"Popular Media Helps Establish the Public Health Agenda" That's What I Said.

"Popular media helps establish the public health agenda". I just read this line in a new article from the March 2010 edition of Preventing Chronic Disease...I thought- that's what I've been talking about. I knew public health and pop culture went hand in hand!
This particular research project was inspired by the CDC/Alzheimer's Association Initiative: National Public Health Action Plan to Promote and Protect Brain Health. The authors conducted a content analysis of the four most circulated Women's magazines (Good Housekeeping, Ladies Home Journal, Women's Day, Family Circle) and Men's magazines (Men's Health, GQ, Men's Journal, Esquire). They conducted a content analysis to see how the magazines described the three strategies correlated with healthy cognitive function (physical activity, healthy diet, and social involvement).
I will say that I was slightly disappointed that there was almost no discussion of the differences in how these issues are presented in Women's vs. Men's magazines. It is always interesting to see how public health issues are marketed differently based on gender. For example, I was fascinated in graduate school to see how cigarettes and smoking have been presented over the years. For example, Virginia Slims cigarettes were advertised in Women's Magazines with slogans like "You've come a long way baby". The products were visibly thin and the slogans focused on being free and empowered.
This content analysis was also interesting however, in that it identified what strategies were being talked about. They found that both types of magazines were focusing on prevention vs. treatment (yay!) Women's articles tended to be longer and were were likely to include contact information (for websites/researchers). It seems the magazines have done their research that women are more likely to seek help for a health issue. They also found that most articles focused on healthy diet, while increasing social involvement was almost never discussed. The authors do not speculate as to why social involvement was not presented. I find that interesting (and a shame) since social support/connection is also a protective factor for other health issues (e.g., suicide).
I think this type of research has great implications for other public health work. How often are pop media channels evaluated for the content/accuracy of their public health messages? How can the evaluation of those channels/messages inform the public health agenda? My message to MPH students: "Study that qualitative analysis textbook!" We're going to be needing researchers that can analyze the content of commercials, magazines, social networking sites...it sounds like a fun job!

If you'd like to check out the article I cited above:
Friedman et al. Cognitive Health Messages in Popular Women's and Men's Magazines, 2006-2007. Prev Chronic Dis. 2010: 7(2).

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Suitable oily / combination skin care products and routines

People that have oily / combination skin type have a very hard time with the proper care of their skin.  Because of over active sebaceous glands that are producing excessive oil or sebum, your skin looks greasy and dirty soon after washing.  Another disadvantage associated with your skin type is that you are very prone to breakouts.  Bacteria love to feed on sebum; skin gets inflamed and you will develop big red pimples. 

Fortunately, with the proper beauty products and daily routine, you can improve the appearance of your skin.  The key to oily / combination skin care is good cleansing, gentle exfoliation, oil control and using suitable skin care products. 

A good cleanser is a must for oily / combination skin care.  Those that are using soap or harsh cleansers that are designed to strip away all facial oil can cause a lot of damage to the skin.  You will need a gentle foaming cleanser that is formulated for oily / combination skin type.  There are some on the market with the active ingredient salicylic acid which targets oily skin with active pimples.  Other cleanser such as Neutrogena’s Transparent Facial Bar for acne-prone skin has no active ingredient but is extremely effective at sebum or oil control.  There is no one cleanser that fits all people; you will have to try different cleansers to find the one that works the best on your skin. 

Here is the proper routine for washing your face: first wet your face with some lukewarm water.  Use your fingers to gently message the cleanser into the skin for a deep clean.  Rinse your face clean with lukewarm water several times to get rid of all traces of cleanser.  Use tissues to gently get rid of all water on face. 

A gentle moisturizer is also very beneficial for those with oily / combination skin types.  However, if you choose the wrong one, it can make those over active sebaceous glands produce even more sebum.  The moisturizer you choose need to be water based, light and non-comedigenic (something that specifically states that or similar to “won’t clog pores”).  In fact, anything you use on the face must state that it does not clog pores.  Apply only once a day.

