Tag: health

Trust issues

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It really pains me to say this, but we have entered an era when we can no longer trust our government’s health agencies or the advice they give us. I know that there are some people who have felt this way for a long time (in some instances for good reason); however, for the most part government agencies like the CDC and the FDA have relied on sound science and expert opinion to guide their recommendations. Sadly, this is no longer true. If we had any doubt about it, it was erased by watching Robert F. Kennedy Jr.’s appearance before a Senate committee yesterday.

So what are we supposed to do? How do we get reliable guidance on things like vaccines and screenings? Who do we trust now?

Some states – such as the consortium formed by California, Oregon, Washington and Hawaii – are going to come up with their own vaccine guidelines based on the most evidence-based medical research. I hope that they are successful and that the people living in those places feel reassured and will place their trust in their local public health professionals. For the rest of us, though, the reality may be that we have to do our own research, apply a critical eye to what we hear and read, and be our own health advocates.

To that end, I’m beginning to compile a list of sources that I believe are reliable, trustworthy, and based on solid medical evidence. Here’s what I have so far (in no particular order):

KFF Health News – If you want all the latest health news about policies and the health system in general, this is a good place to get it. It is published by KFF, an endowed nonprofit organization that doesn’t appear to be beholden to anyone. All of their content is free to everyone. Currently they have articles on their site about the upheaval at the CDC, confusion around back-to-school vaccine policies, as well as health studies that have been published elsewhere. Another source for public health news is the Public Health Newswire published by the American Public Health Association.

Doing Well – A newsletter from Arizona State University Health, Doing Well’s tagline is “Better health, one story at a time.” Because it’s published on Substack, it does require a free subscription, but they don’t send you too many messages, and you can access the stories through audio as well as reading them. Recent stories have covered how to stay healthy when wildfires are nearby, how to get more fiber in your diet, and a podcast about underhydration. In addition, each newsletter defines a medical term that people might not understand, such as “microbiome” and “epigenetics.”

Women’s Health from Johns Hopkins – This site has comprehensive health and wellness information specifically targeted to women’s health concerns at all ages, including preventive care, sexual health, menopause and stress.

Your Local Epidemiologist – Dr. Katelyn Jetelina is a public health professional and epidemiologist who writes this Substack newsletter (you might be asked to subscribe). I haven’t spent a lot of time with it, but I know several people who speak very highly of her writing, and her ability to translate complicated and confusing information into a form that is easily understandable for laypeople. She currently has a guide to the fall 2025 vaccines on her site.

The medical specialty associations – Organizations dedicated to medical specialties continue to issue their own sets of health guidelines and can be a good source of information for consumers. These include the American Academy of Pediatrics, which still maintains its recommendations for childhood vaccinations, the American Heart Association for heart health information, and the American Psychological Association, which supports mental health and has posts on topics like misinformation and “managing uncertainty in a chaotic work environment.”

And for dealing with stress and finding meaning in life, despite the chaos, check out Greater Good Magazine from the Greater Good Science Center at the University of California, Berkeley.

Finally, I want to express my heartfelt gratitude to the employees, past and present, at the CDC who have tried to do the right thing for the American people – thank you for fighting the good fight.

How not to drown in rage

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“The Torqued Man” by Peter Mann is a Nazi-era novel about spies and double agents, truth and lies, and contorting oneself to survive. At one point a character reflects on the changes that have been inflicted on society:

When each day brings unprecedented assaults on civility, each one enough to make you gasp with rage and disbelief, you gradually grow accustomed to this new form of breathing, until you hardly notice you are hyperventilating.

Living in an environment of nonstop rage and disbelief will soon exhaust even the most resilient person’s energy. That’s why it’s so important that we take moments of care for ourselves, in order to rest, replenish, and restore.

