Alcoholism is a terrifying problem for which the Alaska Native community is seeking solutions. Photo by me, carving by my favorite Native artist Bobby Nashookpuk

Alaska summers of 24 hours of  sunlight can make you overly ambitious. During my last summer I spent the mornings learning to herd reindeer, the afternoon taking a course in psychology, and evenings working at a group home for emotionally disturbed boys.  Rise, repeat.

The course was held at University of Alaska Fairbanks which offers fascinating learning opportunities at a more than affordable cost.  Ever since then I’ve been receiving UAF’s magazine- The Aurora.  The cover story for the fall edition was “A Way from Despair- Can Learning Old Skills Save Young Lives?” by Diana Campbell.   I was thrilled to learn about the People Awakening Project which brought together researchers and Alaska Natives in a positive way.

The People Awakening Project was begun as a response to the Pulitzer Prize winning article “People in Peril,” which investigated the toll alcoholism is taking on Alaska Native communities.  In 1996 over 36% of deaths due to alcohol were Alaska Natives, who comprise just 17% of the state population.

While alcoholism is a problem in these communities, what had been ignored were the success stories of those who have always been sober or have recovered from alcoholism. Alaska Natives (AN) were aware of the problem, but they were in need of solutions.

The People Awakening Project (PA), led by the Center for Alaska Native Health Research, was a partnership funded with a multi-million dollar grant from the National Institute of Alcohol Abuse and Alcoholism and the National Center for Minority Health Disparities.  The program sought to understand what was special about those who had a healthy relationship with alcohol, and to use that knowledge to find solutions to end the epidemic. Members of all AN tribal groups were represented in the PA Coordinating Council which served as a co-researcher.  The project was divided into four phases.

Phase I consisted of interviews with 56 women and 45 men, distributed across all AN tribal affiliations, who had either never drank, were non problem drinkers, those who had been abstinent 5 years or more after problem drinking.  The interviews were then combed for common themes. What emerged were protective factors that promoted living “life as it is meant to be lived.”

Some Protective Factors Among Alaska Natives

• Awareness of the consequences of your actions, “Ellangneq”
• Believing in yourself- “self-efficacy”
• Knowing you can work with others to solve problems- “communal-mastery”
• Sober family members
• Families who praise the accomplishments of their children

~For the complete list go here

Phase III used protective factors to create new ways of measuring sobriety and risks for excessive drinking.  These measures are unique in that they are specifically tailored to the Alaska Native community, such as a new adaptation of the “Drinker Inventory of Consequences.”

Elluam Tungiinum- Toward Wellness

Phase II of the project sought to use the protective factors to see if they could be developed into programs and taught in the villages. Two programs emerged- Yupiucimta Asvairtuumallerkaa which addressed substance abuse and Elluam Tungiinum which added in suicide prevention.   Communities sought to find ways to integrate teaching of the protective factors during every day activities, especially traditional ones such as cleaning fish. The video below is a demonstration of how to show children their importance by including them in fish camp work.

Other lessons include using ice as a metaphor for drinking. Children are taught not only how to survive falling through ice, but how like alcohol ice can lead to a false sense of security and should be treated with caution. Lessons such as this are being packaged together in a “manual for intervention and prevention of suicide and substance abuse,” or Qungasvik- “toolbox.”

The community of Alakanuk developed 20 of the 36 prevention activities, and a community on the Yukon-Kuskokwim Delta created the rest.  Phase IV will use another grant from the National Center on Minority and Health Disparities to work with communities to test if the prevention tools work.

In health inequities research we often focus too much on finding the problems.  Equally important is working with the affected communities to find solutions that work. Projects such as People Awakening are a great example of researchers and communities working together to end health inequity.

For More Information:

Listen to the interviews that lead to the development of the protective factors here

See the sobriety model developed as a result of the People Awakening Project here

Read the final report here

Dr. Snow used scientific reasoning to find a simple solution to a deadly epidemic. Photo by erix on Flickr.

Based on my non-scientific analysis based on the number of raised eyebrows when attempting to explain what an MPH is- I’ve come to understand a many don’t know what a public health is. There is there is even a campaign to clear up the confusion.

