How we can prepare for future public health emergencies
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The U.S. is experiencing an increasing number of disease outbreaks and extreme weather events. While state and national preparedness for public health emergencies has improved in some areas, dangerous gaps remain, says a recent report from Trust for Americaโs Health.
Titled, โReady or Not 2024: Protecting the Publicโs Health from Diseases, Disasters, and Bioterrorism,โ the report identifies gaps in national and state preparedness for public health emergencies and provides recommendations for improvement.
Using nine key indicators, the report categorizes all U.S. states and the District of Columbia into three readiness levels: high, medium, and low. The writers hope the report will help policymakers in under-performing states improve public health infrastructure.
Read on to learn more about what the research found and how we can individually prepare for future public health emergencies.
Thereโs work to be done
The report highlights areas with strong performance as well as those that need improvement.
Some areas with strong performance:
- State public health funding: Most states and the District of Columbia either maintained or increased their public health funding during the 2023 fiscal year.
- Health care labor force preparedness: Most states have started expanding the health care labor force for improved emergency response. As of 2023, 39 states participated in the Nurse Licensure Compact, which allows nurses to work in multiple member states without the need for additional state licenses.
Some areas that need improvement:
- Hospital safety scores: Only 25 percent of acute care hospitals earned the highest patient safety grade in fall 2023. These scores measure health care-associated infection rates, intensive care unit capacity, and other metrics. More high-scoring hospitals would improve preparedness for future public health emergencies.
- Access to paid time off: From March 2018 to March 2023, only 55 percent of U.S. workers used paid time off. Access to paid time off is important for reducing the spread of infectious diseases.
We can all do our part by staying up to date on vaccines
While the report focuses on policy changes that would improve emergency preparedness, Trust for Americaโs Healthโs research identifies one way that we can individually prepare for future public health emergencies: staying up to date on vaccines.
The report found that during the 2022-2023 flu season, only 49 percent of those eligible for the flu vaccine received it. Public health experts are concerned that false claims about COVID-19 vaccines have resulted in overall vaccine hesitancy.
A decline in vaccination rates has led to an uptick in life-threatening, vaccine-preventable diseases, such as measles. Increasing vaccine uptake would prevent the spread of vaccine-preventable diseases and reduce strain on hospital systems during public health crises.
Make sure that you and your children have received all recommended vaccines to prevent severe illness, hospitalization, and death. Learn more about recommended vaccines for adults and children from the CDC.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Dial Down Your Pain
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This is Dr. Christiane Wolf. Is than an MD or a PhD, you ask? The answer is: yes (it is both; the latter being in psychosomatic medicine).
She also teaches Mindfulness-Based Stress Reduction, which as you may recall is pretty much the most well-evidenced* form of meditation there is, in terms of benefits:
No-Frills, Evidence-Based Mindfulness
*which is not to claim it is necessarily the best (although it also could be); rather, this means that it is the form of meditation thatโs accumulated the most scientific backing in total. If another equal or better form of meditation enjoyed less scientific scrutiny, then there could an alternative out there languishing with only two and a half scientific papers to its name. However, we at 10almonds are not research scientists, and thus can only comment on the body of evidence that has been published.
In any case, today is going to be about pain.
What does she want us to know?
Your mind does matter
Itโs easy to think that anything you can do with your mind is going to be quite small comfort when your nerves feel like theyโre on fire.
However, Dr. Wolf makes the case for pain consisting of three components:
- the physical sensation(s)
- the emotions we have about those
- the meaning we give to such (or โthe storyโ that we use to describe it)
To clarify, letโs give an example:
- the physical sensations of burning, searing, and occasionally stabbing pains in the lower back
- the emotions of anguish, anger, despair, self-pity
- the story of โthis pain has ruined my life, is making it unbearable, will almost certainly continue, and may get worseโ
We are not going to tell you to throw any of those out of the window for now (and, would that you could throw the first line out, of course).
The first thing Dr. Wolf wants us to do to make this more manageable is to break it down.
Because presently, all three of those things are lumped together in a single box labelled โpainโ.
If each of those items is at a โ10โ on the scale of pain, then this is 10ร10ร10=1000.
