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3/24/2016 3:45:22 PM
There is much talk these days in the medical world about precision medicine. But what does it mean for public health? President Obama announced the Precision Medicine Initiative over a year ago in his State of the Union address on January 20, 2015. As defined by the White House, "the Precision Medicine Initiative will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for which patients." The Initiative was launched with a 215 million dollar investment including 130 million for the National Institutes of Health (NIH) to establish a national voluntary cohort of patients to participate in various research efforts and 70 million for the National Cancer Institute (NCI) to identify genomic drivers in cancer and apply that knowledge in the development of more effective treatments.
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2/23/2016 10:58:12 AM
A recent study highlighted in the New York Times starkly showed how differences in life expectancy between the rich and poor in the United States have grown remarkably over the past few decades. Researchers at the Brookings Institute used data from the University of Michigan's Health and Retirement Study to compare life expectancy by levels of earnings for men and women born in 1920 and those born in 1940. Their analysis showed that for men born in 1920, there was a 6.2 year difference in life expectancy at age 50 between the top 10 percent of earners and the bottom 10 percent. For men born only twenty years later in 1940, that difference had nearly doubled to 11.3 years. The increase was even greater or women: the difference increased from 4.7 years to 10.3 years.
These are striking data not only because of the large increase in disparity over time but also because of the sheer magnitude of the differences themselves: an over 10 year difference in life expectancy between rich and poor for those born in 1940. In men, this increase in the disparity occurred in the context of increases in life expectancy overall, but in women, as reported previously by other research, there appear to have been actual declines in life expectancy in lower income groups.
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1/25/2016 2:26:49 PM
Over the past few weeks we have been reminded once again of the critical links between water and public health. The residents of Flint, Michigan, have been exposed to water contaminated with lead. Residents now have no choice but to utilize bottled water for drinking, cooking, and washing. The economic costs of refitting the Flint water system so that the pipes no longer leech lead into the water supply are astronomical and the repair will take many months, but the potential long term health consequences are in human terms much worse. The community has, rightly, lost any trust it had in those in charge of ensuring that they are protected from environmental hazards, a key responsibility of government.
Environmental injustice is not only about exposures to toxic substances (important as is this) but also about the many often subtle ways in which disadvantaged communities are repeatedly exposed to environments that are not conducive to good health, including things like limited access to healthy foods and pleasant public spaces, poor quality of housing, lack of well-maintained sidewalks, lack of safety, and even simply poor aesthetic quality and absence of trees and green spaces. Some of these health effects may be subtle, but they add up and potentiate each other, and likely contribute to the large social inequalities that we continue to see.
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12/21/2015 12:33:11 PM
This past year illustrated perhaps even more intensely than ever the ways in which population health is influenced by upstream factors. Countries all over the world continue to grapple with the health consequences of sedentary lifestyles and unhealthy diets linked to the ways in which we have organized transportation, work, and the production and distribution of food. At the same time a mind blowing number of people all over the globe lack something as simple as access to clean water. Average world temperatures continue to increase at an alarming pace (just here in Philadelphia last week over 60 degrees in December!). Inequalities in health by race, ethnicity or social class remain unacceptably large in many countries including the United States. But these challenges also present opportunities for public health. As we end 2015 take a minute to read about some of the ways we at the Dornsife School of Public Health are working to improve population health through evidence and action, here and abroad. And as we start a new year, let us redouble our commitment to create the policies and environments necessary for the health of all of us.
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11/17/2015 10:45:59 AM
At a time when there is so much talk of the promise of “big data” it is sobering to see the striking patterns and findings that can emerge from “simple data”, and the classic approaches of demography and epidemiology that have formed the basis of public health for centuries. Just over the past few weeks, two studies reported extensively in the media have demonstrated the insight that can be gleaned from the simple analysis of mortality data.
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10/1/2015 9:56:00 AM
Just a few days ago, here in Philadelphia, we had an unprecedented opportunity to reimagine our very own city. For four days on the occasion of the visit by Pope Francis, a large part of the city was closed to traffic. It made me wonder about the health impact of this new city: what might happen to asthma rates, to traffic-related injuries? Cities, the way we design and operate them, the way we distribute resources within them are of our own making, and it is within our power to transform them. Our goal to improve health in cities is closely linked to the founding principles of our School: that health is a human right and that social justice is critical to improving population health. We at the Dornsife School of Public Health invite you today to come on a journey with us, to reimagine health in cities, to work together to create a city that is more livable, more fulfilling, and yes, healthier for all.
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