 Additional exfoliation will be needed for a deeper clean in the summer time.  Oily / combination skin usually have a harder time in the heat where sebaceous glands produce more sebum.  When your sweat is mixed with sebum, you face can get itchy and dirt / oil accumulates more on your face.  A mask that is designed to deeply clean your pores is a good choice to get rid of anything in the pores that will cause breakouts. 

Contrary to popular beliefs that makeup is bad for oily skin, some make up base is specifically designed for oily / combination skin that is acne prone.  In addition to covering blemishes, these can be beneficial to some women in terms of oil control and acne skin.  There are some make up bases that can actually “cure” acne on the face.  My roommate in college uses a Japanese brand makeup that controlled the level of her acne to about one or two small pimples a month.  I think the brand is called Shiseido, which is a very popular make up brand in Asia and Asian communities overseas.    

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The Commercials for The Heart Truth Campaign: Can We Stop "Raising Awareness" and Change the Environment Instead?

If you are a hard core Olympics watcher like I am, then you have probably been inundated with these Diet Coke commercials. They are so pretty...they have red hearts on the can...they are getting a lot of exposure during Primetime TV...and the goal is...WAIT- I have no idea what the goal is!
According to the commercial, the campaign is aiming to "raise awareness of heart health". Does this mean people should know that their heart could be healthy or unhealthy? Does this commercial give us all we need to create "awareness", or should we be directed to their website for more information? Are people supposed to do something to improve or change their current heart health status after watching?

This is the perfect example of a public health campaign that drives me crazy because it wastes valuable resources on unclear, unmeasurable, and ineffective goals.

For more information, I visited their website. Here I learned that: The Heart Truth is a national awareness campaign, sponsored by the National Heart, Lung, and Blood Institute, being embraced by millions who share the goal of better heart health for all women. The campaign not only warns women about heart disease, but it equips them to take action against risk factors.

Okay- so it sounds like the goal is to achieve better heart health for women. So that will require some actual change to achieve (e.g., increase healthy behaviors like exercise, improve treatment for heart disease, etc). However, the commercial (and most of the website) does not include a "Call to Action". A Call to Action is a clear indication of the action that you would like people to take after viewing your health communication materials. In order for people to make/change their current actions, you must do a lot more than "raise their awareness" of the problem. Awareness raising is simply an increase in knowledge. In addition to knowledge, actions/behaviors are influenced by several layers of factors. For example:

• Individual (e.g., does one feel like they are at risk for heart disease? They may not even think these commercials are applicable to them. Do they have a genetic risk?)
• Interpersonal (e.g., does their family support their wanting to make changes to reduce heart disease? Do family members provide child care so that women can exercise and attend doctors appointments?)
• **Environment ( This layer is so important! But is most frequently ignored by campaigns that are wanting to "raise awareness" among individuals. E.g., what if your neighborhood does not have grocery stores that sell affordable healthy food? What if your neighborhood isn't safe for exercise such as walking/bike riding? What if there is no affordable healthcare within the scope of the public transportation that you rely on for transit?)
• **Society/Policy (What if you do not have health insurance to cover the doctors and/or nutritionist visits that are outlined in the "Action Steps" on the campaign website?)

As you can see from the list above, I would argue that the most daunting barriers to heart health for women fall in the 3rd and 4th categories. However, we continually see campaigns focusing on changing individual knowledge about diseases. Has that ever worked in the past?! Was it enough to tell people that cigarettes were unhealthy? No- we had to look at the environment and policy issues. We had to increase the prices/tax on cigarettes and create smoke-free work places, etc. The same has been seen in alcohol prevention.

So this week when you are watching speed skating in Primetime and this adorable soda can with a heart comes on the screen...picture me rolling my eyes as I sit on the couch. Please- let's spend valuable resources on reducing the barriers that actually impede health. Let's think bigger!

