Global Health Blogs with Professor Swahn

Student Reflections on Topics Covered in our Class

Global Health Blogs with Professor Swahn

Minorities in Mental Health

December 7, 2020 · No Comments · Mental Health

Although our healthcare system has come a long way, there are still disparities in mental health treatment among racial/ethnic minority populations in the United States. The modern mental health care system has struggled with inequality based on socioeconomic status, race, and ethnicity. Those considered to be ethnic minority groups are faced with a number of barriers that prevent them from actively participating in treatment for mental disorders/illness. Due to the negative connotations that surround them, mental disorders/illnesses are commonly overlooked and go untreated. To add, minority groups in the lower socioeconomic status frequently have poor physical health, which adds to the vulnerability to mental illness. Those in this group often have a lack of options for affordable treatment and accessible resources. Both stigma and various cultural beliefs and attitudes generate discrimination and social distancing behaviors towards those suffering from mental illness. This often results in underutilization, underrepresentation, and discrepancy of mental health services amongst minority populations.

July is National Minority Mental Health Awareness Month - Family & Children's Services

In some cases of serious mental illnesses, a person’s ability to carry out essential aspects of daily life can be interrupted. Severity ranges among the several types of mental illnesses, however, the most common disorders are the ones we have discussed when we bring up mental health, those are depression, substance abuse, bipolar disorders, anxiety disorders, panic attacks, phobias, eating disorders, schizophrenia, and dementia. Causes of mental illness have been studied and can range from inherited traits/genetics to environmental factors, biological factors, social/cultural factors, and even life experiences, for example, excessive stress. Left untreated mental illnesses can cause physical and behavioral health problems. However, due to various negative connotations surrounding mental disorders and illness, people will often attempt to ignore, reject, or self-medicate the condition in a state of denial. Minority populations suffering from mental health disorders are also less likely to utilize access to mental health services or seek out a mental health professional, and also receive poor quality mental health care.

What Can Minority Mental Health Awareness Month Do For Your NAMI Affiliate? | NAMI: National Alliance on Mental Illness

Many studies in the past exploring attitudes about mental health services have unfortunately used either too small or large nonrepresentative samples, making it difficult to find the relation between attitudes and service use. Understanding the demographics of the population of those willing to seek mental health care can guide targeted public health interventions to increase treatment effectiveness. The situation of negative stigmas toward mental health treatment can persist beyond the starting of the treatment. It has been studied that certain demographics experience more uncomfortableness speaking with a mental health professional and also do not trust the treatment as they believe it will be ineffective. These same demographics have been observed to exhibit higher treatment dropout rates as well.

Recent studies have shown that specifically, both African Americans and minorities underutilize the professional mental health services available to them, this is probably driven by the uncertainty of the effectiveness of the health care system this results in viewing the mental health service as a place to be fearfully avoided rather than a provider of health service. Using data from questions assessing comfort, probability, and embarrassment when it comes to help-seeking for mental illness was used in a contemporaneous population-based survey. The data from the US National Comorbidity Survey and the Ontario Health Survey were analyzed to examine the correlation of a derived negative attitude. In both America and Canada, negative attitudes towards seeking help for mental illness was prevalent. Negative attitudes towards seeking help were highest among youth in low socioeconomic class, less-educated men, and single people in Ontario and the United States. Also, in both countries, not seeking treatment in the past, antisocial personality disorder and substance abuse was associated with even greater negative attitudes.

In class, we have discussed that there is evidence that different ethnic /cultural minority groups, in one case Black people, are treated differently in hospital settings. For example, they could be prescribed drugs at different rates for the same illnesses as whites. This does translate into mental health. In one case we do find that, among students in similar positions, those who are White are more likely to be diagnosed and to be prescribed medication for ADHD, even if they are displaying the same clinical needs. ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were respectively (95% CI) 69%, 50%, and 46% lower than it was for their white counterparts. This trend was observed in multiple nationally representative datasets. This racial disparity was observed to emerges as early as kindergarten, where black children in the United States were 70% less likely to be diagnosed with ADHD than other similarly situated White children. In this same study, Hispanic children initially seemed to be underdiagnosed for ADHD, however, this disparity became statistically nonsignificant after a controlling factor for whether a language other than English was primarily spoken in the home. Using analysis by kindergarten teachers on classroom behaviors, neither Black nor Hispanic children showed no different rate of ADHD‐related behaviors than Whites.AJPHThinkTank on Twitter: "Wallace et. al.: Exposure to racial discrimination has incremental negative long-term effects on the mental health of ethnic minority people in the UK. [https://t.co/PCqYUMAt1l] @PublicHealth @AMJPublicHealth #PublicHealth ...

So what does this research tell us? That relying simply on the present mental healthcare systems without considering the unique barriers to quality care that apply to racial/ethnic minorities is unlikely to affect the pattern of disparities observed. It is safe to say those populations reluctant to visit the clinic for depression care may have correctly anticipated the limited quality available.

The mental health system’s race-blind approach to both treatment and research is largely the reason that the racial/ethnic minorities are underrepresented in psychological research. Challenges for practitioners and researchers should focus on some long-neglected areas, such as not assuming all ethnic/racial minorities have similar experiences, adversities, cultural backgrounds, and reactions that their reaction to treatment and interventions will vary. The mental health disparity comes in the form of both who has access to mental health treatment, and who feels represented and understood in published research articles and studies, the assumed normative default is often white experiences and behaviors.