Anxiety makes us feel worried and fearful, and it can also lead to rapid, shallow breathing – even hyperventilating. At such times it’s helpful to have an array of breathing practices to counteract the escalating fear and slow the breathing down. A previous post of mine outlines some of those practices, like alternate nostril breathing and 4-7-8 breathing. When you do 4-7-8 breathing, the exhale is twice as long as the inhale (8-count vs 4-count) which works well to dial down the stress response and trigger the parasympathetic nervous system.

Ujjayi breathing, which is used in yoga practice, is also beneficial for anxiety. To do ujjayi breathing, you keep your lips closed and constrict the back of your throat as you breathe so that you make a kind of rushing sound. Some people describe it as sounding like snoring, and others say it sounds like the ocean, which I prefer. The breathing itself calms you like the other practices and the sound adds a resonance that becomes another focal point.

Sometimes repeating the lyrics to a song, a poem, or a favorite prayer can also help ground us when we’re anxious. This week the New York Times has a special feature about the benefits of memorizing a poem, as many of us had to do in school. Using the poem “Recuerdo”, by Edna St. Vincent Millay, they are guiding readers each day through the process of using rhythm and alliteration to memorize it, stanza by stanza, so that by the end of the week, it can be committed to memory. This poem happens to incorporate all five senses, which makes it almost like a guided imagery practice. Try it!

By taking the time to restore ourselves in these kinds of ways, we can develop more long-term resilience for the challenges we face. As James Baldwin said, “There is never time in the future in which we will work out our salvation. The challenge is in the moment; the time is always now.” So let’s be ready to meet our moment by first treating ourselves with compassion and care.

“Health is a thermometer of injustice”

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I can’t get this line out of my head ever since I heard it last Friday during a webinar from Partners in Health. Vincent Lin, who works with the organization on health policy and advocacy, attributed this quote to one of his mentors, and it really resonated with many of us who were watching. The focus of the webinar was on advocacy and action to “save Global Health” because so much of PIH’s work is at risk right now due to funding cuts at USAID. Programs to treat TB and HIV are especially hard hit.

If you’re not familiar with Partners in Health, it is an organization co-founded almost 40 years ago by Dr. Paul Farmer with the belief that everyone deserves quality health care. They combine health care and social justice work in countries around the world to advance health and health equity. (You can watch a documentary about PIH here.) They understand that when everyone everywhere enjoys good health, we are all better off. But right now millions of lives are at risk as the funding that pays for community health workers, medications, and more has been reduced to a trickle.

It’s been really difficult to figure out what to do in the face of all these cuts. Of course we can vote – but not for over a year; we can donate money if we have it; but what else? That’s what people are asking themselves, and it’s a natural question. When we’re confronted with such a stressful situation, sure it helps to engage in some calming practices, but we also want to figure out what we can control. We want some sort of action-oriented strategy that will help us feel that we are doing something. As I wrote in one of my earlier posts, “For any kind of stressor, there are usually two main ways of handling it – either through a problem-focused approach or an emotion-focused approach. The problem-focused approach asks, ‘What actions can I take to either eliminate or change this stressor?’ The emotion-focused approach doesn’t change the stressor, but may change how you think about it, how often you think about it or how you interact with it.”

So it was helpful that the PIH program was focused on actions to address the problem. They discussed emailing and calling your members of Congress but also suggested writing letters to the editor of your local newspaper. As someone who lives in Washington, D.C., without any voting members of Congress, it’s especially important to me to have other ways to take action. There is also a resource guide for people to learn more about TB (a disease about which most of us in the U.S. are probably pretty ignorant) and find out how you can play a part in the fight against it.

It may still not seem like enough, but if a lot of people engage in small ways, I have to believe it will make a difference. We can’t afford to feel helpless right now, we each have to use the power we have.

I’d love to hear back from you – are there other ways that you are taking action right now to change policy or address injustice? Please share them!

Where to now for public health?

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Almost five years ago, I gave up writing in this space because I didn’t have much left to say and I thought there were other voices that needed to be heard. The experiences of the last couple of months, however, have compelled me to speak up again. This platform is a place that I can use my voice, small as it is, to counteract the really devastating changes that are happening to our country — the opportunity to use my voice in the voting booth is way too far off.

