Rice Remedy - Volume 1

vol. 1

Braving Thorns

Rice’s First Student-Run Health Sciences Journal 01

editor’s note Dear readers, Welcome to our first volume of Rice Remedy. Through this journal, we wanted to shed some light on the history of public health and how it has served as the battleground for addressing societal issues. This issue titled, “Braving Thorns’’, embarks on a journey that focuses on exploring the changes in public health policy in response to the tumultuous currents of healthcare. From devastating diseases like cancer and the Black Plague to the present challenges marginalized groups face in accessing healthcare, this issue will focus on struggles, triumphs, and advancements in healthcare.

Our team of writers, editors, and designers have poured their heart and soul into each of the pieces you will read. Through a historical perspective of healthcare and health policy, each article will offer a unique perspective focused on the milestones and communities most affected by health policy.

As you set sail and read through these pages, we encourage you to reflect on the role of public health in socio political justice. The field touches your life far more than many people realize, and we want to encourage critical thinking about the ways we strive to extend and honor human life.

We hope you enjoy our very first issue!

Bryant & Anuska Chief Editors Rice Remedy

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table of contents 05

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faculty address

courses

club spotlight

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Exploring Cancer: This article explores the history of cancer exploration and our progress in oncology.

History Repeats Itself This article discusses the differences between the Black Plague and the COVID-19 pandemic, and the respective responses.

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LGBTQ+ Health This article highlights some of the work taking place at the Montrose Center, an organization focused on caring for LGBTQ+ individuals

Why Health Policy ?

This article explores ongoing health policy in Harris County, and introduces policy ideas that can improve emerging issues in Houston.

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First Bone Marrow Transplant Performed in 1956 The first bone marrow transplant between identical twins is performed by E. Donnall Thomas.

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faculty address An Introduction

Hi all! My name is Dr. Diep, and I am one of the Health Sciences faculty. In case you don’t know me, three identities I highly value are being a mother to 5-year-old Alex and 3-year-old Alyssa, being Cambodian American, and being a Rice alum. To date me, the Rice baseball team won the College World Series the summer before I matriculated. Facebook, which first launched at Harvard and then select universities, extended an invitation to Rice students by the end of my freshman year.

President Leebron was inaugurated as president during my sophomore year and moved the president’s house off-campus. Tudor Fieldhouse, then known as Autry, was where the Rec Center was located. McMurtry and Duncan were not colleges. And Rice football beat Texas … just kidding!

I have many fond memories at Rice and owe a lot to the university, but I especially owe a lot to the Kinesiology Department and Health Sciences. Like many Rice students, I entered Rice as pre-med.

Over the course of my freshman and sophomore years, I realized that I didn’t enjoy the courses I was taking. I memorized, not learned; I couldn’t visualize the micro level; and I struggled to do well.

Long story short, failing a class was my epiphany moment – my “aha” that I needed to reevaluate my path. I looked through the course catalog (a literal and physical catalog at the time) and all the majors available at Rice. I found the Kinesiology major (Health Sciences program), and the rest was smooth sailing! (Well, maybe not, but let’s save the rest for another time.)

I enjoyed a lot about Health Sciences, including the small class sizes, ability to know the faculty (especially my mentor, Dr. I), and the courses themselves. One of my favorite courses was Nutrition

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with none other than Professor Anding. She was (and still is) very knowledgeable with entertaining stories to share. To this day, I highly recommend Nutrition with Professor Anding to students. My other favorite course was Disparities in Health in America. At the time, the course was a collaboration between Rice, UH, and TSU. The course cycled between the three institutions and included students from all three institutions. For each lecture, guest speakers presented and shared more about their work and/or experiences in disparities. This allowed students to network with professionals, which is how I met my eventual mentor, Dr. Beverly Gor. At the time, Dr. Gor was at MD Anderson Cancer Center working on Asian American cancer disparities. Listening to her guest lecture and then interning with her during my senior year motivated me to pursue Asian American health disparities in my career. While Disparities in Health in America is no longer a collaboration between the three institutions, I (now the course instructor) continue to bring in guest speakers because I know the value of learning from and networking with those in the field.

While many of the courses (e.g., Nutrition and Disparities in Health in America) and some of the faculty (e.g., Professor Anding) are still around, the Kinesiology major has changed a lot since my undergraduate years. First, the name. During my undergraduate years, there was only one Kinesiology major. I pursued the Health Sciences Program, but my transcript shows “Kinesiology” (i.e., B.A. in Kinesiology). This makes for some interesting conversations when others ask me for advice on physical activity, sports, and human movement (for which, I know little). Soon after I graduated, Kinesiology added the Health Sciences concentration and Sports Medicine concentration (e.g., B.A. in Kinesiology with a Health Sciences concentration). A few years ago, the Kinesiology major split into the Health Sciences major and Sports Medicine & Exercise Physiology major. Lucky for you, you will receive your B.A. in Health Sciences, which better reflects the courses you’re taking. Another change is the visibility of the Health Sciences major.

Just in the past 10 years, the number of students in the major has doubled. Much of this growth occurred in recent years, “thanks” to the COVID-19 pandemic and increased visibility of public health. Relatedly, there has been evolution in the major’s focus. The Health Sciences major has its roots in health education, health promotion, and behavioral sciences (one subdiscipline of public health), but the major is quickly evolving into more general public health. If all goes as planned, Health Sciences will soon bring in an additional faculty member to expand its focus, including health policy and environmental health.