 

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Measure CDoH: A Targeted Approach for Tackling NCDs

December 6, 2020 · No Comments · CDoH

The cost of treat non-communicable diseases (NCD) has always been a struggle for all countires to address. Even recently, the challenge of treating non-communicable diseases continues to grow across the globe, with the global burden of disease increasing from 43% to 54%  between 1990 and 2016. An during 2018, NCDs accounted for an estimated 71% of total deaths globally, with cardiovascular diseases, cancers, diabetes, chronic respiratory diseases accounting 81% of those deaths. By 2025, the WHO (World Health Organization) estimates out of all annual deaths from NCDs, 85% of them will occur in middle- and low- income countries.

So how do we respond? It is clear we have to shift our focus to addressing these commercial determinants of health (CDoH) during the development of public health interventions designed to prevent and comabt non-communicable diseases such as cardiovascular disease, chronic respiratory diseases, cancer, and diabetes. CDoH are strategies and approaches used by the private sector to promote products and behaviors that are detrimental to the consumers health.

 

In todays world, and by many organization definitions, commercial determinants of health are health influencing factors that stem from the motive of profit and corporation practices used to maximize revenues, political influence, and marke shares. Ultra-processed food items and drinks, alcohol and tobacco, and exposing emplyees to unsafe work conditions or toxic substances are some common examples of how your health can be harmed for the promotion of unhealthy commodities.Researchers define and measure the commercial determinants of health

Nicholas Freudenberg, a distinguished Professor of Public Health at City University of New York School concludes from his research – “Despite clear evidence of the alarming rise in non-communicable diseases globally, the public health community has achieved only limited consensus on effective preventive action,” he continues “The commercial determinants concept promises a more holistic, integrated and targeted approach.”

Freudenberg’s research allows us to look into some of the measures of commercial determinants of health. In order to address NCDs worldwide, it is crucial that we look at commercial determinants of health as a compounded of risk factors, and how these risk factors interact with each one another. A risk factor is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury. This way we can identify vulnerabilities of specific populations over location and time, and across other variables such as socioeconomic status, age, and sex. This could provide researchers a powerful dataset to develop targeted public health interventions to reduce such risks to health and health equity. 

JMI - Incorporating Social Determinants of Health in Electronic Health Records: Qualitative Study of Current Practices Among Top Vendors | Freij | JMIR Medical Informatics

 

This economic burden is a key driver of rising health inequities in our country and of course is especially heavy for marginalized and disadvantaged communities and individuals, more than those in groups with higher socioeconomic status. Remember, Health is not just determined by genetic and biological factors, but also by the socioeconomic situation surrounding people’s lives, which includes both income levels and the level of education reached. Finally, as the COVID-19 pandemic has shown us, higher rates of NCDs put millions of citizens at higher risk of other threats to their health and well being.

Systems Thinking as a Framework for Analyzing Commercial Determinants of Health | Milbank Quarterly | Milbank Memorial Fund

In response, we must develop effective prevention strategies focused on reducing those risk factors associated with these 4 type of diseases. In the past, public health intervention to prevent NCDs has primarily focused on metabolic factors (such as hypertension, hyperlipidemia) and modifiable behavioral risk factors (such as alcohol use, tobacco use, unhealthy diets, physical inactivity). Many political leaders who could make change believe that NCDs are just too large, complex, and expensive to challenge, but this strategy based on four diseases and four risk factors seems makes the situation much simpler. Researchers have now realized NCD prevention plans must address the circumstances in which people are born, live, work, and age, and the systems already put in place to deal with diseases. Public health approaches include screening for hypertension, healthy dieting, quitting smoking  and improvement of food labelling policies.

 

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Want a more personalized experience? Try virtual reality!

December 3, 2020 · 1 Comment · Technology, Uncategorized

Want a more personalized experience? Try virtual reality!

 

Virtual Reality (VR) refers to a simulated experience that can be similar to or completely different from the real world. The application of VR is majorly seen in entertainment, sports, education, and the gaming industry, significantly. What makes VR so interesting is its ability to enable people using it to experience the artificial world up close, and experience and interact with its elements, almost providing them with a real experience.

Despite the maximum application of VR in the sports and gaming industry, it is an equally valuable resource in the field of healthcare. The most important application of VR in the field of global health comes in the form of a learning experience with the use of VR, especially learning about countries or remote locations, otherwise not accessible to everyone.  

“Virtual Reality: Advancing Public Health with New Technologies” published in de Beaumont describes an experience where attendees of the American Public Health Association got a chance to test the VR headset. The users viewed scenes such as an urban community block, an apartment, a school cafeteria, and a residential neighborhood to better understand how social determinants of health such as access to housing, transportation, healthy food, and safe neighborhood influence the health of an individual.

