ICGH sp2025 Monographs

Spring 2025 Intercultural and Global Health Issues

www.b360nc.com

Created by the students in PHSC 48500 Compiled by Cynthia P Koh-Knox Sharp, PharmD, RPh Purdue University College of Pharmacy

Table of contents Topic (Author)

Page

Media Impact ..................................................................................................................................................4 AI misinformation (Spencer Gregar-Skillman) ................................................................................................5 Cyber bullying (Connor Arick) ........................................................................................................................6 Marketing (Ellie Korty) ....................................................................................................................................7 Promotion of unhealthy behavior (Tejaswi Yarram) ........................................................................................8 Awareness and destigmatization (Karolyn Pineiro) .........................................................................................9 Governmental and Non-governmental Organizations ..............................................................................10 World Health Organization (Skyler Kreunen) ................................................................................................12 Planned Parenthood (Jenna Yeager) ...............................................................................................................13 Federal Emergency Management Agency (Ash Hallissey) ............................................................................14 National Institute of Health (Ari Arzumanian)...............................................................................................15 Direct Relief (Krissy Austin) ..........................................................................................................................16 Center for Disease Control and Prevention (Joshua Randall) ........................................................................17 Geriatrics .......................................................................................................................................................18 Hospital acquired infections (HAIs) in long-term care facilities (Allison Bennett) ......................................19 Geriatric loneliness in long-term care (Ava Brock) .......................................................................................20 Geriatric cognitive health (Evelyn Caldwell) .................................................................................................21 Malnutrition in the geriatric population (April Frias) ....................................................................................22 Geriatric physical and occupational therapy (Victor Saca) ............................................................................23 Diabetes in geriatrics (Sara Hartman) ............................................................................................................24 Tackling Nutrition through Global and Intercultural Understanding ....................................................25 Ultra-processed foods and the impact on human health (Logan Hess) ..........................................................26 Nutrition strategies in preventing IBD (Ely Blum) ........................................................................................29 Food insecurity in the United States (Joyce Yu).............................................................................................31 Foodborne illness (Robert Seabold) ...............................................................................................................33 Diet-related NCDs and their relation to malnutrition (Max Liao) .................................................................35 Corruption in food regulation (Reece Fromme) .............................................................................................37 Pandemics and Epidemics ...........................................................................................................................38 Life expectancy (Cecilia Hinsey) ...................................................................................................................39 Educational disparities (Grace Carlson) .........................................................................................................40 Vaccines (Anna Coffman) ..............................................................................................................................41 Mental health (Anthony Pabón) .....................................................................................................................42 Trust in healthcare (Angie Lozano) ................................................................................................................44 Misinformation during pandemics/epidemics (Owen Stephens) ...................................................................46

Topic (Author)

Page

Maternal Health ...........................................................................................................................................48 Postpartum depression (Caitlin Chui) ............................................................................................................49 Prenatal health care (Lex Thorpe) ..................................................................................................................50 Labor and delivery care (Emylee Tennant) ....................................................................................................51 Maternal mortality (Madison Lucas) ..............................................................................................................52 Outsized C-section rates (Trevor Hoodenpyle) ..............................................................................................53 Postpartum health and recovery (Ryan Qu) ...................................................................................................54 Social Determinants of Health/Disparities/Access.....................................................................................55 Neighborhood and built environment (Charles Mann) ..................................................................................56 Economic stability (Aayush Vachharajani) ....................................................................................................57 Healthcare access, quality, and cost (Oliver Hu) ............................................................................................58 Education access and quality (Luke Choi) .....................................................................................................59 Climate Change ............................................................................................................................................60 The impact of climate change on vector-borne diseases (Grace Coomes) .....................................................61 Economic impact due to climate change (Blair Miles) ..................................................................................62 Impact of climate change on chronic diseases (Darren Hung) ......................................................................63 The energy impact due to climate change (Sameer Varma) ...........................................................................64 Global impact of climate change on patient health (3rd world countries (Aaryaman Khurana).....................65 Addiction .......................................................................................................................................................66 Types of addictions/drugs (Sarah Huszar) ......................................................................................................67 Genetic predisposition (Madelaine Driskell) .................................................................................................68 Mental health (Mezani Muniz) .......................................................................................................................69 Economic and societal costs of addiction (Calvin Pickerill) ..........................................................................70 Limitation of addiction treatment (Jasmine Wang) ........................................................................................71 Environmental Factors Affect Health .........................................................................................................72 Societal vulnerability; Disaster impacts (JJ Wu) ............................................................................................73 Water quality: Public health (Mahee Jain) .....................................................................................................74 Chemical exposure: Childhood poisoning (Dylan Nduulu) ...........................................................................75 Solid waste mismanagement: Landfills and open burning (Christian Durbin) ..............................................76 Pharmaceutical supply chain disruption: Extreme weather (Justin Wang) ....................................................77 Mental Health ...............................................................................................................................................78 Increased ADHD prevalence in the past 30 years (Yana Gomon) .................................................................79 Misdiagnosed and medicated: The hidden struggles when diagnosing mental health (Clayton Wimmersberger) ........................................................................................................................81 Understanding the surge in anxiety and depression in college students (Jaxon Oldham)..............................82 Veteran suicide – intercultural issue (Mark Fillar) .........................................................................................83 Mental health in physical disability (Gunnar Johnson) ..................................................................................84

MEDIA IMPACT

Connor Arick, Spencer Gregar-Skillman, Ellie Korty, Karolyn Pineiro, Tejaswi Yarram SPRING 2025

Subtopics Include: AI Misinformation Cyber Bullying Marketing Promotion of Unhealthy Behavior Awareness and Destigmatization

The media plays a crucial role in shaping intercultural and global health by influencing public perception, spreading information, and driving policy decisions. Through news coverage, advertising, and social media, the media can raise awareness about health crises, and promote preventative measures throughout the world.

However, the media can also contribute to misinformation, reinforce stereotypes, and create biases in health narratives, which may lead to mistrust in healthcare systems.

AI MISINFORMATION

Spencer Gregar-Skillman - BSPS/PharmD Student What WhatisisArtificial Artificial Intelligence?

Intelligence?

Artificial intelligence to Artificial intelligence refers torefers computers computers capable ofreasoning learning inand capable of learning and waysreasoning that are representative of are human in ways that intelligence.

Generative AI a subset of representative ofishuman artificial intelligence that can create intelligence.

Generative AI isand a produce its own information based on subset of artificial intelligence that the data it has been trained on.

can create and produce its own information based on the data it has been trained on.

Who Does This Affect?

AI is a tool that is becoming more and more prevalent in everyday life. Most people have used AI especially when looking on google. Many patients look up information about medications which could lead to the wrong information getting shared.

Where Do We Go From Here?

While AI has its flaws from hallucinations and getting information from unreliable sources, there is a huge potential upside for regulated medical information to be explained and easily accessible to patients. I believe AI being trained from reliable sources could help solve some of these issues.

Medical Misinformation Since AI is a mostly automated process, based on where data and information is derived from, it can lead to the spread of misinformation. For example, a patient could ask a question and get information from an unreliable source, which could lead to worse medical outcomes. This is something that has the potential to be dangerous to patients if the wrong information is given.

What do I think?

“Artificial intelligence is a powerful tool for summarizing information, but there are clear limitations. I feel there is a lot more to be done before AI can be used for any sort of medical information purposes and this would be many years into the future.”

S. Gregar-Skillman

Media Impact, Spring 2025

References 1. What Is Artificial Intelligence (AI)? Google Cloud. Accessed April 3, 2025. https://cloud.google.com/learn/what-is-artificial-intelligence 2. Monteith S, Glenn T, Geddes JR, Whybrow PC, Achtyes E, Bauer M. Artificial intelligence and increasing misinformation. Br J Psychiatry. 2024;224(2):33-35. doi:10.1192/bjp.2023.136

CYBER BULLYING Connor Arick - BSPS Student

Media Impact on new method to bullying The emergence of social media and its various platforms has become the most common vehicle for cyberbullying and catfishing victimization and perpetration. About half of American teenagers have experienced cyberbullying and numerous studies have shown that victims of cyberbullying develop psychiatric and psychosomatic disorders including low self-esteem, academic prpblems, violent behaviors towards oneself or others, and suicidal ideations, creating a global health issue

Who’s affected?

Cyberbullying and Catfishing pertains mostly to the young adult population. However, anyone and everyone can be susceptible to cyberbullying and the negative effects associated with perpetration.

What do you think?

“I personally believe that stronger efforts to educate youth on what cyberbullying and how the ‘digital footprint’ can impact more than just yourself in the long run - no one likes a bully and do not be afraid to report the perpetrator!”

C. Arick

What can be done?

Efforts have been made by social media platforms to detect phrases and punctuation that may be flagged as cyberbullying.

Bystanders can also partake in reporting and blocking the perpetrator and take a stand against the perpetrator

Cyberbullying

Statistics: About half of American teenagers have experienced some form of cyberbullying, and 10-20% of victims are involved in repeated cyberbullying events. A study involving 439 college students provided data that claims that of these students, 38% knew someone that had been cyberbullied, 21.9% had been victims of cyberbullying, and 8.6% admitted to cyberbullying perpetration.

Media Impact, Spring 2025

References 1. Ademiluyi A, Li C, Park A. Implications and Preventions of Cyberbullying and Social Exclusion in Social Media: Systematic Review. JMIR Formative Research. 2022;6(1). doi:https://doi.org/10.2196/30286 2. Giumetti GW, Kowalski RM. Cyberbullying via Social Media and Well-Being. Current Opinion in Psychology. 2022;45(45). doi:https://doi.org/10.1016/j.copsyc.2022.101314 3. Whittaker E, Kowalski RM. Cyberbullying via Social Media. Journal of School Violence. 2014;14(1):11-29. doi:https://doi.org/10.1080/15388220.2014.949377 4. Van Bruwaene D, Huang Q, Inkpen D. A multi-platform dataset for detecting cyberbullying in social media. Language Resources and Evaluation. 2020;54(4):851-874. doi:https://doi.org/10.1007/s10579-020-09488-3 5. Johnson L, Haralson A, Batts S, et al. Cyberbullying on Social Media among College Students. https://www.monroecti.org/cms/lib/PA03000492/Centricity/Domain/143/cyberbullying.pdf

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MARKETING ELLIE KORTY - BSPS STUDENT

Media Influence In the United States, there is controversy surrounding the marketing and advertising of various products that can have negative impacts on people’s health. Some of these products include pharmaceuticals, alcohol, tobacco, and unhealthy/fast food. The marketing tactics utilized when advertising these products can capitalize on young and vulnerable audiences. The media plays a key role in shaping public perception of these products, sometimes amplifying the benefits while not adequately addressing side effects or conflicts of interest. w w w.c

Intercultural Issue This is predominantly an intercultural issue within the United States. While other countries may have similar problems, many have made efforts to limit marketing of pharmaceuticals, alcohol, and tobacco. Pharmaceutical direct-to-consumer advertising is only legal in the US and New Zealand.

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Who’s Affected?

Alcohol and tobacco ads can disproportionately influence younger audiences, contributing to early initiation of use. Direct-to-consumer pharmaceutical ads can lead to both positive and negative outcomes. Pharmaceutical ads can pressure doctors to prescribe certain medications, sometimes leading to inappropriate or excessive prescribing.

Efforts and Solutions There are quite a few regulations in place to oversee the advertisement of such products. Tobacco advertising is limited to no TV or radio ads, no misleading terms, mandatory health warnings on all ads and packaging, and no brand sponsorship in sporting or entertainment events. Alcohol advertising must not target minors or depict underage drinking and must not promote excessive consumption or imply health benefits. Pharmaceutical advertising must be truthful and balanced, showing both benefits and risks, and cannot be misleading or omit important safety information.

Personal Opinion “The United States does a pretty good job of limiting advertisements of tobacco and alcohol products. However, the glamorization of these products in the media by influencers can still be very corrupting to vulnerable audiences.

As for the advertisement of pharmaceuticals, I believe that the United States should ban DTC advertising and only market to healthcare professionals.” - E. Korty Media Impact, Spring 2025

References 1. So BK, Kim PY. Understanding Prescription Drug Advertising. StatPearls. 2024.

2. Giesbrecht N, Reisdorfer E, Shield K. The impacts of alcohol marketing and advertising, and the alcohol industry's views on marketing regulations: Systematic reviews of systematic reviews. Drug Alcohol Rev. 2024;43(6):1402-1425. doi: 10.1111/dar.13881.

3. Wellman RJ, Sugarman DB, DiFranza JR, Winickoff JP. The Extent to Which Tobacco Marketing and Tobacco Use in Films Contribute to Children's Use of Tobacco: A Meta-analysis. Arch Pediatr Adolesc Med. 2006;160(12)1285-1296. doi:10.1001/archpedi.160.12.1285.

PROMOTION OF UNHEALTHY BEHAVIOR TEJASWI YARRAM - BSPS STUDENT

Media Influence on Health Media glamorizes harmful behaviors—smoking, drinking, drug use, fast food, extreme dieting, and hustle culture—without addressing long-term health consequences. Theories like Social Learning and Cultivation explain how repeated exposure shapes behavior, increasing risks of chronic illness and addiction.

Who’s Affected?

Youth are especially vulnerable—media exposure triples their likelihood of smoking (CDC). Public health systems face growing burdens, and mediadriven norms reinforce acceptance of unhealthy behaviors.

www.canva.com

Global Reach, U.S Focus Though a global issue, this analysis centers on the U.S. Hollywood influences global smoking trends, while Western dietary trends contribute to rising obesity. Despite strict regulations in some countries, globalization and digital media continue to spread these harmful portrayals.

Efforts & Solutions Countries like the UK and Australia restrict youth-targeted ads. Media literacy programs build awareness, and corporate accountability pushes platforms to reduce harmful promotions.

“I don’t think social media itself is the issue-it’s the influencers who shape narratives and people who blindly follow them, forgetting the importance of thinking for themselves. “ - TYarram www.canva.com

Media Impact, Spring 2025

References Bocci Benucci S, Fioravanti G, Silvestro V, et al. The Impact of Following Instagram Influencers on Women's Body Dissatisfaction and Eating Disorder Symptoms. Nutrients. 2024;16(16):2730. Published 2024 Aug 16. doi:10.3390/nu16162730 Pedalino F, Camerini AL. Instagram Use and Body Dissatisfaction: The Mediating Role of Upward Social Comparison with Peers and Influencers among Young Females. Int J Environ Res Public Health. 2022;19(3):1543. Published 2022 Jan 29. doi:10.3390/ijerph19031543

AWARENESS AND DESTIGMATIZATION

KAROLYN PINEIRO - BSPS STUDENT

The general media, as well as social media, have greatly contributed to the increase in awareness and destigmatization of many conditions. A very high number of people use social media as a way to get healthcare news or connect with others with the same condition, with 80% of cancer patients finding peers on social media, and more than 80% of US health departments have social media accounts.

“The improvements in support, awareness, and destigmatization of mental and physical health conditions would not have been possible without efforts from the media.”

-K. Pineiro

AWARENESS

Peer support and research for rare diseases have been better than ever due to social media. Awareness of these diseases can be spread easily, and it is easier to find peer support. Healthcare professionals also benefit, as they can monitor patients' needs/symptoms, recruit patients for clinical trials/research, and get an overall view of symptoms associated with diseases

DESTIGMATIZATION

Information regarding mental and physical health issues is more widespread and readily available to the public, due to the media. Desensitization begins when accurate information is accessible.

Promotion of social groups, hotline numbers, and other resources all contribute to the destigmatization of some conditions.

One example is the HIV/AIDS epidemic, where in the 1980s, people thought it was spread through casual contact and targeted specific marginalized groups. Now we know that this was all misinformation, and the disease does not carry as much stigma.

Media Impact, Spring 2025 References 1.Chen J, Wang Y. Social media usage for health purposes: Systematic review. Journal of Medical Internet Research. 2021;23(5). doi:https://doi.org/10.2196/17917 2.Miller EG, Woodward AL, Flinchum G, Young JL, Tabor HK, Halley MC. Opportunities and pitfalls of social media research in rare genetic diseases: a systematic review. Genetics in Medicine. 2021;23(12):2250-2259. doi:https://doi.org/10.1038/s41436-021-01273-z 3. NAMI. How Social Media Is Changing the Way We Think About Mental Illness. NAMI. Published June 25, 2021. https://www.nami.org/media-and-pop-culture/howsocial-media-is-changing-the-way-we-think-about-mental-illness/ 4.Images: www.canva.com

SPRING 2025

GOVERNMENTAL & NON-GOVERNMENTAL ORGANIZATIONS ARI ARZUMANIAN KRISSY AUSTIN ASH HALLISSEY SKYLER KREUNEN JOSHUA RANDALL JENNA YEAGER

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OVERVIEW

We wanted to explore various organizations and agencies that are important in helping out individuals living in America.

Within this monograph, we focus on how new and existing policies affect these organizations, and integrate our personal opinions into our subtopics.

TABLE OF CONTENTS Overview

1

Topic

2

The World Health Organization - Skyler Kreunen

3

Planned Parenthood - Jenna Yeager

4

The Federal Emergency Management Agency - Ash Hallissey

5

The National Institute of Health - Ari Arzumanian

6

Direct Relief - Krissy Austin

7

The Center for Disease Control and Prevention - Joshua Randall

8

GOVERNMENTAL & NON-GOVERNMENTAL ORGANIZATIONS - SPRING 2025

THE WORLD HEALTH ORGANIZATION - FUNCTION AND POLICY

In 2020 Trump attempted to cut funding and end membership – this was reversed by Biden in 2021

Skyler Kreunen - BSPS Student

before the decision went into effect. In January 2025 Trump signed an executive order withdrawing the US from the WHO – this order, which takes 12 months to

The World Health Organization is an international intergovernmental organization composed of member states. It detects global health threats, sets guidelines and standards, provides healthcare worldwide and assists with humanitarian response.

This subtopic and the function of the WHO is a global issue, considering that it gets its funding from all over the world and also ensures resources and healthcare is accessible worldwide. However, since the US is the largest financial contributor and there

divest from financial commitments, will take away 1215% of the WHO’s funding, leading to fewer jobs and less ability to perform the WHO’s functions. This includes future pandemic surveillance, which has been a concern with rising bird flu cases in the US. The WHO’s response to COVID was cited as a reason for withdrawal (hoarding of vaccines) because of distrust of the way the organization operates in large crises. The US should rejoin the WHO or negotiate a better funding solution since it is such a large contributor. Most contributions by the US are voluntary and not “membership dues”.

have been recent policy shifts concerning the WHO, it has become an intercultural issue within the US. Low-income and developing countries are most directly affected by the efforts (especially humanitarian) of the organization, for example countries facing health crises. A large-scale example would be during COVID, the WHO was responsible for creating worldwide safety guidelines and declaring states of emergency: a pandemic and the WHO’s intervention affected everyone.

Significant US contributions have included polio eradication and maternal health.

OPINION: THE US SHOULD REJOIN THE WHO, ISOLATION IS NOT THE ANSWER ON THE HEELS OF A PANDEMIC. ~S. KREUNEN

GROUP 2 MONOGRAPH, 2025| PAGE 3 Public Health on Call. The Consequences of the U.S.’s Withdrawal from the WHO. Johns Hopkins Bloomberg School of Public Health. Published January 30, 2025. https:// publichealth.jhu.edu/2025/the-consequences-of-the-us-withdrawal-from-the-who 2. Richter F. Infographic: The U.S. Is the Largest Contributor to the WHO. Statista Daily Data. Published January 21, 2025. https://www.statista.com/chart/33800/top-contributors-to-the-worldhealth-organization‌‌

1.

GOVERNMENTAL & NON-GOVERNMENTAL ORGANIZATIONS - SPRING 2025

PLANNED PARENTHOOD OF AMERICA Jenna Yeager - BSPS and Biochemistry Student BACKGROUND Planned Parenthood of America (PP) is an NGO providing reproductive health care and education services. PP provided 9.13 million services in 2023: 4.6 million STI testing and treatment, 2.25 million birth control, and 500,000 cancer screening and prevention, and 392,715 abortions. PP plays an active role in preventing, detecting, and treating the U.S.’s annual 20 million STIs and 2 million cancer cases. Abortion, a hot topic in media and politiics, has

Planned Parenthood is more likely to service higher volumes of clients than health departments and federally qualified health centers.

been legislated for almost 100 years. Policies affect PP’s services to communities- especially important as more than half of PP centers are in underserved areas. Policy affecting PP to provide reproductive health care and education services is an intercultural issue for the United States, as legislation by the U.S. government primarily enacts

CALLS TO ACTION AND TEMPORARY SOLUTIONS Planned Parenthood may opt to create two different organizations, one which serves its reproductive, education,

legislation affecting the American operating branch.

and family health services, and another, its abortion related

POLICIES AND COURT CASES AFFECTING OPERATIONS OF PLANNED PARENTHOOD

services could keep federal funding aboard. The U.S. must

The “End Taxpayer Funding for Abortion Providers Act”, introduced

reproductive healthcare service demand, especially for low-

into Congress 1/16/2025, would prohibit Federal funding of PP and

income patients. As PP has 2.7 million annual patients,

all entities providing abortions in cases other than rape, incest, or

displacement will cause major strain on healthcare clinics,

life endangerment- a step up from the Hyde Amendment of 1976

hospitals, and physicians' offices.

which asserts Federal funds can only be used for abortion in the

services. Explicit separation of abortion by PP from its other prepare current healthcare facilities for increased

PERSONAL OPINION

cases above. States regulate abortion access through Title X, which provides funding to low-income patients for family planning and

If Planned Parenthood is incorrectly using

reproductive services like STD testing, birth control, abortions, and

Federal funds, prosecution is called for. Opinion

cancer screening. Medina v. Planned Parenthood South Atlantic

on abortion is affecting access to services that

questions if Medicaid recipients have the right to choose their

directly prevent abortion. Education,

preferred provider at an organization that provides abortions,

preventative services, and contraceptives are

examining whether PP can accept Federal dollars for non-abortion-

critical in reducing abortions- taking away bodily

related services.

autonomy will damage progress made on

WORKS CITED

women's rights and cause retaliation and

HOWE A. SUPREME COURT HEARS DISPUTE OVER SOUTH CAROLINA’S BID TO DEFUND PLANNED PARENTHOOD. SCOTUSBLOG. APRIL 2, 2025. ACCESSED APRIL 6, 2025. HT TPS://WWW.SCOTUSBLOG.COM/2025/04/SUPREME-COURTHEARS-DISPUTE-OVER-SOUTH-CAROLINAS-BID-TO-DEFUND-PLANNED-PARENTHOOD/.