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Confirmed: Alexander McQueen Died by Suicide. When will Entertainment Reporters Catch on to Recommendations for Safe Reporting on Suicide?

The fashion world suffered a great loss last week. For those of you who also drool over Sandra Bullock's SAG award dress...or Sarah Jessica Parker's ensemble for the London Premiere of 'Sex and the City', you must be familiar with the designs of Alexander McQueen. The British fashion designer died by suicide last Thursday.
As I read multiple accounts of his death via various sources of entertainment news, I am continually struck by the irresponsible reporting of a celebrity suicide. In 2001, Reporting on Suicide: Recommendations for the Media, a report by the Centers for Disease Control and Prevention, National Institute of Mental Health, Office of the Surgeon General, Substance Abuse and Mental Health Services Administration, American Foundation for Suicide Prevention, American Association of Suicidology, and Annenberg Public Policy Center was released. Research indicates that the way suicide is reported in the media can contribute to additional suicides and suicide attempts. Conversely, stories about suicide can inform readers and viewers about the likely causes of suicide, its warning signs, trends in suicide rates, and recent treatment advances. The above recommendations have been developed to assist reporters and editors in safe reporting on suicide. In 2005, these recommendations were even summarized to be a quick "At a Glance" reference for reporters.
I'm highlighting what I see as a typical entertainment news story on Alexander's death and how this and stories that first surfaced late last week basically do the opposite of what is recommended for safe reporting.

What NOT to Do:

• Avoid detailed descriptions of the suicide, including specifics of the method and location. This article provides a description of the location and method of the suicide.
  
• Avoid romanticizing someone who has died by suicide. Avoid featuring tributes by friends or relatives. Avoid glamorizing the suicide of a celebrity. Many articles have simply included tributes by fellow celebrities, such as Lady GaGa, Madonna, and Sarah Jessica Parker.
• Avoid oversimplifying the causes of suicides, murder-suicides, or suicide pacts, and avoid presenting them as inexplicable or unavoidable. Although many articles have highlighted that Alexander was a survivor of his best friend's suicide three years ago (which can be a risk factor for suicide) and that he lost his mother just a week before his own death...we don't know the myriad of risk factors that could a played a role in this tragedy. Suicide is a complex system of risk and protective factors, that cannot be explored in a two paragraph article.

What TO Do:

• Always include a referral phone number and information about local crisis intervention services. I did not see this in any articles that I read.
• Emphasize recent treatment advances for depression and other mental illness. Include stories of people whose treatment was life-saving or who overcame despair without attempting suicide. Again- Nada.
• Interview a mental health professional who is knowledgeable about suicide and the role of treatment or screening for mental disorders as a preventive strategy. Um- Nope.

But not to be discouraged! Many newspapers and news reporting organizations have begun to ask for training on this issue (SPRC is a resource). However, I would argue that the entertainment news organizations are the last to follow. Are national and statewide suicide prevention organizations reaching out to places like E! News? Access Hollywood? People Magazine? I would bet that these news organizations have a much higher readership than many local/national newspapers. Advocates, are you listening? Contact these organizations! There is a desperate need to improve the safety of reporting on celebrity suicide.

Resources:
Are you feeling desperate, alone or hopeless? Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), a free, 24-hour hotline available to anyone in suicidal crisis or emotional distress. Your call will be routed to the nearest crisis center to you.

• Call for yourself or someone you care about
• Free and confidential
• A network of more than 140 crisis centers nationwide
• Available 24/7

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Kevin Smith 'Too Fat' to Fly Southwest? Discrimination or Legitimate Enforcement of a Public Safety Policy?