On a related note, VR can also be used to study the living conditions, health choices, and built environment across the globe and across all socio-economic classes. The above-mentioned article talks about how VR can be used to elicit strong emotions. Experiencing something in real life is always a better teacher than reading about the same or watching videos or pictures about the same. According to the National Wellness Network’s “Effective Use of Virtual Reality for Public Health Education”, VR helped students from a mixed-ethnicity, student exchange program, understand and tackle the challenges faced by Syrian refugees in Lebanon. The Lebanese students captured 360-degree view videos to allow the users to have a more personalized experience.  Another vital example of the application of VR in remote learning is the work Dr. Swahn has done through the CAVE program in Kampala.

A critical global health concern in the present times is the COVID-19 pandemic. According to the National Institute of Health’s Significant applications of virtual reality for COVID-19 pandemic”, there are 4 main areas through which global healthcare can be made more proficient, namely, through medical training, patient treatment, medical marketing, and disease awareness. Virtual Reality plays a big part in these areas. VR is extremely beneficial in providing the medical staff simulated training for all complex procedures, almost as similar to real patient experiences as possible. Additionally, VR also helps not only in staff training but also provides patient education. In times such as the current, where in-person meetings are extremely limited, VR provides a more personalized experience to the patients. Thus, VR improves accessibility and the quality of patient care delivered, especially, in times of a pandemic.

Another important application of VR is training to respond to global disasters such as the one we are facing currently. As Forbes describes in “10 Ways VR Will Change Life In The Near Future”, emergency situations like natural disasters, humanitarian crises, and global pandemics are hard to respond to, but training for the same by the use of simulated reality is helpful for the emergency responders. One of the biggest global health burden in the present times is a chronic disease, lifestyle, and lack of physical activity is the most crucial contributing factors for the same. One of the main reasons people do not involve themselves in any form of physical activity or exercise is the lack of motivation for the same. This is where VR comes in handy. The use of VR to create scenery on stationary bikes and treadmills will encourage people to be more involved in physical activity.

Furthermore, when all in-person learning is suspended due to the COVID-19 crisis, virtual learning could further be enhanced by the use of virtual reality. Providing examples and real-life experiences in real-time to students, stuck at home, helps them learn trends of diseases or health conditions and the reason behind such health choices. Instead of traveling around to remote locations, students can obtain personalized learning at home.

Virtual reality and its use in the field of public health has more extraordinary benefits. However, it does not come without its limitations. First and foremost, while VR can elicit stronger responses, feelings of empathy, and more personalized experiences for the user, it can also lead to increased anxiety and stress. Certain visuals and graphics can elicit stronger than desired responses, leading to anxiety. Also, because VR itself involves haptic and audio-visual senses, it might interfere with the real-time and space association of the user, causing nausea and dizziness. Hence, it is always advisable to take breaks while using VR headsets. Additionally, VR technology is not cost-effective for several low-and middle-income countries and rural centers. Hence, monetization is an issue that needs to be investigated as well.

To sum up, VR is a vital emerging technology, not only for entertainment or sports or gaming industry, but global health as well. It does come with a few limitations, which when resolved, will encourage the smooth running of the VR technology and will call for increased involvement of VR in the field of global health and education.

 

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How is VR Changing Public Health?

December 3, 2020 · No Comments · Technology, Uncategorized

According to Mitchell in 2020, “Virtual reality refers to a computer-generated simulation in which a person can interact within an artificial three-dimensional environment using electronic devices, such as special goggles with a screen or gloves fitted with sensors”. When someone is using VR, they can look up and down and around them and see images as if they were actually in that place. VR is one of the new and upcoming technology items that has the creative ability to be used in public health in all areas around the world. VR is different than AR (Augmented Reality) though. According to Mitchell in 2020, AR enhances the real world as it already exists, though graphical overlays and does not create a fully immersive experience. To learn more about the basic information about VR, click here.

Until last week, I thought that VR was only used in video games and maybe some training exercises for the military, etc. I was amazed to learn that there are many and many other uses for VR other than video games and trainings such as incorporating them into fields such as global health. I also did not realize that VR is already being used in some current global health studies. Some other current uses for VR are simulating driving a car for a new student driver, giving tours of a house or other property to potential buyers/developers without actually being there, allowing medical students to practice surgical techniques, and training astronauts for space travel (Mitchell, 2020). But beyond all of these other uses lies the most important (in my opinion) use for VR – Education.

It is really easy to show someone a picture of an area. But everyone knows that a picture (normally) never does a place justice. Which can be a good thing and can be a bad thing. A picture probably will not show exactly how beautiful a waterfall is, how tall a building is in relation to a human or the surrounding trees and mountains, or how congested with traffic a busy street in a city is. I know from personal experience that unless something is experienced in person, the full effect of an image will not be grasped.  For example, the picture on the left is a really cool picture and you can tell that is is probably taken in a city, but the viewer has no idea or frame of reference for how tall those buildings actually are. But VR can change this! With a headset on, a person will be able to look up and get a better idea and feeling of just how massive and tall those buildings are in comparison to themselves.  On the flip side, VR will also be able to educate people on how bad something is. For example, a picture will attempt to show how bad a trash covered island is, how polluted our waters are, how crowded slums in a third world county are, etc. but many people will not totally grasp the message that is trying to be sent. VR has the ability to fully immerse someone into these difficult areas and inspire people to change and get involved. 

An example of a current use of VR technology in public health is through the de Beaumont Foundation, the American College of Preventative Medicine, the Prevention Institute, and Brightline Interactive.