PLANNED PARENTHOOD. ANNUAL REPORT 2022-2033. PLANNED PARENTHOOD FEDERATION OF AMERICA INC. HT TPS://WWW.PLANNEDPARENTHOOD.ORG/UPLOADS/FILER_PUBLIC/CE/F6/CEF6EFDB-919A-4211-BB5CCE0D61FDA7F5/2024-PPFA-ANNUALREPORT-C3-DIGITAL.PDF PLANNED PARENTHOOD ACTION FUND. NEW REPORT SHOWS COMUNIT Y HEALTH CENTERS CANNOT REPLACE PLANNED PARENTHOOD. PLANNED PARENTHOOD FEDERATION OF AMERICA INC. HT TPS://WWW.PLANNEDPARENTHOODACTION.ORG/BLOG/NEW-REPORT-SHOWS-COMMUNIT Y-HEALTH-CENTERSCANNOT-REPLACE-PLANNED-PARENTHOOD SILVER D, KAPADIA F. PLANNED PARENTHOOD IS HEALTH CARE, AND HEALTH CARE MUST DEFEND IT: A CALL TO ACTION. AM J PUBLIC HEALTH. 2017;107(7):1040-1041. DOI:10.2105/AJPH.2017.303867 VANDEVUSSE A, MUELLER J, KIRSTEIN M, CASTILLO PW, KAVANAUGH ML. THE IMPACT OF POLICY CHANGES FROM THE PERSPECTIVE OF PROVIDERS OF FAMILY PLANNING CARE IN THE US: RESULTS FROM A QUALITATIVE STUDY. SEX REPROD HEALTH MAT TERS. 2022;30(1):2089322. DOI:10.1080/26410397.2022.2089322 KINSEY HASSTEDT. UNDERSTANDING PLANNED PARENTHOOD’S CRITICAL ROLE IN THE NATION’S FAMILY PLANNING SAFET Y NET. GUT TMACHER. 2017. ACCESSED APRIL 28, 2025.

HT TPS://WWW.GUT TMACHER.ORG/GPR/2017/01/UNDERSTANDING-PLANNED-PARENTHOODS-CRITICAL-ROLE-NATIONSFAMILY-PLANNING-SAFET Y-NET

polarization. ~ J. Yeager

GROUP 2 MONOGRAPH | PAGE 4

GOVERNMENTAL & NON-GOVERNMENTAL ORGANIZATIONS - SPRING 2025

THE FEDERAL EMERGENCY MANAGEMENT AGENCY Ash Hallissey - BSPS Student

What is FEMA, and how does it function as a governmental organization?

FEMA is a governmental agency under the Department of Homeland Security. It was established in 1979 by Jimmy Carter with an overarching mission

FEMA AND LA COUNT Y FIREFIGHTERS IN ALTADENA, CA IN JANUARY ROLLINGSTONE.COM

of helping people before, during, and after disasters.

Types of Grants Available for Pre- and

Release of the New 4 Year Strategic Plan

Post-Emergency Projects

(2022-2026)

Preparedness: Supports citizens and first responders

Goal 1: Instill equity among underrepresented communities that experience differences in

to sustain, improve, and mitigate disasters Hazard Mitigation Assistance: Sustainable action reducing long-term risk to people/property from

preparedness, as well as how quick their communities

future disasters

resume to their social and economic life after natural

Shelter and Services Program: Provides funds to

disasters.

non-federal entities to noncitizen migrants who

Goal 2: Promote climate resilience and literacy to

await immigration proceedings

ensure communities are in a better position to take

Emergency Food & Shelter Program: Supplements

steps to build resilience within their environment.

and expands services to individuals who experience,

Goal 3: Promote and sustain a prepared nation, especially as natural disasters are becoming more frequent, severe, and complex. Efforts are lead to advance the profession by providing comprehensive

or at risk of experiencing, hunger and/or homelessness Next Generation Warning System: Supports investments that improve security of public broadcasting networks and systems

training.

Trump has signed an executive order

Opinion: I believe that FEMA may need some restructuring, which is expected as most organizations need to adapt to

establishing the FEMA review council to assess

the current state of the U.S. politics and climate change.

and recommend improvements to the

Though, it is an important organization that is essential for

operations. This raises concerns about the efficacy, priorities, and competence in disaster response and political bias/mission drift.

pre- and post-emergency assistance for the individuals that reside in the U.S. ~ A.Hallissey 1. FEMA RELEASES NEW STRATEGIC PLAN. FEMA.GOV. ACCESSED FEBRUARY 19, 2025.

HT TPS://WWW.FEMA.GOV/PRESS-RELEASE/20211209/FEMA-RELEASES-NEW-STRATEGIC-PLAN. 2. U.S. DISASTER RELIEF AT HOME AND ABROAD. COUNCIL ON FOREIGN RELATIONS. ACCESSED FEBRUARY 19, 2025. HT TPS://WWW.CFR.ORG/BACKGROUNDER/US-DISASTER-RELIEF-HOME-AND-ABROAD.

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GOVERNMENTAL & NON-GOVERNMENTAL ORGANIZATIONS - SPRING 2025

THE NATIONAL INSTITUTE OF HEALTH (NIH) Ari Arzumanian - BSPS Student

The Trump administration has proposed reductions of up to 15% (roughly $5 billion) from the NIH’s annual budget. Universities, hospitals, and NGO’s are at risk of

The National Institute of Health (NIH) is the primary losing essential grant support. New evidence has agency under the U.S. Department of Health and suggested that more than 2,000 new/existing grants Human Services. It devotes its resources and

may be delayed or cut entirely. This directly impacts

personel to biomedical and public health research.

thousands of scientists and research staff. In response

Through grants, the NIH funds research across

to these proposals, lawmakers and advocacy groups

universities, hospitals, and NGOs which impact both have sprung into action expressing fear that these cuts will set medical innovation in areas such as cancer, domestic and global health. Because the NIH is federally funded its priorities often change with new heart disease, and infectious disease back decades. presidential administrations. Under President Trump there have been concerns about budget and structural changes within the NIH. Area of Funding

Amount ($)

Universities, Medical Schools, Other.

48 Billion USD in 2024 fiscal year

HTTPS://THECONVERSATION.COM/NIH-FUNDING-CUTS-WILL-HIT-REDSTATES-RURAL-AREAS-AND-UNDERSERVED-COMMUNITIES-THEHARDEST-250592

Text 3

Dr. Jay Bhattacharya’s (recently appointed) support for

TRUMP’S NIH OBJECTIVES

these cuts emphasize the administrations goal to align

ALIGN NIH PROJECTS WITH ‘AMERICA FIRST’

NIH activity with national interests. However, this

AGENDA

approach to funding alongside deep cuts/firings have

REVIEW/REDUCE FUNDING FOR NIH

triggered major concerns in the scientific community.

INITIATIVES THAT DON’T FIT ADMINISTRATION’S PRIORITIES

The hope is that America will maintain it’s ability to stay

RESTRICT CERTAIN RESEARCH AREAS

on top of global research efforts and continue to make

(REPRODUCTIVE HEALTH, GENDER-RELATED

progress against chronic disease.

STUDIES) RESTORE PUBLIC TRUST IN RESEARCH BY ENCOURAGING DIVERSE PERSPECTIVES STREAMLINE ADMINISTRATIVE PROCESS BY DIRECTING FUNDING TOWARD ‘HIGHIMPACT’ MEDICAL RESEARCH

OPINION: WHILE IT IS REASONABLE TO ADJUST FUNDING TO ALIGN WITH THE ADMINISTRATIONS GOALS, PRESIDENT TRUMP’S APPROACH MAY BE TOO ABRUPT. - A. ARZUMANIAN

GROUP 2 MONOGRAPH| PAGE 6 1. National Institutes of Health. About NIH. National Institutes of Health (NIH). Published 2019. https://www.nih.gov/about-nih 2. Haney T. What National Institutes of Health funding cuts could mean for U.S. universities. NPR. Published February 12, 2025. https://www.npr.org/2025/02/12/nx-s1-5292359/what-cuts-to-nih-funding- could-mean-for-american-universities 3. Stein R. NIH funding freeze stalls applications on $1.5 billion in medical research funds. NPR. Published February 22, 2025. https://www.npr.org/sections/shots-health-news/2025/02/22/nx-s1-5305276/trump-nih-funding-freeze-medical-research

GOVERNMENTAL & NON-GOVERNMENTAL ORGANIZATIONS - SPRING 2025

DIRECT RELIEF Krissy Austin - BSPS Student 100% of Direct Relief’s funding goes toward the services they provide. They donate medications and supplies to

Direct Relief is a nonprofit organization that provides immediate assistance in emergency situations within healthcare, earthquakes, hurricanes, etc. They provide healthcare professionals in poor communities. Every is

health care professionals and centers around the world who need them to provide the best care possible for their patients. Emergency medical kits are sent out ASAP after natural disasters. Midwife kits have been sent to hospitals in Nepal, Sierra Leone, and Somaliland. Medical care and hygiene resources are

provided with the same care no matter of income,

provided for refugees. In 2018, Direct Relief aided

religion, or politics.

health centers with installing solar power incase of

Direct Relief deals with a global issue. It is active in

power outages. In 2010, they donated $57 million worth

every state in America plus more than 80 other

of medical assistance after an earthquake in Haiti. They

countries. Emergencies, natural disasters, and poor

supported firemen with “advancing firefighter

communities are an issue all over the world. Direct

technology” in 2019 after Australia bushfires.

Relief is considered an NGO because 100% of their funds come from charity and donations.

Who’s affected?

Low-income areas rural areas areas prone to natural disasters healthcare workers in these areas

HT TPS://WWW.DIRECTRELIEF.ORG/?

GAD_SOURCE=1&GCLID=CJWKCAJWZMI_BHACEIWAX4YZUKWMKGPSVXLP3Y YZHI0IPKTO59GAG-5N2ODCOVXKVVPRGQSGJSFZXOC8EYQAVD_BWE

uninsured patients mothers and children OPINION: DIRECT RELIEF IS A CONSTISTENTLY EFFECTIVE HUMANITARIAN ORGANIZATION. ~K. AUSTIN

GROUP 2 MONOGRAPH| PAGE 7 1.

2.

Direct Relief. Direct Relief: Response, Aid, and Support. North America Outlook Magazine. https://www.northamericaoutlookmag.com/healthcare/direct-relief-response-aid-and-support.

Accessed April 6, 2025.

Direct Relief. Direct Relief: Medical Aid Where It’s Needed Most. https://www.directrelief.org/?gad_source=1&gclid=CjwKCAjwzMi_BhACEiwAX4YZUKwMkgPsVXLp3yYZhi0IpkTO59GaG-5N2odcoVxkVvprgQsGjSFZxoC8EYQAvD_BwE. Accessed April 6, 2025.

GOVERNMENTAL & NON-GOVERNMENTAL ORGANIZATIONS - SPRING 2025

CENTERS FOR DISEASE CONTROL AND PREVENTION Joshua Randall - BSPS Student The CDC is an government organization that duty’s is to “To protect America from health, safety and security threats, both foreign and in the U.S” (“About CDC”). Though how they are able to do this and how well they are able to, is dependent on Public Policy.

Because the CDC is a government institution/organization it is heavily affected by public policy of the U.S Government.

For it has to answer and follow any laws pass by Congress but also follow any executive decisions made by the current administration. An example of this is the Trump administration’s halt on the CDC’s research and data on Bird Maxmen A. Trump administration’s halt of CDC’s Flu. weekly scientif ic report stalls bird flu studies. CNN. Though the CDC’s actions mainly concern the American Published January 30, 2025. https://www.cnn.com/2025/01/30/health/bird-flu- public, the data and information they gather is useful to the mmwr-pause-trump-kff-partner/index.html entire world. Like the amount of people who get fluoridated

water in different states, can be use by other scientist to see the impact of fluoridated water abilities to prevent teeth diseases.

With how the CDC covers a broad number of diseases, and how much data and information is gather by it that can be useful to other scientist. Any change in public policy regarding the CDC have great consequences good or bad. This is extremely true when it comes to the CDC’s National Health Initiatives, Strategies & Action Plans, or I.S.APs which are supposed to help inform the public of different risk and give money to different local governments to help prevent or reduce risk So when making public policy that affects the CDC, one should debate and argue over the benefits and negatives that it may bring.

Opinion Section The CDC is a well establish government agency that should not have any partisan policy forced upon it. And recently there have been more and more attempts to do so that have made the American public suffer, like the Bird Flu stop. ~J. Randall

Centers for Disease Control and Prevention. “Data.”

Data.CDC.gov, 2018, data.cdc.gov/.

GROUP 2 MONOGRAH | PAGE 8

US EPA O. Federal Action Plan to Reduce Childhood Lead Exposure. www.epa.gov. Published December 18, 2018. https:// www.epa.gov/lead/federal-action-plan-reduce-childhood-lead-exposure Centers for Disease Control and Prevention. “About CDC.” Centers for Disease Control and Prevention, 2022, www.cdc.gov/about/index.html.

Geriatrics Geriatrics are a category of patients aged 65 and above.1 With life expectancy increasing in many areas across the globe, the geriatric population is increasing rapidly. As geriatrics begin to compose a larger and larger portion of patients, more and more resources begin to be devoted to their care. This monograph includes information on a wide variety of issues the geriatric population faces in this day and age.

Table of Contents: 1. Hospital Acquired Infections (HAIs) in Long-Term Care Facilities: A. Bennett 2. Geriatric Loneliness in Long-Term Care: A. Brock 3. Geriatric Cognitive Health: E. Caldwell 4. Malnutrition in the Geriatric Population: A. Frias 5. Geriatric Physical and Occupational Therapy: V. Saca 6. Diabetes in Geriatrics: S. Hartman

Created in BioRender. Bennett, A (2025)

1. Sieber C. The elderly patient--who is that?. Der ältere Patient--wer ist das?. 2007;48(11):1190, 1192-4. Die Innere Medizin. doi: 10.1007/ s00108-007-1945-3

Geriatrics, Spring 2025

Hospital Acquired Infections (HAIs) in Long-Term Care Facilities Background

“Frail elderly residents in long-term care facilities (LTCFs) are especially at risk of acquiring health careassociated infections (HAIs) due to their dependence on care, sharing of facilities with other residents and living in a confined environment.”

There has been an overall increase in infections via long term care facilities (LTC) where in 2023 it was 0.98 infections per 1,000 resident days, which represents a 11.4% increase from 2022.

Specific treatments that involve catheters (drainage tubes) can cause urinary tract infections and central line-associated bloodstream infections, ventilation mechanical breathing which may cause pneumonia, injections or surgery are all major risk factors.

How is this a global issue

The need for an action plan for HAIs is crucial in terms of preventing the spread of infections and diseases. All hospitals, no matter the country, should abide by certain sanitary precautions to prevent the elderly from contracting an infection from a long-term care facility.

Target Audience

This subtopic predominantly affects the elderly population, as a lot of geriatrics are enrolled in LTC facilities. In addition, the elderly population has a weaker immune system than younger healthier adults, and leads them to being more susceptible to infection.

Solution

Patient on ventilator Created in BioRender. Bennett, A (2025)

As for an HAI action plan, goals and tasks envisioned for an interagency work group can be incorporated in the Patient Safety Working Groups (PSWGs) operations: Provides guidance to enable the integration of HAI data from multiple HHS databases for the purpose of benchmarking progress in reducing HAIs, mobilize health information systems to help reinforce recommended clinical practices for ensuring patient safety and seek strategic opportunities to make varied federal data systems interoperable to enhance understanding of HAIs.

PSWGs: Coordinated by the Agency for Healthcare Research and Quality (AHRQ), serves as a key forum for federal partners to identify and initiate collaborations aimed at integrating HAI monitoring and measurement systems.

Personal Opinion

Central Venus Catheter Created in BioRender. Bennett, A (2025)

References

By abiding by certain sterile standards, the amount of HAIs can be reduced. Performing invasive procedures on elderly patients provides a greater risk of infection due to the weak immunity of the patient. This is also true for invasive treatments that allow pathogens and other bacteria to enter the body. The purpose of PSWGs operations is to track the spread of HAI as well as to educate about the spread and should overall be enforced by all LTC facilities in order to protect their patients.

1. Skilled Nursing Facility Healthcare-Associated Infections Requiring Hospitalization for the Skilled Nursing Facility Quality Reporting Program. February 2021. Accessed April 1, 2025. https://www.cms.gov/files/document/snf-hai-technical-report.pdf.

2. Haenen APJ, Verhoef LP, Beckers A, et al. Surveillance of infections in long-term care facilities (ltcfs): The impact of participation during multiple years on health careassociated infection incidence. Epidemiology and infection. September 9, 2019. Accessed April 1, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC6805744/#:~:text=HAIs%20are%20defined%20as%20infections,infections%20%5B8%2C%209%5D. 3. Hai action plan part 3. National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination. April 2013. Accessed April 1, 2025. https://health.gov/sites/default/files/2019-09/hai-action-plan-acute-care-hospitals.PDF. 4. How to avoid nosocomial infections (healthcare-associated infections). Cleveland Clinic. March 19, 2025. Accessed April 1, 2025. https://my.clevelandclinic.org/health/diseases/16397-avoiding-healthcare-associated-infections-hais.

5. Kepner S, Bennett A, Jones R. Long-Term Care Healthcare-associated infections in 2023: An analysis of 23,970 reports: Published in Patient Safety. PATIENT SAFETY. April 22, 2024. Accessed April 1, 2025. https://patientsafetyj.com/article/116555-long-term-care-healthcare-associated-infections-in-2023-an-analysis-of-23-970-reports.

Geriatrics, Spring 2025

Geriatric Loneliness in Long-Term Care Loneliness is a psychological state a person enters when the quality of their social life fails to meet their expectations. As every person has different expectations regarding their social life, different things can make different people feel lonely. For example, someone who wants a wide and ever-changing web of connections may feel lonely if they only have a small handful of friends, even if someone else would enjoy having a tiny, tight-knit circle.

Despite the many different ways in which loneliness can be experienced, though, a worryingly large portion of geriatric patients in long-term care feel lonely. Nearly 40% of nursing home residents exhibit loneliness.1 These feelings can often be explained by the changes geriatrics face upon leaving their old lives to reside in long-term care. Factors promoting loneliness in long-term care include but are not limited to: the death or absence of a significant other, a lack of connection to family and friends, little engagement with or care from staff, and an inability to communicate meaningfully with others.2

https://www.consumeraffairs.com/health/elderlyloneliness-statistics.html

Loneliness in long-term care is an issue in Western society especially, as it is common for Western families to send geriatric relatives to nursing homes once they can no longer care for themselves, as multiple generations within one home (excluding children) is not the norm. Separating individuals from the lives they used to lead and leaving them in new environments often leads to mismatched social expectations and realities, leading to the loneliness observed in long-term care facilities.

Still, loneliness is more than a negative feeling; it often affects individuals’ behavior negatively. Lonely individuals can be less likely to take proper care of themselves, be it through poor eating, a lack of exercise, substance misuse, or other self-destructive behaviors, all of which decrease one’s quality of life. Some studies have even suggested a link between loneliness and cognitive decline, which is already a prevalent issue in geriatric populations.

The COVID-19 Pandemic also exacerbated feelings of loneliness in the elderly, and geriatric populations have not entirely recovered from this. Restrictions on visiting and increased usage of digital communications have altered the ways people socialize, including how they socialize with the elderly, relatives included. While some changes have been positive, others have been negative, and a majority of the elderly population claims to be more lonely after the pandemic than before.

As loneliness has the possibility of decreasing the quality of life of nursing home residents, it is important to take measures to lessen and/or prevent loneliness in these environments. Strengthening connections to earlier life, encouraging recreational pursuits, and creating new social networks are all productive ways to combat loneliness.3 There are already a plethora of methods placed and efforts made to reduce geriatric loneliness. For example, there are a variety of volunteer opportunities at nursing homes for teenagers and adults alike, giving residents a chance to meet new people and feel more involved with the world around them. Some nursing homes also put on events like bingo and arts and crafts, which occupy residents and sometimes provide common ground with others on which they can forge new relationships. There is also an increased use of technology that has come with changing times as a whole, which allows residents to keep in touch with far-away relatives and friends alike, though some people strongly prefer in-person contact.

Still, more can be done. While the current practices are useful and productive, increased efforts may show even better results. More volunteering, more events, and generally more consistent engagement of residents will make them feel even more involved with the world around them and hopefully less lonely. Better compensation for and treatment of nursing home staff may also prove beneficial, since nursing home staff may become more attentive to residents and leave residents feeling less bothersome or unwanted.

I believe that the culture surrounding nursing homes is one of the biggest roadblocks in reducing loneliness in the geriatric population.

