Fremont to Downtown Berkeley on Bart, I must have passed at least a dozen billboards advertising everything from lottery tickets to the latest smartphones. However, one sign in particular stood out to me. The front end of the billboard displayed an ad for CalFresh -- a federal nutrition program that provides food assistance to families in need. The other end promoted a new deal for burgers at a popular fast food chain. To me, these signs gave a vivid, almost poetic representation of the dual nature of advertising and the inevitable link between health and media. While on one side we have the often criticized advertising of unhealthy fast food, on the other we have a pro-public health institution. Hundreds of Bart passengers, much like myself, see and are influenced by such advertising on a daily basis. In today’s fast-paced world there’s no question that media – whether it is in print on the giant billboard along the Bart tracks or a tiny link on the side of your Facebook newsfeed – is incredibly pervasive in our modern lives. Ads reflect and help morph social attitudes in all areas of modern life including health and wellness. The question posed time and time again, however, is whether this exposure is truly helping or hurting society.

In recent years, media marketing has come under much scrutiny for promoting unhealthy and unsafe behaviors. Alcohol advertising, for example, has been largely accused of relaying sexist messages in order to sell their products. These advertisements often portray women in an explicitly sexualized manner that is dehumanizing and degrading. Furthermore, the ads are mostly targeted towards men, and often imply the idea that drinking XYZ brand alcohol will not only help the ‘average Joe’ have a great time, but also attract hyper sexualized women. Though these ads do not explicitly tell people how to behave, they do mold people's view on what the accepted norms are in a society. These ads can essentially be seen as social cues that influence and shape how a society thinks.

In stark contrast, much of the buzz in the realm of social media has been lauded as helping motivate social change and raise awareness about health issues. With their unique propensity for sharing different forms of media, such as Twitter, Reddit, Facebook and Tumblr, they have been credited with a number of successful social awareness campaigns. In these spaces, the power to speak and be heard belongs to the masses. Any soundbite, video clip, picture or tweet can go viral, including those that are promoting public health. A prime example of this phenomenon is the recent rape/sexual assault prevention campaign with the slogan, “The only way to stop rape, is to not rape”. This campaign attempts to shift away from the common societal view of rape as a failure or lapse in self-defense by the victim and focus instead on accountability of the wrong-doer. Often, spurs in campaigns connect to current events relayed in the news media – in this case, events such as the Steubenville trial or the violent rape of young women in India spurred many people to action. In this way, the rapid speed at which campaigns are able to go viral matches the pace of world events.

Ultimately, though media marketing of unhealthy products or behavior, media can also be a powerful tool to encourage healthy behavior and motivate social change. More frequently we see the trend of public health organizations utilizing the power of not only conventional media outlets to promote healthy habits, but also that of social media to drive positive social change.

Antimicrobial Resistance (AMR)

By Vincent Man

Antibiotics, also known as antibacterials, are types of medications that are used to treat infections by killing or inhibiting the growth of bacteria. For the most part, our immune system is highly competent of destroying the bacteria and naturally fighting off the infection on its own. However in some cases, when there is all too much, then there is a need for the use of antibiotics.

Although antibiotics play a fundamental role in treating infections, it must be used correctly and appropriately. Over the past decades, the widespread use of antibiotics has posed a threat to the health and safety of the community. Antimicrobial resistance (AMR) is the resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive. Every now and then, people become sick with a sore throat, cold, fever, or a cough. They typically purchase some OTC (over the counter) medications from the Pharmacy in hopes of a speedy and successful treatment. When OTC medications fail, patients ultimately believe they need antibiotics. Many patients pressure their doctors to write prescriptions for antibiotics when the reality is, the patient do not have an infection but a virus. For example, a disease caused by bacteria is strep throat and an ailment caused by a virus is the flu. In fact, most infections present in the upper respiratory tract are generally caused by viruses. As mentioned, antibiotics target only microorganisms such as bacteria, fungi and parasites, but are ineffective against viruses. If given antibiotics to treat a virus, it is not only futile but can also be detrimental such that when an infection arises in the future, our body will not respond as effectively due to AMR. Once these infections become acquired, there are only a handful of last-line antibiotics capable of undertaking these superbugs, increasing the chances of death. Better yet, let it alone for the immune system to combat these viruses.