They have created a VR experience called “Health in All Communities”  (a scence from the experience is shown above) that highlights the role of policy in shaping community health (Cinnick & Mulloy, 2020). The users can view scenes like urban community blocks, apartments in different countries and areas, schools, etc. These different places have the ability to highlight things that affect social determinants of health such as housing, safe transportation, healthy food options, etc. 

I am personally very excited to see where VR can take public health (especially global health) in the future. I believe there are and will be amazing opportunities to engage people in areas and situations that are more easily accessible and not potentially harmful to the user. VR technology has also gotten more affordable since the invention of VR. With VR options becoming more affordable, public health will be able to utilize VR more often and in more areas. 

 

References:

Cinnick, S., & Mulloy, N. (2020, May 04). Virtual Reality: Advancing Public Health with New Technologies. Retrieved November 19, 2020, from https://www.debeaumont.org/news/2019/virtual-reality-advancing-public-health-with-new-technologies/

Mitchell, C. (2020, October 14). Virtual Reality. Retrieved November 19, 2020, from https://www.investopedia.com/terms/v/virtual-reality.asp

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It May Not be Robots Yet, but Tech Improvements in Health are Coming!

December 3, 2020 · 2 Comments · Technology, Uncategorized

Being that we are solidly in the 21st century, it shouldn’t be surprising that technology is involved in everything, including advancing global health. Because the Sustainable Development Goals of the U.N. are so bold, one of the best ways to get closer to meeting them faster is using innovative technology to our advantage. It is clear the technology can be used to improve health around the world as a tool to quicken the progress towards improving global health results, especially in low and middle income countries.

descriptionand pictures of the 17 sustainable development goals

Photo obtained from: : https://www.un.org/sustainabledevelopment/blog/2015/09/why-should-you-care-about-the-sustainable-development-goals/

Digital health in particular is important to consider when discussing the relationship between technology and global health. Digital health includes many concepts, including mobile health, health information systems, telehealth, telemedicine, wearable devices, health information technology, and more. Digital health can be separated into 3 main areas (Sciences, Engineering, and Medicine, 2017):

  1. Using health information systems to catch, store, manage, or communicate information regarding patient health or health facility services.
  2. The delivery of important health information to healthcare professionals and health consumers using the internet and other forms of telecommunication.
  3. Using information and communication technology to better public health services (like through training and educating healthcare workers for example).

 

The World Health Organization has a Global Initiative on Health Technologies that they are hoping will make the benefits of health technologies available to populations in resource-limited settings, in an effort to control imperative health problems (Global initiative on health technologies, 2011). The Initiative has two objectives: the first is to encourage the international community to create a framework to develop National Health Technology Programmes that will affect the burden of disease and confirm the most effective use of resources (Global initiative on health technologies, 2011). The second is to challenge the scientific and business community to find and adapt “innovative” technologies that could have an impactful effect on public health (Global initiative on health technologies, 2011).

stethoscope around a globe

Glass globe and phonendoscope on the white surface. Photo obtained from https://www.medicalbag.com/home/medicine/strategies-and-considerations-for-improving-global-healthcare/

 

Excitingly, more breakthroughs could be on the way. In 2012, Lawrence Berkeley National Lab’s Institute for Globally Transformative Technologies began a study to find the “50 most important technology breakthroughs” needed for sustainable global development (Buluswar , 2014). This was began with the idea that knowing these technology breakthroughs will help those working in the field know what to put their collective efforts towards (Buluswar , 2014). Working with over 1000 experts, they analyzed where emerging technologies can make a huge difference in the areas of global health, agriculture and food security, human rights, education, access to water, the digital divide, access to electricity, gender equity, and fighting climate change (Buluswar , 2014). Big goals, right? One of the seven amazing and important breakthroughs identified is “a tool to diagnose several diseases” (Buluswar , 2014). Already a lot of advancements have been made on many diagnostic technologies (including nucleic acid tests and dipstick-type immunoassays), but it is imperative to use technology to integrate these different tests into one tool so that so that patients can get fast, accurate results on the first visit (Buluswar , 2014). Another related to technology is using solar-powered devices for child, primary, and maternal healthcare (Buluswar, 2014). As of 2014, building an averagely equipped clinic can cost over $100,000 (Buluswar , 2014). Additionally, devices needed to be successful are usually hard to install, complicated to use, and cost a lot to maintain (Buluswar , 2014). Using technology to develop a suite that has the main 10-15 devices and designed in a way to make easy installation and use a “clinic-in-a-box” (which costs less than $10,000) would not only improve health in rural areas but help save lives too (Buluswar , 2014). If you’re interested in learning more about the top medical technologies of the future, watch  this video!

Unfortunately, the upward climbing of potential digital technology health solutions is usually slowed by many factors, including a limited amount of peer support and leadership management, a lack of coordinated funding working with government priorities, and a shortage of cheap and easily re-used adapted technologies ( like those made with open source software) (Sciences, Engineering, and Medicine, 2017). Experts believe that creating digital health-focused public-private partnerships based on government and community priorities can help to link stakeholders inside the digital health environment, can help encourage integration and coordination, increase the potential for impact, and involve the private and public sector stakeholders in fixing current challenges (Sciences, Engineering, and Medicine, 2017).