Nursing homes should not be viewed as a fixture outside of the regular workings of society; its members should still be included as much as possible in the workings of real life and made to feel valued and appreciated as members of society. If a family chooses to put a relative in long-term care, I believe that the family should make every attempt possible to maintain connection with that relative and provide attention and care to make the relative feel less alone, because feeling like one still matters and is still loved is absolutely vital to their well-being. ~A Brock 1. Trybusińska D, Saracen A. Loneliness in the context of quality of life of nursing home residents. Open Medicine. 2019;14(1):354-361. doi:10.1515/ med-2019-0035 2. Jansson AH, Karisto A, Pitkälä KH. Listening to the voice of older people: dimensions of loneliness in long-term care facilities. Ageing & Society.

2023;43(12):2894-2911. doi:10.1017/S0144686X21001975 3. Naik P, Ueland VI. How elderly residents in nursing homes handle loneliness—from the nurses’ perspective. SAGE Open Nursing. 2020;6:1-12. doi:10.1177/2377960820980361

Geriatrics, Spring 2025

Geriatric Cognitive Health as an Intercultural and Global Issue Geriatric cognitive health is a critical issue that transcends cultural and national boundaries. Not understanding geriatric cognitive health can lead to numerous challenges for individuals and society. One major issue is the misdiagnosis or delayed treatment of cognitive disorders. Many people mistake normal aging for cognitive decline or fail to recognize serious conditions like dementia, which can prevent early intervention that could slow the progression of these diseases. In many cultures, elderly individuals are either cared for within family units or marginalized due to a lack of resources. Differences in healthcare access, social norms, and economic conditions shape how cognitive decline is perceived and managed. In developed nations, structured healthcare systems provide some support for cognitive disorders, whereas in developing regions, limited medical access and stigma surrounding mental health contribute to underdiagnosis and inadequate care.

Who is Affected

Cognitive health in older adults impacts individuals, families, healthcare systems. It diminishes quality of life, making everyday tasks more difficult and increasing dependence on caregivers. Family members often bear the emotional and financial burden of caring for a loved one with cognitive impairments, leading to stress, burnout, and financial strain. Caregivers may also lack proper training or resources to provide adequate support, resulting in poorer health outcomes for both the patient and the caregiver. Countries with aging populations, such as Japan and many European nations, are struggling to meet the demand for specialized care and long-term support services. In addition, cognitive decline increases vulnerability to financial scams, neglect, and elder abuse, issues that often go unnoticed due to a lack of awareness and advocacy.

What Has Been Done and What Can Be Improved Efforts to address geriatric cognitive health include global awareness campaigns, and medical advancements. Groups that are raising awareness for geriatric cognitive health and developing strategies to promote early diagnosis include the National Institute on Aging and The American Geriatrics Society.

Many countries have implemented dementia action plans, caregiver support, and investment in memory care facilities. Lifestyle modifications have been shown to play a crucial role in cognitive health preservation. Regular physical activity, balanced diets, cognitive training, and social engagement can reduce the risk of cognitive decline.

Personal Opinion

Creating an environment that supports cognitive well-being also involves making communities more age friendly. By raising awareness of brain health and proactive care, society can help the geriatric population maintain their cognitive abilities and overall quality of life. This includes reducing the stigma surrounding dementia in older adults. Healthcare providers should also integrate annual cognitive screenings into standard medical care, allowing for early detection and management of cognitive disorders. -E.Caldwell

References 1. CDC. Cognitive Health and Caregiving. Chronic Disease Indicators. Published February 3, 2025. Accessed April 1, 2025. https://www.cdc.gov/cdi/indicatordefinitions/cognitive-health-caregiving.html#cdc_data_surveillance_section_3-resources 2. Hale JM, Schneider DC, Mehta NK, Myrskylä M. Cognitive impairment in the U.S.: Lifetime risk, age at onset, and years impaired. SSM - Population Health.

2020;11(100577). doi:https://doi.org/10.1016/j.ssmph.2020.100577 3. NIHAging. National Institute on Aging. National Institute on Aging. Published 2019. https://www.nia.nih.gov 4. Center for Aging Research | IU School of Medicine. Iu.edu. Published 2025. Accessed April 1, 2025. https://medicine.iu.edu/internal-medicine/research/centers/aging 5. National Academies of Sciences E. Preventing Cognitive Decline and Dementia: A Way Forward.; 2017. https://nap.nationalacademies.org/catalog/24782/preventingcognitive-decline-and-dementia-a-way-forward

Geriatrics, Spring 2025

Malnutrition and it’s Relevance to the Geriatric Population Malnutrition can be defined as the imbalance of energy, protein, or nutrients that harms the body and it’s functions. There are several factors that can contribute to malnutrition. But specifically within the geriatric population, certain factors make them more susceptible to developing symptoms of malnutrition. With that being said, they are at a higher risk to malnutrition when compared to that of younger populations.

Factors may include: Tooth loss/poor dental health Loss of appetite or changes in taste Acute Illness Depression Lack of mobility Dementia Aging

Symptoms of malnutrition may include: Fatigue Muscle weakness Increased illness/infection

With all of this into consideration, there must be a way to target malnutrition within the geriatric population. Ways we can incorporate change is by: Adjusting the macronutrients and micronutrients within their diet to ensure that the patient has a balanced intake of nutrients that the body requires Inquire on what types of medications can decrease appetite Incorporate exercise into their daily routine to maintain and/or build muscle mass and physical health

Evans C. Malnutrition in the elderly: A multifactorial failure to thrive. The Permanente journal. 2005.

Accessed February 19, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC3396084/.

Malnutrition can be relevant to all types of populations. But why should we be concerned about specifically the geriatric population? Malnutrition can have several impacts on the geriatric population, including: An increase in mortality and morbidity Physical decline An increase in the development of geriatric syndromes (complex multifactorial conditions) Dementia Delirium (mental confusion characterized by a sudden onset of altered consciousness, cognitive impairment, and changes in behavior) Depression Sarcopenia (progressive loss of muscle mass, strength, and function)

Malnutrition: Definition, causes, symptoms & treatment. Cleveland Clinic. March 24, 2025. Accessed April 28, 2025. https://my.clevelandclinic.org/health/diseases/22987-malnutrition.

What actions are we taking to improve this rising issue?

Nutritional assessment and treatment should be a routine part of care for all elderly persons.

We need to incorporate more strategies to improve nutrition in elderly persons Changes in the funding of oral nutritional supplements This covers the idea on restricting funding to people who’re malnourished or who have one of a number of listed specific indications which places certain individuals at a higher risk of malnourishment Malnutrition Universal Screening Tool (MUST): clear treatment plans that are determined on the level of identified risk Oral nutritional supplements Enteral Feeding: feeding method using GI tract Parenteral nutrition: providing nutrition directly into the venous system

164,300+ elderly stock illustrations, royalty-free Vector Graphics & Clip Art. iStock.

Accessed April 28, 2025. https://www.istockphoto.com/illustrations/elderly.

My Professional Opinion on the Issue Prioritizing nutrition will overall benefit the geriatric population. This would potentially prolong life expectancy. A good majority of geriatrics lack support within the area of nutrition. Every situation is different and some individuals may not have support from family, may be living alone, or without a caretaker. So the responsibility of maintaining nutrition is solely on them. This can be difficult because they’re less likely to remember certain tasks, let alone know how to do certain things. So they need more support in terms of maintaining physical health overall. Which is why we need to encourage good nutrition and maintenance of top tier health.

Design F. Happy old people vector art, icons, and graphics for free download. Vecteezy. Accessed April 28, 2025. https://www.vecteezy.com/free-vector/happy-old-people.

Resources Malnutrition. Illinois Department on Aging. Accessed February 19, 2025. https://ilaging.illinois.gov/programs/nutrition/malnutrition.html.

Norman K, Haß U, Pirlich M. Malnutrition in older adults-recent advances and remaining challenges. Nutrients. August 12, 2021. Accessed February 19, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC8399049/.

Marian A.E. van Bokhorst-de van der Schueren a, a, b, et al. Prevalence and determinants for malnutrition in geriatric outpatients. Clinical Nutrition. May 17, 2013.

Accessed February 19, 2025. https://www.sciencedirect.com/science/article/pii/S0261561413001465.

Evans C. Malnutrition in the elderly: A multifactorial failure to thrive. The Permanente journal. 2005. Accessed February 19, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC3396084/.

Strategies to improve nutrition in elderly people. Strategies to improve nutrition in elderly people - Prescription foods. Accessed February 19, 2025. https://bpac.org.nz/bpj/2011/may/elderly.aspx#:~:text=The%20best%20option%20for%20treating,and%20protein%20meals%20and%20snacks.

Geriatrics, Spring 2025

Geriatric physical and occupational therapy Background Information: As people age, their bodies undergo a variety of changes that can significantly impact their strength and mobility.

These new physical limitations can impact their ability to perform daily tasks like walking, bending over, dressing, going up and down stairs and therefore they become less independent. This decline in physical ability can also cause difficulties in balance, coordination and reaction time, which significantly increases the risk for falls. Falls in the elderly population are a leading cause of injury and can cause very serious damage. Every year there are about 3 million emergency department visits and nearly 319,000 older people are hospitalized for hip fractures due to falling. falls are the most common cause of traumatic brain injuries (TBI). To address the physical challenges that come with aging, occupational therapy and physical therapy play vital roles in promoting safety, independence, and overall well-being among older adults.

Canva. (2025). Older adults [Graphic]. Canva. https://www.canva.com/

Personal opinion I believe occupational therapy and physical therapy are essential for the geriatric population because they help older adults maintain their independence and quality of life.

Physical Therapy Focuses on restoring and improving strength, balance, coordination, and flexibility. Therapists design personalized exercise programs to help elderly individuals regain or maintain mobility, reduce pain, and prevent falls. PT can also retrain movement patterns after injuries or surgeries, helping patients recover function and remain active in their daily lives.By identifying and addressing factors like uneven steps or irregular gait patterns, physical therapists help improve posture and stability, ultimately lowering the risk of falls.

Occupational Therapy Emphasizes helping individuals perform daily tasks more easily and safely. OTs assess how agerelated changes impact a person’s ability to carry out activities like dressing, cooking, or bathing.

They may recommend adaptive equipment, modify home environments, or teach new techniques to increase independence and reduce strain or risk of injury.

1. Centers for Disease Control and Prevention. (2023, September 6). Important facts about falls. CDC.https://www.cdc.gov/falls/data-research/facts-stats/index.html 2. Cleveland Clinic. (2023, December 20). Physical therapy. Cleveland Clinic.https://my.clevelandclinic.org/health/treatments/physical-therapy.

3. Cleveland Clinic. (2023, November 16). Occupational therapy. Cleveland Clinic.https://my.clevelandclinic.org/health/treatments/occupational-therapy 4. Shaker Place Rehabilitation & Nursing Center. (2023, June 22). Seniors and balance: How physical therapy prevents falls. Shaker Place. https://www.shakerplace.org/news/seniors-and-balance-how-physical-therapy-prevents-falls/

Geriatrics, Spring 2025

Diabetes in Geriatrics Diabetes is a growing public health concern worldwide, and geriatric populations are disproportionately affected. Type 2 diabetes is a chronic condition where the body either doesn’t use insulin properly or doesn’t make enough insulin. This causes high levels of sugar (glucose) to build up in the blood. As people age, their risk of developing type 2 diabetes increases due to factors such as decreased physical activity, loss of muscle mass, and increased insulin resistance. According to the Centers for Disease Control and Prevention (CDC), approximately 29.2% of adults aged 65 and older in the United States have diagnosed or undiagnosed diabetes. This prevalence is concerning, especially given that older adults may struggle with recognizing symptoms or adhering to complex treatment regimens.

Misconceptions about diabetes in older populations further complicate the issue. For example, some individuals believe diabetes is inevitable with age, while others may downplay symptoms like fatigue or increased thirst, attributing them to aging rather than a serious medical condition. This lack of awareness contributes to delayed diagnoses and poor health outcomes.

Why is type 2 diabetes so prevelant in older adults?

The primary population affected by this issue is older adults, particularly those in underserved or marginalized communities. Limited access to healthcare, language barriers, and cultural stigmas may prevent some geriatric patients from receiving proper treatment. Family caregivers are also impacted, as they often take on the responsibilities of managing medications, monitoring blood sugar, and ensuring dietary changes.

Healthcare systems also face strain from the increasing burden of diabetes in older adults. Hospital admissions, medication costs, and long-term complications such as cardiovascular disease, neuropathy, and kidney issues all contribute to the growing impact on public health resources.

Strategies for reducing incidence rates of type 2 diabetic adults

1. Education Campaigns: Programs like the American Diabetes Association's "Living Well with Diabetes" campaign provide resources specifically tailored to older adults. These programs emphasize symptom recognition, diet management, and medication adherence.

2. Community-Based Programs: Local health organizations and senior centers have developed culturally appropriate diabetes workshops to address language and literacy barriers.

3. Telemedicine Services: Telehealth programs have improved access to diabetes specialists for older adults in remote areas, especially following the COVID-19 pandemic.

4. Pharmacist-Led Interventions: Pharmacists are critical in educating patients about their medications, managing drug interactions, and promoting blood sugar monitoring.

Personal Opinion

In my opinion, addressing diabetes in geriatric populations requires a more targeted and compassionate approach. Older adults often face unique challenges in managing their health, so expanding culturally tailored diabetes education programs in community centers and care homes is essential. It’s also vital to increase access to screenings in convenient places like pharmacies, grocery stores, and local events where older adults are more likely to be present. Primary care visits should include regular conversations about diabetes to help with early detection and ongoing management. Additionally, involving family members in the care process can lead to better medication adherence and support for lifestyle changes.

-S. Hartman

“Type 1 Diabetes Mellitus: Symptoms, Treatment, Causes, Medications, Definition, Pathophysiology.” EZmed, EZmed, 17 Jan. 2025, www.ezmedlearning.com/blog/type-1diabetes-mellitus-symptoms-treatment.

Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine.

2010;40(2):218-227. doi:10.1007/s12160-010-9210-8 Trybusińska D, Saracen A. Loneliness in the context of quality of life of nursing home residents. Open Medicine. 2019;14(1):354-361. doi:10.1515/med2019-0035 Sutin AR, Stephan Y, Luchetti M, et al. Loneliness and risk of dementia. The Journals of Gerontology. 2018;75(7):1414-1422. https://doi.org/10.1093/geronb/gby112

Geriatrics, Spring 2025

Tackling Nutrition Through Global and Intercultural Understanding

By Joyce Yu, Logan Hess, Ely Blum, Max Liao, Reece Fromme, & Robert Seabold

Nutrition, Spring 2025

Ultra-Processed Foods and the Impact on Human Health By: Logan Hess, BSPS Undergraduate Abstract: Ultra-processed foods (UPFs) have become a dominant part of the modern diet, especially in developed countries such as the US, which is where this monograph will focus on.

These foods make up over half of the daily caloric intake of the average American.1 This monograph will dive deep into the classification of ultra-processed foods, how they’re made, trends, and associated health risks such as various cancers, cardiovascular diseases, and cognitive decline, and how they affect Americans of all ages.

Introduction: Ultra-processed foods are designed to be extremely palatable and ready to eat, in order to encourage consumers to buy more products. These products are high in refined sugar and unhealthy fats, while severely lacking fundamental nutrients such as vitamins and minerals.

They are made by extracting ingredients of food such as starches and oils, which strips away key nutrients, and combining them with others made in a laboratory such as emulsifiers, food dyes, and preservatives. The rapid rise in rate and amount of ultra-processed foods consumed worldwide has been a cause for public health concern due to their link with chronic conditions.

Classification: The NOVA food classification aims to group foods by their extent of processing, which can help consumers make informed decisions. Group 1 is defined as unprocessed or minimally processed foods; unprocessed foods are products obtained directly from plants or animals and undergo no alteration. Minimally processed foods have been subjected to cleaning, removal of unwanted parts, dividing, freezing, or anything else that may alter the original form of the food. Group 2 refers to processed culinary ingredients such as oils, sugars, and starches.

Group 3 is defined as processed foods, meaning additions of sugars, oils, or other substances to preserve the product or increase palatability. These foods are classified as versions of the original food. Finally, group 4 are ultra-processed foods which are industrial formulations containing substances extracted from foods (oils, fats, sugar, etc.) and ingredients made in a laboratory such as emulsifiers and color enhancers. Some examples include potato chips and cookies.2 Becoming familiar with this classification system will allow individuals to balance their diet more effectively and avoid health complications associated with overconsumption of ultra processed foods.

Consumption Patterns and Health Risks: A 2018 study determined that consumption of ultra-processed foods among US adults from 2001-2002 to 2017-2018 increased from 53.5% to 57% of daily total calories as well as the consumption of minimally processed foods decreasing from 32.7% to 27.4% of daily caloric intake.3 This poses a significant issue due to the link of ultra processed foods with health complications. As shown in figure 1, research has shown that diets containing a high quantity of ultra processed foods are linked to 30+ health conditions; Nutrition, Spring 2025

some of these include cardiovascular disease, mental health disorders, type 2 diabetes, and obesity. A study conducted over a span of 19 years shows that there is a 31% mortality increase for the highest consumers of ultra processed food versus the lowest consumers. These foods are the perfect combination to promote overconsumption as they are engineered to maximize appeal, high in calories, have little to no dietary fiber, and are stripped of other beneficial micro/macronutrients.

What should we do? : As this issue becomes more and more prevalent in the United States, it is time to employ strategies that can decrease the consumption of ultra processed foods. One potential strategy is to ban certain ingredients and techniques. For example, bleached flour helps to give the flour a whiter color, softer texture, and finer grain which enhances the look and feel. These bleaching agents such as chlorine gas and benzoyl peroxide are banned in the EU but are recognized as safe by the FDA.4 The issue with this strategy is that many individuals don’t believe the government should tell them what they can and cannot eat.

Another method is increased public education on the risks of these foods, although programs such as My Plate are already in use, this may not be enough.

While UP foods make up 57% of the typical American diet, this number is even higher in children, at 67%, as shown in figure 2 (Berg 2024). Starting with increased education at public schools may help to bring this number down and set children up for healthier Nutrition, Spring 2025

futures. Personally I believe this issue is so common but remains unaddressed and unacknowledged by so many. In my opinion, until higher intervention comes into play, conscious individuals should aim to shop at the perimeter of the grocery store (where less processed and natural food is) and be conscious of the nutrition label, opting for foods with less ingredients and higher amounts of protein and whole grains.

References 1. Monteiro CA, Cannon G, Levy RB, Moubarac J-C, Louzada ML, Rauber F, et al.

Ultra-processed foods: What they are and how to identify them [Internet]. U.S. National Library of Medicine; 2019 [cited 2025 Apr 6]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10260459/ 2. [Internet]. [cited 2025 Apr 6]. Available from: https://ecuphysicians.ecu.edu/wp-content/pv-uploads/sites/78/2021/07/NOVA-Classificati on-Reference-Sheet.pdf 3. Berg S. What doctors wish patients knew about Ultraprocessed Foods [Internet]. 2024 [cited 2025 Apr 6]. Available from: https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew -about-ultraprocessed-foods# 4. Minassian L. 12 banned foods Americans should stop eating [Internet]. 2025 [cited 2025 Apr 6]. Available from: https://foodrevolution.org/blog/banned-ingredients-in-other-countries/ 5. Time to inform the public about the adverse effects of ultra-processed foods, researchers say [Internet]. 2023 [cited 2025 Apr 6]. Available from: https://medicalxpress.com/news/2023-10-adverse-effects-ultra-processed-foods.html 6. LeDuc B. The sadness of ultra-processed foods [Internet]. 2024 [cited 2025 Apr 6].

Available from: https://islandhealth.org/the-sadness-of-ultra-processed-foods/

Nutrition, Spring 2025

Nutrition Strategies in Preventing IBD

By Ely Blum, BSPS Student Inflammation of the gastrointestinal tract is a hallmark of inflammatory bowel disease (IBD), a chronic illness that includes Crohn's disease and ulcerative colitis. A key factor in the therapy and prevention of IBD is nutrition. According to recent studies, some food patterns, particularly the Mediterranean diet, can help reduce inflammation, maintain a balanced gut flora, and protect the intestinal barrier. Although there is no treatment for IBD, these tactics can greatly lower its risk and severity, making diet a key weapon in the fight against the condition.

IBD is a widespread medical condition that is becoming more common in both developed and developing nations. There are significant cultural differences in dietary practices, and the adoption of Westernized diets that are heavy in processed foods and additives has been connected to an increase in the prevalence of IBD globally.

Millions of individuals worldwide suffer from IBD, with North America and Europe having the highest rates, while Asia, Africa, and South America are seeing a sharp rise in incidence. This chronic illness affects patients, their families, and healthcare systems.

Promoting the Mediterranean diet, consuming more fruits and vegetables high in fiber, opting for ancient grains rather than modern wheat, and including omega-3-rich fish and fermented foods are all ways to prevent IBD through nutrition. It's also crucial to avoid processed foods, trans fats, and dangerous additives.

To further reduce IBD risk, healthcare providers should integrate nutrition counseling into routine care, emphasizing evidence-based dietary patterns. Governments and organizations can support this by regulating food additives, subsidizing healthy foods, and funding research on diet-microbiome interactions.

As a BSPS student, I believe that nutrition should be recognized as a cornerstone in both the prevention and management of IBD. The evidence supporting dietary interventions, especially the Mediterranean diet and the exclusion of processed foods is compelling. However, these strategies must be adapted to fit diverse cultural contexts and individual needs.