If our pain is at 1000/10, thatโs a lot. We want to leave the pain in the box, not look at it, and try to distract ourselves. That is one possible strategy, by the way, and itโs not always bad when it comes to giving oneself a short-term reprieve. We balanced it against meditation, here:
Managing Chronic Pain (Realistically)
However, back to the box analogy, if we open that box and take out each of those items to examine them, then even without changing anything, even with them all still at 10, they can each be managed for what they are individually, so itโs now 10+10+10=30.
If our pain is at 30/10, thatโs still a lot, but itโs a lot more manageable than 1000/10.
On rating pain, by the way, see:
Get The Right Help For Your Pain
Dealing with the separate parts
It would be nice, of course, for each of those separate parts to not be at 10.
With regard to the physical side of pain, this is not Dr. Wolfโs specialty, but we have some good resources here at 10almonds:
- The 7 Approaches To Pain Management
- 10 Tips To Reduce Morning Pain & Stiffness With Arthritis
- Science-Based Alternative Pain Relief: When Painkillers Arenโt Helping, These Things Might
When it comes to emotions associated with pain, Dr. Wolf (who incidentally is a Buddhist and also a teacher of same, and runs meditation retreats for such), recommends (of course) mindfulness, and what in Dialectical Behavior Therapy (DBT) is called โradical acceptanceโ (in Buddhism, it may be referred to as being at one with things). Weโve written about this here:
โHello, Emotionsโ: Radical Acceptance In CBT & DBT
Once again, the aim here is still not to throw the (often perfectly valid) emotions out of the window (unless you want to), but rather, to neutrally note and acknowledge the emotions as they arrive, รก la โHello, despair. Depression, my old foe, we meet again. Hello again, resentment.โ โฆand so on.
The reason this helps is because emotions, much like the physical sensations of pain, are first and foremost messengers, and sometimes (as in the case of chronic pain) they get broken and keep delivering the message beyond necessity. Acknowledging the message helps your brain (and all that is attached to it) realize โok, this message has been delivered now; we can chill about it a littleโ.
Having done that, if you can reasonably tweak any of the emotions (for example, perhaps that self-pity we mentioned could be turned into self-compassion, which is more useful), thatโs great. If not, at least you know whatโs on the battlefield now.
When we examine the story of our pain, lastly, Dr. Wolf invites us to look at how one of the biggest drivers of distress under pain is the uncertainty of how long the pain will last, whether it will get worse, whether what we are doing will make it worse, and so forth. See for example:
How long does back pain last? And how can learning about pain increase the chance of recovery?
And of course, many things we do specifically in response to pain can indeed make our pain worse, and spread:
Dr. Wolfโs perspective says:
- Life involves pain
- Pain invariably has a cause
- What has a cause, can have an end
- We just need to go through that process
This may seem like small comfort when we are in the middle of the pain, but if weโve broken it down into parts with Dr. Wolfโs โbox methodโ, and dealt with the first two parts (the sensations and the emotions) as well as reasonably possible, then we can tackle the third one (the story) a little more easily than we could if we were trying to come at it with no preparation.
What used to be:
โThis pain has ruined my life, is making it unbearable, will almost certainly continue, and may get worseโ
โฆcan now become:
โThis pain is a big challenge, but since Iโm here for it whether I want to be or not, I will suffer as I must, while calmly looking for ways to reduce that suffering as I go.โ
In short: you cannot โthink healing thoughtsโ and expect your pain to go away. But you can do a lot more than you might (if you left it unexamined) expect.
Want to know more from Dr. Wolf?
We reviewed a book of hers recently, which you might enjoy:
Outsmart Your Pain โ by Dr. Christiane Wolf
Take care!
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Are Grounding Mats Grounded In Good Science?
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Itโs Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where weโve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future tooโthereโs always more to say!
As ever: if the question/request can be answered briefly, weโll do it here in our Q&A Thursday edition. If not, weโll make a main feature of it shortly afterwards!
