Public Health On Call

More than a decade after electronic cigarettes became broadly available in the United States, their merits are still being debated. Do these products help people quit smoking? How serious are the health risks associated with these products? In a two-part series, we hear from two researchers in tobacco control about their views. In part one, Dr. Nancy Rigotti, Professor of Medicine at Harvard Medical School talks with Dr. Josh Sharfstein about the use of e-cigarettes for smoking cessation. Read her editorial in the New England Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJMe2314977

Virologist Dr. Andy Pekosz and public health veterinary expert Dr. Meghan Davis return to the podcast to talk with Stephanie Desmon about what we’ve learned so far from viral sequencing of H5N1, its presence in milk, what we know about infections in humans, the status of the overall response to a major pathogen of concern on the heels of COVID-19, and more. Read Dr. Davis’s recent New York Times essay on protecting the dairy workforce here: https://www.nytimes.com/2024/05/01/opinion/bird-flu-dairy-workers.html

An alarming and dangerous syphilis surge across the Great Plains Region, an area spanning North Dakota, South Dakota, Nebraska, and Iowa, has prompted tribal officials to urge HHS Secretary to declare a public health emergency. Dr. Meghan Curry O’Connell, chief public health officer at the Great Plains Tribal Leaders Health Board and a member of the Cherokee Nation, talks with Lindsay Smith Rogers about the outbreak and why public health officials are struggling to respond. Learn more: https://www.greatplainstribalhealth.org/news/tribal-leaders-urge-hhs-secretary-to-declare-syphilis-emergency-189.html https://www.vox.com/24006120/south-dakota-syphilis-congenital-indigenous-tribal-native-american-meghan-oconnell-health-board

In part two of a two-part series about the crisis of health care for immigrants and refugees at the U.S.-Mexico border, Dr. Alexander Tenorio, a neurosurgical resident at the University of California, San Diego, talks with Dr. Josh Sharfstein about the influx of traumatic brain and spinal injuries his team has seen from people attempting to climb the border wall. They discuss the scope of the problem and the policies behind it, and why it often takes hours for victims to get critical care. They also talk about Dr. Tenorio’s personal connection to the situation as a first-generation American born to Mexican immigrants.

In part one of a two-part series about the crisis of health care for immigrants and refugees at the U.S.-Mexico border, Dr. Janine Young, a pediatrician at the University of California, San Diego, talks with Stephanie Desmon about the tenuous situation for children and families. More and more people are showing up at the border in poor health—dehydrated, malnourished, some severely injured and many traumatized—without any adequate care to meet them. They talk about the immigration policies that have led to a system ill-equipped to properly triage and treat the children and families seeking refuge in the U.S., and the misconceptions around people who are fleeing for their lives.

Methadone is a highly effective treatment for substance use disorder but strict regulations like daily clinic visits have led to its nickname, “liquid handcuffs.” Dr. Yngvild Olsen, director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services administration, talks with Lindsay Smith Rogers about new federal regulations that expand access to this life saving medication. They talk about how the COVID era showed that changes can make methadone much easier to prescribe and access, and how these updates are part of a critical cultural shift towards making substance use treatment more reasonable, equitable, and compassionate. Resources for this episode: https://www.samhsa.gov/medications-substance-use-disorders/statutes-regulations-guidelines/methadone-guidance https://findtreatment.gov/

World Malaria Day is April 25. Today, guest host Thomas Locke takes us to Capitol Hill where we meet malaria scientists who have joined an advocacy group to lobby members of Congress to fund critical interventions against malaria. They talk about their work and what scientific messages they bring to DC to impart on policy makers who play a major role in efforts to combat this preventable and deadly disease. This special episode is an extended version of Malaria Minute, a podcast from the Johns Hopkins Malaria Research Institute. Learn more: https://publichealth.jhu.edu/malaria-research-institute https://publichealth.jhu.edu/events/2024/world-malaria-day-symposium https://publichealth.jhu.edu/malaria-research-institute-1

Humans are transforming, degrading, and altering Earth’s natural life support systems so profoundly that our actions have created an existential crisis. For Earth Day, Sam Myers, founding director of the Planetary Health Alliance and director of the brand new Johns Hopkins Institute for Planetary Health, talks with Dr. Josh Sharfstein about the concept of planetary health, an interdisciplinary approach to understanding how the state of the earth affects the health of us all. Learn more: http://Planetaryhealthalliance.org https://planetaryhealth.jhu.edu/

The presence of infectious diseases can be picked up through wastewater surveillance but how can this data be useful in predicting future outbreaks? Dr. Dylan George, director of the Center for Forecasting and Outbreak Analytics at the CDC, talks with Dr. Josh Sharfstein about how the Center’s forecast for the 2023-2024 respiratory virus season performed and the role of wastewater surveillance as part of a multifaceted approach to aggregating data. Resources from this episode: https://johnshopkinssph.libsyn.com/699-an-update-on-the-cdcs-new-center-for-forecasting-and-outbreak-analytics https://magazine.jhsph.edu/2020/cloudy-chance-covid https://www.theinvisibleshieldseries.com/

There’s a lot of research around Type 2 diabetes that has informed patient care when it comes to diagnosis, treatment, and lifestyle management. But much less is known about Type 1, long mislabeled “childhood diabetes.” Johns Hopkins epidemiologists Elizabeth Selvin and Michael Fang talk with Stephanie Desmon about new research debunking a lot of previously held assumptions about Type 1 diabetes, the prevalence of adult onset and correlation with obesity, and why different approaches to diagnosis and management are necessary. They also discuss the cost of insulin and why more research is needed around medications like Ozempic for Type 1 diabetes.