E Blum Nutrition, Spring 2025

References: 1. Tralongo AC, Ferraù F, Tomasello G, et al. The role of diet in the prevention and treatment of Inflammatory Bowel Disease. Acta Biomed. 2018;89(9-S):60-75. doi:10.23750/abm.v89i9-S.80001 2. Kolacek S, Hojsak I. Should the Mediterranean diet be recommended for inflammatory bowel disease? Nutrients. 2023;15(2):362. doi:10.3390/nu150203625 3. DeFilippis EM, Tabani S, Warren RU, et al. Personalized Nutrition for Inflammatory Bowel Disease. Nutrients. 2020;12(6):1612. doi:10.3390/nu12061612 4. What is inflammatory bowel disease (IBD)? IBD Relief website. https://www.ibdrelief.com/learn/what-is-ibd. Accessed April 15, 2025.

5. Legg TJ. How Inflammatory Bowel Disease (IBD) Is Diagnosed. Verywell Health website. https://www.verywellhealth.com/ibd-diagnosis-1942637. Accessed April 15, 2025.

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Food Insecurity in the United States By: Joyce Yu, BSPS Undergraduate Student Spring 2025 Food insecurity, defined as limited or uncertain access to sufficient, safe, and nutritious food, remains a pressing issue across the United States. Despite the expansion of federal assistance programs like SNAP, and the presence of food pantries, many families continue to struggle due to systemic barriers and social stigma. With rising food insecurity rates, particularly among racial and ethnic minority households, it is critical to understand the complex interplay between structural challenges and public assistance efforts in order to promote lasting solutions.

Food insecurity has become an increasingly urgent concern in recent years, as millions of American households face challenges in obtaining reliable access to safe and nutritious food. Defined by the USDA as a condition in which consistent access to adequate food is limited by a lack of money and other resources, food insecurity affects over 12.5% of U.S. households, with an even greater impact on marginalized and minority communities.

Government programs like the Supplemental Nutrition Assistance Program (SNAP), accessed via EBT cards, have been effective in reducing food insecurity by 5–20% among participants compared to eligible non-participants. However, other community support systems such as food pantries have not seen increased usage despite a dramatic rise in food-insecure families—from 11% to 38% since 2020.

Stigma surrounding food assistance continues to limit access to healthy food options, particularly in underserved areas known as food deserts. There’s a need to both reframe the view of assistance, which can also be titled as issue of food justice, and also address policies and better target marketing practices while diverting additional resources to food deserts.

Additionally, transportation and locations are major barriers to food access for many low-income and food-insecure households. The Economic Research Service approximates that 13% of the US population, or around 39 million people live in rural neighborhoods over 10 miles from a

Nutrition, Spring 2025

grocery store. Due to the location, families might not have access to a personal vehicle. Families without a personal vehicle are often forced to rely on limited or unreliable public transit to reach grocery stores. This lack of mobility restricts access to affordable, nutritious food—even for those receiving SNAP benefits—forcing many to depend on nearby convenience stores or fast-food options that lack healthy choices. As a result, transportation issues contribute directly to poor nutrition and worsening health outcomes.

These barriers are intensified by geographic challenges, particularly the existence of food deserts—areas with limited access to grocery stores offering fresh foods. Residents in these areas often rely on processed, less nutritious options, leading to higher rates of diet-related illnesses such as diabetes and obesity. Over 12.5% of U.S. households are food insecure, with racial and ethnic minority groups disproportionately affected, according to the National Institute on Minority Health and Health Disparities.

As a Pharmaceutical Sciences student, I believe that addressing these issues requires targeted solutions like mobile food markets, improved transit options, and incentives for grocery stores to serve underserved communities. There has been progress made utilizing current efforts, but there’s more work to be done to best serve our entire community and make nutritious food accessible to everyone.

J Yu References 1. Ali A. A Hospital’s “Open-Access” Pantry Model Fuels Usage. Food Bank News. January 10, 2023. Accessed April 30, 2025.

2. Harvesters. Getting to the Root of Food Insecurity with Food+. Published March 2024.

Accessed April 30, 2025. https://www.harvesters.org/getting-to-the-root-of-food-insecurity-with-food 3. U.S. Department of Agriculture, Economic Research Service. Food Security and Nutrition Assistance. Updated January 8, 2025. Accessed April 30, 2025. https://www.ers.usda.gov/data-products/ag-and-food-statistics-charting-the-essentials/foo d-security-and-nutrition-assistance 4. U.S. Food and Drug Administration. An Introduction to Food Security Awareness.

Updated July 1, 2021. Accessed April 30, 2025. https://www.fda.gov/training-and-continuing-education/office-training-education-and-dev elopment-oted/introduction-food-security-awareness

Nutrition, Spring 2025

Foodborne Illness Robert Seabold, BSPS Undergraduate Spring 2025 Foodborne illnesses are a preventable public health issue that is combated every single day in the kitchens of restaurants, and people's homes. 48,000,000 cases are reported every year, which is the equivalent to 1 out of every 6 Americans, but this is an issue that is not taken seriously as food poisoning has become easier to deal with as medicine improves, but still a challenge that can put people at risk. Everyone that eats food is at risk for getting sick with foodborne illnesses, and is worse for people with compromised immune systems. Keeping food clean and safe should be the main priority of any person preparing food.

These main ways to stop foodborne illness only pertain to when the pathogens are only on the food, but these illnesses can also be passed from the person preparing the food to the person eating the food. Norovirus, or Norowalk virus, is a highly contagious respiratory illness caused by the influenza virus, and is the leading cause for foodborne illness outbreaks in the United States. This is why preparing food while sick can lead to you infecting anyone who would eat said food, so it is highly discouraged for a sick person to be in the kitchen or working at a food service job.

Foodborne illnesses are caused by harmful bacteria, viruses, or fungus contamination ready to eat food and are then passed to a person after they eat the contaminated food. Salmonella, or Salmonellosis, is a bacteria that lives in the intestinal tracts of animals, and is usually transmitted by eating not fully cooked meats, but can be transmitted to produce as well. E. Coli, or Escherichia Coli, is another bacteria that lives in the intestines of healthy people and animals, which can become transmitted primarily because of unwashed hands, or unwashed produce.These foods can become contaminated even after the cooking process has ended so all safety precautions should be followed: ● Wash hands before starting and in between every task change ● Wash all produce under cool, running water and gently scrub ● Cook meats to FDC recommended internal temperature ● Hot foods must be kept at above 140°F and cold foods must be kept below 40°F ● Stop cross contamination at all stages of cooking from beginning to end

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The reason that these practices are in place and that concerns about foodborne illness are everywhere is that the effects can be fatal depending on the pathogen transmitted. Annually about 128,000 people are hospitalized because of foodborne illnesses, and 3,000 of those people will die. Most illnesses begin within 12-96 hours after exposure and last for upwards of two weeks. Common symptoms of foodborne illnesses are diarrhea, abdominal cramps, and fever but more severe cases can lead to fatigue, chills, muscle aches, and dehydration. In extreme circumstances these symptoms can lead to dysentery which can be fatal if not treated.

I believe that foodborne illness is a problem that can be remedied because of modern medicine, but is a completely avoidable issue that can be dangerous for some. These issues stem from people not understanding proper food handling procedures and cautions to avoid these illnesses. So the best way to address these issues is to teach people about these issues with importance, but I understand the difficulty with adding to curriculum in schooling. The ability to prevent foodborne illness is obtainable by any person with the proper education about it, which means that this is an end result that we should push for.

References Minnesota Department of Health. Causes and Symptoms of Foodborne Illness - Minnesota Dept. of Health. State.mn.us. Published October 26, 2022. https://www.health.state.mn.us/diseases/foodborne/basics.html USDA. Foodborne Illness and Disease | Food Safety and Inspection Service. Usda.gov. Published October 21, 2020. https://www.fsis.usda.gov/food-safety/foodborne-illness-and-disease WHO. Foodborne diseases. www.who.int. Published 2021. https://www.who.int/health-topics/foodborne-diseases#tab=tab_1 FDA. What You Need to Know about Foodborne Illnesses. Fda.gov. Published February 17, 2022. https://www.fda.gov/food/consumers/what-you-need-know-about-foodborne-illnesses California Department of Public Health. Foodborne Diseases and Outbreaks. www.cdph.ca.gov. Published December 18, 2024. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/FoodborneDiseasesandOutbreaks.aspx

Nutrition, Spring 2025

Diet related NCDs and their Relation to Malnutrition

By Max Liao, BSPS Student Spring 2025 NCDs, or non-communicable diseases, are chronic conditions that are not contagious and don't spread from person to person, including heart disease, stroke, cancer, diabetes, and chronic respiratory diseases. They are the leading cause of death worldwide, accounting for 74% of all deaths. The 4 leading risk factors for NCDs include tobacco use, malnutrition, physical inactivity, and harmful alcohol use.

The NCDs most affected by malnutrition include: ● ● ●

Increased risk of heart disease and/or stroke Type 2 diabetes and hypertension Some cancers – including oesophageal cancer; tracheal, bronchus and lung cancer; lip and oral cavity cancer; nasopharynx cancer; colon and rectum cancer

Tableau.com. Published 2025. Accessed April 27, 2025. https://public.tableau.com/app/profile/willistowerswatson/viz/GlobalBurd enofNon-communicableDisease/GBD2015_1

Malnutrition, in all its forms, includes undernutrition (wasting, stunting), inadequate vitamins or minerals, being overweight/obesity. In recent years, it has become more and more of a global issue. For example, many countries now experience a ‘double burden’ of malnutrition. This is where under-nutrition occurs alongside over-nutrition, where unhealthy diets are contributing to unhealthy weight gain and diet-related poor health.

In a study of 141 countries, 88% (124 countries) experience more than one form of malnutrition, with 29% (41 countries) having high levels of all three forms. In addition, around the world, 1.9 billion adults are overweight or obese, while 462 million are underweight. A study from 2022 looked at global deaths from 1990 to 2017, it was found that one in every five deaths were the result of poor nutrition.

While malnutrition and NCDs are a global issue, they also affect countries disproportionately. Around two-thirds of Africans with non-communicable diseases (NCDs) die prematurely, before the age of 70. In Europe, less than a third of people living with NCDs die that early. In addition, Asia and Africa account for nine out of ten of all children with stunting and wasting and more than seven out of ten children who are overweight.

One way to improve this situation can be seen in Mexico. In 2014, Mexico implemented a 10% tax on sugary drinks and another tax on junk foods. These taxes resulted in a decrease in the consumption of these and an increase in education on the dangers of sugary beverages and malnutrition. Another thing that can be done is banning or greatly limiting advertising on junk foods.

My personal opinion on this topic is that there hasn’t been enough done to prevent it or to educate people on the dangers of malnutrition. However, I recognize that it is very difficult for any action to be taken due to the lobbying power of companies who benefit from poor diets. This is a very serious issue that will continue to greatly affect the livelihood of people.

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References Fan Y, Yao Q, Liu Y, Jia T, Zhang J, Jiang E. Underlying Causes and Co-existence of Malnutrition and Infections: An Exceedingly Common Death Risk in Cancer. Frontiers in Nutrition. 2022;9(814095). doi:https://doi.org/10.3389/fnut.2022.814095 NCD Alliance. Unhealthy diets and malnutrition. NCD Alliance. Published July 30, 2015. https://ncdalliance.org/why-ncds/risk-factors-prevention/unhealthy-diets-and-malnutrition WHO Unveils “Invisible Numbers” Of The NCD Crisis As Leaders Meet At United Nations - Health Policy Watch. Health Policy Watch.

Published September 21, 2022. https://healthpolicy-watch.news/who-unveils-invisible-numbers-of-the-ncd-crisis-as-leaders-meet-at-un/ World Health Organization. Malnutrition. World Health Organization. Published March 1, 2024. https://www.who.int/news-room/fact-sheets/detail/malnutrition Winichagoon P, Margetts BM. The double burden of malnutrition in low- and middle-income countries. PubMed. Published 2017. https://www.ncbi.nlm.nih.gov/books/NBK565820/

Nutrition, Spring 2025

Corruption in Food Regulation By: Reece Fromme, BSPS Student Corruption within the U.S. food regulatory system presents a critical barrier to ensuring public health and safety. Many agencies tasked with food inspection and regulation, such as the FDA and USDA, are subject to corporate influence and political pressure, leading to lapses in oversight and enforcement. One major issue is the role of bribery and corporate lobbying, where large food corporations exert influence over inspectors and policymakers through financial incentives and campaign contributions. This dynamic can allow unsafe products to enter the market, such as food items containing additives that are banned in other countries due to health risks, including Red 3, brominated vegetable oil (BVO), and titanium dioxide (Minassian, 2025).

This corruption extends beyond just bribery; it includes regulatory loopholes and weakened enforcement. Although laws like the Food Additives Amendment of 1958—particularly the Delaney Clause, which prohibits carcinogenic substances in food—were designed to protect consumers, later modifications such as the “de minimis” interpretation (allowing substances if the cancer risk is less than 1 in a million) have significantly diluted their impact (We Are What We Eat, 2018). This has resulted in the continued use of potentially dangerous compounds, despite scientific evidence suggesting links to cancer and other health risks.

Understaffing, lack of funding, and insufficient accountability within federal agencies further exacerbate the problem. Even when food safety violations are identified, the absence of adequate enforcement mechanisms means that many companies face minimal consequences (The Role of Corruption in Global Food Systems, 2021). In some cases, officials may deliberately overlook violations in exchange for personal gain or job security in the private sector after leaving government roles (Food Security and Corruption, 2021).

The food industry also exerts significant political pressure through lobbying, shaping policy to favor corporate interests over consumer health. This has led to deregulation and the watering down of food safety standards. For example, despite growing concerns and international bans, some additives remain legal in the U.S. simply because of industry resistance to change (Crimes Against Food, 2023).

Ultimately, corruption in food regulation undermines public trust and compromises the safety of the American food supply. Reforming the system will require greater transparency, stricter conflict-of-interest laws, and stronger protections for whistleblowers to ensure that health—not profit—is the top priority.

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References 1. Food Security and Corruption. (2021). Knowledge Hub, Transparency International. https://knowledgehub.transparency.org 2. Minassian, L. (2025). 12 banned foods Americans should stop eating. Food Revolution Network. https://foodrevolution.org/blog/banned-ingredients-in-other-countries/ 3. Reece, [Author First Initial]. (2025). Corruption in food inspection/regulation agencies [Unpublished manuscript or personal communication].

4. The Role of Corruption in Global Food Systems: A Systematic Scoping Review. (2021).

U.S. National Library of Medicine, National Institutes of Health. https://pmc.ncbi.nlm.nih.gov 5. We Are What We Eat: Regulatory Gaps in the United States That Put Our Health at Risk.

(2018). U.S. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC5737876/ 6. Crimes Against Food: Characteristics, Health Risk, and Regulations. (2023). Wiley Online Library. https://onlinelibrary.wiley.com

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‭Pandemics and Epidemics‬ ‭Spring 2025‬ ‭Anna Coffman, Grace Carlson, Cecilia Hinsey, Angie Lozano,‬ ‭Anthony Pabón, Owen Stephens‬

‭ ur topic is epidemics and pandemics and how they have affected people's‬ O ‭lives in many different ways. We have six different subtopics that we will be‬ ‭going through: mental health, life expectancy, misinformation, trust in‬ ‭healthcare, vaccines, and educational discrepancies. From these topics, we‬ ‭are conducting research to see how pandemics and epidemics can be taken‬ ‭care of differently in order to keep people safe. Coming out of the COVID-19‬ ‭pandemic, we are able to look back on how we handled it and what we‬ ‭could have done differently, along with epidemics such as the flu.‬

‭Pandemics & Epidemics, Spring 2025‬

‭Cecilia Hinsey, BSPS Student‬

‭Life Expectancy‬

‭The Results of a Pandemic/Epidemic on Human Life‬

‭Overview‬

‭ andemics and epidemics are outbreaks of infectious disease — pandemics affect the globe;‬ P ‭epidemics, localized regions. Both cause major mortality and disrupt social, economic, and political‬ ‭systems. By studying past pandemics, we can identify patterns and improve future responses.‬

‭Pandemics Throughout History‬

‭ he 1918 Influenza was the deadliest modern‬ T ‭pandemic in history, claiming the lives of ~50 million‬ ‭globally, over twice the number of WWI deaths.‬ ‭The virus came in two waves, with the second‬ ‭being the most detrimental. It targeted young‬ ‭adults (avg age 28 y/o), devastating the working‬ ‭age population and disrupting the economy.‬ ‭In late 2019, COVID-19 emerged in China and‬ ‭rapidly spread worldwide. Opposingly, the elderly‬ ‭faced the highest mortality, and indirect impacts‬ ‭(mental health, isolation, suicide) were widespread.‬ ‭Despite the prior knowledge of pandemics, modern complexities introduced new‬ ‭challenges.‬ ‭● ‭●

‭Statistics: Changes in Life Expectancy‬

‭1918: life expectancy dropped 12 years to the average of 39.1 years

‭2020-2021: life expectancy dropped 2.4 years to the average of 76.4 years

‭Understanding Trends to Mitigate Future Losses‬

‭Preparation for such events must be an ongoing effort, with flexibility as new‬ ‭threats emerge. Once a pandemic begins, responses should include‬ ‭surveillance, health communication, transmission control, and effective and ample‬ ‭medical care. Alongside preparation and response, proactive measures to‬ ‭prevent the emergence and spread of unknown pathogens are equally critical.‬

‭References‬ ‭1.

‭2. ‭3.

‭ adhav N, Oppenheim B, Gallivan M, Mulembakani P, Rubin E, Wolfe N. Pandemics: Risks, Impacts, and Mitigation.‬‭Nihgov‬‭.

M ‭2019;17(3).‬‭https://www.ncbi.nlm.nih.gov/books/NBK525302/‬‭.‬‭Accessed March 27, 2025. ‭James JJ. Of Lives and Life Years: 1918 Influenza vs. Covid-19. Disaster Medicine and Public Health Preparedness. Published ‭online July 15, 2021:1-7. Doi:‬‭https://doi.org/10.1017/dmp.2021.230‬‭.‬ ‭Accessed March 27, 2025. ‭‌QuickStats: Life Expectancy at Birth, by Sex — National Vital Statistics System, United States, 2019–2021. MMWR Morbidity ‭and Mortality Weekly Report. 2023;72. doi:‬‭https://doi.org/10.15585/mmwr.mm7228a5‬‭.‬ ‭Accessed April 1, 2025

‭Pandemics & Epidemics, Spring 2025‬

‭Educational Disparities‬

‭By: Grace Carlson, BSPS Student‬

‭ uring pandemics and epidemics, there is a gap in education, whether the students‬ D ‭continue online or there is a complete stop in education during the disruption. The‬ ‭duration and impact of these disruptions vary depending on the outbreak. This is a‬ ‭global health issue to due pandemics and epidemics affect everyone in the world.‬

‭Spanish flu pandemic vs COVID-19‬ ‭ uring the Spanish Flu outbreak of 1918, schools in big cities such as Chicago and‬ D ‭California remained open for the entirety of the pandemic, while others closed while‬ ‭the flu was in the community. The schools that closed were closed for a maximum of‬ ‭3.5 months. When looking at COVID-19, all schools were ordered to shut down, and‬ ‭most were online for months to even years. To add, schools during COVID-19 closed‬ ‭prematurely before COVID came to the area, while during the Spanish flu, they only‬ ‭shut down while the flu was contracted in the area.‬

‭Other Pandemics/Epidemics‬ ‭ uring the Ebola virus in 2014, schools in various countries closed for months at a time without technology‬ D ‭for 8 months to a year. In the SARS pandemic in 2003, Hong Kong had to shut down, and at the time, there‬ ‭was no widespread technology to teach online, leading to academic gaps in learning. These lead to‬ ‭significant setbacks in students' education, especially in developing children who need social interaction‬ ‭and one-on-one help.‬

‭Effects of Pandemics on Students‬ ‭ losing schools for months to years during COVID and other pandemics‬ C ‭created some negative consequences, such as a decrease in math and‬ ‭reading proficiency, social interaction due to isolation, and an increase in‬ ‭anxiety and depression in students This loss of learning was especially‬ ‭prevalent in younger children because they rely on hands-on instructors in‬ ‭structured environments to develop those necessary foundational skills. While‬ ‭schools have now resumed instruction, the challenges caused by COVID-19‬ ‭have caused students to have long-term setbacks in learning.‬

‭Personal Opinion:‬‭Recent e-learning strategies have‬‭been effective for teaching during pandemics ‭but are not as effective as in-person learning.‬

‭References‬ ‭1.

‭ NESCO. COVID-19 education response.‬‭UNESCO.‬‭Published‬‭2020. Accessed April 1, 2025.

U ‭https://www.unesco.org/en/covid-19/education-response ‭2. ‭Hallgarten J. Evidence on efforts to mitigate the negative educational impact of past disease ‭outbreaks.‬‭The Education Development Trust.‬‭Published‬‭April 16, 2020. Accessed April 1, 2025. ‭https://www.pmc.ncbi.nlm.nih.gov/articles/PMC8641925/ ‭ . ‭World Bank. COVID-19 school closures caused a significant drop in student learning outcomes.