“Public Health is the science of protecting and improving the health of communities through education, promotion of healthy lifestyles, and research for disease and injury prevention. Public health professionals analyze the effect on health of genetics, personal choice and the environment in order to develop programs that protect the health of your family and community.”

The profession is in part to blame for this- public health professionals wear many hats, play many roles, and are active in many arenas. Going back to one of the origins of public health- John Snow and the Broad Street Pump- can provide some clarity.

In 1854 London was being ravaged by a cholera epidemic.  The accepted belief by most, including physicians, was the disease was caused by bad air, or “miasma.”  Inhalation of miasma would result in falling sick with cholera.  Since miasma was believed to be a product of the environment, little effort was made to prevent the disease.

Dr. John Snow, now known as one of the founders of epidemiology and anesthesiology, had a different perspective. He believed cholera was contracted by ingesting of infectious agents and spread through contaminated water.

In September of 1854 cholera struck the community of Broad Street- killing 500 people in less than ten days after the first case. Dr. Snow sought to test his hypothesis that a contaminated water source was the cause of the outbreak.  To support his hypothesis and disprove the miasma theory, he employed a technique still used by public health professionals today- he mapped the residences of afflicted individuals.

Quickly a pattern emerged. Those who lived near the Broad Street Pump- the community’s public water source- were dying in the greatest numbers.  Had the miasma theory been correct the deaths would have been equally distributed, not clustered near the pump.

Dr. Snow petitioned the area government, and the handle was removed from the pump- rendering it unusable.  The epidemic declined.  Simple rational thought and an even simpler solution spared many from suffering.

A simple map supported the hypothesis a public water pump was to blame for the epidemic.

How does this help define public health?

Public health is a broad umbrella, some professionals specialize in one area like epidemiology, while others, like me, draw on multiple areas to find solutions. The Snow story illustrates much of what public health is about.

First, Dr. Snow was aware of a problem- an epidemic of cholera had broken out.  Public health is currently examining problems such as high rates of diabetes in the Native American community, increased risk of cancer for farm workers, unprecedented rates of childhood obesity, etc.

Second, he formulated a hypothesis about the possible cause.  In the Broad Street case he believed contaminated water was the source of the epidemic- not miasma.

Third, he tested the hypothesis. Using death certificates and interviews he mapped deaths due to cholera.  The cluster of deaths around the pump supported his hypothesis.  Today, in addition to mapping, public health professionals utilize statistical analysis, case-control studies, cohort studies, and others to study and test a hypothesis.

Finally, and this is the area I’m the most interested in, he developed a simple intervention to solve the problem. He simply removed the handle.  Public health professionals and advocates target a broad range of “handles-” from providing stable housing to the homeless as a means to stem the HIV epidemic, to elimination of dangerous substances like asbestos from construction which is responsible for mesothelioma.

So what did cause the Broad Street epidemic?

The Broad Street pump was initially contaminated by leakage from a septic tank just 3 feet away. Sewage from the first person, the index case, had been dumped into the tank and seeped into the drinking water.  The socio-economic conditions that lead to a damaged septic tank- that’s for another post.

For more information:

Investigate careers in public health here

Dr. Kessler's new book explores the psychology and neurobiology of why we find processed food so irresistible.

I finally completed one task on my summer to do list.  I finished David Kessler’s new book “The End of Overeating- Taking Control of the Insatiable American Appetite.”

Dr. Kessler is the former commissioner of the FDA who worked on tobacco reform.  His new book takes a step away from social determinants of obesity, such as poverty, and instead examines the interplay between the food industry and human psychology.

Kessler weaves together neuropsychology, addiction studies, and tales from food industry defectors to reveal how the food industry has hijacked our appetites for profit.  Foods are crafted in a way to make them delicious yet unsatisfying- marketed to be constantly on our minds and never kept far from reach.

As a consequence we have created a culture of what Kessler terms “conditioned hypereating.”  We consume pleasurable to eat, highly palatable foods at any time of the day, irrespective of appetite, and often fueled by emotion. Short chapters packed with high quality studies, which make for an extremely convincing argument.

Highlights:

Food scientists willingly admit they manipulate the fat, sugar, and salt content in processed foods to create irresistible concoctions. In a rat study where two strains, obesity prone and obesity resistant, were given unlimited access to hyper palatable mixtures of fat, sugar, and salt.  Both strains uncontrollably gorged themselves and became obese.