So, no question/request too big or small ๐
โCould you research grounding mats? Fact or fiction?โ
We could! There are a couple of layers to this:
The Down-to-Earth basics (No mats yet)
Grounding, also called earthing, is first and foremost a matter of making literal contact with the ground. The Earth’s surface contains (usually) a negative electrical charge, meaning that it is expected that an ion exchange will happen when we touch it. Specifically, we’ll gain electrons. This is not proven, since it’s hard to measure rigorously, but the principle is reasonable, simple science, and is broadly uncontentious. There are scenarios in which something can be expected to play out differently, if something unusual is going on electrically for example (e.g. thunderstorm, Van de Graaff generator, just rubbed yourself against a nylon carpet for some reason, etc), but for the most part: the ground indeed has a negative charge and touching it should usually cause us to gain electrons unless we also were negatively charged.
So, the first question is: why would we want that?
It’s suggested that grounding has many health benefits, including reduction of inflammation, pain, and stress, improvement of blood flow, sleep, and vitality:
That’s a paper in the International Journal of Psychophysiology, which is neither a very well-known journal, nor a journal of ill-repute. As best we can tell, it is a legitimate journal functionally, i.e. it doesn’t appear to be a scam journal etc, but the standard of evidence looks to us to be quite low. For example, many of the references are not from high quality sources, and some are simply dead links.
This means that meaningful evidence for these claimed benefits is, ironically, thin on the ground.
Should-be-decent sources that we were able to follow up on, i.e. that were peer-reviewed studies, were methodologically weak insofar as they relied on subjective reports of stress reduction, inflammation symptoms (when there are clear biomarkers of inflammation that could have been measured), sleep improvement, and so forth.
Most of the other papers we could access had Gaรฉtan Chevalier as an author, whose PhD is from Quantum University, which is not accredited, and appears to be a diploma mill.
See also: Quantum University Misuses Physics to Train Fake Doctors
What about grounding mats?
Grounding mats aim to recreate the benefit of the ground, without actually having to get one’s feet dirty. Bearing in mind that most modern shoes are already sufficient to insulate against the very modest ion exchange that could otherwise be occurring.
So, with a grounding mat, it’s possible to do it without going outside, and indeed while living on the tenth floor of an apartment block or such.
How do they work? Usually it involves a conductive wire running from the mat to the Earth itself, or to the Earth/ground port of an electrical outlet.
Yes, that does create an electric shock risk if something is incorrectly connected, so do be careful about that.
So, do they help? In all honestly, probably not. Or at least, not beyond placebo.
Which is not nothing! A benefit that’s “just” placebo is still a benefit, but there are other ways to leverage placebo effect (yes, even if we know about it) that don’t involve connecting yourself the mains:
How To Leverage Placebo Effect For Yourself
And if you do want to practice grounding/Earthing, the best way to do so is a) in direct contact with the actual Earth b) somewhere that you’ve checked is safe to stand barefooted (please don’t cut your feet, get tetanus, etc).
Take care!
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Peanut Allergy Diagnoses Have Been Halved: What Did They Do?
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Good news: it wasn’t “they raised the diagnostic criteria so that peanut allergy sufferers can be ignored”โwhich kind of switcheroo sometimes performed by institutions who are being hounded to lower their case numbers, which can be a problem for sufferers of a given malady, but more often the opposite is the case in the US, because after all, one has to diagnose a disease to sell a cure.
Bad news: there’s still a long way to go, because it was hoped to reduce the diagnoses by more than 80% (well: reduce the incidence, but scientists speak for what is measurable, so “diagnoses” is a good word to use here, since there could be cases going undiagnosed).
A LEAP of
faithscienceNot long back, doctors started telling parents something surprising: feeding babies peanuts early might actually prevent peanut allergies. Now, new research from the Childrenโs Hospital of Philadelphia shows this advice is working.
The shift began after the success of the huge Learning Early About Peanut Allergy (LEAP) trial in 2015, which found that introducing peanut-containing foods to high-risk infants between 4 and 11 months of age reduced their risk of peanut allergy by more than 80%.
That evidence prompted new guidelinesโfirst in 2015 and 2017 for high-risk babies, and then in 2021 for all infants, recommending peanut, egg, and other allergenic foods be introduced between 4 and 6 months, unless the baby had already reacted to them. โ important to note!