Bacteria, unlike humans, evolve and replicate themselves exponentially in their lysogenic cycle to produce the millions that dwell inside our bodies. These bacteria and other microbes that cause infections are remarkably resilient and have developed ways to resist antibiotics and other antibacterial drugs. Antibiotic overuse is one of the factors that have contributed towards the growing number of bacterial infections, which are becoming resistant to antibacterial medications. According to the ECDC (European Centre for Disease Prevention and Control), antibiotic resistance continues to be an increasing public health threat worldwide. In a statement issued in 2012, the ECDC reported that an estimated 25,000 people die each year in the European Union from antibiotic-resistant bacterial infections. In addition to the misuse of antibiotics, antibiotic-resistant bacterial infections can also be caused by a patient’s incompletion of the medication course used to prevent the infection from coming back. If a course is not completed, there is a higher risk the bacteria may become resistant to future treatments- because the ones that survive have had exposure to the antibiotic and may therefore have built up a resistance to it.

A solution to this public health concern is to better educate our patients and more importantly our health care professionals regarding the use of antibiotics. Rather than succumbing to the use of antibiotics, health care professionals should act logically and prescribe medications in interest of the long-term care for the patient. In recent years, programs such as the Antimicrobial Stewardship was created to slow the spread of antimicrobial resistance. The program aims to make rational approaches to the use of antimicrobial agents in order to accomplish optimal success. Actions must be taken now to prevent antibiotic resistance from proliferating. As bacteria become resistant to antibiotics, it is possible for previously treated infections to resurface and become ever more so lethal.

About the Author: Vincent is a 3rd year intended molecular toxicology major and planning on applying for Pharmacy School. Vincent is also doing research on protein crystallography at Lawrence Berkeley National Laboratory. He is part of the Pre-Pharmacy Club (PILLS) on campus as well as the pharmacy facilitator for the Pre-Health Decal. Some of his hobbies include playing basketball, tennis, puzzle-solving, and biking.

The Mediterranean Diet

by Nisha Sarla Chandra

A new study published in the New England journal of medicine in early February 2013 definitively shows the effect that diet can have on one’s cardiovascular health. The 5-year long study, which took place in Spain, used participants who were at high risk for heart disease. Each of the 7,447 people had at least one risk factor, such as smoking, being overweight, or having diabetes. They were then separated into three groups; one group was assigned a low-fat diet and the two others followed different variations of a traditional Mediterranean diet.

The Mediterranean diet is one that has been followed by the people of the region for hundreds of years. The diet has moderate amounts of fat in the form of olive oil and nuts. It also involves multiple servings of fish each week, lots of fresh fruit and vegetables, and a daily glass of wine. Those who adhere to the Mediterranean diet stay clear of red meat, dairy, and store-bought bakery goods. Researchers in the past have noticed a slightly lower incidence in heart disease for people who live in the Mediterranean. However, without definitive proof, it was hard to ascribe this lower prevalence to diet, rather than other factors like genetics or lifestyle. In fact, many leading experts in cardiovascular health have long recommended either low-fat diets or veganism to those with heart issues.

But it seems that a low-fat diet is not the solution. The group assigned to a low-fat diet had a hard time sticking to it, despite intensive nutritional counselling. As a result, the study ended up comparing the Mediterranean diet with a modern, moderate-fat diet. The end result was astonishing – a 30% decrease in heart attacks, strokes, and deaths from heart disease in those following the Mediterranean diet. In fact, the study was supposed to run for a longer period of time, but researchers could not in good conscious allow a study to go on that showed such a large health disparity between groups.

Of course, as with any study, there are detractors. But the majority of experts are impressed with the parameters researchers used and the ensuing results. The study only explored the effects on the diet on those with risk factors for heart disease, but it is expected to have preventative benefits for those at low risk.