Processed foods are created to be reinforcing, encouraging us to come back for more irrespective of if we’re full. A study done at UNC used a progressive ratio experiment- rats had to poke their noses in a hole an increasing number of times to get a reward of a fat/sugar mixture.  The rats maxed out at fourteen rewards, which took them over an hour, and the last reward requiring seventy-seven nose pokes.  The only other substance a rat will work that hard for is cocaine.

Emotional eating really does make you feel better. High fat/high sugar foods stimulate the release of opioids in the brain resulting in pain relief.  Rats given unrestricted access to sucrose solutions feel less pain than those given opioid like drugs. When opioid receptors in the brain are blocked rats eat significantly fewer calories.  Sucrose is a known analgesic for human newborns.

Your brain will not tire of eating the same processed snack foods. We do not become habituated to food- the hit of the feel good neurotransmitter dopamine does not decrease after repeated exposure.  Rats given high fat, high sugar chocolate drinks continued to release high levels of dopamine after each ingestion, regardless of the number of times they were exposed.  Similar responses are seen with cocaine use.

Chapter by chapter, study-by-study Kessler provides a scientific perspective on behaviors many of us find personal and embarrassing.  I now understand why I, a person who loves healthy food, find Oreos completely irresistible, will eat the whole package, and still want more.

Food companies are exploiting these behaviors to sell billions of dollars worth of food that is sickening our nation.

Every snack food and chain restaurant dish has been concocted by food scientists, enhanced with flavorings, and tested by focus groups to ensure maximum irresistibility and minimize satiety.  Conferences are held on how to optimize flavor.  Chemists devise new formulas for additives to achieve what nature cannot.  Advertisements are developed to keep food constantly on our minds.  No wonder why willpower alone is often not enough to protect ourselves.

The end result?  Items like Chili’s “Crispy Honey Chipotle Chicken Crispers” which come in at a whopping 1,930 calories per serving! Applebees will only provide nutritional information on foods “where required by law.”

Kessler pulls away the veil, moving our anger from our inability to resist such foods, and towards an industry that is profiting at our expense.

At the conclusion of the book Kessler implores the food industry to use it’s research and production capacity to make foods that satisfy us without the unnecessary calories. Readers are given some tips, many derived from addiction studies, on how to readjust our relationship with food.

I found the book to be a fascinating scientific perspective on the obesity epidemic, but written to be accessible to the average reader.  The book did drag at a few points.  Kessler sometimes provides too many details which confuse his points rather than reinforce them.  Despite these complaints, I strongly recommend this book to anyone interested in learning the neural roots of our love affair with processed foods.

For more information:

Interested in counting calories? Daily Plate or Everyday Health provide good resources

Links to nutritional information of major food chains listed here

Michelle Obama addressing Unity staff and clients. In the lower left is Jessica Wallace- program coordinator for We Can. Top left- a photo I took during one of our classes. Photo by Unity.

Michelle Obama- the first place you visited in DC was a health center, then you planted an organic garden on the White House lawn, to top things off you appeared on my favorite childhood show, Sesame Street, to deliver a public health message.

I wondered how you could make me happier.

Well- now you’ve done it. On June 29 Mrs. Obama came to Upper Cardozo Health Center, a FQHC (Federally Qualified Health Center) filled with dedicated professionals devoted to serving DC residents, especially the Latino population.

Here she announced FQHCs like Upper Cardozo would receive $851 million to “address immediate and pressing health center facility and equipment needs and increase access to health care for millions of Americans.”

Upper Cardozo alone will receive $2.5 million to build 20 (much needed) exam rooms to reach %24 more patients. Currently Upper Cardozo’s staff provide a phenomenal level of care in a very cramped space in Columbia Heights.

Michelle also learned about Upper Cardozo’s “We Can” program, the intervention I’ve been assisting with under the direction of project coordinator and physician assistant Jessica Wallace.

“We Can” is a public health program developed by the National Heart, Lung, and Blood Institute that incorporates the entire family in reducing childhood obesity. Two of the women in the photo are program participants.