Today I’m most concerned about the state of public health in America. Yesterday we saw lines of health agency employees locked out of their offices, finding out when they showed up for work that they were out of a job or put on leave. The advisory committees that help keep our food supply safe and determine the makeup of next year’s flu shots have either been disbanded or had their meetings cancelled. Research dollars have been cut off from the academic centers where new treatments for cancer or heart disease might be discovered.

Who is protecting us, the people, if all these institutions are dismantled? I’ve never been a person who lacked trust for the government, but my trust is going to be really shaken if these changes aren’t overturned. So, my goal here is to provide you with information, links and resources where you can still find trustworthy health information, and to amplify the voices of those who are fighting for us.

One of those organizations is the American Public Health Association, which has introduced a new undertaking, For Our Health, to bring together people in the public health sphere, and defend evidence-based health initiatives. Last week, they wrote to Congress about the cuts to public health agencies, saying in part,

Public health is not a partisan issue—it is a core responsibility of the government and essential
to our nation’s security, stability, and prosperity. HHS and CDC play an irreplaceable role in
safeguarding American lives, yet their mission is sabotaged by neglect and misinformation at
the highest levels. Failure to act now will result in preventable suffering, deaths, and the further
deterioration of our nation’s standing as a global leader in health and innovation.

I encourage you to check out For Our Health, and to use your voices too. Let’s protect ourselves and each other.

Do you know the lonely one?

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The front page story yesterday about how loneliness is “lethal” would lead you to think that we just discovered it. The fact is that scientists have known for some time that loneliness and social isolation put people at higher risk for heart attacks, cancer, Alzheimer’s disease and other conditions. What’s new in the past couple of months is that studies of the genome are yielding information on the specific mechanisms that make it happen.

Because social cohesiveness and cooperation were vitally important in early human history, the brain is rigged to see a lack of strong ties as a signal of danger. Just like any other kind of stressor, that signal puts the body on the alert, even down to the cellular level. In studies of both humans and macaque monkeys, researchers have discovered that social isolation leads to specific genetic changes that turn up inflammatory processes in the body and turn down the production of antibodies against viruses and other pathogens. These genomic adaptations are linked to human evolution, designed for our survival, and are closely related to the body’s stress response.

This heightened fight-or-flight response, activated on a chronic basis, results in increased inflammation and a reduced immune response, leading to significant long-term damage. The mechanism is observed in both directions: a change in gene expression predicts future loneliness, and loneliness predicts future gene expression. In older adults, perceived loneliness leads to an increase of 14% in premature deaths.

Sydney_142It’s worth mentioning that loneliness is not the same as being alone. What matters is whether someone feels connected, and feels satisfied with the connections he or she has. Plenty of people (myself included) relish some solitude on a pretty frequent basis, but that doesn’t equate to loneliness or isolation.

While we often focus on the elderly being socially isolated, loneliness can strike anyone, from the bullied schoolchild to the working adult with social anxiety. In the book “Fear”, Thich Nhat Hanh wrote about original fear and original desire. He says original fear started at birth when we were pushed, helpless, out into the world, unsure whether anyone would take care of us. That fear “was born along with the desire to survive. This is original desire.” Original fear and original desire stay with us as we grow, especially the fear that no one will love and care for us. To me, loneliness is one manifestation of that fear.

You may be reading this and thinking, “I’m not lonely – I don’t need to worry about this.” There’s a bigger picture, however, that might concern you. Analysis of social networks by Nicholas Christakis and James Fowler has shown that loneliness (like obesity, quitting smoking and other habits and trends) is contagious. So the more time that people in your social network, even those on the fringes of it, spend feeling isolated, the more likely it is to spread to others in the network. Over time, there’s a possibility that more of us start experiencing those feelings.