3 ‭World Bank Blogs.‬‭Published October 29, 2021. Accessed‬‭April 1, 2025. ‭https://blogs.worldbank.org/en/education/covid-19-school-closures-caused-significant-drop-student ‭-learning-outcomes ‭4. ‭Van Lancker W, Parolin Z. COVID-19, school closures, and child poverty: A social crisis in the ‭making.‬‭Perspect Psychol Sci.‬‭2023;18(3):543-556.‬‭Accessed April 1, 2025. ‭https://journals.sagepub.com/doi/full/10.1177/17456916231181108

‭Pandemics & Epidemics, Spring 2025‬

‭Vaccines‬ ‭ y: Anna Coffman, PharmD Student‬ B ‭Pandemics and epidemics cause a huge concern in people all around the world especially with‬ ‭how to stop these diseases from spreading. The biggest way that pandemics and epidemics can‬ ‭stay controlled are vaccines. Vaccines have been a large controversy considering the safety for‬ ‭patients. Globally, we have been dealing with COVID-19 and are continually dealing with the‬ ‭influenza epidemic year after year. Both of these diseases have vaccines that are highly‬ ‭recommended by healthcare professionals each year to save all from getting diseases.‬ ‭How can vaccines help patients?‬ ‭Each fall, patients are told to get the flu vaccine to prevent the spread and to prevent them from‬ ‭getting the sickness. The flu vaccine prevents 7,000,000 cases of the flu each year which is‬ ‭stated by the Mayo Clinic. Along with this, the COVID-19 vaccine is continually updated each year‬ ‭to prevent the contraction of the newest strand of the disease.‬ ‭What are patients' biggest concerns with vaccines?‬ ‭When looking to stay safe from a certain disease, we do not also want to put harm to our body‬ ‭with a vaccine. That is why many patients look into the clinical trials that are done on the vaccines‬ ‭before getting them, especially with new ones such as COVID-19.‬ ‭In a recent study at the University of Georgia (image 1), it showed‬ ‭that people are more likely to get the influenza vaccine over the‬ ‭COVID-19 vaccine and this may have to do with the newness of‬ ‭the COVID-19 vaccine. The influenza vaccine has been around‬ ‭much longer therefore people know the effects that it may have.‬ ‭Robert Jacobson, M.D. (Mayo Clinic) also stated that one of the‬ ‭biggest concerns for not getting the vaccine is the side effects‬ ‭and allergic reactions that some patients‬ ‭may have.‬ ‭ ow can healthcare systems convince more patients’ they are safe?‬ H ‭In terms of the healthcare system, they want to make sure as many people‬ ‭are vaccinated so that less people are contracting these illnesses. There are‬ ‭patients that do not feel safe enough to receive these vaccines due to lack‬ ‭of clinical trials. After the COVID-19 pandemic, Science Direct stated that the‬ ‭number of patients that were confident in getting vaccines decreased to‬ ‭23.4% shown in image 2. This study also stated that vaccines are one of the‬ ‭safest options when trying to protect those around us. Even though there‬ ‭are many ways that vaccination is backed up, after the COVID-19 pandemic,‬ ‭the confidence in it went down.‬ ‭From the research conducted, I believe that enough studies have proven that vaccines can help‬ ‭slow the spread of epidemics and pandemics happening all around the world.‬

‭Pandemics & Epidemics, Spring 2025‬

‭Mental Health‬ ‭How Mental Health Is Affected During Pandemics/Epidemics‬ ‭By: Anthony Pabón, BSPS Student at Purdue University‬

‭ verview:‬ O ‭During times of pandemics/epidemics, a large global issue is that everyone’s mental health and‬ ‭psychological states are negatively affected. These decreases in mental wellbeing can look different from‬ ‭person to person based on profession, age, employment status, gender, socioeconomic status, and‬ ‭location with respect to healthcare access. As seen with Covid-19 and previous pandemics/epidemics, hard‬ ‭times and dramatic daily life changes do detrimental harm on everyone and widespread diseases have‬ ‭well-documented histories of deteriorating the mental health of the people going through them. ~ Anthony‬ ‭Pabón‬ ‭What Is Mental Health?‬ ‭According to the World Health Organization (W.H.O.), mental health is defined as “a state of mental‬ ‭well-being that enables people to cope with the stresses of life, realize their abilities, learn/work well, and‬ ‭contribute to their community.”‬‭1 ‭Covid-19 (2019-2022):‬ ‭Worldwide, some of Covid-19’s effects include: a global 25% increase in cases of anxiety and depression‬ ‭within the first year of the pandemic‬‭2‬‭,‬‭as well‬‭as increases in post-traumatic stress disorder (PTSD,‬ ‭between 7%-53.8%), psychological distress (between 34.43%-38%), and stress (between 8.1%-81.9%) within‬ ‭the general populations of China, Spain, Italy, Iran, the U.S., Turkey, Nepal, and Denmark.‬‭3 I‭mage 1: Covid-19 pandemic triggers 25% increase in prevalence of anxiety and‬ ‭depression worldwide. World Health Organization. Accessed April 5, 2025.‬

‭ ttps://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depr‬ h ‭ession-worldwide‬‭.‬ I‭mage 2: Covid-19 response. United Nations. Accessed April 5, 2025.‬ ‭https://www.un.org/en/coronavirus‬‭.‬

‭ bola (2014-2016):‬ E ‭In West Africa, the main effects of Ebola Virus Disease (EVD), for everyone, include increases in‬ ‭depression‬‭4‬ ‭and post-traumatic stress disorder (PTSD).‬‭5 I‭mage 3: Greshko M. What is the ebola virus, and can it be stopped? Science. April 9, 2019. Accessed‬ ‭April 5, 2025.‬‭https://www.nationalgeographic.com/science/article/ebola-virus‬‭.‬

I‭mage 4: Dahir AL. Congo was close to defeating Ebola, then one more case‬ ‭emerged. The New York Times. April 11, 2020. Accessed April 5, 2025.‬ ‭https://www.nytimes.com/2020/04/11/world/africa/congo-ebola-coronavirus.html‬‭.‬

‭Pandemics & Epidemics, Spring 2025‬

‭ he Great Influenza Outbreak/Spanish Flu (1918-1919):‬ T ‭Worldwide, the most severe effects the Spanish Flu were sleep disturbances, depression, mental‬ ‭distraction, dizziness, difficulties coping at work, and suicidal ideation (which also led to increased suicide).‬‭6‬ I‭mage 5: Klass P. A centennial of death: The great influenza pandemic of 1918. The New‬ ‭York Times. October 22, 2018. Accessed April 5, 2025.‬

‭https://www.nytimes.com/2018/10/22/well/family/a-centennial-of-death-the-great-influenza-pandemic-of-1918.html‬‭.‬ I‭mage 6: 1918 historical image gallery. Centers for Disease Control and Prevention.‬ ‭March 2, 2018. Accessed April 5, 2025.‬

‭https://archive.cdc.gov/www_cdc_gov/flu/pandemic-resources/1918-commemoration/historical-images.htm‬‭.‬

‭ hat We Can Learn From All This/How To Prevent This:‬ W ‭Looking at the previous statistics/information, it should be noted that the main psychological effects‬ ‭plaguing the people during these moments of uncertainty and disease are some form of anxiety,‬ ‭depression, and PTSD. While there are many lessons we can learn about how to react and respond more‬ ‭appropriately to worldwide infectious outbreaks, I believe the biggest one is that we should work towards‬ ‭continuing to destigmatize mental health and its various services provided to others so that people can‬ ‭receive the help they need and deserve before another pandemic/epidemic comes around. If people are‬ ‭more aware of the state of their mental health beforehand, then their psychological wellbeing won’t take‬ ‭such a large hit during the next big historical pandemic/epidemic event because they’ll know how to better‬ ‭handle themselves (and maybe others) to keep their heads (and the people around them) afloat throughout‬ ‭it all. Hopefully by destigmatizing and learning from our past mistakes, we can better prevent the future‬ ‭impact of such a historically significant event and hopefully react and respond better to the less-than-ideal‬ ‭mental health effects of global pandemics/epidemics. ~ Anthony Pabón‬ ‭References:‬ ‭1. ‭Mental health. World Health Organization. June 17, 2022. Accessed April 5, 2025. ‭https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response‬‭. ‭2. ‭Covid-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. World Health ‭Organization. Accessed April 5, 2025. ‭https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-‬ ‭and-depression-worldwide‬‭. ‭3. ‭Xiong J, Lipsitz O, Nasri F, et al. Impact of covid-19 pandemic on Mental Health in the general population: A ‭systematic review. Journal of affective disorders. December 1, 2020. Accessed April 5, 2025. ‭https://pmc.ncbi.nlm.nih.gov/articles/PMC7413844/‬‭. ‭4. ‭Jude Mary Cénat et al. Prevalence of mental health problems in populations affected by the ebola virus ‭disease: A systematic review and meta-analysis. Psychiatry Research. April 29, 2020. Accessed April 5, 2025. ‭https://www.sciencedirect.com/science/article/abs/pii/S0165178119325272‬‭. ‭5. ‭Schindell BG, Fredborg B, Kowalec K, Shaw S, Kangbai JB, Kindrachuk J. The state of mental health among ‭ebola virus disease survivors through a cross-sectional study in Sierra Leone. BMJ global health. May 23, ‭2024. Accessed April 5, 2025. ‭https://pmc.ncbi.nlm.nih.gov/articles/PMC11116873/#:~:text=Research%20has%20shown%20that%20in,criteria ‭%20for%20major%20depressive%20disorder‬‭. ‭6. ‭Greg Eghigian P. The Spanish flu pandemic and Mental Health: A historical perspective. Psychiatric Times. ‭November 16, 2020. Accessed April 5, 2025. ‭https://www.psychiatrictimes.com/view/spanish-flu-pandemic-and-mental-health-historical-perspective‬‭.

‭Pandemics & Epidemics, Spring 2025‬

‭Trust In Healthcare‬ ‭Angie Lozano, BSPS‬ ‭ t a Glance:‬ A ‭Public trust in healthcare systems is the cornerstone of public health, especially among‬ ‭pandemics and epidemics. During outbreaks of disease, public compliance with health‬ ‭measures—e.g., vaccination, quarantine, and sanitation regimens—is absolutely crucial.‬ ‭Nevertheless, this compliance largely depends on public faith in healthcare providers,‬ ‭scientists, and organizations. Distrust can lead to misinformation, vaccine hesitancy, and‬ ‭widespread nonadherence, amplifying the spread of the disease. In the COVID-19‬ ‭pandemic, for example, governments and healthcare institutions' lack of trust was an‬ ‭enormous setback in effective control and response.‬ ‭Locating the Impact:‬ ‭Healthcare trust is a very global and intercultural challenge because its determinants and‬ ‭expressions vary by culture and political system. In others, historical exploitation by‬ ‭medicine exists, or an absence of access to care underlies a longstanding mistrust. Other‬ ‭high-income nations have witnessed growing distrust fueled by misinformation and‬ ‭political polarization. For instance, COVID-19 vaccine coverage was significantly lower in‬ ‭communities with disenfranchised populations historically or where institutions lacked‬ ‭credibility. Trust disparities, globally, shed light on where public health, culture, and‬ ‭inequality merge.‬ ‭Echoes Through the Community:‬ ‭Most affected are the poor, marginalized groups, and those who live in areas where‬ ‭healthcare systems traditionally were‬ ‭weaker. Even healthcare workers‬ ‭themselves are affected because low trust‬ ‭could foster hostility, violence, and refusal to‬ ‭collaborate among them in medical settings.‬ ‭In the general picture, a whole public health‬ ‭campaign can be doomed to failure if trust‬ ‭fails. In the West African Ebola outbreak‬ ‭(2014–2016), fear and suspicion of health‬ ‭workers led to symptom concealment and‬ ‭attacks on health teams. Due to this, many‬‭individuals‬‭turned to traditional healers and‬ ‭herbal remedies instead of seeking medical care at hospitals. Some communities‬ ‭believed hospitals were places where people went to die, or that traditional medicine‬ ‭would be more effective. As a result, herbal concoctions became a popular alternative in‬ ‭certain regions. Similarly, during the 1918 flu pandemic- also known as the Spanish flu, the‬ ‭healthcare system was overwhelmed, and there was widespread distrust of medical‬

‭Pandemics & Epidemics, Spring 2025‬

‭ uthorities, especially when treatments seemed ineffective. In response, many people‬ a ‭relied on home remedies as well, including herbal teas, steam inhalation, and even‬ ‭whiskey, which was believed to disinfect the throat.‬ ‭From Awareness to Action:‬ ‭Several efforts have been made to rebuild trust.‬ ‭Community-based health communication, transparent‬ ‭governance, and engaging local leaders in health‬ ‭campaigns have worked. For instance, in the‬ ‭2018–2020 Ebola epidemic in the Democratic‬ ‭Republic of Congo, involving trusted community‬ ‭members contributed to greater acceptance of‬ ‭treatment and safe burial practices. Over the long‬ ‭term, establishing strong health systems and‬ ‭advancing health equity are crucial to establishing trust. Moving forward, strategies need‬ ‭to strengthen transparency, provide cultural competence in healthcare provision, and‬ ‭combat misinformation through international collaboration and localized communication‬ ‭(A.Lozano).‬ ‭Resources:‬ ‭ ho policy brief: Building Trust through Risk Communication and community engagement and‬ W ‭Infodemic Management. World Health Organization. December 14, 2024. Accessed April 3, 2025.‬ ‭https://www.who.int/publications/m/item/who-policy-brief-building-trust-through-risk-communication-‬ ‭and-community-engagement-and-infodemic-management.‬ I‭mage 2:‬‭Barclay W, Openshaw P. The 1918 influenza‬‭pandemic: One Hundred Years of Progress, but‬ ‭where now? - the Lancet respiratory medicine. The Lancet. June 22, 2018. Accessed April 1, 2025.‬ ‭https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(18)30272-8/fulltext.‬ I‭mage 1:‬‭Berehulak D. A photographer documents ebola’s‬‭deadly spread. The New York Times.‬ ‭January 26, 2015. Accessed April 3, 2025.‬ ‭https://www.nytimes.com/interactive/2015/01/26/world/africa/photos-ebola-daniel-berehulak.html.‬ ‭ han MS, Mohsin Ali SA, Adelaine A, Karan A. Rethinking vaccine hesitancy among minority groups -‬ K ‭the Lancet. The Lancet. April 21, 2021. Accessed April 1, 2025.‬ ‭https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00938-7/fulltext.‬ ‭Privor-Dumm L, Excler J-L, Gilbert S, et al. Vaccine access, equity and Justice: Covid-19 vaccines and‬ v‭ accination. BMJ global health. June 2023. Accessed April 3, 2025.‬ ‭https://pmc.ncbi.nlm.nih.gov/articles/PMC10254992/#:~:text=Furthermore%2C%20both%20vaccine%‬ ‭20hesitancy%20and%20the%20ability,have%20the%20potential%20to%20erode%20trust%20not.‬ ‭ NICEF. Ebola: Getting to Zero. UNICEF. March 1, 2015. Accessed April 3, 2025.‬ U ‭https://www.unicef.org/reports/ebola-getting-zero.‬ Ebola outbreak 2018-2020- North Kivu-ituri. World Health Organization. Accessed April 5, 2025. https://www.who.int/emergencies/situations/Ebola-2019-drc-#:~:text=Led%20by%20the%20Governm ent%20and,with%20equitable%20access%20to%20advanced.

‭Pandemics & Epidemics, Spring 2025‬

‭Misinformation During Pandemics/Epidemics‬ ‭Owen Stephens, BSPS student‬ ‭ obert Califf, the FDA’s former Commissioner, once‬ R ‭said that “misinformation & disinformation are now‬ ‭arguably the leading causes of death in America,‬ ‭and people are dying for completely preventable‬ ‭reasons”. Misinformation is classified as incorrect or‬ ‭misleading information. While misinformation is a‬ ‭fairly new buzzword, it has a history of relevance‬ ‭during pandemics and epidemics throughout the‬ ‭world, making this a‬‭global health issue‬‭. For‬ ‭instance, during WW1, misinformation was used by‬ ‭the US government to downplay the severity of the‬ ‭pandemic to increase war efforts. Another epidemic‬ ‭that was characterized by misinformation, was an‬ ‭outbreak of AIDS/HIV in which anonymity of transmission methods and unknown treatments of‬ ‭the disease from health officials led to mass speculation about the origins of HIV/AIDS.‬

‭Misinformation hinders response efforts/trust in public‬ ‭health‬ ‭Social media has accelerated misinformation, with‬8 ‭ 0% of people‬

r‭ eporting relying on the internet for healthcare information and‬ ‭61.5% of people turning to social media for healthcare‬ ‭information (Image 2). A cultural shift whereby turning to the‬ ‭internet for healthcare information has presented a massive‬ ‭opportunity for misinformation, which was a defining undertone‬ ‭of the 2020 COVID19 pandemic and presented real problems‬ ‭for health officials.‬ ‭The Scope of Misinformation during the COVID19 Pandemic‬ ‭Misinformation was present in various forms, most of‬ ‭which was spread through social media‬ ‭(Image 3), to push many agendas during‬ ‭the pandemic; the first of which fit the‬ ‭anti-vax movement’s narrative that the‬ ‭COVID19 mRNA vaccine contained:‬

‭Pandemics & Epidemics, Spring 2025‬

‭ icrochips, altered DNA, and caused infertility. These‬ m ‭claims have since been rejected and disproven by the‬ ‭scientific community. Another form of misinformation‬ ‭that arose during the pandemic were misleading‬ ‭treatments intended to kill the virus, which included‬ ‭overconsumption of alcohol, colloidal silver‬ ‭supplementation (implicated in cognitive dysfunction‬ ‭and altered skin pigmentation), and bathing in bleach.‬ ‭ he Burden of Misinformation‬ T ‭Perhaps the most dangerous aspect of misinformation is its ability to cause a burden to‬ ‭the healthcare system; either by directly harming participants of online treatments, or‬ ‭undermining the efforts of health officials. Another burden misinformation carries is its‬ ‭economic impact through the delay of public health measures, leading to prolonged‬ ‭economic recovery from government shutdowns, business closures, and inflation.‬ ‭Efforts to Reduce Misinformation‬ ‭Although the effects of misinformation can be detrimental, especially to those who rely‬ ‭on the internet and social media for healthcare information, new organizations have been‬ ‭formed to combat the spread of misinformation online. Notably, FactCheck.org, PolitiFact,‬ ‭and the World Health Organization (WHO) provided accurate, science-backed responses‬ ‭to posts containing misinformation on major social media platforms (Instagram and X).‬ ‭Social media sites also removed posts containing blatant misinformation, and in some‬ ‭cases, permanently banned users who violated guidelines repeatedly.‬ I‭ believe that the burden of misinformation, particularly during pandemics and epidemics,‬ ‭is especially detrimental to both the healthcare system and society as a whole. Despite‬ ‭the ongoing efforts to reduce online misinformation, more resources are needed to‬ ‭combat the spread of misinformation and establish trust between people and healthcare.‬ ‭The government should employ some form of online regulation to hold social media‬ ‭users and companies accountable for the content displayed online.‬ ‭- Owen Stephens

‭Pandemics & Epidemics, Spring 2025‬

MATERNAL HEALTH Spring 2025 Caitlin Chiu, Lex Thorpe, Emylee Tennant Madison Lucus, Trevor Hoodenpyle, Ryan Qu

Maternal health is a critical aspect of healthcare, yet many mothers face significant challenges that impact their well-being and that of their infants. High maternal mortality rates, postpartum depression, and complications from C-sections pose serious risks, while inadequate postpartum recovery and prenatal care further contribute to poor outcomes. Additionally, disparities in delivery quality and access to healthcare leave many women vulnerable to preventable complications. Addressing these issues through improved maternal care, enhanced mental health support, and safer childbirth practices is essential to ensuring better health outcomes for mothers and their children.

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Postpartum Depression- Caitlin Chiu BSPS Student Background Po st pa r t u m d e p re s s i o n ( P P D ) i s a t y p e o f m o o d d i s o rd e r t h at a f fe cts i n d i v i d u a l s a f te r c h i l d b i r t h , m o st co m m o n l y m ot h e r s , a l t h o u g h i t ca n a l s o a f fe ct fat h e r s a n d n o n - b i r t h i n g pa r t n e r s . M ate r n a l h ea l t h e n co m pa s s e s t h e p h y s i ca l , e m ot i o n a l , a n d m e n ta l we l l - b e i n g o f w o m e n d u r i n g p reg n a n c y, c h i l d b i r t h , a n d t h e

Global Health Problem

p o st pa r t u m p e r i o d .

Affects women across all regions, cultures, and socioeconomic backgrounds. Symptoms may var y

Who’s affected?

depending on cultural norms and beliefs, the

Those who have a histor y of anxiety or mood

emotional and psychological impact of the

disorders

condition is universally significant. Limited access

30-35% more at risk Genetics and family histor y also play a crucial

to mental health ser vices, stigma surrounding

role

mental illness, and cultural expectations of

Increased risk if related to someone with depression or mood disorders

motherhood contribute to the underdiagnosis and undertreatment of PPD.

Efforts/Solutions Made Ps yc h ot h e ra py F i r st l i n e o f t reat m e n t A n t i d e p re s s a n ts a n d A n t i - a n x i et y m e d i cat i o n s B re xa n o l o n e a n d Zu ra n o l o n e

What could / should be done More should be done to ensure all mothers receive the support they need. Making counseling and psychiatric ser vices more accessible, especially in rural and low-income communities and training more healthcare providers in perinatal mental health, especially in countries with limited resources. In my personal opinion, I think there should be more awareness and advocacy about this issue so we can help moms and lower the chances of long term consequences between mom and baby. (C. Chiu)

Resources

1. Johns Hopkins Medicine. Postpartum Mood Disorders: What New Moms Need to Know. Johns Hopkins Medicine. January 4, 2022. Accessed April 6, 2025. https://www.hopkinsmedicine.org/health/wellness-and-prevention/postpartum-mood-disorders-what-newmoms-need-to-know.

2. South Dakota Department of Health. Postpartum Depression . South Dakota Department of Health. Accessed November 4, 2025. https://doh.sd.gov/topics/mch/pregnancy-early-childhood/first-1000-days/you-and-baby/postpartum-depression/.