 

References

Buluswar, S. (2014, December 17). Seven breakthroughs that will transform global health. Retrieved November 16, 2020, from https://www.theguardian.com/global-development-professionals-network/2014/dec/17/seven-breakthroughs-transform-global-health-technology

How American Policy & Funding are Addressing Gender-Based Violence Globally. (2019, October 01). Retrieved November 12, 2020, from https://www.futureswithoutviolence.org/american-policy-funding-addressing-gender-based-violence-globally/

Sciences, Engineering, and Medicine, N. (2017, November 17). Introduction. Retrieved November 16, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK538094/

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COVID-19 and a Mental Health Crisis

November 19, 2020 · 1 Comment · Mental Health

The National Institute of Mental Health defines mental illness as a mental, behavioral, or emotional disorder. “Any mental illness can vary in impact, ranging from no impairments to mild, moderate, and even severe impairment” (NIMH, 2019). Mental health is a term that has many different connotations. Most of the connotations associated with it throughout the years have been extremely negative. Not that long ago, people who suffered from any mental illness were sent to an asylum, hidden away from the world by their family, etc.  The negative stigma that surrounds mental illness has changed since the days of leaving people locked away in mental asylums, but it has not changed that much. People today are still not receiving the professional help they need, looked down upon, let go from jobs, lose friends and family’s support, etc. But more than anything else, people with mental illnesses need support from those who are trained to help them, and those who love and care for them. For many people all over the world, cost is a major barrier to receiving the help that they deserve and need. 

According to the National Institute for Mental Health, nearly one in five adults in the United States live with a mental illness (about 46.6 million in 2017). The prevalence of mental illness was higher in 2017 among women (22.2%) than men (NIMH, 2019). It was also found that young adults between the ages of 18 and 25 had the highest prevalence of mental illness (25.8%) compared to those of other ages (NIMH, 2019). Shown below is a graph of the prevalence of mental illness among the adults living in the United States. For more information on the National Institute of Mental Health and their data/resources, here is their website.  

Mental illness is not only a problem in high income countries. Many low and middle income countries have problems with mental illness that affect people in the same and different ways as those living in a high income country. A major problem in low and middle income countries is the lack of mental health workers or lack of access to a mental health worker. The WHO estimates that in low income countries, the rate of mental health workers can be as low as 2 per 100,000 population as compared to 70 per 100,000 in high income countries (WHO, 2018). In addition to mental health staffing issues, financial resources and the lack there of is another one the most common problems across low and middle income countries. The WHO states that “every US $1 invested in scaling up treatment for common mental illnesses such as depression and anxiety leads to a return of US $4 in better health and ability to work of the people”. One of the recent ways that has been used to combat this problem is through the use of technology in medicine such as telehealth and lay health workers and educators. Telehealth and lay health workers increase the area in which a mental health worker can serve. If someone can essentially “bring” the health care worker to a remote village but not actually have the mental health worker there, this could drastically change the way people are served. It has the potential to work well even with the usual flaws of technology. 

Another way in which the world has seen the flaws of technology recently is through the COVID-19 pandemic. COVID-19 has played not only a major role in the physical health of people around the world in 2020, but also the mental health of people around the world. People have basically had to move their whole lives online. From working from home every day, to cancelled plans and family time, to missing doctors appointments due to offices being closed. I can speak from experience that quarantine with or without being sick has an affect on your mental health. Here is an interesting video from the WHO on some ways that COVID-19 has affected mental health in the workplace and outside of the workplace. But COVID-19 has done more than create new mental health problems for people, it has also highlighted the old problems that have existed in the workplace for a long time. One of the big questions people are asking now is where do we go from here? The world of medicine has adapted to the coronavirus in ways such as the use of telehealth and limiting numbers of patients seen day to day. But how has the mental health world faired? There have been drastic increases in anxiety, fear, and grief with the coronavirus for many people throughout the world.  The National Institute of Mental Health has a webpage (see here) that contains some resources regarding mental health and the coronavirus. Thankfully, the views surrounding mental illness are beginning to change. And due to the perceptions of people surrounding mental illness changing, people are now more accepting of help and more likely to seek out help. Shown below is one of the resources from the National Institute of Mental Health.

 

 

References:

  • National Institute of Mental Health. (2019). Mental Illness. Retrieved November 05, 2020, from https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
  • World Health Organization (WHO). (2018, October 31). Mental health: Massive scale-up of resources needed if global targets are to be met. Retrieved November 06, 2020, from https://www.who.int/mental_health/evidence/atlas/atlas_2017_web_note/en/

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Technology and Global Health: The Way Forward

November 19, 2020 · 1 Comment · Technology, Uncategorized

Technology and Global Health: The way Forward

Technology is creeping its way into every aspect of our lives. There is almost no field left untouched by the bountiful gifts’ technology has to offer. The impact of technology on global health is crucial.

Global health places priority on reducing disease burden, enhancing the quality of life, and improving health outcomes of the world population. Advancing technology has been extremely instrumental in the motto of global health. From designing health applications to telehealth, better research facilities, and improved accessibility.