In a world where connection is constant, but often feels unsatisfying, how can we feel less lonely? How can we help others who are lonely? Forced togetherness is not the answer. Interestingly, some research has shown that a mindfulness based stress reduction program is more successful than social networking or community programs are at reducing feelings of loneliness in the elderly. MBSR has also been shown to turn down the pro-inflammatory processes in the body. The focus on present moment may be guiding attention away from the fear of being alone.

Christakis has said that when you help “the people on the margins of the network, you help not only them but help stabilize the whole network.” It would be wise to consider how we can do more to reach those people and offer them positive social connections. Maybe we can light up the network with love rather than fear.Lights

Making your resolutions reality

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Debbie Ford wrote that “New Year’s resolutions often fail because toxic emotions and experiences from our past can sabotage us or keep us stuck with the same old thoughts, patterns and regrets.” It can be scary to look closely at ourselves, to acknowledge some of our fears and emotions. That’s why having a plan for dealing with those negative voices boosts the staying power of your resolutions. Here’s part 2 of stress management as a foundation for resolutions:

Live purposefully — What drives you? What are you passionate about? When you combine  your values with the gifts and strengths you offer to others, that synergy helps you feel engaged, connected, and part of something larger than yourself. If, as Sean Johnson suggests, you ask yourself every day, “What is worth my time, attention, prana, love?”, and then follow that path, your actions will bring you an authentic feeling of happiness, rather than anxiety.

Move more — This advice doesn’t have anything to do with a resolution you might have about exercising more. This is movement for the joy of motion. Just move more, even when you don’t exercise. Walk somewhere that you usually drive – you’ll notice different things! Dance when you’re cleaning the house. Go ice-skating. Take the stairs instead of the elevator at least once a day. Movement is what our bodies crave when we are overloaded with the products of stress. It just feels good to move, so do it!Skaters

Practice compassion — starting with yourself! This is probably the most helpful thing you can do for yourself if you are trying to stick to resolutions. Don’t beat yourself up when things aren’t going as planned. Observe your own struggles, and those of others, with compassion. Try this meditation from Jack Kornfeld: “May I be held in compassion. May I be free from pain and sorrow. May I be at peace.” After you have directed these thoughts toward yourself for a while, turn them to others you know.

Learn something new everyday — Knowledge is power. Are you trying to have a healthier diet? Instead of following the latest fads, read some reputable nutrition literature and educate yourself in a way that will make your actions more successful. Try a different source for the news of the day to get another perspective. Read a book about something you know nothing about — it may be a great distraction from the focusing obsessively on what you are trying to change.Laughing woman

Laugh – then laugh again, and again. The other day I found a little collection of comic strips that I’ve cut out of newspapers. Even though I’ve read them many times, they still make me laugh every time I see them. We laugh for all sorts of reasons – sometimes it’s because things are genuinely funny, other times we laugh because a situation is so absurd, often we laugh just so we don’t cry. Like movement, laughter helps us rid the body of stress hormones. It also helps shift perspective, realize that we are not alone, and take the mind off of problems. Remember that your resolutions are supposed to make your life better, so don’t take them so seriously – resolve to laugh more in 2016!

Out of the holidays, a home

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When you think of New York City’s Rockefeller Center at this time of the year, their famous Christmas tree probably comes to mind. It could easily be the most visible holiday tree in the world, because of its size (often close to 100 feet tall), its prominent role in many holiday movies, its presence in New York, and its annual lighting featured on live TV. But its most important role comes after the holidays, when it helps provide affordable housing for one lucky family each year.

Perhaps you’ve heard this story before, but it’s new to me. Every year for the past 9 years, the company who owns Rockefeller Center has donated the lumber from the Christmas tree to Habitat for Humanity for use in building a home. The lumber is marked with the year and “Rockefeller Center tree”. In addition, the company’s employees volunteer their time to work on the build, along with the family who will live in the home, transforming the Christmas tree into a safe and solid shelter. When these families celebrate their own holidays, in new homes far from New York City, they are surrounded by that glorious tree.