The last change I want to highlight is HEALAR (shout-out to Julia Shi)! Thanks to Julia’s efforts and the efforts of those who have been involved in HEALAR since its founding in late 2020, we now have a majors club. From social events to personal and professional development to Rice Remedy, HEALAR has been instrumental in pushing Health Sciences forward.

In short, I owe a lot to Health Sciences. I wouldn’t be where I am today without the faculty, students, and courses from my undergraduate years. I hope that one day, long after you graduate from Rice and start your career and/or family, you will look back and think the same. I am excited to see the continual evolution of Health Sciences, and I can’t wait to see what Health Sciences looks like in the future.

Cheers, Dr. Cassandra Diep Health Sciences Faculty Advisor

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courses FALL 2023 This is a list of courses offerred in the fall of 2023 at Rice! Utilize this list of courses to plan your schedule during Add/Drop week, or to keep some of these courses in mind for future years!

HEAL HEAL 222: INTRODUCTION TO PUBLIC HEALTH Principles of Public & Community Health examines aspects of the community that relate to health including health issues within community subgroups; identification and analysis of community health programs; organizational patterns and functions of voluntary and governmental health agencies and coordination of community health programs.

Notes: Guest speakers that work in public health, exams and projects, average workload

HEAL 132: MEDICAL TERMINOLOGY This course introduces the student interested in medical and health professions to a large vocabulary of medical language which develops skills in understanding and remembering new words. It describes word origins, basic terms in anatomy and terms pertaining to each body system as well as pharmacology and medical equipment, and many frequently used medical terms, abbreviations and symbols.

Notes: great introduction to the medical world, good for practicing memorization skills

HEAL 350: UNDERSTANDING CANCER Examination of cancer from a biological, psychological and sociological perspective with emphasis on cancer epidemiology, prevention, and early detection.

Notes: this class is very personal to Dr. Hughes and involved a lot of guest speakers to let students get a real look into the varying facets of cancer from both the patient and doctor perspective

HEAL 208: UNDERSTANDING CANCER Examination of social, cultural psychological, physiological causes and effects of drug use and abuse. Individual, family, and community factors related to prevention and treatment will be addressed.

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KINE KINE 319: STATISTICS FOR THE HEALTH PROFESSIONALS Topics include displaying and describing data, the normal curve, regression, statistical inference including parametric and non-parametric analyses, and hypothesis testing.

Students also have the opportunity to analyze data using SPSS and Excel software.

Notes: exams and homeworks, emphasis on conducting health sciences studies and statistical literacy for use in healthcare (was this treatment effective, does this study represent the population well, how can healthcare professionals evaluate efficacies of research for use in clinical practice)

KINE 300: HUMAN ANATOMY WITH LAB An introduction to normal human anatomy structure and function. All major body systems will be examined in both lecture and laboratory format using a variety of physical and virtual models.

KINE 301: HUMAN PHYSIOLOGY This course will address the fundamental principles of human physiology at the cell, tissue, organ, organ system, and organism levels. Emphasis will be placed on mechanisms of function and homeostasis as achieved through the coordinated function of homeostatic control systems.

Dr Laura Kabriri: “My teaching philosophy is simple: nurture, mentor, pay it forward.

Foster innate curiosity. Build self-confidence. Teach the importance of relationships.

Emphasize that everyone is there on purpose, for a purpose. I want students to feel welcome and empowered in their own learning process.

I love my core “Kabiri Trifecta” courses (Human Anatomy, Human Physiology, and Medical Terminology). The human body is absolutely incredible and I hope my enthusiasm is contagious! However, it’s never about the content. It’s about creating an engaging and inclusive learning environment where everyone feels valued, contributory, and capable of succeeding.”

OTHER ENGL 272: LITERATURE AND MEDICINE ENGL 273: MEDICINE AND MEDIA MDHM 201: INTRODUCTION TO MEDICAL HUMANITITIES GLHT 201: INTRODUCTION TO GLOBAL HEALTH

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club spotlight

HEALAR Health Sciences at Rice

The goal of HEALAR is to build a community amongst Health Sciences majors at Rice and foster a supportive environment for majors’ professional and personal development. We are committed to using our channels of communication to encourage more inter-class year interactions, promoting member engagement through volunteering and experiential learning, and exposing students to diverse careers in health sciences. Non-majors, although not eligible for officer positions, are welcome to join our listserv + GroupMe and attend events.

upcoming events HEALAR GENERAL BODY MEETS HEALAR will host general body meetings throughout the semester to share information with members and get them to know each other!

PANELS WITH GUEST SPEAKERS HEALAR will invite Rice alumni and individuals who studied or pursued health sciences as a career. It is the perfect chance to connect and network with individuals

STUDY BREAK Take a break from midterm or exam season through HEALAR study breaks with various snacks and food!

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T H E

H I S T O R Y

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CANCER FROM HISTORICAL PERSPECTIVES

TO MODERN DAY UNDERSTANDING Written by Abby McKellop Design by Bryant Polanco

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Since the dawn of humanity, we have been searching for the key to outlive time. From the quest for an eternal elixir to the development of modern techniques to minimize aging, humans have continued to have an obsession with the preservation of life. The earliest records of time describe magical or religious healers, the Renaissance brought about the first understanding of modern medicine, and the present day champions the work of bright physicians (Encyclopedia Britannica, 2023). On the journey to improve quality of life, humanity is facing one of its greatest obstacles: cancer.

