Understanding Covid-19 and the Vaccine Mandate in the United States
By: Sukhdeep Gill, Karina Peterson, and Jimmy Fang
What is the coronavirus disease?
Coronavirus, also known as Covid-19, is an infectious disease that is caused by the SARS-CoV-2 virus. This virus tends to transmit from small liquid particles from an infected person’s mouth or nose when they cough, sneeze, speak or breathe (CDC, 2021). Most infected people will recover after experiencing mild to moderate symptoms. Those most likely to develop serious illnesses include the elderly and those with underlying medical conditions such as cardiovascular disease, diabetes, chronic respiratory disease, or cancer (CDC, 2021).
Symptoms of Covid-19
According to the Centers of Disease control the following list are symptoms of Covid-19.
- fever
- cough
- tiredness
- loss of taste or smell
- sore throat
- headache
- aches and pains
- diarrhea
- a rash on skin, or discoloration of fingers or toes
- red or irritated eyes
- difficulty breathing or shortness of breath
- loss of speech or mobility, or confusion
- chest pain
How to prevent Covid-19
It is recommended to practice respiratory etiquette, as this virus tends to spread through large to small respiratory droplets. This can be done by practicing the vampire cough in which one coughs in their flexed elbow. Remember to self-isolate for 14 days if positive for Covid-19.
Tips on how to prevent the Coronavirus:
- Stay 6 feet away for others whenever possible
- Wear a fitted surgical mask if N95 isn’t easily accessible
- Get vaccinated as vaccines become available
- Choose open areas with lots of air ventilation over closed areas. Open a window indoors.
- Wash hands regularly with soap and water or alcohol-based hand sanitizers
- Cover mouth and nose when coughing or sneezing
Covid-19 Vaccines
Everyone 5 years of age and older is currently eligible to get vaccinated for Covid-19. There are currently three manufacturers for this vaccine with FDA approval in the United States: Pfizer-BioNTech, Moderna, and Johnson & Johnson’s Janssen (FDA, 2019). Centers for Disease Control does not recommend one vaccine over another (CDC, 2021). All three manufactures currently have a booster available (CDC, 2021).
Pfizer-BioNTech
This vaccine is currently recommended for individuals ages five and older (CDC, 2021). The vaccine is administered in a two-dose series that is given ideally 21 days apart (CDC, 2021). An individual is considered fully vaccinated two weeks after the second dose is administered. A booster is available for everyone ages 18 and older at least six months after the last dose of the series (CDC, 2021). Any of the three vaccines listed can be used as the booster (CDC, 2021).
Moderna
This vaccine is currently recommended for individuals 18 years of age and older and is administered in a two-dose series given 28 days apart (CDC, 2021). An individual is considered fully vaccinated two weeks after the second dose is administered (CDC, 2021). Individuals ages 18 and older are currently eligible for a booster 6 months after the final dose of the series (CDC, 2021). Any of the three vaccines listed can be used as the booster (CDC, 2021).
Johnson & Johnson’s Janssen
This vaccine is currently eligible for all individuals over the age of 18 and is administered in a one dose series (CDC, 2021). An individual is considered fully vaccinated two weeks after receiving the vaccine. Individuals over the age of 18 are eligible for a booster two months after getting the one-dose series vaccine (CDC, 2021). Any of the three vaccines listed can be used as the booster (CDC, 2021).
Vaccine Mandates in the United States
The Biden-Harris administration is requiring all personnel that work in a healthcare facility that participate in the Medicare and Medicaid program to get vaccinated for Covid-19 (CMS, 2021). The administration does offer an exemption to this mandate for qualifying individuals based on a health condition, religious beliefs, observances, or practices. (CMS, 2021). Employers must obtain adequate documentation to justify the exemption. Healthcare Facilities must ensure all eligible staff receive their first dose of a two-dose series vaccine (Moderna and Pfizer) or a one-dose in a One-dose vaccine series (Johnson & Johnson) by December 6, 2022 (CMC, 2021). All eligible staff must be fully vaccinated with either a two-dose or one-dose series by January 4, 2022 (CMS, 2021).