Via Twitter and/or popular media, I am sure many of you have seen the story regarding Kevin Smith and Southwest Airlines. Kevin Smith, a New Jersey native like myself, is well known for comedies such as the 90s favorite- Clerks. This past weekend, Kevin was removed from an Oakland to Burbank, CA flight because he did not fit comfortably into the passenger seat. Kevin has since published multiple tweets documenting the humiliating experience of being kicked off that flight. He argues that Southwest Airlines was wrong in their actions- that he posed no flight/safety risks.
I would argue that even though Kevin Smith is a celebrity (so he can make a louder rebuttal to a larger audience when he feels he is wronged), Southwest Airlines was correctly enforcing a clear and specific public health/safety policy. (A policy that is certainly not unique to this airline- almost all major airlines have a similar policy with similar definitions/actions). The Southwest Travel Policy website clearly lays out FAQs for "Customers of Size" (this term varies a bit airline to airline). The policy clearly defines what it means by Customers of Size (i.e., the armrest is the definitive gauge- if the customer is unable to lower both). It also clearly defines the action that can be taken proactively by customers in this category- they can buy a second seat (this will ensure their comfort and reduce any embarrassment having to deal with this at the airport or on the flight). In an upgrade over many other airlines' policies, customers are offered a refund for the second seat if that flight does not oversell. The website indicates that 98% of extra seat purchases qualify for a refund.
The article highlighted above states that "Smith originally purchased two tickets- as he's been known to do when traveling Southwest, but when he decided to fly standby on an earlier flight, only one seat remained." Since Smith originally purchased two tickets, I would argue that he was very familiar with (1) the Southwest policy on customers of size and (2) his inclusion in that category. Therefore, his cry of discrimination is unfounded and somewhat slanderous. The purpose of these policies is not to embarrass individuals, but instead to protect the health and safety of all individuals on the flight. All customers must have ample opportunity to access plane facilities as well as emergency exits if necessary. Having clear and specific written policies should protect Southwest and their actions...and Kevin Smith should probably lay off his Twitter attack.

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What are real causes for adult acne and adult cystic acne?

There are so many adults that are still suffering from acne; some even suffer from cystic acne that never seems to go away. Exactly what causes acne to flare up continuously even when you have long passed puberty? There are so many causes for acne and there is no one treatment that will work for everyone.

According to some studies, around fifty percent of adult women and twenty five percent of adult men suffer from acne. This is a significant percent of the population that are still burdened with this problem even well into their adulthood. Acne is not just a surface problem that affects the skin. It is very devastating to self esteem and confidence. In extreme cases, people will lose social interactions and opportunities at love all because they are embarrassed from acne. I experienced too many breakouts that made me extremely self conscious about my own skin. Those that do not understand the problem will say, “oh, it will go away eventually”, “it’s not really that bad, I am sure other people won’t notice”. These people do not understand our problem because they never suffered from it; the worse thing you can do is not get any treatment and hope it will go away by itself. Understanding the cause of adult acne or adult cystic acne is the first step toward successful treatment.

The biggest cause for any adult acne is heredity. If one of your parents suffers from acne when they are younger, you might inherit those bad genes for acne prone skin. From what I understand, heredity is the worst when it comes to acne. My dad inherited his oily, sensitive and acne prone skin from his dad. I received the same genes for oily, sensitive and acne prone skin. My breakouts are more severe than most people where it was treated and then returned slowly to a point that it was comparable to the previous levels. You can also use that to your advantage because what works on your parent that suffered from acne will most likely work for you.

Stress is another factor that can cause you nasty breakouts. Stress will stimulate facial oil glands and make your face oilier than usual. Excess oil on the face can clog pores, attract bacteria and result in more pimples than usual. Depending on the amount and severity of the breakout, you will have to get prescription medicine to get rid of existing pimples. They have several kinds of prescription medicine that will either lessen your acne problems or completely get rid of it. Reducing stress is essential to make sure acne doesn’t come back. If stress levels are high, acne prone skin is very hard to manage.

Most adult women suffer from a monthly breakout right before the menstrual cycle; this acne tends to be adult cystic pimples that are painful and have a tendency to scar. This is extremely difficult to treat with normal over-the-counter or prescription medicine. In this case, only birth control pills will do the trick. Most women notice that not only their acne disappears but the skin also gets so much better overall. However, you should be aware that when you suddenly stop the medicine, acne can come back with more force than ever. Birth control pills are medicine that helps with your hormone imbalances.