Although still a battle, we have made great strides in our understanding of the disease and our ability to treat it. But, our understanding had to start somewhere, so let’s flash back to the past for a journey through our understanding of cancer.

Carcinos: The Medieval Cancer The earliest understanding of cancer is accredited to Hippocrates, a Greek physician often referred to as the father of medicine.

Hippocrates described the thin projections of tumors as carcinos or carcinoma, the root of each of these words referring to ‘crab,’ in relation to what he saw. This word was later translated into ‘cancer’ by Roman physician Celsus, and Greek physician Galen used the root word oncos to describe tumors. This terminology manifests today as oncology, the study of cancer (American Cancer Society, 2018).

A Journey through Biological Understanding After Hippocrates’ description of tumors with the word carcinos, the next major development in understanding cancer occurred in 1761, when Giovanni Morgagni of Padua conducted an autopsy on a patient in order to try and determine the cause of death. This was a step in the right direction, building the foundation for the field of oncology (American Cancer Society, 2018).

In 1882, William Halsted made major strides by conducting the first mastectomy on a patient with breast cancer. This operation removed the breast and surrounding tissues, and this showed a major development in cancer treatment that is still used today. In 1886, Hilário de Gouvêa made great progress in our understanding of cancer by proving a cancer may have some hereditary component. He reported that two of seven children developed cancer in the eye after their father also had that cancer (National Cancer Institute, 2020). In as early as the 18th century, doctors had already developed one viable treatment option and were beginning to understand that cancer involved genetic material.

The 20th century represents an explosion in our understanding of the disease, with a discovery in the middle of the century that truly changed our understanding of molecular biology. In 1902, Theodor Boveri suggested that uncontrolled cell division could be stemming from chromosome damage, as he identified this pattern in cells with this damage (National Cancer Institute, 2020). Throughout this time period, various scientists discovered that cancer could be induced by certain viruses and some chemicals, contributing to the modern understanding of cancer causes. Throughout the rest of the century, more treatment options such as radiation, hormone therapy, and chemotherapy were developed (National Cancer Institute, 2020). Many of these treatments were created even before the discovery of DNA, an integral part in our modern understanding of the disease.

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First radical mastectomy performed in 1882 by William Halsted, technique became known as “Halsted Mastectomy”.

The Modern-Day Understanding of Cancer Our modern-day understanding of cancer could only have arisen from the discovery of the DNA, a winding macromolecule with the ability to hold all of our genetic information.

In 1951, James Watson and Francis Crick discovered the double-helix structure of the molecule, providing insight into how information was stored and transferred (National Library of Medicine). Later, scientists would learn that genetic information is encoded by sequences of base pairs: nitrogenous building blocks bound to a deoxyribose backbone (Urry et. al, 2016).

With the valiant efforts of many scientists, we came to more thoroughly understand the process of cell division. This process is entirely controlled by the activation and deactivation of particular genes at specific times to ensure that genetic information is copied with high fidelity. Cell division requires the orchestration of many processes, like coordinating the operations of the busiest airport; there are many necessary prerequisites and security checks to ensure the entire operation runs smoothly. And the most amazing part is that most of the time, it

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does. But, as seen in cancer, the impacts of even a seemingly small malfunction can be detrimental.

The commonly cited definition of cancer is uncontrolled cell growth (City of Hope, 2022).

This uncontrolled growth is caused by mutations to particular genes that play a role in governing the regulation of the cell cycle.

The two major gene types that experience driver mutations are proto-oncogenes and tumor suppressor genes. Proto-oncogenes encode the proteins for several necessary cell functions: promoting cell division and determining cell differentiation (cell specialization into a certain tissue, for example a skin cell or a muscle cell), and stopping programmed cell death, apoptosis.

When these proto-oncogenes are mutated, they become oncogenes and the proteins they encode tend to be overproduced. The overproduction of these proteins leads to malfunctions, such as increasing division, decreasing differentiation, and inhibiting of the apoptosis pathway (Chial, 2008). On the other hand, tumor-suppressor genes inhibit uncontrollable growth by regulating the division step of the cell cycle (Cooper, 2000).

Mutations to these genes activate them, which essentially removes the regulatory mechanisms in place to counteract the overproduction of cells that could be caused by an oncogene.

One of the major problems with treating cancer is that it causes a snowball effect. Not only are growth mechanisms operating at an increased level, but regulatory mechanisms are also unable to identify damaged DNA and shut down the process. Therefore, as the cells continue to grow and divide, mutations from the precursor cells are passed on to daughter cells, creating more cells with mutated DNA. Additionally, the fact that DNA is being modified describes why it is hard to find a ‘cure’ for cancer, as there are many complex pathways that genes enable. Therefore, learning how to specifically target these pathways can require quite some ingenuity.

The State of The Field: Oncology Equipped with a foundational understanding of genetics and molecular biology, many of the underlying pathways that lead to cancer are better understood. Although the nuances of particular genes and regulatory pathways are not yet understood completely, scientists have come a long way. Many current research efforts seek to better understand these particular pathways to develop drugs or other molecules to counteract the cascading effects of cancer.

While research is being conducted in search of better treatments, understanding the nuance of the disease helps to explain why it is difficult to treat. Some common techniques used to treat cancer today are surgery, radiation, or chemotherapy: these techniques look to remove or break down the cancer cells. Some other techniques include immunotherapy or targeted therapies, which look to increase the immune response to cancer cells and target specific pathways impacted by mutated genes, respectively (American Cancer Society 2014).