So, how did that work out? Researchers (Dr. Stansislaw Gabryszewski et al.) investigated pediatric data of tens of thousands of children’s health records from across the US, and found:
โThe cumulative incidence and risk of development of peanut IgE-FA (0.79%โ0.53%; hazard ratio [HR], 0.65; 95% CI, 0.55โ0.77) and any IgE-FA (1.46%โ1.02%; HR, 0.69; 95% CI, 0.61โ0.78) decreased significantly (Pโ<โ.0001) from the preguidelines to postguidelines period. Furthermore, the cumulative incidence and risk of development of peanut IgE-FA (0.79%โ0.45%; HR, 0.55; 95% CI, 0.46โ0.66) and any IgE-FA (1.46%โ0.93%; HR, 0.63; 95% CI, 0.55โ0.72) decreased significantly (Pโ<โ.0001) from the preguidelines to postaddendum guidelines period. A decline in IgE-FA diagnosis postguidelines was confirmed in the interrupted time series analysis.โ
Translating from sciencese, we can say:
Since the guidelines were adopted, peanut allergy diagnoses dropped from 0.79% to 0.45% of children, and the rate of any IgE-mediated food allergy (i.e., any allergy that arises by the exact same mechanism as peanut allergies) fell from 1.46% to 0.93%.
That means for about every 200 infants exposed to allergenic foods early, on average one (life-threatening, and usually lifelong!) allergy will have been prevented.
For perspective: as there are about 3,500,000 children born per year in the US, that means each year, 17,500 fewer of them will have this crippling disability (it might not seem like a disability, because if you avoid peanuts you’re fine, but take a moment to think about the level of precautions you’d have to take not just with your own food, but that of people around you, and even what happens if someone you meet now ate peanuts earlier in the day and didn’t wash their hands as thoroughly as a surgeonโif a medical condition takes away your ability to engage with life normally, it is a disability).
You can read the paper itself here: Guidelines for Early Food Introduction and Patterns of Food Allergy
And in case you were wondering: Yes, adults can develop food allergies. Here are 4 types you need to know about
Want to learn more?
For much more detail than we can go into here, check out this excellent book that we reviewed a while back:
It’s worth noting that with regard to the first-named author there, the bio begins:
โKari Nadeau, MD, PhD, is the director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford University and is one of the worldโs leading experts on food allergyโ
We mention this, because thereโs a lot of quack medicine out there [in general, but especially] when it comes to things such as food allergies. So letโs be clear up front that Dr. Nadeau is actually a world-class professional at the top of her field.
Enjoy!
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Asparagus vs Green Beans โ Which is Healthier?
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Our Verdict
When comparing asparagus to green beans, we picked the asparagus.
Why?
Both have their strong points, but one has more:
In terms of macros, asparagus has 2x the protein (a fair feat for a plant whose last name is not “beans”!) while green beans have nearly 2x the fiber and just under 3x the carbs. With that spread of data, we say it all evens out to a tie in this round.
In the category of vitamins, asparagus has considerably more of vitamins A, B1, B2, B3, B5, B7, B9, C, E, K, and choline, while green beans have more vitamin B6โan overwhelming 10:1 win for asparagus.
Looking at minerals next, asparagus has more copper, phosphorus, potassium, selenium, and zinc, while green beans have more calcium, iron, magnesium, and manganese, yielding a modestly marginal 5:4 victory to asparagus here.
In other considerations, asparagus has a higher polyphenol content, mostly quercetin. So that’s another point for asparagus.
Adding up the sections makes for a clear overall win for asparagus, but by all means enjoy either or both, as diversity is good!
Want to learn more?
You might like:
Fight Inflammation & Protect Your Brain, With Quercetin
Enjoy!
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A Surprisingly Accessible Treatment For Migraines
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…and other items from this week’s health news:
Cannabis’s very good stats for migraine relief
Migraine attacks are thought by many people to be “just a bad headache”, but in fact, there’s a lot more to it than that, and they’re also famously resistant to a lot of usual headache-relief medications and other remedies.