Habitat for Humanity estimates that one in four people worldwide lives in poverty housing. For almost 40 years, they have been building, rehabbing and repairing homes for people in need around the world. With the help of 2 million volunteers each year, they have served 6.8 million people in that time period, offering them hope and a chance for stability.

A lack of affordable housing affects people of all ages and races. The MacArthur Foundation is funding $25 million in research to determine what the impacts are, and how best to address the need. Their premise is that “affordable housing may be a ‘platform’ that promotes positive outcomes in education, employment, and physical and mental health…” In other words, if we address the housing issue first, other things may fall into place.

The French philosopher Gaston Bachelard once wrote, “If I were to name the chief benefit of the house, I should say: the house shelters day-dreaming, the house protects the dreamer, the house allows one to dream in peace.”

So how does a Christmas tree live forever?  When it becomes a home, the platform on which dreams are built.

Wishing you peaceful dreams for the new year…

What will you fight for?

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There’s a moment in the film “Fed Up” when Dr. Harvey Karp says that if a foreign nation were “doing this to our children, we would defend our families.” He’s talking about the way food manufacturers market products full of sugar to our kids, leading to addiction that is every bit as powerful as that caused by drugs like cocaine. The potential for a lifetime of health problems caused by the resulting obesity is both real and heartbreaking.

He could just as easily be talking about the gun lobby, though, another instance where big money and weak politicians combine to create open season on our children. The parallels between the two industries, and our lack of political will, hit me as I walked by a neighborhood church last week. On their front lawn was a memorial to victims of gun violence – rows of t-shirts with the names and ages of people in the area who died by guns in 2013.

Would we fight an outsider who was doing this to our children? What do we fight for anymore? I feel like we, as a society, are in a state of learned helplessness. That’s a condition where someone stops looking for a way to help himself, or change a bad situation, because experience has taught that nothing but pain or disappointment comes from trying. We’ve just stopped fighting the way we should be.

Sure, there are people like Tom Harkin in the U.S. Senate who have fought the good fight on school nutrition standards and food marketing to kids, just as there are groups and individuals who have passionately worked for tighter gun laws. But both efforts are uphill battles that seem marked by more defeats than successes. Just this week, there were two or three more school shootings. When the news comes on, we can no longer tell if we’re hearing about yesterday’s shooting or a new one today; we’ve become so inured to such news that hardly anyone is even calling for a change in gun laws.

People on the other side of this debate – for both food and guns – say that it’s about individual responsibility. “Kids need to eat less and exercise more.” “Guns don’t kill people, people kill people.” But we can no longer control everything individually. That just doesn’t work in a modern country where everyone is exposed to huge social networks and an unstoppable media barrage. At this point the only changes that will be of significance are the ones that alter the conditions in which we live, that transform the toxic environment for everyone.

Clarence Darrow said that “Lost causes are the only ones worth fighting for.” So let’s stop the helplessness. We all need to stand up and say we’re fed up.

Let the sun shine

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I’m smiling at the news that the health benefits of sunshine may outweigh the risk of getting skin cancer from its rays.

Just in time for summer, new research has shown that exposing our skin to sunshine can lower blood pressure, cut our risk of heart attack and stroke, and perhaps help us live longer. High blood pressure is such a common condition (68 million Americans have it) that it leads to 80 times more deaths than skin cancer does. Now it turns out that when our skin gets sun exposure, a compound is released in the blood that actually lowers blood pressure. This effect is separate from the previously known benefits of Vitamin D from the sun.

