Different Stores, Different Impact on Food Deserts

A food desert is an area with no local source of fresh fruits and vegetables (grocery stores, farmers markets, etc). This absence has been linked with increased risk of obesity and other cardio-vascular health issues.

But what about price? In some urban areas, the only grocery store is a more expensive chain, like Whole Foods (hello Washington D.C. and Providence, R.I.).

We do see price changes due to market competition. For example, this interesting article. Adding a Wal-mart may decrease grocery store prices, but adding a Costco increases them.

Zach Galifinakis makes me smile

I just heard something from comedian/actor Zach Galifinakis (that bearded guy from "The Hangover") that made me smile.

"For five years now I've been addicted to cold turkey"

How complicated is life when even quitting seems addictive?

Young and Proud Smokers Dig Smoking MORE when they see death warnings on the package

Ever wonder how smokers react to "Smoking Kills"? Well it depends on the smoker.

The British Psychological Society's research digest blog puts its spotlight yesterday on a study among student smokers. Those who find that derive some of their self-esteem from smoking and believe that it is cool react to these warnings differently as intended. Instead, they smoke more, "to buffer themselves against the depressing reminder of their own mortality".

Instead, authors recommend other warnings, such as, "Smoking makes you look unattractive" to reduce smoking among this group.

Finding and understanding your target group is essential for any behavioral public health intervention. Otherwise, you may be promoting the behavior you intended to discourage.

Photo: The Telegraph.

Heritage Foundation Hates Your Family

I've run out of disappointment in conservative think tanks like the Heritage Foundation. In a "webmemo" by Katherine Bradley (what, "blogs" are only for commie-pinkos, Ms. Bradley?), she asserts that the budget included policies that "devalue human life, weaken civil society, and undermine the family".

What draconian policies could be doing this?

- The change in sex education. Bradley WILLFULLY MISREPRESENTS this change, saying that is "defunds the asbstinence-based education program" and puts a "condom-based sex education program" in its place. What is the truth? Peer-reviewed studies have time and time again showed that sex education programs that include a section on condom use are effective. Abstinence-only programs, on the other hand, have only been shown to be effective sometimes- these cases were smaller groups in peer-reviewed studies. With the overwhelming scientific evidence supporting sex education programs, Congress has chosen to mandate that all sex education programs include BOTH abstinence and condom-use components. Abstinence education is still funded and on-going.

- Allowing federal funding to be used for needle exchange. She writes, "Ostensibly to prevent the spread of infection, these programs settle for "harm reduction" rather than overcoming drug addiction." Ostensibly??? It has been PROVEN. Needle exchange programs serve as an important conduit for drug users to access drug addiction treatment programs. A lot of drug users are not ready for treatment services but still have health and social needs that aren't being met otherwise.

- Supporting family planning services domestically and abroad. Use of modern contraceptives improve rates of survival among mothers and their children under 5. Reducing access to family planning services and products would meaningfully contribute to death of mothers and children worldwide and increase the numbers of abortions.

Congress has made an important step to support families with important health and education programs.

Bradley's myopic view and representation of the issues perpetuate rumors and lies that undermine rational discussion. By blindly pushing a political agenda, she devalues the lives of injecting drug users and their families, of American youth, and of mothers and children worldwide. I wish she'd be more Christian, especially during the holiday season.

To read Bradley's article click here

Hurrah for Needle Exchange

As a wonderful Christmas/Chanukah/Kwanzaa/Saturnalia present, Congress has finally passed the national budget that also removes the ban on federal funding for needle exchange.

As I've said before needle exchange is an effective tool to improve the lives of people who inject drugs.

Here is more: needle exchange has been thoroughly reviewed for (1) impact on HIV among injecting drug users, (2) uptake by injecting drug users of drug treatment programs, (3) impact on initiation of others to drugs and injecting, (4) impact on the neighborhood where the needle exchange point is placed.

What have the studies shown? Needle and Syringe Exchange Points: (1) reduce HIV incidence among injecting drug users- which also reduces the potential for HIV to be passed on to non-injectors through unprotected sex, (2) increase uptake of drug treatment programs, (3) DO NOT increase initiation among non-injectors and non-users to injecting drugs,(4)DO NOT hurt the neighborhoods around the points.

Needle and Syringe Exchange points are one of the few interventions that have been proven to effectively reduce HIV transmission rates among injecting drug users. There are really not many to choose from for this group. Finally, public health professionals funded by the US federal government can use these effective tools to address HIV among vulnerable groups.

Dear President Obama, It is Time to Put Out....the Approval for Federal Funding of Needle Exchange

After an outright declaration of support for the needle exchange (based on the overwhelming evidence) and sending out coy signals through the choice of health appointees who are supporters of needle exchange, I feel disappointed in your decision not to go ahead an remove the ban on federal funding for needle exchange for the 2009-2010 budget.

Do you think we just aren't ready for this commitment?

This non-action represents a dangerous uncertainty. The other side of the aisle-- or more precisely, the celebritextreme right pundits on Fox News-- is happy to jump on any hint of doubt. While I understand that polls and some backroom deals may be at play in your decision- this moment of reflection indicates that the OVERWHELMING evidence from IOM and other numerous studies that prove the benefit of needle exchange is not enough.

In fact, the evidence is sufficient for needle exchange to not be controversial in the science and health community.

This is truly unfortunate as in this next year, HIV prevention funding for Russia and Central Asia is due to be in the budget for the upcoming fiscal year. Eastern Europe and Central Asia have the unhappy honor of having the fastest growing HIV epidemic which is largely due to injecting drug risk behavior. Incorporating the intervention with the best track record for injecting drug users (IDUs) would benefit these countries immensely. It may be another 5 YEARS until the next round of USAID funding for these countries comes up--- at the cost of thousands of people newly infected with HIV (as well as Syphilis and Hepatitis C).

This sends the wrong message. Just as you repealed the global gag rule and supported stem cell research, you should let the science do the arguing for you and move ahead with removing the restriction on federally funded needle exchange.

Kaiser Network Update on Obama on Needle Exchange

HIV and Income

Hans Rosling, of Gapminder, did a great
presentation of the complicated picture of HIV.


Some key points:

(1) The poorest countries/poorest population quintiles aren't necessarily the ones with the highest HIV prevalence.
(2) Africa is a diverse continent, home to countries with different HIV epidemic stories. We see different epidemiological stories even within those countries.
(3) We need to think about and test other explanations of different HIV/STI epidemic stories e.g. number of partners and concurrency (vs serial monogamy).


Please see the presentation in full at the Hans Rosling TED presentation