Although we have many treatments, we have yet to find an end-all cure. But, with a disease as dynamic and complex as cancer, our

progress is incredible; we have developed many different approaches for treatment that can be catered to the specific type of cancer. Reflecting on the history of cancer truly shows just how far we have come, and sheds light on just how much further we will inevitably go in improving outcomes for cancer.

Works Cited American Cancer Society. (2023).The history of cancer. First Cancer Diagnosis. (n.d.). Retrieved April 9, 2023, from https://www.cancer.org/treatment/understanding-yourdiagnosis/history-of-cancer.html Encyclopædia Britannica, inc. (2023). The spread of new learning. Encyclopædia Britannica. Retrieved April 9, 2023, from https://www.britannica.com/science/history-ofmedicine/The-spread-of-new-learning Jaime R. Herndon, M. S. (2022, December 11). When was cancer first discovered? Verywell Health. Retrieved April 9, 2023, from https://www.verywellhealth.com/the-history-ofcancer-514101 National Cancer Institute. A historic perspective. Cancer.

Retrieved April 9, 2023, from https://www.training.seer.cancer.gov/disease/history/ National Cancer Institute. (2020, August 31). Milestones in cancer research and Discovery. National Cancer Institute. (n.d.). Retrieved April 9, 2023, from https://www.cancer.gov/research/progress/250-yearsmilestones National Institutes of Health. The discovery of The double helix, 1951-1953 | Francis Crick - profiles in Science. U.S. National Library of Medicine. Retrieved April 9, 2023, from https://profiles.nlm.nih.gov/spotlight/sc/feature/doublehelix National Library of Medicine. Tumor suppressor genes - the cell - NCBI bookshelf. (2000). Retrieved April 10, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK9894/ Nature Publishing Group. (2008). Nature news. Retrieved April 9, 2023, from https://www.nature.com/scitable/topicpage/protooncogenes-to-oncogenes-to-cancer-883/ What is cancer, is it common & how do you get it. Cancer Treatment Centers of America. (2022, August 18). Retrieved April 9, 2023, from https://www.cancercenter.com/what-iscancer Urry, L. A., Cain, M. L., Wasserman, S. A., Minorsky, P. V., & Reece, J. B. (2017). Campbell Biology. Pearson.

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History Repeats ItselfComparing COVID-19 to the Black Plague Written By: Madison Barendse Designed By: Abby McKellop

Introduction

It is a beautiful day. People should be filling the streets, going about their business and enjoying the weather.

Instead, a sense of unease fills the air.

As you prepare to head out, you wonder about the rumors you have been hearing - rumors about a strange new illness spreading through the countryside. No one knows what it is, how it spreads, or how to stop it. All they know is that the disease is spreading, and it is spreading fast.

People are starting to get worried. You linger for a moment, then decide to stay away from crowded areas for a little while, just to play it safe. This should be over soon… right?

While reading this description, you may have been reminded of early 2020, when news about COVID-19 started to circulate. However, that guess is a few centuries too late. You felt the perspective of someone living in 14th century Europe during the Black Death.

For many Europeans, it therefore seemed natural to blame the Jewish community for the Black Death, an accusation which would lead to widespread violence. Contemporary testimonies and archaeological digs have provided evidence of dozens of antisemitic massacres, or pogroms, which occurred during the Black Death (Colet, et al., pp. 63-91). Moixé Increased Prejudice and Hate Nathan, a contemporary author and Crimes financier, directly linked the rioters’ The Y. pestis bacterium wasn’t the only cause of death between 1347 and violent antisemitism to their 1351. As the Black Death spread, pre- uncertainties about the plague when he paraphrased the assailants’ existing societal tensions reached a motivations (Colet): boiling point. Unsure of what was happening and desperate to protect themselves from an invisible, insidious “On the day that any plague or famine threat, people quickly became hostile occurs that threatens the Earth, the towards social minorities, whom they people cry ‘All this happens because blamed for the spread of the disease. of the sins of Jacob! Destroy this nation, kill them!’ And during the As a result, the spread of the Black Death was accompanied by a spike in disaster [...] they undertake in a violently thoughtless way to destroy prejudice and hate crimes. the unfortunate Jews.” (p. 68) However, history has a way of repeating itself. Despite the massive societal, technological, and scientific advancements that have occurred since the 14th century, humanity still managed to repeat some of its worst mistakes.

One group which suffered considerably during the Black Death was the Jewish community. During the The Black Death was a devastating epidemic that struck Europe and Asia Middle Ages, Europe was dominated by the Catholic church, a body which in the mid-14th century. Caused by held as doctrine many antisemitic the Yersinia pestis bacteria, this beliefs. As a result, the Jewish disease killed over 20 million people, community was subjected to or almost one third of the European widespread prejudice and mistrust, population (History.com, “Black and was often used as a scapegoat for Death”). The COVID-19 pandemic, on the other hand, began in 2020 and has all manner of natural events (USHMM, “Antisemitism in History”). since spread across the globe. It is caused by the SARS-CoV-2 virus, and has caused the deaths of nearly 7 million people as of April 2023 (https://covid19.who.int).

