Better Off

There are widespread power outages and shortages of food and water in Puerto Rico in the wake of Hurricane Maria. The storm is being blamed for at least two dozen deaths. It also devastated the island’s infrastructure, destroying the power grid and leaving millions without electricity. According to estimates from the U.S. military, half of the island does not have access to clean drinking water. To get some perspective on the public health and medical challenges facing the island we spoke with Stephanie Kayden, vice-chair and chief of international emergency medicine and humanitarian programs in the department of emergency medicine at Brigham and Women’s Hospital and Harvard Medical School. Kayden is also an assistant professor in the Department of Global Health and Population at the Harvard Chan School. Kayden has delivered emergency medical care around the world—including constructing a field hospital for survivors of the 2010 Haiti earthquake.

A recent report published in The Lancet finds that health systems in sub-Saharan Africa are largely unprepared to deal with that region’s rapidly expanding epidemic of diabetes. According to the Lancet Diabetes & Endocrinology Commission nearly a quarter of adults in some countries now have diabetes, but only half of those with diabetes are diagnosed, and of those, only 1 in 10 are receiving treatment. More than 90% of cases of diabetes in sub-Saharan Africa are type 2 diabetes, suggesting that modifiable risk factors are major contributors to the burden of disease. In this week’s podcast we’ll speak with Rifat Atun, professor of global health systems at Harvard Chan School and one of three lead authors of the report. Atun will explain what’s driving this rapid increase in diabetes and what health systems can do to respond effectively.

More than 90,000 schools in the U.S. have participated in the Box Tops for Education program—one of the largest school-based brand marketing initiatives. The program was launched by General Mills in 1996, and participating schools can earn money by collecting Box Tops from select products. While eligible goods include paperware and office supplies, Box Tops are featured on a wide array of packaged foods and beverages. Because these products are not actually sold in schools, they're not subject to federal nutrition standards. But if they were, how would they stack up nutritionally? New research from Harvard T.H. Chan School of Public Health and MassGeneral Hospital for Children finds that less than a third of the products would meet federal "Smart Snacks" standards. In this week's episode we speak with Elsie Taveras, Division Chief of General Academic Pediatrics at MassGeneral Hospital for Children and professor of nutrition at the Harvard Chan School, and Alyssa Moran, a doctoral student at the Harvard Chan School. They'll explain why the Box Tops program may be driving parents and children to make unhealthy food choices—and unwittingly turns kids into brand ambassadors for these products.

In Texas the focus is shifting from saving lives to recovery in the wake of Harvey. The storm is being blamed for at least 64 deaths and the devastating flooding caused billions of dollars worth of damage. The region faces a long and difficult recovery—one that will be complicated by Hurricane Irma. The category 5 storm has already caused widespread devastation across the Caribbean and is bearing down on Florida.

In this week's podcast we're focusing on disaster recovery from two angles. First, Eric McNulty, director of research and professional programs at the National Preparedness Leadership Initiative at Harvard T.H. Chan School of Public Health and Harvard Kennedy School, will explain why the recovery from a disaster like Harvey is so difficult. And in the second part of the episode, we'll explore the best ways to help support the recovery effort. Julia Brooks, legal research associate at the Harvard Humanitarian Initiative, will explain why it's almost always better to donate cash, instead of clothes or supplies.

August 31, 2017 — Tropical storm Harvey has caused devastating flooding around Houston, Texas since making landfall as a hurricane on August 26. The storm has dumped nearly 50 inches of rain—and is being blamed for more than two dozen deaths—though that number is likely to rise. Houston is now assessing the damage as Harvey moves to Louisiana. In this week's episode we speak with Richard Serino, distinguished visiting fellow at the National Preparedness Leadership Initiative at Harvard T.H. Chan School of Public Health and Harvard Kennedy School and former deputy administrator of the Federal Emergency Management Agency (FEMA). Serino says that the focus in Texas and Louisiana right now is still on saving lives—then emergency responders can turn their attention to a recovery that is likely to take years.

More than half of the world's population lives in so-called emerging markets—countries such as China, India, Brazil, and Mexico. These are middle-income countries on the rise, experiencing rapid economic and population growth—and in many cases improvements in health. These nations wield enormous economic power, but experts say that has come with environmental consequences. In this week's podcast, we'll be speaking with two of the authors of a new report warning of the dangers of unchecked economic growth: Ian Scott, executive director of the Emerging Markets Symposium, and Ana Langer, director of the Women and Health Initiative at Harvard T.H. Chan School of Public Health. Scott and Langer will explain how emerging markets can balance rapid economic growth with the need to protect the environment and natural resources.

esarean delivery of a baby—or C-section—is the world's most commonly performed surgery. Rates have been rising across the globe, but there has been a particularly notable increase in the United States. The C-section rate in the U.S. has jumped 500 percent since the mid-1970s and 1 in 3 babies are now born via C-section. C-section is incredibly common, but the surgery comes with risks for mothers, including hemorrhage and infection. In this week's episode, we'll take a look at efforts to figure out what is driving rising C-section rates, and what can be done to prevent them. Neel Shah, director of the Delivery Decisions Initiative at Ariadne Labs, will explain why the hospital where a woman gives birth may the single most important factor in whether or not she has a C-section.

In this week's episode we're revisiting two stories on important mental health issues. First, the importance of changing the language surrounding addiction. Howard Koh, Harvey V. Fineberg Professor of the Practice of Public Health Leadership, and Michael Botticelli, former director of the White House Office of National Drug Control Policy, will explain how the words we use to describe addiction can affect the treatment people receive—and why changing language is critical to reducing the stigma surrounding substance use disorders.

In the second part of the podcast, we speak with Morgan Shields, SM '16, who recently authored a paper raising concerns about the psychiatric care that veterans receive.

In a new advisory the American Heart Association (AHA) strongly urges people to swap out saturated fats in favor of healthier unsaturated fats. The AHA says doing so can lower a person’s heart disease risk as much as cholesterol-lowering statin drugs. In this week's episode we speak to one of the authors of the advisory, Frank Sacks, professor of cardiovascular disease prevention. Sacks and other researchers reviewed decades worth of evidence on saturated and unsaturated fats, and we spoke to him about the state of the science on dietary fats—and some simple swaps you can make to include more healthy fats in your diet.

A new study of 60 million Americans is strengthening the link between air pollution and premature death. Harvard T.H. Chan School of Public Health researchers found that long-term exposure to airborne fine particulate matter (PM2.5) and ozone increases the risk of premature death, even when that exposure is at levels below the National Ambient Air Quality Standards (NAAQS) currently established by the U.S. Environmental Protection Agency. In this week's episode we speak with two of the study's authors, Francesca Dominici, professor of biostatistics at Harvard Chan School and co-director of the Harvard Data Science Initiative, and doctoral student Qian Di about why the U.S. needs stricter standards to keep the air clean.