The biggest boon to global health has come in the form of health apps and telehealth or mobile health. MHealth has proved to be a boon in bridging the gap between patients or parents/guardians and doctors. They serve as a great educational tool, providing post-operative instructions, and sending/receiving health updates rapidly. The best part about these apps is that they operate at the touch of a finger. Smartphones have been a part and parcel of everyday life and a large part of the world population now owns a smartphone. The biggest boost to telehealth is by way of improved connectivity. Earlier, technological barriers such as low connectivity, limited internet coverage, proved to be the biggest hurdle in adopting telehealth. With changing times, almost all urban centers and several rural centers have better connectivity, thus, helping them adopt mHealth/telehealth.

A recent article published in HealthAffairs Will Connectivity Be The Next Cure? Health Care Implications of 5G Cellular Technologies” very aptly describes better connectivity and technological advancement will better facilitate real-time sharing of data, including MRIs, prescription, treatment plans, advanced imaging information, and most importantly, haptic information (interpreting motor and sensory movements), and video/audio information and improve accessibility and provide better and faster decision making.

Another crucial technological boon is the use of drones. These drones or unmanned aerial vehicles, aid in the transportation of medical equipment, blood units, and lab samples to remote locations. This improves access and timeliness of treatment and test results.

“Four Technologies That Can Improve Global Health” published in Oxford Academic outlines some vital technological developments that aid in improving health outcomes across the globe. Some of these innovations are mHealth, health apps, and drones, as I talked about earlier. Low-cost gene sequencing is another critical tool in better identifying infectious diseases, surveillance and control, and designing future interventions. It can also help in understanding gene mutations, and drug resistance.

In addition to better and faster access to treatment, technology has also paved the way for efficient and reliable care. The ease of recording patient data and sharing it across borders instantly, real-time updates on patient health status, the provision of a centralized platform that can be accessed from anywhere across the globe, and a vast online resource of patient history is extremely instrumental in enhanced care and patient-centered care. Additionally, software for storing information about illnesses, their symptoms, causes, and medications serves as a vast database of information and knowledge available to one and all globally.

An article published in World Economic Forum “The top emerging health technologies to end this pandemic and avert the next one” describes how technological innovations might prove vital in tackling this pandemic. Virtual patients with simulations can replace humans and aid in faster clinical trials. Microneedles that provide painless injections and operate as drug delivery systems, and whole-genome synthesis that encourages researchers to design genetic sequence that could be introduced into microbes to turn into medicine-making bio-machines, are just a few examples of technological advances.

Such innovations are the need of the moment. However, an important consideration while implementing these innovations is to make sure that those reach the grassroots levels. Low- and middle-income countries would bear the maximum benefits of these advances, namely, enhanced care, better accessibility, and faster service. However, it is crucial to understand that some of the most rural centers do not have access to the simplest of the technological discoveries, which might act as a hurdle. For instance, telehealth, telemedicine, health and fitness apps, wearable devices, and health trackers are some of the most fundamental innovations, and yet not all people have access to those. The reason for this is the absence of a smartphone, language barriers, finances, resources, and most important, connectivity. Almost 45% of the world population owns a smartphone but that distribution globally is not uniform. 82% of the total population in the United Kingdom and 77% of the US population owns a smartphone. In contrast, only 35% of the South African population, 28% of the Indian population, and a mere 11% of the total population in Ethiopia own a smartphone. This hurdle is far too vital to ignore. With smartphone comes connectivity problems and the ability to understand and use a smartphone for its intended purpose.  

The article “Using Technology to Advance Global Health” does a great job of explaining how a lack of coordinated funding with government priorities, limited peer support, lack of human resource, and a dearth of low-cost easily reused technologies are severely limiting the progress of low-income countries can make in the field of health care.

Furthermore, the cost of these technologies, most of them if not all, is skyrocketing, especially when used for healthcare and treatment. This again puts the rural population and those who cannot afford care in a vulnerable position. Hence, efforts should be made to use these innovations in disease prevention and health promotion.

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Let’s Get Technical in Global Health!!

November 19, 2020 · 2 Comments · Technology, Uncategorized

Public health is a constantly evolving field. As the environment continues to change, populations continue to grow, and society continues to evolve, humans adapt by creating new instruments to fit any new needs prevalent. Public health is a field whose mission is to protect the overall health of a community while improving the quality of life for those in the population.

Global health care trends survey | Deloitte InsightsTherefore, it is sensitive to the constant changes in the environment and tries to match the most pertinent needs in a given community. This is evident when reviewing policies and medical techniques that were valid twenty years ago and realizing that they have been replaced a few times over. As newer diagnoses and worsening epidemics become more prevalent, the public health sector reacts by implementing new research, new medical advancements, and new programs in an attempt to restore balance. However, in a world that is changing at a lightning fast pace, it can be difficult to maintain efforts necessary to bear the weight of necessary interventions placed for the population at risk. Technology helps to provide an opportunity to maintain the stability of health in the population while also creating solutions to issues that did not have a prior solution identified. Medical innovations, research, health information systems, and more sectors of digital technology in health all provide population with the opportunity to create a more sustainable and efficient future.