3. Postpartum Depression. org. Postpartum Depression Statistics. Accessed November 4, 2025. Postpartum Depression.orghttps://www.postpartumdepression.org/resources/statistics/.

4. Carlson K, Mughal S, Azhar Y, Siddqui W. Prenatal Depression. In: StatPearls. Statpearls Publishing; 2025. Accessed November 4, 2025. https://www.ncbi.nlm.nih.gov/books/NBK519070/ 5. Kozhimannil KB, Hardeman RR, Henning-Smith C, et. al. Postpartum Depression by Race, Ethnicity, and Pregnancy Body Mass Index. JAMA Netw Open. 2024. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2826508 6. Barranquero Gomez M, Salvador Z, Fernandez S. Risk Factors for Postpartum depression. Published September 21,2023. Accessed April 28,2025. https://www.invitra.com/en/postpartum-depression/risk-factors-for-postpartumdepression/

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Prenatal Health Care - Lex Thorpe BSPS, PharmD Student What Is Prenatal Care? healthcare recieve while pregnant. provided by your preffered Doctor (an OB/GYN) or Midwife.

An OB/GYN offers a traditional approach to prenatal care midwife offers a more hollisstic approach.

1st visit with your OB/GYN or midwife should be within the first 6-8 weeks of pregnancy.

Optimal prenatal visiting schedule: 4-28 weeks (1 visit/month), 28-36 weeks (1 visit/2weeks), 36-40 weeks ( weekly visits) https://depositphotos.com/photo/pregnantafrican-american-woman-101288826.html

My opinion: Many women/ppl around the world can benefit from approriate prenatal health care. This is a global issue.

Early and Consistent Prenatal Care: Find a trusted primary care professional Stress from not trusting your preferred doctor can cause pregnancy complications Start prenatal care as soon as you know you’re pregnant to Ensures the best possible outcomes during pregnancy.

Establishing an early care plan helps to ensure a healthy pregancy when it does occur.

Mothers who don’t recieve prenatal care are: 3x more likely to have babies with low birth weight(less than 5.5 pounds defined by WHO) 5x more likely to have babies die in infancy/preterm birth.

3-4x more likely to die from pregnancy related complications (likely to go up for POC mothers)

*Changes should be disscused with your doctor 1st!!

At Home Prenatal Care Methods: At home prenatal care is in ADDITION to your professional doctors visits and should NOT be used as a substitue.

Implementing health and wellness habits Light exercise and improved diet, Increse on essential vitamins ex: folic acid, A, D, and calcium Massages are also benefical can reduce fatigue, muscle tension, swelling, and increase blood circulation.

Pelvic floor exercises Can reduce the chance of experinecig pelvic organ prolapse (POP) during childbirth.

https://www.shutterstock.com/image-photo/pregnancymassage-physiotherapy-by-medical-doctor-2322441403

References:

1. https://medlineplus.gov/prenatalcare.html#:~:text=Prenatal%20care%20is%20the%20health,many%20problems%20and%20prevent%20others.

2. https://health.clevelandclinic.org/prenatal-appointment-schedule 3. https://www.webmd.com/baby/pregnancy-choosing-obstetric-health-care-provider 4. https://www.americanprogress.org/article/ensuring-healthy-births-prenatal-support/#:~:text=Compared%20with%20infants%20born%20to,likely%20to%20die%20in%20infancy.

5. https://www.acog.org/womens-health/faqs/pelvic-support-problems

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Labor and Delivery Care- Emylee Tennant BSPS Student Preventing Hemmoraging While responding to global health emergencies, preventing postpartum hemorrhage (PPH) is the leading cause of maternal mortality. PPH accounts for about 70,000 deaths a year, despite being manageable.

Quality maternity care, which includes well-trained professionals and critical supplies like oxytocin and transfusion blood, is necessary for effective prevention and treatment. Addressing this problem needs an all-encompassing approach regarding PPH that focuses on both prevention and mitigation strategies, control strategies through quality antenatal care, and address the risk factors such as anemia and placental disorders. Developing healthcare systems to ensure timely access to necessary treatments is critical in reducing maternal mortality rates and safe childbirth around the world.

Women’s Patient Safety Initiatives (WHO) The WHO (World Health Organization) underscores the gender gap in health issues, safety and security of women patients, and gendered patient experiences. In context of women, these challenges extend to all levels, primarily the primary health level as it serves as the first point of interaction within the health system. Therefore, health systems across the globe need to foster safe access and eliminate barriers for women patients, nurses and doctors to enable safe conditions for improved care and treatment. To address this gap in healthcare, WHO launched Global Patient Safety Action Plan 2021-2030 which eliminates avoidable harm in the healthcare and ensures respectful care for all patients. The Global Patient Safety Collaborative was launched alongside the plan focusing on the need to enhance action on patient safety at the country level. For WHO, safety is a vital component of strengthening health system resilience for women worldwide. I think there should be an increased involvement from WHO to address this global health issue.

Screening for Risk Factors (genetic and environmental) Implementing prenatal screening for environmental and genetic risk factors associated with a labor and delivery is essential for continuously improving global health. Early detection of risk factors can greatly reduce the potential for adverse outcomes associated with childbirth. Genetic considerations include hemophilia and cystic fibrosis of the mother or child. Environmental factors include a variety of aspects such as smoking, air pollution, and inadequate food. Effective screening is done with comprehensive antenatal care that includes genetic counseling, environmental assessment, and monitoring maternal health conditions. Decreasing these risk factors by systematic measures enables healthcare systems to improve maternal and neonatal care, leads to safer deliveries and improved health for mothers and children across the globe.

References 1. 15.2: Factors Influencing the Process of Labor and Birth. Medicine LibreTexts. Published October 24, 2024. Accessed April 22, 2025. https://med.libretexts.org/Bookshelves/Nursing/MaternalNewborn_Nursing_%28OpenStax%29/15%3A_Process_of_Labor_and_Birth/15.02%3A_Factors _Influencing_the_Process_of_Labor_and_Birth 2. World. The 7th Global Ministerial Summit on Patient Safety 2025. Who.int. Published April 4, 2025. https://www.who.int/news/item/04-04-2025-the-7th-global-ministerial-summit-onpatient-safety-2025 3. High 5s: Standard operating procedures. www.who.int. https://www.who.int/initiatives/globalpatient-safety-collaborative 4. World Health Organization. Many pregnancy-related complications going undetected and untreated – WHO. Who.int. Published March 8, 2025. https://www.who.int/news/item/08-032025-many-pregnancy-related-complications-going-undetected-and-untreated--who 5. World Health Organisation. WHO issues global plan to tackle leading cause of death in childbirth. www.who.int. Published October 11, 2023. https://www.who.int/news/item/11-102023-who-issues-global-plan-to-tackle-leading-cause-of-death-in-childbirth

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Maternal Mortality- Madison Lucas BSPS Student Summary Maternal mortality, the death of a woman during pregnancy or within 42 days of its termination, remains a pressing global health challenge.

In 2020, approximately 800 women died daily from preventable causes related to pregnancy and childbirth. The leading causes include severe bleeding, infections, high blood pressure disorders like preeclampsia, unsafe abortions, and pre-existing health conditions. Despite a 40% global decline in maternal mortality between 2000 and 2023, progress has slowed in recent years, with low- and lower-middle-income countries accounting for 95% of maternal deaths in 2020

Efforts/Solutions Made The World Health Organization emphasizes the importance of skilled professionals during pregnancy, childbirth, and the postpartum period.

Solutions like the "Zero Mothers Die" initiative uses mobile technology to provide pregnant women with vital health information and connect them to healthcare services. Additionally, the Beginnings Fund, a $500 million initiative launched by philanthropies including the Gates Foundation, aims to improve maternal and newborn health in Sub-Saharan Africa by expanding quality care for 34 million recipients .

Who’s Affected?

Maternal mortality disproportionately affects women in low- and lower-middle-income countries, particularly in Sub-Saharan Africa and Southern Asia. These regions accounted for 95% of maternal deaths in 2020. These maternal health outcomes highlight the inequalities in healthcare access and quality based on regions in which a mother resides.

Opinion Maternal mortality isn’t an issue that can be 100% prevented due to pre-existing health conditions and

References World Health Organization: WHO. Maternal mortality. https://www.who.int/news-room/factsheets/detail/maternal-mortality. Published April 7, 2025.

5 1.

Cdc.gov. Published 2025. Accessed May 5, 2025. https://archive.cdc.gov/#/details? q=maternal%20mortality&start=0&rows=10&url=https://www.cdc.gov/reproductivehealth/mat ernal-mortality/erase-mm/mmr-data-brief.html Maternal Health, 2025

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Outsized C-section rates Trevor Hoodenpyle - BSPS Student In America today, the C-section is the most common surgery performed throughout the whole nation.1 While these surgeries can often be necessary, America’s current C-section rate of 32% is far beyond the 19% figure above 2 which maternal or infant outcomes are no longer improved. But why is this the case? And is it a cause for concern?

The Maternal Risks

These additional C-sections aren’t just superfluous, but dangerous.

For instance, C-sections lead to a 3.6x increase in maternal mortality, most often due to hemorrhaging or an embolism 3 .

Along with this, with each Csection received, the changes for placenta accreta, bowel injury, and other harmful outcomes increase.4 In general, when a Csection is given, maternal risk increases in step with recovery time, showing us the need to mitigate the instances of these 5 procedures.

The Incentives

One of the highest indicators of receiving a Csection is which hospital you walk into, showing the immense provider discretion when it comes to C-sections.1 For example, simply having private insurance increases the chances of a Csection, and rates spike during times of increasing provider demand such as midday.5 This is compounded by the fact that physicians receive a 15% increase in compensation as compared to a vaginal birth, with the patient paying significantly more for it.5 All in all, this system provides many incentives for the procedure without many disincentives.

Statista (2013)

The Neonatal Risks

In addition to the maternal risks, unnecessary C-sections can but newborns at risk as well. Most often, this manifests in immune system impairments due to the lack of exposure to maternal bacteria during vaginal birth.6 These impairments can follow these infants for the rest of their lives, the product of a surgery that may not have even been needed

The Solutions

To alter this course, disincentives need to be put it place, and there have been many examples.

For one the use of a midwife has shown to 7 decrease rates by 30-40%. Though on a larger scale, states like Minnesota with blended payment programs to reduce financial incentives have shown decreases in C-section rates.8 In my opinion it is important to be informed on this issue for one’s own well being, as well as to push for greater accountability in our medical system (T. Hoodenpyle).

References

1. Haelle T. Your Biggest C-Section Risk May Be Your Hospital. Consumer Reports. May 10, 2018. Accessed March 29, 2025. https://www.consumerreports.org/c-section/biggest-c-section-risk-may-be-your-hospital/ 2. Ledbetter A. C-section Rates Are Way Too High. We Need to Hold Doctors and Hospitals Accountable. Scientific American. Accessed March 29, 2025. https://www.scientificamerican.com/article/c-section-rates-are-way-toohigh-we-need-to-hold-doctors-and-hospitals-accountable/ 3. Deneux-Tharaux C, Carmona E, Bouvier-Colle MH, Bréart G. Postpartum maternal mortality and cesarean delivery. Obstet Gynecol. 2006;108(3 Pt 1):541-548. doi:10.1097/01.AOG.0000233154.62729.24 4. Silver RM, Landon MB, Rouse DJ, et al. Maternal morbidity associated with multiple repeat cesarean deliveries.

Obstet Gynecol. 2006;107(6):1226-1232. doi:10.1097/01.AOG.0000219750.79480.84

5. Oster E, McClelland WS. Why the C-Section Rate Is So High. The Atlantic. October 17, 2019. Accessed March 29, 2025. https://www.theatlantic.com/ideas/archive/2019/10/c-section-rate-high/600172/ 6. Free T. Do c-section babies have a weaker immune system? BioTechniques. December 20, 2018. Accessed March 29, 2025. https://www.biotechniques.com/immunology/birth-by-caesarean-can-alter-the-path-of-immune-systemdevelopment/ 7. Ledbetter A. Maternity care in the U.S. is in crisis. It’s time to call the midwife. STAT. October 12, 2022. Accessed March 29, 2025. https://www.statnews.com/2022/10/12/maternity-care-in-the-u-s-is-in-crisis-its-time-to-call-the-midwife/ 8. Kozhimannil KB, Graves AJ, Ecklund AM, Shah N, Aggarwal R, Snowden JM. Cesarean Delivery Rates and Costs of Childbirth in a State Medicaid Program After Implementation of a Blended Payment Policy. Med Care. 2018;56(8):658-664. doi:10.1097/MLR.0000000000000937

Maternal Health, 2025

6

Postpartum Health and Recovery- Ryan

Background Information and Definitions Postpartum health and recovery refers to the process in which women gradually return to their prepregnancy state in terms of physiological, psychological and social functions within 6 months to 1 year after childbirth. This process not only involves the recovery of the reproductive system (such as uterine involution, lochia discharge, perineum or cesarean section wound healing), but also includes complex physiological changes such as endocrine regulation, breast function adaptation, and pelvic floor muscle repair.

The impact of cultural customs on health Positive case: Dietary nutrition in China's "confinement" (such as iron supplementation with pork liver) has been proven to help anemia recovery.

Controversial practice: In some areas of Southeast Asia, mothers are required to "roast" (high temperature environment), which may cause dehydration or burns.

Resource inequality High-income countries: Sweden, for example, provides up to 480 days of paid parental leave and is equipped with professional postpartum therapists.

Low-income countries: Only 51% of mothers in sub-Saharan Africa receive postpartum follow-up, leading to a high incidence of preventable complications.

References World Health Organization. WHO Recommendations on Maternal Health: Guidelines Approved by the WHO Guidelines Review Committee. Geneva: WHO; 2022.

Chen L, Zhang Y. Cultural barriers to evidence-based postpartum care in rural China. Lancet Glob Health. 2023;11(4):e512-e523. doi:10.1016/S2214109X(23)00078-9.

National Institute for Health and Care Excellence. Postnatal Care up to 8 Weeks 7 After Birth. London: NICE; 2024.

Maternal Health, 2025

7

Social Determinants of Health/ Disparities/ Access Spring 2025 Neighborhood and Built Environment

Education Access and Quality

The physical and built environment include all the physical things surrounding where a person lives or works. These factors have a significant amount of influence over a person’s mental and physical health, in both positive and negative ways.

Education Access and Quality received play a major role in short-term as well as long-term health consequences. Limited Access to Quality education can affect a person’s health literacy, access to resources, and overall healthcare experiences. Promoting improved Education Access and Quality in lower income neighborhoods can help transform how patients understand their conditions and become more aware about their own health outcomes.

Healthcare Access, Quality, and Cost

Economic Stability

Often referred to as the “Iron Triangle of Healthcare”, these factors lay in a balance, when improvements in one area can negatively impact the others. In this section, we will explore how these factors interact with each other, how it affects our healthcare in the States, and the systems other countries use.

The study of how economically stable a population is and how the status of stability impacts the community’s health and access to care.

By: Luke Choi, Oliver Hu, Charles Mann, and Aayush Vachharajani

Neighborhood and Built Environment Charles Mann - BSPS Student Background The neighborhood and built environment are social determinants of health that play a significant role in an individual’s physical and mental health. The neighborhood and built environment encompass all the physical parts where people live or work. This can include things such as parks, roads, buildings, infrastructure, and so much more. These are things present in everyday life for people all across the globe.

By understanding the role of these factors, health literacy can be improved which empowers people to make the best decisions for themselves and their health.

Physical health The walkability of neighborhoods has been associated with reduced body fat levels in both adolescents and adults. Furthermore, a higher density of unhealthy food outlets like fast food restaurants was associated with a higher prevalence of obesity in adolescents. In Shanghai and New Delhi, the amount of garbage and trash in neighborhoods and the built environment were perceived to have a high impact on infectious and chronic diseases.

Mental health People living in homes characterized by poor internal and external conditions generally had higher alcohol usage. Suggesting that alcohol is being used as a coping mechanism for the stress caused by living in a poor environment. Additionally, living in a poorer environment has been associated with higher instances of lifetime depression. Furthermore, urban areas with more green spaces had a positive effect on mental health and overall well-being. Highlighting the positive effects things like parks can have on an individual.

Solutions Because of the many effects the neighborhood and built environment can have on an individual’s health, solutions are required that can mitigate the negative effects or enhance the positive ones. Increasing the amount of parks in a city or having a green belt that can be used for recreation would have positive effects on physical and mental health. Ensuring greater access to healthy food options by either increasing the amount of healthy stores/restaurants or upgrading public transport systems are also viable options to improve mental and physical health.

Professional/Personal Opinion I believe that systemic changes are needed to have the greatest impact. Municipalities need to consider the built environment and aforementioned factors when conducting urban planning. Moreover, the physical environment and neighborhood where people live is not always left up to choice. Therefore, greater work needs to be done at the governmental level to mitigate physical and mental health problems. ~ C. Mann References 1. Clark C, Myron R, Stansfeld S, Candy B. A systematic review of the evidence on the effect of the built and physical environment on mental health. J Public Mental Health. 2007;6(2):14-27. doi:10.1108/17465729200700011.

2. Gascon M, Vrijheid M, Nieuwenhuijsen MJ. The Built Environment and Child Health: An Overview of Current Evidence. Current Environmental Health Reports. 2016;3(3):250-257. doi:https://doi.org/10.1007/s40572-016-0094-z 3. Krefis AC, Augustin M, Schlünzen KH, Oßenbrügge J, Augustin J. How Does the Urban Environment Affect Health and Well-Being? A Systematic Review. Urban Science. 2018; 2(1):21. https://doi.org/10.3390/urbansci2010021 4. Mmari K, Lantos H, Brahmbhatt H, et al. How adolescents perceive their communities: a qualitative study that explores the relationship between health and the physical environment. BMC Public Health.

2014;14:349. doi:10.1186/1471-2458-14-349.

5. Renalds A, Smith TH, Hale PJ. A Systematic Review of Built Environment and Health. Family & Community Health. 2010;33(1):68-78. doi:https://doi.org/10.1097/fch.0b013e3181c4e2e5

SDOH/Disparities/Access - Spring ‘25

Economic Stability Luke Choi - BSPS Student Background The economic stability of a community is based on individuals’ own economic stability. Understanding how certain factors that contribute to this idea is crucial to understanding how a community behaves when faced with challenges that threaten their health.

Financial How much disposable income a certain population has a significant impact on their willingness to seek medical attention. However, disposable income is not enough to capture the entire picture. A closer look at spending habits, savings, and the development of an emergency fund is just as important to assessing someone’s willingness or unwillingness to receive treatment that they may need.

Affected Peoples Economic stability reaches a broad community of people regardless of background. Of course, individuals with lower income levels will be affected, but when associating healthcare with this topic, other individuals must be included. This includes individuals who put a lack of emphasis on attributing the necessary resources to an unforeseen healthcare emergency, which ties into the subtopic of healthcare education.

Professional/Personal Opinion There are many different organizations and foundations that are dedicated towards improving the economic stability of individuals within the US. However, the topic is so encompassing and vague that finding data to back the claim that these efforts are actually improving the cause can be troublesome. A deeper insight into how these structures have attempted to improve economic stability provides unmeaningful results and there does not seem to be a positive correlation between resources spent versus outcome. Perhaps this is insight to the conclusion that there are greater foundational errors that should be corrected before blindly pouring more resources into these attempts, and what these foundational errors are should be the first goal to reach. ~ L. Choi

References Aguirre, D. L., Perez, C., & Burkett, E. K. (2022). Stability, security, and the social determinants of health.

Global Security: Health, Science and Policy, 7(1), 13–23. https://doi.org/10.1080/23779497.2022.2047092 National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Review of Federal Policies that Contribute to Racial and Ethnic Health Inequities; Geller AB, Polsky DE, Burke SP, editors. Federal Policy to Advance Racial, Ethnic, and Tribal Health Equity. Washington (DC): National Academies Press (US); 2023 Jul 27. 3, Economic Stability. Available from: https://www.ncbi.nlm.nih.gov/books/NBK596400/ SDOH/Disparities/Access - Spring ‘25

Healthcare Access, Quality, and Cost Oliver Hu - BSPS Student Background When analyzing social determinants of health, it is impossible not to examine the most influential factor in health—healthcare itself. While it is a heated topic in current American society, objectively, we can divide it into the “Iron Triangle”—access, quality, and cost. As proposed by William Kissick, this Iron Triangle model suggests that an increase in one area, quality, for example, will always lead to an increase in either one or both other areas (access and cost in this case). This is because there are inherent trade-offs between the factors that counteract one another.

So the subsequent question is this: what balance should we strike regarding these three factors? In America, we struggle immensely with cost, but is it worth giving up quality in the pursuit of cheaper care? In Sweden, they lack access to specialized healthcare, but make up for it in much lower costs and universalized healthcare. If we turn to our northern neighbor, Canada, they have universal access, but very slow wait times for simple procedures such as an MRI. This makes this issue highly globalized.

As a society, we must find a way to strike a happy medium that can satisfy most people. This question only becomes more pertinent as society advances in both technology and medicine, allowing us to live longer, but also burdening our healthcare system more. Such changes affect everyone in our society, no matter the race, religion, gender, or economic status, who will all eventually get sick and need healthcare. Governmental institutions, healthcare institutions, and insurance companies will also be affected by any changes that we make. This makes it more difficult, but all the more important to find a solution that benefits as many people as possible.