At first glance, the similarities between these outbreaks may seem superficial. After all, Y. pestis and SARS-CoV-2 cause entirely different symptoms and death rates. They are separated by hundreds of years – and surely we have changed since the Middle Ages. There should be no comparison.

By the early 1350s, thousands of people across multiple regions had been massacred (History.com, “Black Death”). In the midst of a biological catastrophe, the people of Europe had the chance to overcome prejudice and hatred to combat an inhuman threat.

Instead, they turned against each other, and created an even greater tragedy.

While COVID-19 has not led to the same level of outright violence as the Black Death, studies have demonstrated that it has led to increased discrimination against racial and ethnic minorities. It has also caused a spike in anti-Asian hate crimes (Strassle, P., 2022). Now, like then, uncertainty and fear contribute to increased prejudice as people seek to protect themselves from an invisible threat. While we have made significant progress towards tolerance, this shows that we still have a long way to go.

It can be tempting to label disease an equalizer. While it is true that viruses and bacteria do not discriminate based on race, ethnicity or economic status when infecting people, social inequalities still have a significant effect on exposure and mortality.

Moreover, differences in social status Additionally, research has shown that created differences in health status people of lower socioeconomic status prior to infection. Evidence has shown are more likely to have underlying that people already in poor health due health conditions that could put them to malnutrition or other causes were at risk of severe disease if infected more likely to die due to the Black (Blundell et al., 2020, paras. 39-40).

Death (Wade, 2020, para. 10). Given Once again, illness exacerbates social that people of lower socioeconomic inequalities.

During the mid-1300s, doctors status were more likely to be prescribed a variety of treatments and malnourished or otherwise at low Quarantine ways to avoid the plague. These health during the plague, this means The response to the Black Death was treatments ranged from the that socioeconomic status had a littered with serious mistakes. ineffective (e.g., using incense to clear significant influence on one’s chances However, some of the responses to away ‘bad air’) to the harmful (e.g., of survival once infected (Wade, 2020, the epidemic were surprisingly bloodletting), but very few actually para. 11). advanced, considering that they were helped the patients. The only carried out in the Middle Ages. Key generally beneficial advice given by Due to these factors, researchers have among these was the implementation plague doctors was to leave infected estimated that people of lower of early social distancing. cities for less populated areas in order socioeconomic status had a mortality to avoid exposure to the disease rate almost double that of wealthy (Mark, 2020, paras. 2-3). landowners (Wade, 2020, para. 11).

This is supported by the words of John of Fordun, a contemporary Scottish chronicler (Russell, 2020): “This sickness befell people everywhere, but especially the middling and lower classes, rarely the great.” (para. 5) This early method of social distancing was famously depicted by “The Decameron,” a collection of short stories written by the fourteenthcentury Italian author Giovanni Boccaccio. In this work, a group of people travel from Florence to the surrounding countryside to avoid the plague currently ravaging the city (Boccaccio, 1349). This method of social distancing would have been beneficial, as it decreased one’s chances of exposure. However, not everyone could afford to leave their homes to escape the plague, so this method of social distancing mainly benefited the affluent.

Social inequalities have had a similar effect throughout the COVID-19 pandemic. For example, when social distancing mandates were first implemented, many people began working from home to reduce potential exposure to the disease.

People with higher levels of education and higher earnings were more likely to be able to work from home, and were therefore less likely to be exposed to COVID-19 (Blundell et al., 2020, paras. 22-23). Additionally, research has shown that people of lower socioeconomic status are more likely to have underlying health conditions that could put them at risk of severe disease if infected (Blundell et al., 2020, paras. 39-40). Once again, illness exacerbates social inequalities.

The first city to pass legislation mandating quarantine was the Venetian-controlled port city of Ragusa, on July 27, 1377. This legislation required that “those who come from plague-infested areas shall not enter [Ragusa] or its district unless they spend a month on the islet of Mrkan or in the town of Cavtat, for the purpose of disinfection.” While this edict was passed some time after the initial outbreak of the Black Death in the 1340s and 1350s, it was a direct response to the previous epidemic and continued outbreaks of the Y. pestis bacteria (Roos, 2020).

The effects of this legislature are more far-reaching than one might expect.

You see, people arriving at Ragusa were initially required to remain in isolation for a thirty day period, which became known in Venetian law as a trentino. However, to ensure that no disease entered the city, officials would later extend this period of isolation to forty days (Roos, 2020).

For them, the name of this new period of isolation was obvious, and it will be deeply familiar to anyone alive during the COVID-19 pandemic.

Disease is life’s constant companion.

Humanity has faced countless They called it a quarantino. illnesses, microbial threats that tested us to the limits of our capacity but could not destroy us. The Black Death Conclusion and the COVID-19 pandemic brought The last eight centuries have been out the worst in people, but they also marked by countless technological demonstrated humanity’s ingenuity advances and significant societal and resilience. Perhaps, if we learn change. We have achieved levels of from the past, we can ensure that globalization and equity unimaginable history never repeats itself again. to someone living in the 1300s.

However, over the past few years, we have also seen history repeat itself in several key ways.

Colet, A., et al. (2015). The Black Death and Its Consequences for the Jewish Community in Tàrrega: Lessons from History and Archaeology, Pandemic Disease in the Medieval World: Rethinking the Black Death (pp. 6396). Arc Medieval Press, Kalamazoo and Bradford. https://doi.org/10.2307/j.ctvmd83jc Strassle, P., et al. (2022, March 1).