At Upper Cardozo’s “We Can” program we provide weekly classes where families learn to change to healthier habits, such as:

• Restricting soda intake
• Switching from whole milk to skim
• Enjoying a minimum of one hour of physical activity a day
• Portion control
• Limiting “screen time” to one hour a day

At class families enjoy healthy snacks, take part in fun activities like Capoeira, and learn about healthy living. Nurses help participants track their blood pressure, BMI, and weight through the sessions.

Thanks to the enthusiasm of Ms Wallace and the other Upper Cardozo staff, the program has continued to increase in participation and popularity.

Childhood obesity is one of Michelle’s issues has been taking on while in the White House.  Although I wasn’t there for her visit, those in attendance at the meeting enjoyed her warm presence. One of the programs youth participants, Christian, even received a hug from Mrs. Obama for his 15th birthday.

In the field of public health we are often fighting an uphill battle.  The “We Can” program provides a positive atmosphere for addressing and combating the childhood obseity epidemic. The stimulus bill includes one billion for programs addressing prevention and wellness. Mrs. Obama’s visit further energized the dedicated participants and staff who support “We Can.”

Thank you Mrs. Obama for thinking locally and taking the time to see the great work going on at DC’s Upper Cardozo Health Center!  Hope to see you at the ribbon cutting ceremony for the new exam rooms!

For More Information:

Learn how the stimulus will be used for health centers here

Fun and interesting blog on the “Obama Foodscape” here

Read the White House press release here

Read the First Lady’s remarks here

See more photos from the special day here

Should public health interventions tailor interventions to mothers to the point of excluding fathers? Photo by Ctd 2005 on Flickr.

One of the requirements to graduate from an MPH program is the completion of 120 hours working with an agency on a project.  The staff at Upper Cardozo have been kind enough to let me complete my required practicum hours at their wonderful clinic.

For the past month or so I’ve been working on a literature review on childhood obesity interventions for the health center.  I love going through research, learning what works, and what doesn’t.

However, with Father’s Day approaching, I couldn’t help but notice the absence of fathers.  Instead- many public health  programs focus only on mothers, as if the inclusion of fathers is hopeless.  Sadly even those programs labeled “family intervention” often just means mom plus the kids.

For example:

• Families on the Move- an adaptation of the SHAPEDOWN program for Latino families.  In both feasibility study focus groups only mothers were interviewed.(1) 
• Parents as Teachers High 5 Low Fat Program- dietary intervention for African American families.  Over 98% of parent participants were female.
• Move America- Family pedometer step counting program combined with calorie reduction.  Among those that completed the post-intervention assessment only 32% were fathers.(2)

It’s not that public health practitioners have something against dad. 

Instead- many studies have shown a strong link between the knowledge/health of mothers and the health of their children.  When money is tight, it often seems best to focus funding on where it will have the greatest impact.

Unfortunately designing programs for mothers isn’t a holistic solution to public health problems.  For example, in a cross sectional obesity study among New York Latino women and their children, dads still influenced the eating habits of their children, even if they didn’t live at home.(3)  

In an effort to maintain a connection with their children, many brought unhealthy “treat” foods to share with their kids.  Even if an intervention was successful in changing the mother’s behavior in feeding her children- half of the problem would still persist.

After searching ERIC, MEDLINE, and Scoupus I was only able to locate one intervention that focused on fathers- the REAL Men HIV prevention program.  Sons of fathers who participated in the program were more likely to remain abstinent, and those who were sexually active were significantly more likely to use protection.  The program was found to be more effective than similar family based programs, including those that were just for mother/daughter pairs.(4)

However, with the emphasis on targeting mothers, the opportunity to include dads and multiply program benefits is missed.  

Participants in the BOUNCE program- an exercise intervention for Latino mothers and daughters- reported an increase in engaging in physical activity together, such as playing basketball.(5)  I thought back to the fathers in the NYC study- why not encourage them to play with their children instead of bonding through excess calories? 

As public health professionals we need to reconsider the value we place on fathers.  If program attendance was low among mothers the program would be appropriately adapted.  The same would be true if moms found the program uninteresting or useless.  The input of fathers must be sought out and paid attention.  Men must be included from the initial program planning to final implementation in order to develop programs that are truly for the entire family.  