Efforts/Solutions Of course, being such a pressing issue, the American government has taken massive steps to address the costs for the average American. In 2010, the Obama administration introduced the Affordable Care Act, which had the dual goal of increasing insurance coverage and decreasing costs. This was done through expanding Medicaid in many states so more people had coverage, increasing subsidies for health insurance marketplaces, and requiring large companies to offer health insurance with employment. The Biden Administration has also taken steps to reduce costs by requiring price transparency from hospitals to encourage competition, while signing the Inflation Reduction Act that lowers prescription drug costs for those under Medicare.

Personal/Professional Opinion Personally I think we will never reach the optimal balance for our healthcare. Even if we take the Swedish system, which is highly regarded as one of the best, they only exist because of their near 50% tax bracket to fund much of their healthcare. Try putting a 50% tax in the States and see how that turns out. Swedes also on average are a more healthy population in general. I think as a society, instead of looking internationally, we should be focusing more on insurance, pharma, and hospitals that lobby our government for laws they want in place for their benefit. However this is a monumental task, as even the most honest of politicians often get corrupted the power of these companies. -O Hu References 1. Lehman E. The health care ‘iron triangle’ and the Patient Protection and Affordable Care Act. CCJM. 2015;82(2):73-80 2. Rosenbaum S. The Patient Protection and Affordable Care Act: implications for public health policy and practice. Public Health Rep. 2011;126(1):130-135

SDOH/Disparities/Access - Spring ‘25

Education Access & Quality Aayush Vachharajani - PharmD, BSPS Student Background There is plenty of evidence suggesting that lower-income neighborhoods or populations suffer from worse health outcomes when compared to higher-income neighborhoods. The underlying cause for this can all be traced back to the issue of education access and quality. Disparities in educational access driven by SDOH directly correlate with a persons overall healthcare experience due to the lack of understanding of health needs, preventative care, managing multiple health conditions, and also the potential lack of health literacy, which can affect their understanding of care instructions.

Affected Population Generally, the population affected the most by this disparity are those who may be considered lower-income. This includes rural areas, ethic minorities, the homeless population, or even the immigrant population. In a study conducted to determine the association of income-disparities with patient-reported healthcare experience, 32% of the participants were high-income earners while 23% were very low earners. It was found that the very low earners had a 1.34x greater odds of experiencing poor communication and were more likely to report poor provider satisfaction.

Concern Lack of educational access or quality only worsens the health inequities that are seen with lower income populations.

The lack of exposure and understanding to how health insurance plans work and how they can take advantage of what they have access to can lead to a poor healthcare experience - and lead to patients avoid care altogether.

Furthermore, it can lead to a increased rate of preventable conditions, non-adherence to potentially life saving medications and even increased mortality rates due to the lack of exposure to iife-saving skills such as CPR.

Solution To address a problem that is faced at such a large scale. ideally federal intervention would be a solution to improve the disparity in education access and quality. Investment in practical skills or adult learning programs, public health education courses, or even community-based training programs could be a leap towards improving the overall health outcomes. Additionally, providers can take an extra step to ensure understanding my using plain language and asking patients to repeat instructions back to them, or even hiring translators to make sure patients who’s primary language isn’t English can have all their questions answered.

Professional/Personal Opinion As a student working to become a part of the healthcare industry and potentially work in patient centered care, making sure the patient understands the extent of their conditions and how they can better treat or control it is the forefront of our practice. As providers I feel that it is important that we take the extra step in making sure that our patient’s healthcare experience is as idealistic as possible, and that they feel comfortable asking any questions. I personally believe that health literacy isn’t something that is determined by your socioeconomic status, and everyone should have an equal opportunity to properly care for themselves. ~ A. Vachharajani

References 1. August KJ, Billimek J. A theoretical model of how neighborhood factors contribute to medication nonadherence among disadvantaged chronically ill adults.

Journal of Health Psychology.

2016;21(12):2923-2933. doi:https://doi.org/10.1177/1359105315589391 2. CDC. Education Access and Quality | Prepare Your Health | CDC. www.cdc.gov. Published March 27, 2023. https://www.cdc.gov/prepyourhealth/discussionguides/education.htm 3. Chisholm-Burns MA, Spivey CA, Gatwood J, Wiss A, Hohmeier K, Erickson SR. Evaluation of racial and socioeconomic disparities in medication pricing and pharmacy access and services.

American Journal of Health-System Pharmacy.

2017;74(10):653-668. doi:https://doi.org/10.2146/ajhp150872 4. Lazar M, Davenport L. Barriers to Health Care Access for Low Income Families: A Review of Literature. Journal of Community Health Nursing.

2018;35(1):28-37. doi:https://doi.org/10.1080/07370016.2018.1404832

5. Okunrintemi V, Khera R, Spatz ES, et al. Association of Income Disparities with Patient-Reported Healthcare Experience. Journal of General Internal Medicine. 2019;34(6):884-892. doi:https://doi.org/10.1007/s11606-019-04848-4

SDOH/Disparities/Access - Spring ‘25

Climate Change Spring 2025

Grace Coomes, Darren Hung, Aaryaman Khurana, Blair Miles, Sameer Varma

In this monograph we will be addressing how climate change is a global crisis with widespread effects on health, economy, and energy systems. It intensifies natural disasters like wildfires, hurricanes, and droughts, leading to severe economic and health burdens, including malnutrition, respiratory and cardiovascular diseases, and increased mental health issues. Vectorborne diseases such as malaria and Lyme disease are becoming more prevalent as changing climates extend the active seasons and geographic ranges of disease-carrying organisms. Developing countries face disproportionate impacts, with extreme weather displacing millions and exacerbating healthcare challenges. Additionally, climate change strains energy systems, reducing hydropower output, stressing fossil fuel infrastructure, and increasing demand for cooling, which can lead to grid instability.

The Impact of Climate Change on Vector-Borne Diseases Grace Coomes, BSPS

What are vectors?

Vectors are organisms that transmit an infectious pathogen to an unaffected human. Vector-borne diseases account for 17% of all infectious diseases1.

Common vectors: Fleas Ticks Mosquitoes Common vector-borne diseases (VBD): Malaria Zika Dengue fever Lyme disease

Who is impacted?

Historically,vector-borne disease prevalance has been highest in tropical and sub-tropical regions. These diseases disproportionately impact lower socioeconomic classes. However, climate change may be expanding these regions, furthering its impact as a global health issue.

Climate Change and Disease Transmission Since 1900 , the world average temperature has increased by 1.1°C, with the majority of the temperature increase occurring in the past 50 years2 .It is expected that the end of the century will result in a 2.5 °C warming. Increased temperatures in tropical regions, where many vectors populate, may cause tropical expansion. It is expected that climate-sensitive vector borne infections such as Malaria, Dengue fever, and West-Nile Virus will increase. A study found that temperature increases in the highlands of Columbia and Ethiopia by 0.2 °C are associated with malaria spreading to higher elevations in these regions3. Furthermore, stronger storms attributed to climate change have impacted VBDs. Severe flooding in Pakistan in 2022 was paritally attributed to climate change. The flood caused many areas to have stagnant water. As a result, there was a surge of Dengue fever cases during this time period.

Current Efforts Surveillance Real time monitoring using GIS and remote sensing to track vector populations Climate predictive models that use variables such as temperature, humidity, and rain to predict vectorborne disease oubreaks Vector Control Efforts Ongoing reserch for more environmentally friendly and effective pesticides Climate resiliant mosquito nets

1. Vector-borne diseases. Accessed April 2, 2025. https://www.who.int/news-room/factsheets/detail/vector-borne-diseases 2. Pörtner HO, Roberts DC, Tignor MMB, et al., eds. Climate Change 2022: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change.; 2022.

3. Siraj AS, Santos-Vega M, Bouma MJ, Yadeta D, Ruiz Carrascal D, Pascual M. Altitudinal changes in malaria incidence in highlands of Ethiopia and Colombia. Science.

2014;343(6175):1154-1158. doi:10.1126/science.1244325 4. Critical Components in working on vector-borne diseases.

5. Obame-Nkoghe J, Agossou AE, Mboowa G, et al. Climate-influenced vector-borne diseases in Africa: a call to empower the next generation of African researchers for sustainable solutions. Infectious Diseases of Poverty. 2024;13(1):26. doi:10.1186/s40249-024-01193-5

Therapeutic Developent New vaccines targeting malaria are currently in advanced stage clinical trials New efforts for mRNA vaccines Public Healthy and Community Initiatives Integrated Vector Managment- an approach that considers environmental management, chemical interventions, and biological control Urban planning for water management systems to decrease mosquito breeding Moblie apps to allow citizens to report mosquito activity

Personal Opinion

(Critical components in working on vector-borne diseases5)

References

(Climate Change: An enduring challenge for vector-borne diseases4)

Climate change is accelerating the spread of vector-borne diseases.

Despite advances in vaccines and vector control, current responses remain slow and underfunded. We urgently need coordiated global efforts that utilize climate change data with disease survillance, alongside investments in healthcare infrastructure and education. ~ G. Coomes Climate Change, Spring 2025

Economic Impact due to Climate Change What's been affected by climate change?

Effects due to Climate Change

1. Intensity of Natural Disasters a.

Tornadoes b.

Droughts c.

Tropical Storms 2.

Mental Health Ailments a.

Depression b.

Alcohol Abuse c.

Drug Abuse 3.

Nutrition a.

Malnutrition

My personal opinion on what can be done?

Climate change has triggered a cascade of devastating effects, including intensified natural disasters, worsening public health, and severe mental health consequences. Rising temperatures fuel wildfires, increasing air pollution, and exacerbating respiratory and cardiovascular diseases. Droughts lead to food insecurity and malnutrition, particularly in vulnerable populations. Extreme weather events displace millions, creating economic instability and widening global inequality.

Beyond physical harm, climate change also takes a psychological toll, contributing to rising rates of depression, anxiety, and substance abuse. These interconnected issues highlight the urgent need for global cooperation, improved disaster preparedness, and sustainable solutions to mitigate the long-term consequences of a warming planet.

Having identified the damage and strain that climate change has had, it is all the more reason why we need to have more early warning systems, especially in countries that are less fortunate. By bringing awareness and addressing these issues now, we can help diminish some of the ailments caused by climate change, whether mentally, physically, or economically (BM).

More on the weather

“Droughts lead to higher levels of malnutrition, causing the stunting of growth and development among children, and an array of pervasive infectious diseases.” This is alone leads into malnutrition which can effect overall health and the economy since people will go without food.

Mental Health

The impact of climate-driven disasters extends beyond just immediate destruction. These disasters affect mental health, economic stability, and public health. "Finally, the incidence of mental health illnesses including depression, alcohol and drug abuse, and schizophrenia, is also expected to rise precipitously because of climate change, at an anticipated cost of $6 trillion by 2030 to cover treatment and productivity loss."1 Additionally, climate change has also led to people losing their jobs, forced relocation, and destruction of social cohesion and community resources, all of which have mental health consequences. "In addition, fear of the phenomenon of climate change and related consequences for our national security and individual well-being can cause significant distress."3

References 1. Oliver Wyman. Mounting Data: Climate-Tied Public Health Crisis Ahead. Published November 2023.

Accessed [date]. https://www.oliverwyman.com/our-expertise/insights/2023/nov/mounting-dataclimate-tied-public-health-crisis-ahead.html 2. World Economic Forum. Climate Change and Health. Published November 2023. Accessed [date]. https://www.weforum.org/stories/2023/11/climate-change-health/ 3. American Psychiatric Association. Climate Change and Mental Health Connections. Accessed [date]. https://www.psychiatry.org/patients-families/climate-change-and-mental-health-connections

Climate Change, Spring 2025

Blair Miles BSPS Climate Change, Spring 2025

Impact of Climate Change on Chronic Diseases Darren Hung, BSPS

How climate affects chronic diseases The most well-known effect of climate change is global warming causing increasing temperatures. Due to the upward trend in temperature, heat waves and wildfires also saw an increased presence. Many chronic diseases are heavily influenced by the patient’s environment, and with climate change being an increasingly severe problem, its impact on those afflicted with chronic diseases continues to deepen.

Cardiovascular and Respiratory Diseases Those with cardiovascular diseases, such as high blood pressure, and arrhythmia can be exacerbated by heat waves and cause further complications such as stroke.

Wildfires generate pollution serving as extra irritant for those with respiratory problems, such as asthma, and chronic obstructive pulmonary disease (COPD), causing additional and prolonged flare-ups.

Diabetes Diabetic individuals are also susceptible to the detriments of climate change. Increasing prevalance of heat waves increase chances of dehydration, causing blood sugar levels to fluctuate, which is dangerous for diabetics due to poor control of glucose levels.

Inherent nerve damage common in diabetic individuals can also negatively affect sweating functions, leading to increased chances of heat stroke.

Methods to mitigate risk + Professional Opinion Be mindful of the weather, minimize outdoor events during peak heat hours.

Use air filters indoors and masks outdoors if pollution/irritant levels are too high.

Always maintain hydration and regular monitoring of blood pressure levels.

Maintain healthy diet to prevent aggravation of chronic disease, cut back on sugars and pro-inflammatory foods.

References 1. Managing diabetes in the heat. Centers for Disease Control and Prevention. Accessed April 6, 2025. https://www.cdc.gov/diabetes/articles/managing-diabetes-in-theheat.html#:~:text=Heat%20affects%20people%20with%20diabetes,that%20combines%20temperature%20and%20humidity.

2. Climate change and noncommunicable diseases: Connections. World Health Organization. Accessed April 2, 2025. https://www.who.int/news/item/02-11-2023-climate-change-andnoncommunicable-diseases-connections.

3. Climate Change and the Health of People with Chronic Medical Conditions. EPA. Accessed April 2, 2025. https://www.epa.gov/climateimpacts/climate-change-and-health-people-chronicmedical-conditions.

4. Medicine BMC. Diabetes and climate change: Breaking the vicious cycle - BMC medicine. BioMed Central. July 31, 2023. Accessed April 2, 2025. https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02980-x.

Climate Change, Spring 2025

The Energy Impact Due to Climate Change

Sameer Varma, BSPS Student

THE RELATIONSHOP BETWEEEN ENERGY IMPACT DUE TO CLIMATE CHANGE CHALLENGES DUE TO CLIMATE CHANGE Impact of Climate Change on Energy Systems Alters energy supply and demand patterns.

Increases energy use due to rising temperatures (cooling).

Reduces hydropower capacity due to droughts.

Strains grids during heatwaves.

Damages infrastructure through storms, wildfires, and floods.

Climate change is transforming the global energy landscape. As temperatures rise and extreme weather events become more frequent, energy systems face increasing pressure. From greater electricity demand for cooling to disruptions in power supply caused by wildfires, storms, and droughts, the reliability and resilience of our energy infrastructure are at risk. Addressing these challenges is essential for ensuring a secure and sustainable energy future.

Solutions to Reduce Cooling Energy Demand Improve building insulation Use energy-efficient cooling systems Increase use of renewable energy Plant trees and expand green spaces Install cool roofs and reflective materials Upgrade to smart grid technology Promote off-peak energy use Encourage energy-saving habits

My Personal opinion Climate change is increasing global energy demand, especially for cooling during extreme heat. This puts pressure on power systems and worsens emissions where fossil fuels dominate. We urgently need coordinated efforts to expand renewable energy, improve energy efficiency, and modernize power grids to meet demand sustainably.

S.Varma

https://www.epa.gov/climateimpacts/climate-change-impacts-energy

The map , sourced from EPA.gov, illustrates the projected increase in energy use driven by rising temperatures due to global warming. It clearly shows that warmer states are expected to experience significantly higher energy consumption, primarily for cooling, as temperatures continue to climb.

References Environmental Protection Agency. (n.d.). EPA. https://www.epa.gov/climateimpacts/climate-change-impacts-energy U.S. Energy Information Administration - EIA - independent statistics and analysis. U.S. energy facts - imports and exports - U.S . Energy Information Administration (EIA). (n.d.). https://www.eia.gov/energyexplained/us-energy-facts/imports-andexports.php USGCRP. Fourth National Climate Assessment. Globalchangegov.

Published online 2013:1-470. https://nca2018.globalchange.gov/chapter/4/

MAP: How Climate Change Threatens America’s Energy Infrastructure in Every Region. Energy.gov. Published 2015. Accessed May 4, 2025. https://www.energy.gov/articles/map-how-climate-change-threatensamericas-energy-infrastructure-every-region?nrg_redirect=428426 RECS: One in three U.S. households faced challenges in paying energy bills in 2015. www.eia.gov. https://www.eia.gov/consumption/residential/reports/2015/energybills /

Spring 2025, Climate Change

Global impact of climate change on patient health (3rd world countries) Aaryaman Khurana BSPS | PharmD

Climate change is a global crisis, but its impacts are uneven.

Developing nations, though least responsible for emissions, face the worst consequences—threatening food security, health, and economic stability. Lacking resources for adaptation, they remain vulnerable to displacement and poverty. This highlights the urgent need for global cooperation on both environmental and humanitarian fronts.

Background

The impact of climate change is particularly severe for marginalized groups, making it an intercultural issue that transcends national borders. Climate-related disasters often displace entire communities, worsening social inequalities and increasing the likelihood of resource conflicts. Furthermore, lower-income populations— regardless of ethnicity—bear the brunt of environmental degradation, making this a crisis that demands global attention and ethical responsibility from high-emission countries.

Intercultural issue that I transcends borders

Here’s a shortened, bullet-point version focusing on affected populations and sectors:

Women and children, Low-income communities, Public health systems, Farmers and rural populations

Affected Populations References U.S. Global Leadership Coalition. Climate change and the developing world: A disproportionate impact – USGLC. USGLC. Published March 2021. https://www.usglc.org/blog/climate-change-and-the-developing-world-adisproportionate-impact/ Bhargawa R, Bhargava M. The climate crisis disproportionately hits the poor.

How can we protect them? World Economic Forum. Published January 13, 2023. https://www.weforum.org/stories/2023/01/climate-crisis-poordavos2023/ .‌ Naser K, Haq Z, Naughton BD. The Impact of Climate Change on Health Services in Low- and Middle-Income Countries: A Systematised Review and Thematic Analysis. International Journal of Environmental Research and Public Health. 2024;21(4):434. doi:https://doi.org/10.3390/ijerph21040434.

Solutions and Personal opinion

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Current efforts include climate adaptation funding, renewable energy, disaster preparedness, and agreements like the Paris Accord. Healthcare systems must be strengthened to manage climaterelated health crises. Investment in green energy reduces fossil fuel reliance and creates jobs. Climate education empowers local communities with sustainable solutions. High-emission countries should be held accountable and support vulnerable populations. Global collaboration is crucial to prevent worsening inequality and instability. Individual actions like recycling, reducing consumption, and reusing products also contribute to climate solutions.

Climate Change Spring 2025

Addiction Spring 2025

By Mezani Muniz, Sarah Huszar, Madelaine Driskell, Calvin Pickerill, Jasmine Wang

The Dangerous Cycle of Addiction - The Freedom Center

Addiction is a deeply complex and chronic condition that drives individuals to repeatedly engage in substance use or compulsive behaviors despite knowing the negative consequences. It is not merely a matter of willpower but a disorder that alters brain chemistry, particularly in the reward system, making it increasingly difficult for individuals to resist cravings and maintain self-control. The effects of addiction extend far beyond the individual, impacting physical health, mental well-being, relationships, and overall quality of life. Furthermore, addiction is not limited to any one cause; it develops through a combination of biological, psychological, socioeconomic, cultural, and political factors, making it a widespread and multifaceted issue. While some individuals may have a genetic predisposition that makes them more vulnerable to addiction, others may develop it as a response to stress, trauma, or environmental influences. Additionally, the economic burden of addiction is significant, affecting healthcare systems, workplaces, and communities as a whole. Addressing addiction requires a comprehensive understanding of its many dimensions, including the different types of addiction, its connection to mental health, its financial and societal costs, and the various treatment approaches available. Through this discussion, we aim to explore these aspects in depth, shedding light on the complexities of addiction and the strategies for prevention and recovery.

Addiction, Spring 2025

Types of Addictions/Drugs Sarah Huszar, BSPS There are multiple classes of drugs that have high risks of addiction and abuse. There are depressants, stimulants, and psychedelics. Depressants slow down the CNS, stimulants speed up the CNS, and psychedelics, also known as mind-altering drugs, cause hallucinations as well as many other side effects. The main depressants are alcohol, fentanyl, and opioids. Some stimulants are cocaine, methamphetamine, Adderall, and nicotine. Vaping is more addictive and harmful than the traditional cigarette due to the harmful chemicals such as lead, diacetyl, and formaldehyde. Cocaine is an extremely unreliable product as it can be mixed with many other things, such as fentanyl.

Drug addiction has become more of a global health issue as the years go on. One drug in particular, fentanyl, has become more prevalent whether by itself, or found in other drugs.

Opioid drug abuse/overdose has become one of the leading causes of death in the United States. Other countries are now becoming involved as many of these dangerous drugs are coming from them, such as China and Mexico (Ferragamo & Klobucista, 2025). The World Health Organization, also known as WHO, has discussed the ‘world drug problem’ several times and has produced several different strategies for countering this issue. This being a global issue, will take more than just a few countries to contribute in order to see a real impact.

J Palamar, et al. National and Regional Trends in Fentanyl Seizures in the United States, 2017-2023. International Journal of Drug Policy.

DOI:10.1016/j.drugpo.2024.104417 (2024).

Studies show that the individuals that are being the most affected by drug abuse and addiction are teens and individuals with mental disorders.

These individuals being prescribed medications for their mental illnesses can easily become addicted. This works by them taking the drug as prescribed, feeling better, and wanting to continue to feel better all the time. Slowly they will become dependent on these drugs and may start experimenting with others to get that desired effect they once had. In today’s world, teens are often subject to peer pressure from their peers.