“COVID-19–Related Discrimination Among Racial/Ethnic Minorities and Other Marginalized Communities in the United States.” American Journal of Public Health 112, no. 3: pp. 453466. https://doi.org/10.2105/AJPH.2021.30 6594 Mark, J. (2020, April 15). Medieval cures for the Black Death. World History Encyclopedia. https://www.worldhistory.org/article/1 540/medieval-cures-for-the-blackdeath/ Boccaccio, G. (1349). The Decameron.

Wade, L. (2020, May 14). From Black Death to fatal flu, past pandemics show why people on the margins suffer most. American Association for Then, as now, humanity made terrible the Advancement of Science.

References mistakes. The threat of disease https://www.science.org/content/artic contributed to increased prejudice History.com editors. (2023, March 28). le/black-death-fatal-flu-pastand violence, though it was expressed “Black Death.” History.com. pandemics-show-why-peoplein different ways and against different https://www.history.com/topics/middl margins-suffer-most groups. Social inequalities were e-ages/black-death Russell, E. (2020, June 3). How exacerbated as the wealthy had more World Health Organization. “WHO pandemics past and present fuel the opportunities to social distance and Coronavirus (COVID-19) Dashboard.” rise of large companies. The generally stood a better chance of who.int. https://covid19.who.int/.

Conversation. surviving the illness if infected.

Accessed on [2023, April 5] https://theconversation.com/howHowever, we have also learned from United States Holocaust Memorial pandemics-past-and-present-fuelthe past, as shown by the wide Museum. “Antisemitism in History: the-rise-of-large-companies-137732 adoption of social distancing to From the Early Church to 1400.”

Blundell, R., Costa Dias, M., Joyce, R., prevent the spread of disease.

Holocaust Encyclopedia. & Xu, X. (2020). COVID-19 and https://encyclopedia.ushmm.org/cont Inequalities. Fiscal studies, 41(2), 291– ent/en/article/antisemitism-in319. https://doi.org/10.1111/1475history-from-the-early-church-to5890.12232 1400?series=30. Accessed on [2023, Roos, D. (2020, March 25). Social April 5].

Distancing and Quarantine Were Used in Medieval Times to Fight the Black Death. History.com. https://www.history.com/news/quara ntine-black-death-medieval

How Society Traumatizes Queer People story by Anuska Santra edited by Caroline Huynh

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Trigger warning: Homophobia, Hatecrimes If you’ve ever googled “am I gay,” you probably are. The percentage of queer people has increased with each generation, with 20.8% of Generation Z identifying as the L, G, B, or T (1). as increasingly safe and inclusive attitudes towards queerness sweep society. But just because it’s getting better doesn’t mean it’s good. According to the National Center for PTSD, LGBTQ+ people are almost “4 times more likely” to be violently assaulted (2).

In addition, “LGBT people are nine times more likely than non-LGBT people’’ to experience a violent hate crime, often called a gay bashing (3). Though being proudly out can compromise both social and physical safety, hiding in the metaphorical closet isn’t much safer. The inner turmoil from hiding one’s sexual identity has resulted in a public health issue for queer people that can only be addressed by tackling the systems in place that force people into the closet.

Being closeted can spiral into trauma for queer people. “The most dangerous place for anybody to be is in the closet,” says Bob Hergenroeder, a counselor at Montrose Center. The Montrose Center has catered to the LGBTQ+ population of Houston from its conception in response to the AIDS epidemic, and Hergenroeder has dedicated the greater part of his life to AIDS advocacy and giving back to the queer community by providing counseling. “People do horrible things when they’re in the closet because you’re hiding and you’re vulnerable…”

(4). When asked if queer people experience any psychological issues at a disproportionate rate, Hergenroeder said queer people tend to come into his office with trauma - specifically, trauma that results from being queer,

not trauma that results in being queer. He pointed out that kids can encounter homophobia during the normal process of socialization - from being in school, church, or extracurriculars, children are exposed to so many different personalities that sometimes even having supportive parents isn’t enough to help queer youth feel safe enough to come out. He presents the very harsh reality that many queer people share: before they themselves realize they’re queer, they can get clocked by their peers. In that way, a child with too much strut in their step can be a target of ostracization before they can understand why.

It’s no surprise then that the queer community experiences higher rates of anxiety and depression (5). According to the US Census Bureau, from the period of June 1-August 8, 2022, LGBT people of all ages had higher rates of depression and anxiety than non-LGBT people. These rates, and the difference between the two rates, increase as the ages decrease. Of the youngest group of LGBT people recorded, ages 18-29, 60.5% reported experiencing depression and 50% reported experiencing anxiety. The queer experience, closeted or not, takes a major toll on the mental stability of the community. These rates become more complex as intersectionality is introduced - a study published in 2016 reported that men experience greater rates of major depressive order and generalized anxiety disorder when out of the closet than while in the closet, while the reverse is true for women. In addition, in 2021 the Advisory Committee on LGBTQ Issues and Minority Affairs Section of the American Medical Association asserted that black LGBTQ people have higher rates of depression than non-Black LGBTQ people across all genders. The increased difficulty of navigating intersecting marginalized identities demonstrates the inherent trauma

THE MONTROSE CENTER is a beacon of support and community for all.

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disorder when out of the closet than while in the closet, while the reverse is true for women. In addition, in 2021 the Advisory Committee on LGBTQ Issues and Minority Affairs Section of the American Medical Association asserted that black LGBTQ people have higher rates of depression than non-Black LGBTQ people across all genders. The increased difficulty of navigating intersecting marginalized identities demonstrates the inherent trauma of experiencing social, political, and economic discrimination – oppression is thereby a public health issue.