Technology in public health has provided ample opportunity towards the improvement of health access, efficiency, and quality. As the world continues to move towards digital innovations, one important resource technology has provided the public health sector with is the opportunity to increase access to healthcare. Some of the barriers that many patients faced when seeking medical attention from their provider included high costs, lack of transportation, and the inability to present to a provider’s office due to issues pertaining to their condition. As technology has advanced, providers have been able to communicate with patients Virtual Visits: Telehealth and Older Adults | National Poll on Healthy Agingthrough Telehealth networks, patient portals, and other online accessible options. Through these online platforms, patients have been able to discuss any concerns they are having with their provider without the hassle of physically presenting to the office building or hospital. This advancement has created more efficient health methods in which patients and providers have the opportunity to discuss any issues or worries without the pressure and time constraint. Telehealth methods have also been proven to reduce the cost of health care for some patients as these visits often cost $40-$50 vs the $136-$176 in-person care can average (Yamamoto, 2014).  

Another way in which technology has been an increasingly beneficial tool in the public health sector includes the advancements made in medicine and medical innovations. As the world continues to evolve, so do illnesses and other chronic ailments that plague the population. Diseases, such as the chicken pox, that used to be responsible for multiple hospitalizations and deaths in the population each year are now considered “curable” with easy and accessible solutions. It is extremely prevalent that the future of medicine relies heavily on technological advancements that can provide cures to chronic diseases, such as cancer, as well as other tools to serve patients in the fastest, highest quality, and least expensive manners possible. Technology has the ability to provide the means for  providers to practice medicine more efficiently, effectively, and intelligently through tools such as virtual reality. Apple Watch Series 4's ECG Feature Will Work Internationally When Set to U.S. Region - MacRumorsFurthermore, technological advancements in medicine have not only assisted professionals in the medical community, but have also improved patient’s lives. As devices, such as Apple Watches and Fitbits, are created to track fitness goals, there are certain functions that allow the average person to monitor certain vitals like heart rate and heart rhythm. These innovations are important as they allow a patient to be more active in their healthcare, which can lead to a decrease in the incidence of chronic diseases. As the world continues to grow and change, the future of medicine is heavily reliant on technology in order to create the best possible outcomes for those around the world.

Although technology has become an extremely important and crucial aspect in healthcare, there are still many barriers in low- and middle-income countries that prevent them from reaping the benefits. Many communities in low- and middle-income countries often miss out on the benefits that technological advancements in public health provide due to the fragmented digital health landscape they maintain. In these countries, one of the issues preventing the benefits these technologies provide include the variation of technology and interests of the public and private sectors within each respective country. These sectors are often found to be working separately and often do not have the support of the government to invest in such advancements. Furthermore, if advancements in technology are permitted in which patients can use Telehealth methods through mobile devices, the quality of care they are provided is still lacking due to barriers in funding. As a lack of funding and government support prevents the use of certain effective technologies in the public health sector, the populations in low- and middle-income countries are continuously plagued with preventable diseases and a lack of treatment options.

Overcoming the barriers to greater use of mobile technology in healthcare

Technology in the public health sector has become one of the most important tools in creating a healthier tomorrow. As the world continues to grow, technology is only going to continue to rise in new, life-saving interventions for populations globally. Therefore, I believe that it is especially important for low- and middle-income populations to obtain the funding and assistance necessary to provide technological advancements to their communities. As a global nation, we have a responsibility to one another to lend a helping hand to those in dire need. If the world wants to accomplish the seventeen Sustainable Development Goals by the year 2030, we need to chip in for our neighbors sake. Health is not an individual field. Public health is sensitive to the environment and is dependent on a series of factors in order to thrive. Thus, the status of health in our world is dependent on one another to rise above any barriers and find the best course of action to create a healthier tomorrow for each and every person in our global community.

Strategies and Considerations for Improving Global Healthcare - Medical Bag

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What Can Technology such as Virtual Reality Do for Global Health?

November 19, 2020 · No Comments · Technology, Uncategorized

With the current pandemic, public health learning has been forced to be altered through technology. With these circumstances people have really approached the issue in unique ways. At the GoGlobal 360 event for GSU’s International Education Week, Dr. Kyle Anderson from Clemson University spoke about a project under development to bring study abroad experiences to students through virtual reality. As someone who is interested in studying abroad and hopes to participate in one this coming summer, this is an exciting idea. It could never really fully replace actually experiencing a new country and culture, but as we work with the hand given to us, it is a phenomenal solution. It also creates a flexibility and possibly an affordable solution for students who want to study abroad but are limited by finances. Another aspect is the creativity that can be used here. Creating a virtual reality space that reflects different time periods so students can really see the progress made in public and global health is another interesting idea. It could also be used in general for lessons creating empathy for the situations people lived in and really putting yourself in someone’s shoes in a virtual setting.