Programs such as D.A.R.E have been implemented in schools to instruct children of the dangers of drugs. Drug abuse programs and facilities have been established across the country and the world to be there for individuals seeking help. There can never be enough awareness about the dangers of drug use. Continuing to educate the youth as well as anyone who is willing to listen will be beneficial for the global health crisis.

I think there should be more control of what is coming in and out of the country as well as how quickly doctors are willing to prescribe drugs for mental health disorders. We should be looking into non-pharmacological solutions before getting individuals hooked on medications which can later lead to drug addiction and abuse. ~ S Huszar Professional CC medical. What are addictive substances? Cleveland Clinic. November 19, 2024. Accessed February 23, 2025. https://my.clevelandclinic.org/health/articles/addictive-substances Ferragamo M, Klobucista C. Fentanyl and the U.S. opioid epidemic. Council on Foreign Relations. March 28, 2025. Accessed April 5, 2025. https://www.cfr.org/backgrounder/fentanyl-and-us-opioid-epidemic.

Drug misuse and addiction. National Institutes of Health. January 30, 2025. Accessed April 4, 2025. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction.

Addiction, Spring 2025

Genetic Predisposition

Madelaine Driskell, BSPS Student

Alcohol Use Disorder (AUD) commonly referred to as Alcoholism is defined as a chronic disease characterized by persistent alcohol use that causes distress in one’s daily life despite the negative consequences they may face. Although only one form of addiction, alcoholism has affected an estimated 400 million people worldwide according to WHO. Both family history and individual genetic factors contribute to the risk of developing alcoholism as well as other environmental factors. The body metabolizes alcohol primarily in the liver, however, mutations in specific genes can impact the process. Analogous to alcoholism, other substance use disorders are influenced by individual genetics as well as family history. Both of these are critical when understanding a person’s predisposition to SUD, more specifically AUD. In determining whether AUD is a global or cross-cultural problem, it is important to remember that genetic mutations can occur throughout varying cultures. Environmental factors based on cultural norms, social attitudes, and alcohol availability also plays a large role in the prevalence of AUD. The issue at hand is considered to be a worldwide problem.

Building on previous statements, prior family history has been shown to significantly influence the risk of developing AUD. Research done on twins across several studies has shown consistent results. Li and Burmeister suggest that 50-70% of dependence and abuse in twins is due to related heritability. The high rate of vulnerability suggests that the heritability of specific genes is critical in increasing the risk of developing AUD. In some cases, AUD is associated with other substance addictions, but evidence for the genes involved is limited.

Researchers have identified two genes with known effects on alcohol metabolism.

These two are known as ADH1B and ALDH2. As stated before, mutations in the associated genes can increase the risk of developing AUD, however, there are often societal and environmental factors at play as well. Alcohol dehydrogenase (ADH1B) works in the first step of alcohol metabolism. This gene acts in the catalyzation of ethanol oxidation to acetaldehyde. Aldehyde dehydrogenase 2 (ALDH2) acts in the second step of alcohol metabolism. This gene works to convert the acetaldehyde, synthesized in the first step, into acetate. The buildup of the intermediate molecule, Acetaldehyde, is what accounts for the effects of alcohol consumption. Mutations in either of these genes can impact the buildup of the Acetaldehyde. Edenberg and Foroud discuss the example of genetics and dependence is seen in the “Asian Flushing Reaction.” It is common in East Asia, where people carrying one allele of the mutated ALDH2 take effect even when drinking tiny amounts of alcohol.

In note of this global issue, studies should continue to focus on how genetics plays a role in all types of SUDs. Even though studies are limited, other forms of SUD research on AUD should be used as a starting point in identifying genes related to increased risks.

Understanding the body process and genetics is the starting point for decreasing the number of those suffering from substance use disorders (~M Driskell).

Edenberg H J, Foroud T. Genetics and alcoholism. Nature reviews. Gastroenterology & hepatology. August 2013. Accessed March 28, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC4056340/.

Li MD, Burmeister M. New insights into the genetics of addiction. Nature reviews. Genetics. April 2009. Accessed March 28, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC2879628/.

Alcohol. World Health Organization. Accessed March 28, 2025. https://www.who.int/news-room/fact-sheets/detail/alcohol.

Addiction, Spring 2025

Mental Health

Mezani Muniz, BSPS student

Background Addiction and mental health disorders are deeply interconnected, with each influencing and exacerbating the other. Individuals with conditions such as depression, anxiety, PTSD, and schizophrenia are at a higher risk of developing substance use disorders (SUDs), while chronic substance abuse can contribute to or worsen mental illness. This relationship, often referred to as co-occurring disorders or dual diagnosis, presents unique challenges in treatment and recovery.

Who is this affecting?

This is affecting individuals who are vulnerable and surrounded by stress. This can range from places of work, previous trauma, cities and universities. Many individuals with mental health issues turn to drugs or alcohol to alleviate distressing symptoms, unknowingly creating a cycle of dependence. Past trauma increases susceptibility to mental health disorders, with substances often used as a coping mechanism (Giordano, 2021).

Psychologically, substance use can temporarily alleviate symptoms such as anxiety, intrusive thoughts, or mood instability, creating an illusion of control or relief. However, this coping strategy often becomes counterproductive, as individuals become reliant on external substances rather than developing internal emotional regulation skills.

How we move forward Both addiction and mental health alter brain function, particularly in areas dealing with reward, impulse control, and emotional regulation. Substances of abuse directly act on the reward center of the brain, involving an intense release of the neurotransmitter dopamine.

The consistent release weakens the activity of the brain’s decision-making center in the prefrontal cortex. This behavior hijacks our dopamine system, allowing our body to become used to elevated levels and your body starts to produce less (Smith, 2022).

Focusing research on our dopamine cycle is how we can get a grasp on addiction and mental health disorders to help people get the treatment they need. Genetic research also plays a large role in new treatments in order to personalize it from patient to patient. More programs are now integrating treatment for both mental health and addiction focusing on the link between them.

Personal Opinion I believe that people do not change unless they want to. Although the cycle of addiction and mental health is hard to get through and continues to be a struggle, change cannot happen unless the person themselves reaches out to get that help. ~M. Muniz References Giordano A. Why Trauma Can Lead to Addiction. Psychology Today. Published September 25, 2021. Accessed February 16, 2025. https://www.psychologytoday.com/us/blog/understanding-addiction/202109/why-trauma-can-lead-toaddiction?msockid=0d26f3c513926e431e26e25f123a6fea Smith L. Addiction and Mental health: What’s the connection? | recovered.org. Recovered. Published October 11, 2022. Accessed February 11, 2025. https://recovered.org/mental-health/addiction-and-mental-health

Addiction, Spring 2025

Economic and Societal Costs of Addiction

Calvin Pickerill, BSPS Student

While drug addiction has a significant impact on those abusing the drug as well as those immediately surrounding them, it also has a much broader impact on both the economy and society as well. According to the US department of health and human services, the economic impact of alcohol misuse is around $249 billion, with the impact of illicit drug use being around $193 billion.

Orlando Recovery Center. Orlando Recovery Center Drug, Alcohol and Mental Health Rehab. The Recovery Village. Accessed April 5, 2025. https://www.therecoveryvilage.com

One of the ways drug addiction and abuse has this large of an impact on the economy is due to the negative health effects produced by addiction, which require money, time, and resources to treat. For example, nicotine addiction can lead to health problems such as lung cancer and gum disease. So, if someone has smoked or vaped their whole life and end up developing lung cancer because of it, money, time, and effort are now being put into treating this person. Depending on the availability of healthcare within certain areas, it could lead someone else with lung cancer or similar disease to receive less medical attention. Another way drug addiction and abuse can have an economic and societal impact is due to the destructive behavior brought about by certain types of addiction. An example of this is alcohol abuse, which leads to an increase in reckless behavior as well as an increase in car accidents. According to the National Highway Traffic Safety Administration, about 37 people in the United States die each day due to drunk-driving crashes.

The best way to reduce the economic and societal costs of drug addiction is to treat those that are addicted, which is done through rehab centers.

While rehab does help decrease the number of people addicted to drugs, rehab centers require copious amounts of money in order to operate properly. According to the National Center for Drug Abuse Statistics, the total public cost is over $5 billion. This means that in order to treat addiction and reduce the economic impact, more money must be spent. ~ C Pickerill Orlando Recovery Center. Orlando Recovery Center Drug, Alcohol and Mental Health Rehab. The Recovery Village. Accessed April 5, 2025. https://www.therecoveryvillage.com/locations/orlando/

Drug Abuse Statistics. Cost of Rehab. DrugAbuseStatistics.org. Published April 3, 2023. Accessed April 5, 2025. https://drugabusestatistics.org/cost-ofrehab/ National Highway Traffic Safety Administration (NHTSA). Drunk Driving. NHTSA. Updated March 2024. Accessed April 5, 2025. https://www.nhtsa.gov/risky-driving/drunk-driving U.S. Department of Health and Human Services, Office of the Surgeon General. Addiction and Substance Misuse. U.S. Department of Health and Human Services. Updated November 2023. Accessed April 5, 2025. https://www.hhs.gov/surgeongeneral/reports-andpublications/addiction-andsubstance-misue/index.html

Addiction, Spring 2025

Limitation of Addiction Treatment

Jasmine Wang, BSPS student

Background and Relation to Main Issue Addiction is a chronic, relapsing disease that requires ongoing, multifaceted treatment.

However, poor adherence is a major challenge for all forms of substance abuse treatment, including opioids, stimulants, and alcohol. For example, between 2011 and 2018, among U.S. Medicare beneficiaries, discontinuation of long-term opioid therapy, with short-term spikes in suicide attempts, withdrawal symptoms, and emergency visits. Medication alone is not enough without long-term psychological and behavioral support, especially when cravings and environmental triggers remain unaddressed.

Intercultural and Global Dimensions Substance use disorders are prevalent globally, yet attitudes towards addiction and treatment differ across cultures. In many countries, addiction is still viewed as a moral defect rather than a disease, which leads to stigma against addiction and prevents people from receiving treatment. Immigrants and marginalized populations often face language barriers, legal fears, and cultural misunderstandings when it comes to healthcare, which further contributes to poor adherence. Therefore, effective treatment must consider these.

Who or What is Affected Patients with addiction suffer the most immediate effects of poor compliance, including relapses, overdose, deteriorating health, and loss of employment or relationships. Their families, communities, and care providers are also heavily impacted. Healthcare systems face increased emergency visits and hospitalizations, while public health policies struggle to curb rising addiction-related mortality rates.

Efforts/Solutions and Future Directions Measures to address poor adherence include integrating behavioral therapies such as CBT, motivational interviewing, peer rehabilitation counseling, and harm reduction approaches.

BMC Health Services Research (Hoffman et al., 2019) supports combining medication with tailored psychosocial interventions to improve retention and efficacy. Globally, expanding access to culturally appropriate care, reducing stigma, and investing in workforce training are essential next steps.

Professional/Personal Opinion As a future pharmacist, I believe that improving adherence to addiction treatment requires a change in the way we view and treat patients with substance use disorders. We must meet patients where they are, with empathy, flexibility, and ongoing support. Medication has a powerful role in the treatment process, but treatment must be comprehensive, communitybased, and take cultural realities into account. ~ J Wang References 1.

2.

3.

Sabety AH, Neprash HT, Gaye M, Barnett ML. Clinical and healthcare use outcomes after cessation of long term opioid treatment due to prescriber workforce exit: Quasi-experimental difference-in-differences study. The BMJ. May 16, 2024. Accessed April 5, 2025. https://www.bmj.com/content/385/bmj-2023076509?utm_source=chatgpt.com.

The Lancet, 29 March 2025, volume 405, issue 10484, pages 1027-1118. Accessed April 6, 2025. https://www.thelancet.com/journals/lancet/article/PIIS01406736(21)00476-1/abstract.

1. Hoffman KA, Terashima JP, McCarty D. Opioid use disorder and treatment: Challenges and opportunities - BMC Health Services Research. BioMed Central.

November 25, 2019. Accessed April 5, 2025. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4751-4?utm_source=chatgpt.com.

Addiction, Spring 2025

Mental Health PHSC 48500 Group 11

Investigative Topics: Increased ADHD prevalence in the Past 30 years Author: Yana Gomon Misdiagnosed and Medicated: The Hidden Struggles When Diagnosing Mental Health Author: Clayton Wimmersberger Understanding the Surge in Anxiety and Depression in College Students Author: Jaxon Oldham Mental Health in Physical Disability Author: Gunnar Johnson Military PTSD and Suicide Rates Author: Mark Fillar

Intercultural and Global Health Issues, Mental Health, Spring 2025

Increased ADHD Prevalence in the Last 30 Years Yana Gomon BSPS Spring 2025

Intercultural and Global Health Issues, Mental Health, Spring 2025

References: Video Games and ADHD in Adults: The Good, the Bad, and the Ugly | Online Anxiety therapy for anxious Millennials. https://www.millennialtherapy.com/anxiety-therapy-blog/adhd-and-video-games.

Auro K, Holopainen I, Perola M, Havulinna AS, Raevuori A. Attention-Deficit/Hyperactivity Disorder diagnoses in Finland during the COVID-19 pandemic. JAMA Network Open. 2024;7(6):e2418204. doi:10.1001/jamanetworkopen.2024.18204 Danielson ML, Claussen AH, Bitsko RH, et al. ADHD Prevalence among U.S. Children and Adolescents in 2022: Diagnosis, severity, Co-Occurring Disorders, and Treatment. Journal of Clinical Child & Adolescent Psychology. 2024;53(3):343-360. doi:10.1080/15374416.2024.2335625 General Prevalence of ADHD in Adults - CHADD. CHADD. https://chadd.org/about-adhd/general-prevalence-adults/. Published April 10, 2025.

Facts about ADHD throughout the years. Attention-Deficit / Hyperactivity Disorder (ADHD). https://www.cdc.gov/adhd/data/adhd-throughout-the-years.html. Published October 23, 2024.

Data and statistics on ADHD. Attention-Deficit / Hyperactivity Disorder (ADHD). https://www.cdc.gov/adhd/data/index.html. Published November 19, 2024.

Diallo F, Pelletier É. Morbidities and mortality of diagnosed attention deficit hyperactivity disorder (ADHD) over the youth lifespan: A population‐based retrospective cohort study. ResearchGate. https://www.researchgate.net/publication/357326108_Morbidities_and_mortality_of_diagnosed_attention_defici t_hyperactivity_disorder_ADHD_over_the_youth_lifespan_A_population-based_retrospective_cohort_study.

Published December 1, 2021. Accessed May 4, 2025.

Intercultural and Global Health Issues, Mental Health, Spring 2025

Misdiagnosed and Medicated: The Hidden Struggles When Diagnosing Mental Health - Clayton Wimmersberger BSPS Class of 2025 Diagnosing mental health conditions such as anxiety and depression presents significant challenges due to their subjective nature and the absence of definitive testing. This often leads to an overreliance on prescribing antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). While these medications can be beneficial for some individuals, newer research has shown them not to be as effective as once thought.

Effectiveness of Antidepressants

Potential Downsides of Antidepressant Use

Research shows that ~50% of individuals with moderate to severe depression experience symptom improvement within six to eight weeks of starting antidepressant treatment. While this is already pretty low for a prescription drug, it is also seen that 30% of those taking a placebo also report improvements, showing that it might not even be the drug doing the work.

While antidepressants can provide relief for some, they are associated with many side effects including emotional numbness and weight gain. Long-term use may lead to dependence and withdrawal symptoms upon discontinuation. ​

Overprescription Concerns A combination of the difficulty in diagnosing mental health disorder and the pressure doctors have to prescribe medicines can lead to an overprescription of antidepressants. This is a major concern due to the severe side effects of antidepressants and due to the fact that this does not help the mental health crisis, in fact it counteracts it.

Also, recent studies suggest that certain antidepressants may accelerate cognitive decline in dementia patients, particularly with higher doses of SSRIs like escitalopram, citalopram, and sertraline.

References:

Personal Opinion: Creating more streamlined ways for doctors to diagnose mental health by addressing the root causes of mental health issues (therapy, intervention, diet etc.) and exploring non-pharmacological interventions are essential steps toward improving patient outcomes and the mental health crisis in general.

Intercultural and Global Health Issues, Mental Health, Spring 2025

Understanding the surge of Anxiety and Depression in College Students Globally, college students in recent years have been facing greater challenges in mental health. Recent studies have revealed an alarmingly high rate of depression and anxiety.

44% of all college students are experiencing depression, 37% with anxiety, and 15% struggle with suicidal thoughts. These figures have grown 50% since 2013, marking an all time high and a frightening societal issue.

The Problem of the Academic Pressure Cooker With over 78% of college

Personal Opinion

academic performance and outcomes.

From Crisis to Care Universities have responded to this by adopting new solutions and innovating. For example, in Dartmouth, the university has reformed many policies to address certain aspects of the issue. They have expanded their free wellness programs, and revised medical leave policies to cater to those struggling with mental health.

students reporting moderate-to-high stress levels, the ever increasing academic demands need to be addressed. Stress from exams, homework, and performance expectations are causing many students to resort to unhealthy coping mechanisms like sleep deprivation and substance abuse. This creates a vicious cycle, as poor mental health is directly linked to lower Intercultural and Global Health Issues, Mental Health, Spring 2025

I believe universities must continue expanding mental health services to see greater improvement. The learning environment must be geared to combat or mitigate the alarming rise in depression and anxiety to see a genuine result.

More universities should take from Dartmouth and revise or expand policies accordingly.

Intercultural and Global Health Issues, Mental Health, Spring 2025

Intercultural and Global Health Issues, Mental Health, Spring 2025

MENTAL HEALTH IN PHYSICAL DISABILITY GUNNAR ANDREAS JOHNSON, BSPS BACKGROUND

autoimmune disorders (4). The Korean National

A time of awakening in mental health brings a light

Health Insurance Database recorded mental health

impact

with

prevalence in individuals diagnosed with ALS (5). The

autoimmune disorders. Autoimmune disorders bring a

graph displays that during early onset of diagnosis is

new sense of pain management and way of life that

suicidal tendencies most prevalent. The trends have

often overshadows the emotional and mental impact

been observable worldwide marking it a global issue.

of those diagnosed. Autoimmune disorder increases

PROGRESS

the risk of mood disorders by 45%, affecting one out

Individuals

of ten people (1).

undergo immune based therapy that helps general

to

a

new

demographic,

those

with

autoimmune

disorders generally

symptoms of the autoimmune disorder, primarily Autoimmune disorders including Rheumatoid Arthritis,

inflammation. The reduction of inflammatory factors

Multiple Sclerosis (MS), Type 1 Diabetes, Amyotrophic

directly reduces factors that affect mood related

Lateral Sclerosis (ALS) have links to elevated levels of

symptoms (6).

anxiety and depression. Symptoms of declining

STATEMENT

mental health are seen in over 50% of populations

Coming to terms with an autoimmune disorder is not

with MS (2).

easy for anyone. Having personal experience with

CAUSE

the matter has enabled myself to see the struggles

Chronic Illness promotes uncertainty of the future,

that one undergoes in the process of coping and

unpredictability, disability, finance issues, and of

adjusting. While medication is effective, remembering

course physical pain, all of which being major factors

that there are many affected who share similar

to affect mental health (3). Autoimmune disorders

experiences can bring reassurance and enable

can affect anyone at any time regardless of factors

empathy. Support groups and charitable activities

such as age, race, and sex.

occur worldwide to help keep those affected on track to pursue dreams and life. ~G. A. Johnson SOURCES 1.​

Harvard Health Publishing. (2013, June 17). Infection, autoimmune disease linked to depression. Harvard Medical School. https://www.health.harvard.edu/blog/infection-autoimmune-dise ase-linked-to-depression-201306176397

2.​

Kim, M., Kang, T. W., Oh, K. W., Lee, S. Y., Oh, I. H., & Kim, S. H. (2021). Prevalence of psychiatric disorders among people with amyotrophic lateral sclerosis in Korea: A nationwide population-based study. Journal of Affective Disorders, 293, 315–321. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369283/

3.​

Mediterranean Journal of Rheumatology. (2020). Psychiatric disorders and autoimmune disease. https://www.mjrheum.org/

4.​

A

study

from

the

Mediterranean

Journal

A longitudinal cohort study.

of

Rheumatology urges pregnant women who display psychiatric disorder symptoms should be paneled for

ScienceDirect. (2021). Depression and anxiety in multiple sclerosis: https://www.sciencedirect.com/science/article/abs/pii/S2211034 821001711

5.​

Cleveland Clinic. (n.d.). Chronic illness. https://my.clevelandclinic.org/health/articles/4062-chronic-illness

Intercultural and Global Health Issues, Mental Health, Spring 2025

Reference Understanding the surge of Anxiety and Depression in College Students: Alonso, J. (2023). Student mental health worsens, but more are seeking help. Inside Higher Ed | Higher Education News, Events and Jobs. https://www.insidehighered.com/quicktakes/2023/03/17/student-mental-health-worsens-more-are-seeki ng-help Newport Institute (2024, November 21). Depression in college students: New Statistics and Research. https://www.newportinstitute.com/resources/mental-health/depression-on-college-campuses/ Heinze, J. (2023, March 9). College students’ anxiety, depression higher than ever, but so are efforts to receive care: News: University of Michigan School of Public Health: Mental Health: Healthy Minds Study. College Students’ Anxiety, Depression Higher Than Ever, but So Are Efforts to Receive Care | News | University of Michigan School of Public Health | Mental Health | Healthy Minds Study |. https://sph.umich.edu/news/2023posts/college-students-anxiety-depression-higher-than-ever-but-soareefforts-to-receive-care.html

Intercultural and Global Health Issues, Mental Health, Spring 2025