Hergenroeder did offer ample hope for the mental health of LGBTQ+ youth. In his years of counseling, he has noticed a stark rise in the number of parents who choose to be active allies so that their children feel supported should they need it. Parents will bring their children to youth groups or even counseling in order to better understand their transgender child or build a stronger relationship with their closeted teen. After a long history of parents sending children to conversion therapy in order to “fix” their children, parents are beginning to try to make changes within themselves in order to help with their own understanding. Though simply being queer was

once seen as a public health issue, clinicians are now beginning to pivot towards viewing the worse mental health of queer people as a public health issue.

The queer experience in the US is both harrowing and beautiful. Some of the most rich aspects of queer culture, such as voguing, ballroom, and chosen family, were born from hardship and systemic oppression. One of the most major tragedies of queer history, the HIV/AIDS epidemic, is an ongoing public health issue, and yet gender affirming health care for queer people continues to be stripped around the US. Increased cultural competence about the queer community is non-negotiable if doctors, researchers, and public health officials want to serve this growing population in the US adequately. This means not just addressing mental health issues in queer people, but tackling the deeply rooted systems of oppression that fuel them.

References Roberts, A. L., Austin, S. B., Corliss, H. L., Vandermorris, A. K., & Koenen, K. C. (2010). Pervasive trauma exposure among US sexual orientation minority adults and risk of posttraumatic stress disorder. American journal of public health, 100(12), 2433–2441. https://doi.org/10.2105/AJPH.2009.168971

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The queer experience in the US is both harrowing and beautiful. Some of the most rich aspects of queer culture, such as voguing, ballroom, and chosen family, were born from hardship and systemic oppression.

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HEALTH for POLICY HARRIS COUNTY Written by Akshay Sethi Design by Bryant Polanco

Zip codes can determine health outcomes in cities in the United States—Houston is no exception. Areas in the city can be predicted to have lower life expectancies, for example, simply by looking at the makeup of the neighborhoods. Zip codes 77016 and 77026 are a part of the city’s historical wards—marked as hazardous in Figure 1. Zip code 77506 is in the middle of Galena Park, known for its oil refinery (now a part of Texaco). The city of Houston is touted as the most diverse major city in the country, boasting a variety of cultural events and fusion food to the rest of the world.

However, underneath the advertising for its diversity that is found across the city, lies a myriad of Houston is separated by three ring roads, with many from the city calling those living within I-610 to be from Houston proper. The city stretches far and wide across Harris County, which is larger in area than Rhode Island. Houston’s city limits extend all the way on its southwestern border till Beltway 8 (adjacent to Sam Houston Tollway), and other areas of the city are a mess of roads spining throughout the 4th most populous county in the country.

The city also holds a special feature making it stand alone against other major cities in the States—there are no zoning laws. The City of Houston’s website proclaims that it “[does] not address land use.” The reality of having no zoning laws means clusters of “central business districts” throughout the city like Downtown Houston, the Galleria, Downtown Montrose, the Medical Center as prominent nexuses of a multinodal city. One important consequence of the City keeping out of private investment and development is the cultural formation of the “Houston Arrow,” which is known in the area as a wealthy region consisting of the richest zip codes in the state, as well as six small “sister cities” that were formed because of no zoning laws in Houston.

Their higher life expectancy and overall health outcomes can be a model for the city.

Every year, billions of dollars are spent on lobbying for a variety of policies and on either side of each issue. In part because of high amounts of money being spent on various general population dissatisfied with Congressional action.

We expect that due to gridlock and a small number of legislation being passed, lobbying dollars will be the variable to push bills through committee and to passage. This culminated in our question of if the amount of lobbying dollars towards a piece of legislation increases the probability it is passed?

Methodology: Employment of a multivariate OLS model using lobbying and legislative data to build 2 separate models LBJ Hospital has been an essential part of the Harris Health System, contributing significantly to the delivery of healthcare services to a diverse and growing community. The hospital has played a crucial role in serving the medical needs of Houston's uninsured residents, offering a broad spectrum of services, including emergency care, primary care, specialty clinics, and various medical programs. Harris County and its residents should be commended for the 2.5 billion dollar bond being put up to a vote and it being passed so Harris Health System can better support its large community base. .

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The funding will go to much-needed improvements within public health in the county, including the upgrade of LBJ Hospital to a Level 1 Trauma center, which the American College of Surgeons recommends 1 per every 1 million people (Harris County has 4.8 million residents and 2 current Level 1 Trauma centers).

The bond also calls for funding for additional clinics in Harris County. Public health initiatives are crucial in addressing the social determinants of health prevalent in underserved areas. These determinants include factors such as socioeconomic status, education, and access to healthcare, all of which significantly impact overall well-being. The addition of clinics in Harris County aligns with a broader vision of creating a more equitable healthcare landscape, ensuring that individuals in underserved communities receive comprehensive and timely medical attention. The critical needs in public hospitals in Harris County will require further funds and manpower to support a system that serves a diverse and growing uninsured population.

Proposal: Houston needs to implement comprehensive zoning laws that strategically regulate the location and expansion of petrochemical facilities and industrial zones within the city.