So, what’s new? Researchers (Dr. Dawn Buse et al.) tested cannabis vs placebo for the treatment of migraine, and got great results:
How it worked: 92 participants used vaporized cannabis containing 6% tetrahydrocannabinol (THC) and 11% cannabidiol (CBD), which are considdered relatively low potencies.
And the results?
- 67% of participants experienced a reduction in migraine pain within two hours of treatment
- 35% of participants became completely pain-free after treatment
These benefits lasted for up to 48 hours across 247 treated migraine attacks, and in terms of safety, no serious adverse events were reported during the study.
Read in full: Cannabis shows anti-migraine benefits
Related: Migraine: When Headaches Are The Tip Of The Neurological Iceberg
Alcohol use disorder: what are the key factors affecting relapse?
Long-term relapse in alcohol use disorder was most strongly linked to a gradual reduction in recovery focus or vigilance, making it the most prevalent and potent risk factor. As for what this looked like, it often involved deprioritizing recovery-related attitudes and routines, alongside disengagement from mutual-help groups and other recovery supports.
In other words, rather than a sudden failure as such relapses are generally assumed to be, it was usually more of a slow erosion of commitment to ongoing recovery maintenance.
That, perhaps, explains why psychological and social factors also play a major role, particularly worsening mental health symptoms, loneliness, social isolation, and increased exposure to alcohol-related environments, generally increasing in the year leading up to relapse:
Read in full: Key risk factors identified for long-term relapse in alcohol use disorder
Related: Which Addiction-Quitting Methods Work Best?
Not “basically just steam” after all
Vapes have enjoyed a (so far, it seems, well-earned) reputation of being less harmful than cigarettes. One of the ways in which they are considered less bad healthwise is when it comes to passive consumption, i.e., second-hand smoke/vapour. In the case of smoke, it’s smoke, and whatever else is in it, everyone knows smoke is bad to inhale, right? Whereas vapour… Steam inhalation is good for the health, no?
And in this case: no
As it turns out, secondhand vape plumes can contain ultrafine particles loaded with metals and reactive peroxides that interact to form lung-damaging free radicals. Additionally, volatile organic compounds in vape vapor can react with indoor ozone to form peroxides, which then interact with metals to generate reactive radicals.
It gets worse: because ultrafine particles can penetrate deep into your lungs and reach fluid-lined alveoli, they may damage lung tissue and impair lower respiratory function. And, paradoxically, ultrafine particles carry higher proportions of metals and peroxides than larger particles.
Read in full: Secondhand vape plumes could form lung-damaging radicals
Related: Vaping: A Lot Of Hot Air?
Take care!
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Salads Are More Than Leaves โ by Elena Silcock
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Thereโs a lot of value in this one already before we even get to the recipes, as she outlines first the foundations of a good salad, how to โbuildโ it, how to mix-and-match as appropriate, and how to make substitutions are appropriate for dietary restrictions or availability of ingredients.
The recipes themselves are organized not by time of day as many recipe books go for, and of course they are all salads, so the โtype of mealโ approach doesnโt really work either. How does she categorize them instead?
Her classifications are: fresh, fruity, hot โnโ spicy, spiced by not spicy, wintery, grilled, creamy, cheesy.
As one might expect from a book of salads, the recipes are very plants-forward, though not always vegan or even vegetarian. Again, substitutions are suggested where appropriate, though.
In terms of healthiness, while the author mentions that making things healthy was not her top concern, it is nevertheless good to see that the recipes are mostly very healthy anywayโalso something one might have expected of a book of salads, but it bears mentioning in any case.
Are they salads to get excited about? Well, one personโs excitement is another personโs Tuesday, but there sure is a lot of flavor in here, and the author, a chef by the way, also certainly knows what sheโs doing with textures. Whatโs enjoyable is subjective, but itโs got this reviewer all fired-up for a salad dinner tonight.
Bottom line: if youโd like to eat more salad but find yourself rotating through the same three or so basic salads, this book will expand your repertoire exponentially (literally, because as well as there being a lot of diverse recipes here, each comes with suggestions for modifications, and of course thereโs the section on mix-and-match tips and tricks to build your own).
Click here to check out Salads Are More Than Leaves, and get excited about salads!
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