Do you know of a family based intervention where fathers had a significant presence?  Are you aware of another intervention focusing on dads?  Email me at elpisandjustice@gmail.com and I’ll gladly update the post!

(1)  James. K.S et al. Family Based Weight Management with Latino Mothers and Children.  Journal for Specialists in Pediatric Nursing. 2008: 249-262

(2) Rodermel, S.J.  Small Changes in Dietary Sugar and Physical Activity as an Approach to Preventing Excessive Weight Gain: The America on the Move Study.  Pediatrics.  2007; 120; e869-879

(3) Kaufman, L. and Karpati, A.  Understanding the sociocultural roots of childhood obesity: Food practices among Latino families of Bushwick, Brooklyn.  Social Science and Medicine. 2007; 64; 2177-2188

(4) Dilorio, C. et al.  REAL Men: A Group-Randomized Trial of an HIV Prevention Intervention for Adolescent Boys.  American Journal of Public Health.  2007; 97; 1084-1089

(5)  Olvera, N.N. et al.  A Healthy Lifestyle Program for Latino Daughters and Mothers: the BOUNCE Overview and Process Evaluation.  Ameican Journal of Health Education. 2008; 39; 283-295.

Latinos are 1.5 times more likely than non-Hispanic whites to develop diabetes. Her disease may likely come up in Ms Sotomayor's confirmation hearing. Photo by upsidedownsphere on Flickr.

President Obama’s speech announcing Sonia Sotomayor celebrated her life’s many challenges and successes.

Obama’s nomination may bring the first Latino to the bench of the Supreme Court.  If she is confirmed, I’m glad the newst portrait of the justices will better reflect the multi-ethnic face of America.

From living in a South Bronx housing project to becoming a judge on Court of Appeals for the Second Circuit of New York, Ms Sotomayor’s has come from little and achieved much.

One of Sonia’s long term challenges has been dealing with diabetes.  At the age of 8 she was diagnosed with the disease. Unfortunately, unlike Lady Justice, diabetes is not one for blind impartiality.  Some communities are more greatly affected than others.

The Latino community bears a disproportionate burden. The problem is exacerbated by Latinos having the lowest rates of health insurance coverage in the country.

Compared to non-Hispanic whites:

• Hispanics are 1.5 times more likely to have Type 2 Diabetes
• Mexican Americans are 1.7 more likely to have Type 2 Diabetes
• Residents of Puerto Rico are 1.8 times more likely to have Type 2 Diabetes

National data specific to this community is limited.  It wasn’t until 1997 the CDC started collecting data on Hispanics.

In addition to the risk data we also know:

• Compared to non-Hispanic whites, Latinos are 4 times more likely to hospitalized for uncontrolled diabetes
• When adjusted for age, the death rate for Latinos due to diabetes is 50% greater than that of non-Hispanic whites

This disparity is due to a combination of  factors including environmental, social, and financial.  A report by the Robert Wood Johnson Foundation found that Latinos who were more acculturated to the US lifestyle were more likely to adopt “less desirable dietary habits.” Many Latinos face language barriers when seeking medical care.  Also, Latinos are more likely to forgo medical care due to financial constraints.

In light of such statistics, it is a triumph Ms Sotomayor has control over her diabetes. The complications of diabetes can be devastating, including nerve damage, loss of eyesight, increased risk of heart disease, and kidney disease.

However, the risks associated with diabetes are no grounds to deny confirmation to Ms Sotomayor.  Some are hoping she will break the “diabetes glass ceiling” by being confirmed as a Supreme Court justice.  My hope is those who conduct her hearing see her as more than a disease or a label- but as an extremely competent and experienced woman our highest court so desperately needs!

For More Information:

Publications on diabetes prevention, treatment, and management through the National Diabetes Education Program

Are you at risk for diabetes?  Information in English and Spanish

Become active in advocating for Latino civil rights with the National Council of La Raza

The Más que comida, es vida. (It’s more than food. It’s Life.) campaign offers healthy modifications of traditional foods

Hmong child in northern Vietnam

Being in DC during Memorial Day is an experience to say the least.  However, in the midst of the flag waving, concrete memorials, and concerts- I feel like we’re glossing over profound human suffering.  So here is my small protest.

We fill the craters left by the bombs
And once again we sing
And once again we sow
Because life never surrenders.