I see technology having the largest impact in environmental public health. For example, clean and renewable energy has become more accessible. In many areas of the world solar and wind energy is actually cheaper than fossil fuels. In America we have gone from 2001 with .5% of our energy being from renewable sources to now we are at 10%. At the rate we are going we can get to 23% by 2030 but honestly, I don’t think that’s enough. To combat the tremendous damage caused by fossil fuels we need to be pushing renewable energy across the world. We in America are not really taking advantage of this technology to the extent needed. Compared to other parts of the world we have been replacing our coal powered energy with natural gas instead of renewable sources. Europe for example has increased renewable energy use by 18% almost twice as much as we have reducing emissions and increasing air quality. One approach to this I think would be really resonating, would be larger establishments switching to renewable energy use and causing a sort of domino effect and creating a campaign that generates a lot of positive energy and awareness. Georgia State University would be a good candidate because it is in the heart of Atlanta while being very spread out. We also have a lot of community connections that can create a sort of net of support for this cause. One of the organizations to partner up for this would be Environment Georgia as their main initiative is renewable energy throughout the state of Georgia.

With these positive advancements there are significant barriers in place. The barriers of advancement in any venture are money and politics. Public health particularly requires a lot of collaborative effort and politicization of these public health issues hinders progress. The budget for Public health versus the healthcare system itself shows a lack of priority and the understanding of their inter-dependency. The lower budget that is split between so many different organizations and different parts of public health really limits the amount of change that can be made. Along with that the slow approval form chain of commands and the lack of authority given to public health professionals slows our overall progression. 

The incorporation of young unique talents to come up with innovative ideas to solve our public health problems is one of the greatest initiatives I’ve seen. Having engineering and designing competitions for the youth gives the younger generations voice in changing the world that will directly impact their future. They also have new and fresh ideas because of their different perspectives enabling them to think of problems creatively. Organizations like The Center for Health Experience and Design incentivize and encourage solutions to current public health problems from all ages. They are currently hosting a collaboration to solve problems associated with the pandemic and the home environment.

One of the more unique ways technology has affected public health is through monitoring and detection of outbreaks through web search locations. It is used for example to trace flu outbreaks when people search up symptoms. Being able to monitor these initial stages of outbreak gives more time for preparations and allows predictions to be made earlier than before. We can limit outbreaks and quickly mobilize efforts in containing and treatment services. This monitoring is also really helpful in public health research when looking at the efficacy of interventions and spotting possible issues or barriers quickly. This is really important as ever changing environments surrounding a deadly disease or physical environment changes.

In healthcare there has been more data consolidation technology like health information centers that is really helpful in creating more efficiency. This technology also supports the use of team approached healthcare by making sure all medical professionals receive the same information and make the greatest decisions for the patients. This technology also comes with barriers like data security, data quality and general ease in use. These are more logistical issues that deal with the interactions between healthcare professionals and the system rather than the system itself but this is crucial for effective usage. Technology has also advanced for patient doctor interaction without being face to face. We have begun virtual consultations both in physical and mental health which really expands our possibilities even after the pandemic is over. Completing tasks and consultations online when face to face is unnecessary could cut back on cost and time. It could be particularly useful to less mobile populations with limited access to transportation or those who have to make great effort to be mobile. Once again technology allows a flexibility that can really evolve the healthcare system.

 

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Technology Can Change the World and Global Health!

November 19, 2020 · No Comments · Technology, Uncategorized

Technology has changed significantly and how technology relates to healthcare has also drastically changed over the past two decades. As everyone is aware, the use of technology in everyday healthcare has drastically changed over the past year. In current healthcare, it is nearly impossible to run a hospital or medical office without the use of technology. Patient charts and records are now all electronic, diagnostic tools such as CAT scan, MRI, ultrasound, and x-rays are connected to computers and sometimes even cell phones in order to deliver the images, smart watches that track health indicators are commonly used, and vaccinations and other life saving drugs are readily available (but sometimes expensive) across the world. But technology has the ability to change more than just healthcare practices. The advances in technology can also change the way people farm, travel between areas that previously have been inaccessible, and many other ways that have the potential to drastically change lives.

Since technology has become more accessible to people across the world, one would assume that healthcare technology has also increased around the world. Medical machines and equipment have become more affordable and transportable, increasing the diagnostic capabilities of doctors and other practitioners in lower income areas. It has also allowed for people to become more active in their health (mental and physical). Another example is the use of artificial intelligence (AI) in healthcare. Artificial Intelligence has great potential for use in the healthcare world. From the most basic uses such as appointment and medication reminders on a phone or tablet to the use of robotics in hospitals/surgery centers. For other new and exciting information on some top new technology available in healthcare, check out this article. This article also mentions the new and upcoming use of virtual reality (VR) in healthcare. Some early uses of VR in healthcare have been through therapeutic methods such as in mental health and in physical therapy) and tours of not easily accessible places and facilities. 

Another article by Time (find it here), discusses some of the major health innovations that were expected to come out in 2020. Time notes that the world of public health is changing drastically and technology has played a major part in the changes that have and will occur. For example, drones are starting to be used in the transportation of medical supplies such as medications, blood for transfusions, and samples for lab testing. UPS and Wing have started using drones for medical deliveries in the United States and a company called Zipline is currently delivering medical supplies and other essential items to rural villages in Ghana and Rwanda. Another example is a portable, small ultrasound that was developed by Butterfly iQ. The ultrasound machine is less than an eighth of the cost of a traditional ultrasound machine and it connects to an iphone or ipad. The Gates Foundation is distributing the machines to 53 countries around the world who will greatly benefit from this diagnostic technology that is common in the United States. Routine scans with an ultrasound machine has the potential to be a great screening tool for doctors everywhere.

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