Today we use the term “sun worship” to describe people who like to sit out in the sun and tan. But ritual worship of sun gods and goddesses goes back for millennia. People have long known and appreciated the life-giving force of the sun. It is the source of all energy and life on earth, through the process of photosynthesis and from the warmth it provides our planet. Sunrise and sunset are magical times of the day, when colors blaze across the sky. In yoga, we do sun salutations to open our practice by welcoming the sun.IMG_2347

So today I salute the sun for these life-giving blessings:

  • Sunlight helps improve mood, and lessens the effects of seasonal depression. As Wilma Rudolph said, “When the sun is shining I can do anything; no mountain is too high, no trouble too difficult to overcome.”
  • The sun provides Vitamin D, which helps us absorb calcium (keeping bones strong), and may protect against certain types of cancer, diabetes, rheumatoid arthritis and other conditions.
  • The sun powers our hot water heaters, homes, watches, and maybe someday, our cars.
  • The sun gives order to our days, orienting us to time and space.
  • Sunny days get us outdoors, so we get more exercise.
  • The sun stimulates the production of melatonin, which helps us get a good night’s sleep.
  • The sun gives us rainbows.
  • The sun ripens and sweetens the fruit we eat. In the words of Galileo, “The sun, with all those planets revolving around it and dependent on it, can still ripen a bunch of grapes as if it had nothing else in the universe to do.”IMG_03521

And isn’t true that when the sun is shining, we feel as if it shines just for us? We bend toward the sun like flowers do, waiting to be opened up, growing just a little bit taller in its light.

Shouldn’t “holiday stress” be an oxymoron?

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The emails are starting to arrive. “Holidays Stressing You Out?” says one. “Staying Healthy During the Holidays“, with managing stress as the first topic, reads another. What’s wrong with this picture? The word holiday suggests festivity, recreation, and a vacation mentality. The word stress suggests discomfort, a lack of balance, perhaps even unhappiness. These two words do not belong together.shiny tree

Someone once suggested to me that managing stress is all about managing expectations. While I don’t agree with that 100%, I do think it applies to holiday stress. Much of the stress around holidays comes from what might be considered unreasonable or unnecessary expectations:

  • The expectations we have about  spending time with family and friends.
  • The expectation that we have to give gifts to a specified list of people, and/or the expectation that  we have to spend a certain amount of money.
  • The expectation that we will eat and drink too much.
  • The expectation that we will hold on to traditions, even ones that aren’t serving us anymore.

Another way of putting this?  Too many shoulds, musts, oughts, have tos.

Tips for managing holiday stress are useful, but only as a second step. Like any kind of stress, managing stress around holidays has to start with values clarification, with doing some of the inner work.One of my yoga teachers has observed that for many of us, the default is to do as much as we possibly can, without asking ourselves if it is appropriate, or if we are suffering because of it.

What is values clarification? It could start with questions such as these:

  • What is most meaningful to me about this holiday?
  • What are the things or activities that bring me joy? Which cause me or others to suffer?
  • What do I need in order to be most fully present for the people I love?

When we do this kind of inquiry, we might be able to change our interaction with the holiday for the better. But like coping with any stress, that can’t happen unless we’re willing to make changes, and even rock the boat a little. Doing all the same things in the same old way won’t lead to any significant improvement.

Advice from healthfinder.gov
Advice from healthfinder.gov

Once you’ve clarified what’s important to you, and what is going to bring the most happiness to you and those you love, that’s the time to turn to techniques like the planning calendar, keeping up your exercise, and drinking more water. If you start with those things, without stopping to examine your values, you’ll find yourself returning to the default — just using prioritizing and planning as a way to cram more into each day. Even if one of those things you eke out time for is “relaxing”, it might not be as beneficial as it could be if you knew you were living each day in alignment with what’s truly important to you.

Can you wake up each morning during the holiday season knowing that the day will bring you something good? I know of someone who takes a moment before getting out of bed each morning to remember something positive about the day before, and something joyful to look forward to in the day ahead. Stress hormones are typically at a cyclical peak when we first wake up in the morning — so you could do yourself a lot of good by starting each day with a smile instead of a feeling of dread. That’s easier if you’re clear on what you value.

Let’s make “holiday stress” a thing of the past.