- anonymous Vietnamese poem

"First American Dream" by Rick Kennedy under Creative Commons. Click on the photo to learn about the symbolism of the frog and eagle.

In Yu’pik the word ellangellemni is translated “when I became aware.”  It’s usually in reference to children, when they first become aware of their surroundings or can begin to retain memories. In the Yu’pik orratories I’ve read, it’s often used to indicate the start of a story from the speaker’s early childhood.

I love this word.  After learning it my personal definition has become a bit embellished.*  To me, “to become aware” means the moment you come across a new piece of information, experience, or history that changes your perspective. It means to move from childlike naivete to understanding.  When I created this blog ellangellemni came to mind. I wanted this blog to bring awareness to others- using short articles in an attempt to spark passion- not to deliver soapbox speeches.

When I went to Alaska and worked at Presbyterian Hospitality House with emotionally disturbed teenage boys, many of them Alaska Native, I became aware.  Their files revealed not only a lifetime of suffering, but generations, largely due to cruel actions by the US government. Suddenly the horrors of policies like “Termination and Relocation,” “Boarding School,” and “Assimilation” became very tangible and real.

Awareness weeks have become trite, and a bit overused, but I feel they have value.  They provide an opportunity to consider issues that may ordinarily receive little attention.

May 19-22 is Aboriginal Awareness Week in Canada. The event was started in 1992 and “was designed to increase awareness of Aboriginal peoples among [Canadian]  federal public service employees.” To celebrate the week I’m including some of the resources I’ve come across in my studies. They are not intended to be representative or complete.  Please email me at elpisandjustice@gmail.com if you would like to see additions made!

Did you know?

• According to the 2006 Census, the Aboriginal population is over 1,172,790
• There are over 60 Aboriginal languages spoken in Canada
• The history of Aboriginal art in Canada is over 80,000 years old!  The oldest remaining examples are around 5,000 years old.

Residential Schools

Starting in the 1870s, similar to the Americans, the Canadian government set up a system of residential schools, run by religious groups, to forcibly assimilate over 150,000 Aboriginal children. Children were deprived of their cultures, isolated from  their families, and endured severe emotional, physical and sexual abuse.  In 1996 the last federally funded residential school,  the Gordon Indian Residential School, closed in Saskatchewan. In June, 1998, the Canadian government gave an official (but controversial) apology for the residential school era.

• Learn more about the residential schools through the online exhibit “Where Are the Children“
• Watch Prime Minister Harper’s apology here or you can read it here.

History and Culture

• Check out the Canadian Museum of Civilization’s online exhibit on the First People of Canada
• Gateway to Aboriginal Heritage, again by the Museum of Civilization

Government

• The Assembly of First Nations is the “national organization representing the First Nations of Canada”
• For a list of tribal government websites, please go here

Art

• My favorite book on arctic art, Arctic Spirit, includes photos as well as interviews with the artists
• Online gallery of Canadian Aboriginal art, produced by the Department of Canadian Heritage

Some of the blogs I follow (not exclusive to Canada)

• American Indian Policy Blog
• Pretty Bird Woman House
• Promoting Aboriginal Health

Have you had an experience of ellangellemni, when you suddenly became aware of an issue and experienced a change in perspective? Post it in the comments section!

Have a blog or website you would like to recommend?  I’m especially interested in promoting sites run and maintained by American Indians/Alaska Natives/First Nations.  Email me at elpisandjustice@gmail.com

*I do not take ownership of the word “ellangellemni,” but am just using poetic license. This word is solely the product of Yu’pik linguistic genius and not my own!

MWPHA and DCFB members march in an anti HIV/AIDS rally held last November in South East. Photo by FightHIVinDC under the Creative Commons License.

Do you live in Washington DC?  Are you interested in becoming involved in a grass roots effort to eliminate health inequities? Consider becoming involved in the Metro Washington Public Health Association, (MWHPA).  No public health experience is required- just passion!

Upcoming Activities:

Health Disparities Committee Meeting:

Thursday, May 14th
6:30 to 8:30pm
Columbia Heights Community Center
1430 Girard St. NW

Outreach Event!