Cigarette butts are the most littered object in the world. With their plastic filters and toxic substances, they are a significant source of contamination for soil and water. Grazi Grilo, a researcher at the Global Institute for Tobacco Control, talks with Stephanie Desmon about her work quantifying the scope of the problem, and why some of the very things that make cigarettes so environmentally hazardous also provide enormous benefits for the tobacco industry.Read more about her work here: https://publichealth.jhu.edu/institute-for-global-tobacco-control/2024/assessment-of-littered-cigarette-butts-in-brazil-informs-strengthening-of-global-treaty

Dr. Antonia Novella served as the 14th Surgeon General under President George H.W. Bush from 1989 - 1993. She is the first female and first Hispanic Surgeon General in U.S. history. Dr. Novella talks with Dr. Josh Sharfstein about her life and career, from being born with a rare condition called Hirschsprung’s disease to her childhood in Puerto Rico and her notable career in medicine and public health. She also discusses facing prejudice, staring down Big Tobacco, and even buying support hose for a U.S. Senator. You can read more in her new autobiography: https://www.fulcrumbooks.com/product-page/duty-calls-lessons-learned-from-an-unexpected-life-of-service Read more about the epic surgeons general event here: https://pages.jh.edu/gazette/aprjun98/apr1398/13surgen.html

Much research has been dedicated to the long-lasting negative impacts of adverse childhood experiences—far less has focused on the powerful effects of positive experiences. Dr. Melissa Walls, co-director of the Center for Indigenous Health and a member of the Bois Forte and Couchiching First Nation bands, talks with Lindsay Smith Rogers about her research with benevolent childhood experiences among Indigenous communities. They discuss the importance of researching the positive, not only for public health, but in celebrating the inherent strengths of Indigenous individuals, their families, and culture. Read more: https://pubmed.ncbi.nlm.nih.gov/38419503/

On March 26, Baltimore’s iconic Francis Scott Key Bridge was hit by a cargo ship and collapsed, killing six people. Since then, many have found themselves watching endless loops of the video and ongoing coverage, and some are feeling symptoms of anxiety or even intense fear. Dr. George Everly, a Johns Hopkins psychologist, talks with Stephanie Desmon about the phenomenon of “psychological contagion” and how something so rare but so spectacular can suddenly make us question our sense of safety. They also discuss how to talk to kids about events like these and what to do when healthy curiosity becomes problematic. Read Dr. Everly’s Psychology Today piece here: https://www.psychologytoday.com/us/blog/when-disaster-strikes-inside-disaster-psychology/202403/the-dangers-of-the-baltimore-bridge

Recent reports of spillover of avian virus H5N1 into cows, cats, and even one human are concerning to the scientific community for a number of reasons. But what does the public need to know? Virologist Dr. Andy Pekosz and public health veterinary expert Dr. Meghan Davis return to the podcast to talk with Stephanie Desmon about these spillovers events and what they mean for biosecurity and our safety.

Per- and polyfluorinated substances are in all kinds of products from waterproof makeup to fire retardants. Dr. Ned Calonge, co-author of a new report from the National Academies of Sciences, Engineering and Medicine, talks with Stephanie Desmon about these “forever chemicals” and what is known about their impact on health, who is most at risk, and what people should do if they have high levels of exposure. Read the report here: https://nap.nationalacademies.org/catalog/26156/guidance-on-pfas-exposure-testing-and-clinical-follow-up

Xolair is the first FDA-approved therapy to prevent severe and potentially life-threatening reactions in adults and children who are allergic to dairy, eggs, wheat, nuts and other foods. Dr. Robert Wood, the director of pediatric allergy and immunology at Johns Hopkins, talks with Lindsay Smith Rogers about this drug that has the potential to make life a little easier for patients and parents of children with severe allergies.

A hidden population of children serve as caregivers for family members who are chronically ill, elderly, disabled or injured. Left out of the systems that support adult caregivers, these youths often sacrifice their education, health, well-being, and childhoods. Connie Siskowski, founder and president of the American Association of Caregiving Youth, and Dr. Julie Belkowitz, a pediatrician at the University of Miami School of Medicine talk with Dr. Josh Sharfstein about these young people and the enormous responsibilities they take on, and what is needed to help support them so they can thrive. Learn more: https://aacy.org/

How can a play about rural Norway in 1882 help us process the trauma of the COVID-19 pandemic? That's the question posed by Theater of War Productions, which is hosting readings of The Enemy of the People, by Henrik Ibsen—and then is leading intense community conversations immediately following the productions. Bryan Doerries, artistic director of Theater of War Productions, speaks to Dr. Josh Sharfstein about how this old Norwegian play speaks to the trauma experienced by the public health field and by community members during the pandemic. You can watch the Ohio productions live via Zoom and participate in the conversation afterwards on April 6 and 7 at 6pm. You can sign up for free under the events tab at http://theaterofwar.com. If you missed our first conversation about the parallels between the COVID-19 pandemic and The Enemy of the People, you can listen here: https://johnshopkinssph.libsyn.com/132-the-enemy-of-the-people-by-henrik-ibsen-and-parallels-to-the-covid-19-pandemic

Despite a national plan to eliminate syphilis by 2010, the sexually transmitted infection has reached the highest rates since the 1950s. Dr. Khalil Ghanem, a researcher of sexually transmitted infections at the Johns Hopkins Bloomberg School of Public Health, talks with Stephanie Desmon about syphilis infections and the disease course, and why rates are so high not just in the US but around the world. Learn more: https://publichealth.jhu.edu/2024/why-is-syphilis-spiking-in-the-us