What cosmetics are you using on your face? Some people that are suffering from acne are suffering because of the products that they use on their faces. Many products are made so it is oil free, non-comedogenic. If you are using a product without these words, chances are it is either worsens your acne or it’s causing them.

Any treatment for adult acne or adult cystic acne is trial on error. There is no one thing or medicine that will cure all types of acne. In my case, it is a combination of different remedies that “cured” my acne. But remember, you will have to keep on trying to get the clear skin. The more you work on your skin, the better it will get. You should always keep an open mind about your skin because one day it will be completely free or your condition will be under control. I never thought that day will come, but now my skin is better than ever after more than 7 years of suffering from active acne, here is my daily acne skin care routine. Acne skin care systems on the market are worth a try. Although, it won’t work for everyone, there is always a chance that it is the right product for you.

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Types of acne and your options for treatment – explained in details

There are so many different types of pimples that affect the face and body. Some are minor and will go away without any treatment, whereas other types of pimples are more severe that might require extensive treatments and care. I am listing very common types of acne and what you should do in each case to properly treat / care for them. This list is in the order of mild to severe forms of acne.

Whiteheads – it is very small pimple that is not inflamed at all. They are small bumps and not very visible to the eyes unless you look closely. It is not painful and heals very quickly without using any over-the-counter or prescription medicine. They don’t scar even when you pick at it. However, it is still not recommended that you pick any kind of acne. Our skins are different and what scars for one person will not for another. Over-the-counter face washes that unclog pores (active ingredient: salicylic acid) should be enough to treat this kind of acne.

Blackheads – these are acne that is not inflamed at all. They are mild acne that is mainly on the nose and part of the cheeks. It takes a long time for them to go away because it is a very stable structure under the surface of the skin. Your best options here are using a gentle exfoliating scrub or a strip that pulls out the blackheads. These pimples will not scar but are the hardest to permanently get rid of among all types of acne.

Papules – these are moderate acne that is inflamed. These are a small bump in the center that is surrounded by an area of redness. This type of acne needs treatment such as benzoyl peroxide gel. The most important thing to remember about this type of acne is absolutely do not pick these lesions. It will cause the bacteria to go into deeper layers of the acne which has very high risks of scarring. Popular acne system sold on the market today such as Proactive is sometimes effective at this type of acne. If no treatment is effective and amount of acne increases, you should seek a dermatologist’s advice.

Pustules – these are very similar to papules with the exception of having a white center. The acne is pus filled and the visible pus in the middle will get bigger. Most of these pimples will break open by itself and many people speed up healing by squeezing out the pus. If you do it wrong, it has the risk of scarring. Again, depending on the severity and amount of pimples, you might need to consult a dermatologist when it doesn’t respond to over-the-counter treatments. Theses are moderate to severe type of acne.

Nodule – this is one of most severe type of acne that you can get. It is red, huge and hard. It can be under the skin for months without anything happening. Most over-the-counter medicines will have no effect on this type of acne. Your best bet is to see a dermatologist for a cortisone injection that can help it go down. If you don’t do anything to it, it can take several months to up to a year for the nodule to heal. Fortunately, Accutane is an extremely effective drug for people suffering from severe acne. Most dermatologists will prescribe it to you when all the other treatment options failed. For more than half of the people, Accutane will completely get rid of your acne. Other people will see a dramatic reduction in the severity and amount of acne that they suffer from. At the very least, skin will be a lot more manageable with Accutane treatment.

Cyst – this is also one of the most types of acne that you can get. It is very similar to nodule because it is very painful as well. It differs from nodule because it is pus filled. And it has a lot of pus. This type of acne is large and very noticeable. Not even makeup can cover all of it. You should visit a dermatologist for this type of pimple. Effective treatments are similar to what people use for nodules.

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