Saturday- May 16th- and every 3rd Saturday of the Month

Meet 11:30am at the Washington Highlands Library
115 Atlantic St. SW
202.645-5880

Unfortunately due to class, work, and volunteering I’ve only been able to attend a few Health Disparities Committee meetings, but have attended many more outreach events.  Outreach events are a great opportunity to get out in the community and talk to residents.  It’s also a great wake up call for those living in the sheltered west-side of DC about the gross inequity and racism occurring in our city. No experience required- new participants will be paired with an experienced partner.

The Health Disparities Committee:

“focuses on these upstream factors in several ways. We support living wage campaigns, worker demands for health care and better working conditions, and affordable housing. We conduct outreach and education on the social determinants of health through films, exhibits, rallies, and slide shows. Our major efforts focus on HIV because it represents the most severe inequalities in health and society.”

Other projects include “Save Lives- Free the Condoms!” which is dedicated to stopping CVS pharmacies from locking up their condoms, and the “Community Health Advocate Project” which educates residents on how to find reliable online health information.

MWPHA members are a diverse, caring, and welcoming group.  If any of these activities interest you- consider getting involved!

Other Related Groups:

• DC Fights Back
• RAP, Regional Addiction Prevention
• Save Lives! Free the Condoms
• Campaign to End AIDS
• Prevention Justice Mobilization
• CHAMP
• Jobs with Justice DC
• EmpowerDC
• American Public Health Association

For More Information:

Find out more on the MWPHA Health Disparities Committee here

Have an event you would like Elpis to post?  Email me at elpisandjustice@gmail.com

Michelle, Elmo, and anthropomorphized vegetables teach children about healthy eating.

Michelle Obama- are you trying to make me weep with joy? You come to DC and the first thing you do is visit a community health center.  Next you plant an organic garden on the White House lawn.  Now you come on my favorite childhood show and deliver a public health message! What on earth will be next?

Sadly, childhood obesity has become increasingly widespread problem in the United States. The National Health and Nutrition Examination Survey found between the first survey (1971-1974) and the most recent one (2003-2006) increases in the prevalence of overweight children to be:

• 5% to 12% among the Sesame Street crowd, preschoolers age 2-5
• 4% to 17% among the Sponge Bob Square Pants crowd, kids 6-11
• 6% to 18% among the Aqua Teen Hunger Force crowd, youth 12-19

When broken down by race, health inequities become evident.

In 2003-2006, among boys 12-19, the prevalence of obesity to be

• 17% among non-Hispanic white youth
• 19% among African American youth
• 22% among Mexican-American youth

In 2003-2006, among girls 12-19, the prevalence of obesity to be

• 15% among non-Hispanic white youth
• 28% among African American youth
• 20% among Mexican-American youth

Although genetics can play a role in whether or not an individual will become obese, behavioral and environmental factors are a more likely responsible for the huge jump in prevalence.

During Mrs. Obama’s PSA she encourages parents to be healthy role models for their children. The 2005 Institute of Medicine report “Preventing Childhood Obesity: Healthy Bodies in Balance” also recommended parents “serve as positive role models for their children regarding eating and physical activity.”  Other IOM recommendations for parents include:

• “Choose exclusive breastfeeding as the method for feeding infants for the first 4 to 6 months of life.
• Provide healthful food and beverage choices for children by carefully considering nutrient quality and energy density.
• Assist and educate children in making healthful decisions regarding types of foods and beverages to consume, how often, and in what portion size.
• Encourage and support regular physical activity.
• Limit children’s television viewing and other recreational screen time to less than 2 hours per day.
• Discuss weight status with their child’s health-care provider and monitor age- and gender-specific BMI percentile.”

With possible consequences such as Type II diabetes and asthma, the growing prevalence of overweight children is cause for worry.

Fortunately people, including the president and his wife, are starting to pay attention. Schools are pulling soda from vending machines, recess is being resuscitated, and some are even reintegrating local produce into their cafeterias.  In September, 2008, Takoma Park Middle School students celebrated their first “Homegrown School Lunch Week.”

Want to learn more?

Haven’t seen Mrs. Obama’s adorable PSA yet?  Watch it here

Sesame Street has resources for parents and fun activities for children as part of the Let’s Get Healthy program

Want to find a Farm to School program near you?  Go here

Crave more statistics on obesity?  The CDC has plenty!