The absence of zoning laws has allowed industrial facilities to operate in close proximity to residential areas, leading to increased exposure to air and water pollutants. This proposal seeks to address this issue by introducing zoning regulations that carefully allocate industrial zones away from densely populated neighborhoods, schools, and healthcare facilities. The following measures should be taken: 1. Define specific zones for industrial and petrochemical activities, ensuring they are located in areas with minimal residential presence.

2. Establish buffer zones to protect sensitive areas such as schools, hospitals, andm residential neighborhoods from the adverse effects of industrial activities.

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The city needs a divestment from the petrochemical industry. This is the toughest ask. Houston was built on the large oil booms in Southeast Texas, and with 10 refineries— providing nearly 15% of the nation’s daily oil production—the city is still dominated by fossil fuels. ExxonMobil, with two locations of operation in the region, has lobbied nationally over 6,000,000 on average every year in the last decade—making it one of the top lobbyists in the country. It is hard for the city to get rid of the industry that brought it so much economic wealth, but the reality remains that the petrochemical industry is a major source of air and water pollution, adversely impacting the environment and public health.

Petrochemicals have caused a ‘cancer belt’ of sorts where communities with a noted lack of health infrastructure are suffering. The threshold for carcinogenic measurements is a hot topic within the scientific community, where one side claims that there are Threshold Limit Values (TLVs) to which there is a safe level of exposure to a carcinogenic substance —while others posit that any level of exposure is harmful. Regardless of the discussion on hazardous carcinogenic levels, these communities are exposed to harmful chemicals as an externality of the petrochemical production nearby.

One harmful chemical, which has been denoted as a “confirmed carcinogen” by the National Institute for Occupational Safety and Health (NIOSH), is benzene, which is in higher concentration than in other areas of the country that are close to petrochemical plants.

The policy would include the following measures: 1. A cap on the amount of petrochemical production in the city.

2. The creation of a task force to monitor and enforce compliance with the cap.

3. The implementation of stricter environmental regulations on petrochemical production.

4. The promotion of alternative industries that are more sustainable and diverse.

5. The development of a plan to transition workers in the petrochemical industry to other industries.

The cap on petrochemical production would be determined based on scientific studies and the recommendations of the task force. The task force would consist of experts in environmental science, public health, and economics. They would be responsible for monitoring compliance with the cap and recommending adjustments as needed.

Stricter environmental regulations would include limits on emissions, waste disposal, and water usage. These regulations would be enforced by the task force, and penalties would be imposed on violators.

The promotion of alternative industries would be done through targeted incentives for businesses that invest in sustainable and diverse industries. This could include tax breaks, grants, and other forms of financial assistance.

Finally, the plan to transition workers in the petrochemical industry to other industries would be developed in collaboration with labor unions and other stakeholders. This plan would include training programs, job placement services, and other forms of support to help workers transition to new industries.

Improving healthcare policy in Houston requires a multi-faceted approach that includes implementing zoning laws, limiting the petrochemical industry, and investing in public hospitals in Harris County. These measures are essential for promoting public health outcomes and reducing the impact of pollution on the community.

By implementing this policy proposal, Houston will be able to create a more sustainable and equitable healthcare system that benefits all residents.

References:

Association, Texas State Historical. “Galena Park, TX.” Texas State Historical Association.

Accessed May 2, 2023. https://www.tshaonline.org/handbook/entries/galen a-park-tx.

“Development Regulations.” Accessed May 2, 2023. https://www.houstontx.gov/planning/DevelopRegs/.

“Gulf Coast Refining Capacity | Houston.Org.” Accessed July 8, 2023. https://www.houston.org/houston-data/gulf-coastrefining-capacity.

“Houston Maintains Position as Most Diverse City in Nation.” Accessed September 4, 2023. https://www.houston.org/news/houston-maintainsposition-most-diverse-city-nation.

III, Harry Hurt. “The Cancer Belt.” Texas Monthly, May 1, 1981. https://www.texasmonthly.com/news-politics/thecancer-belt/.

“Trauma Center Designation Based upon System Need and the Economic Drivers Impacting Trauma Systems | ACS.” Accessed September 4, 2023. https://www.facs.org/aboutacs/statements/trauma-center-designation-basedupon-system -need-and-the-economic-drivers-impacting-traumasystems/.

“U.S. Census Bureau QuickFacts: Harris County, Texas.” Accessed November 11, 2023. https://www.census.gov/quickfacts/fact/table/harris countytexas/PST045222. writer, McKenna Oxenden / Staff. “Voters Approve $2.5B Harris Health Bond Issue to Renovate, Expand LBJ Hospital and Clinics.” Houston Landing, November 8, 2023. http://houstonlanding.org/harris-health-bond-issueto-renovate-expand-lbj-hospital-and-cl inics/.

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Acknowledgments Thank you to HEALAR and Dr. Cassandra Diep for their continued support throughout the creation of this journal.

This would not have been possible without your support, thank you.

To our amazing staff, from the countless emails and meetings discussing the articles and designs to the culmination of our work through this journal, we hope you feel proud of your accomplishments presented here.

STAFF Chief Editors Anuska Santra

Akshay Sethi

Bryant Polanco

Abby McKellop

Editors

Madison Barendse

Akshay Sethi Catherine Cook Caroline Huyhn

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Writers

Designers Caroline Huyhn

Scott Koh

Abby McKellop

Zabrina Sidhu

Mirely Nieto

THANK YOU FOR READING! 28