Adderall Abuse

By Karen Louie

What is supposed to be a prescription drug for individuals with attention deficit hyperactive disorder (ADHD) is now being touted as the miracle that college students have been looking for. Adderall – it’s the small capsule that’s making big news across the nation as finals approach.

For non-ADHD students who are using Adderall, the common effect seems to be prolonged periods of concentration. Superficially, it seems like a win-win. Students are cranking out those papers and don’t seem to experience any side effects -- sounds too good to be true. Let’s get real. The moment an individual without ADHD ingests an Adderall capsule, the chemistry of the brain is being manipulated. The amygdala, the regulating sector of your emotions, can be altered leading to heightened aggression, depression, and generally feelings of being on edge.

It is becoming more apparent to public health officials that Adderall abuse is now a social norm. No longer is there a taboo of discussing illicit usage in public. Walking around campus, you can hear conversations of extraordinary late-night cramming sessions thanks to Adderall. The risks are forgotten or unconcerned as the usage of this drug becomes standard among the college population.

In the spirit of finals week, here is a brief, informative Adderall study guide:

1.)Adderall is a mixture of different ingredients, one being amphetamine salts. Another amphetamine drug? Speed.

2.)It’s listed as a Schedule II drug by the FDA, meaning it has a high potential for abuse and said abuse can lead to severe dependence.

3.)Possible psychotic effects of Adderall abuse: bipolar disorder, insomnia, Tourette’s

4.)Possible physical effects of Adderall abuse: unintentional weight loss, impotence, digestive issues, hives, strokes

The academic pressure is high here in Berkeley. We are prompted to evolve into the leaders of tomorrow, innovators, and cancer-curers. With academic pressure and competition high, it is understandable why so many students succumb to using illicit resources to aid our studies. However, It is important to look at our experience here at Cal, or any university and college, with perspective. Do not gamble away your mental and physical well-being just for an A on that exam.

For more information:
1.) http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm111441.htm
2.) http://www.cdc.gov/media/pressrel/2010/r100603.htm

PH 113: A Review

Public Health 113 is a course offered at UC Berkeley that focuses on developing and implementing community health promotion strategies.  This course is a great opportunity for Public Health students to apply what they have learned in their theoretical Public Health classes.  This course applies skills covered in Epidemiology, Community Health and Environmental Health courses.

What does this class entail?  For the Spring of 2012, Public Health 113 required students to create a community action project focused on the sexual health of the Berkeley community.  You can create projects using strategies such as behavior change, harm reduction and social norms amongst others.

For example, one student evaluated the sexual health of a premedical organization on campus.  The student found that around 36% of members of this organization do not use condoms consistently once in a monogamous relationship.  In response, the student developed a program to address this sexual health issue.

How to identify a problem?
This student used an anonymous online survey to assess the sexual health practices of the defined community.  The survey results indicated that consistent condom use was a problem within the community.

Why is consistent condom use important?

1. Mutual Monogamy is not an objective form of protection - you can never objectively guarantee that your partner is honoring the commitment.  There is still a risk of contracting an STI if there has been any infidelity.

2. STI Status may be unclear - many people are unaware of their STI status.  People may assure their partners that they are STI free while in actuality they are putting their partner at risk.  Why the confusion?  People may not have been tested.  People may had been tested but are confused about their results and what they were actually tested for.  For example, many women think that their annual pelvic exam includes a check for STIs when in actuality it does not.  Many people think that HIV screenings telling you if you are clear of all STIs.  Finally, some STIs go unnoticed (like recurring genital herpes) or undiagnosed due to long latency periods.

3. Unwanted pregnancy - there is always a risk of unwanted pregnancy even if a person is tang oral contraceptives.  They are not 100% effective and lose effectiveness if not taken correctly.

How to address the problem?
In this action project, the student used the model of behavior change to try to improve the sexual health practices of the community.  The student developed a comic strip displaying the issue of consistent condom use and distributed this comic during an information session about sexual health.

If you are interested in engaging in public health activism then sign up for Public Health 113.  The class offers students the opportunity to make a difference in their community and practice the skills taught by the Public Health courses at Cal.








-Anonymous