California becomes first state in the Nation that plans to mandate Covid-19 vaccine for schools. Under this mandate students enrolled in in-person learning will be mandated to get vaccinated for Covid-19 starting the term following FDA approval of the vaccine for their grade span (Office of Gavin Newsom, 2021). These grade spans are divided into two categories: k to 6 and 7 to 12. With this mandate all in-person schools will add on Covid-19 vaccination requirements to previously required vaccines such as measles, mumps and rubella (Office of Gavin Newsom, 2021).
Challenges/ Issues/ Reactions to Vaccine Mandate
Although the covid-19 vaccine mandate is a solution to reopening states and cities, the mandate also poses many problems. Prior to the coronavirus pandemic, there has always been high controversy surrounding vaccinations. Many people fear the short-term and long-term effects due to the history of medicine. Others question the amount of time it took to develop the vaccine despite how much technology has grown since past vaccine development. President Joe Biden signed an action plan called “The Path Out of the Pandemic.” causing the workplace to be one of the most affected by the vaccine mandate.
American Airlines was the first to mandate all of their employees to get vaccinated against Covid-19. According to the national public radio report, American Airlines received a great employee response and reported having 99.5% of United employees vaccinated and approximately 2,000 who have applied for religious or medical exemptions in early September (NPR, 2021). In healthcare settings, vaccinations have always been a priority, but the mandate’s response has not been the same. Hospital’s directors and staff members report that the benefit of receiving the vaccine is essential to patients and staff. The Association of American Medical Colleges reports, “In health care, we are called to do amazing work, and part of that calling is a responsibility to keep patients safe; they put their lives in our hands.” Although believed that people will be more willing to take the vaccine on their own after weighing the pros and cons of allowing a self-made decision, a vaccine mandate was deemed more beneficial to most hospitals in America. The mandate comes with losing staff in many workplaces, but perceived benefits of the vaccine show a more negligible risk on the companies.
Healthy People 2030
As we move forward to what is hoped to be the end of a pandemic and settle into our new normal, it is essential to incorporate the covid-19 vaccine and virus into our national goals. One of Healthy People 2030 focuses is preventing infectious diseases by increasing vaccination rates. The covid-19 vaccine development and vaccination mandate will further reduce the number of children who do not receive vaccines, eliminate or minimize coronavirus, and increase the number of adults 19 and above who receive recommended vaccines for preventable diseases. The vaccine mandate will further assist in preventing an infectious disease that brought on a worldwide pandemic.
References
Boyle, Patrick. “Should Hospitals Mandate Covid-19 Vaccination?” AAMC, 15 June 2021,
https://www.aamc.org/news-insights/should-hospitals-mandate-covid-19-vaccination.
California, S. of. (2021, October 1). California becomes First State in nation to announce
COVID-19 vaccine requirements for Schools. Retrieved November 30, 2021, from https://www.gov.ca.gov/2021/10/01/california-becomes-first-state-in-nation-to-announce-covid-19-vaccine-requirements-for-schools/.
Centers for Disease Control and Prevention. (2021). Different covid-19 vaccines. Retrieved
November 30, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html.
CMS. (2021, November 4). Press Release Biden-Harris Administration issues emergency
regulation requiring COVID-19 vaccination for health care workers. Retrieved November 30, 2021, from https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care.
DeSilver, D. (2021, October 8). States have mandated vaccinations since long before COVID-19.
Pew Research Center. https://www.pewresearch.org/fact-tank/2021/10/08/states-have-mandated-vaccinations-since-long-before-covid-19/.
Hsu, A. (2021, November 8). Blocked for now, Biden’s vaccine-or-test rule for workers faces
uncertain future Updated November 8, 20219:25 PM ET. NPR. https://choice.npr.org/index.html?origin=https://www.npr.org/2021/11/08/1053625789/blocked-for-now-bidens-vaccine-or-test-rule-for-workers-faces-uncertain-future.
Hsu, Andrea. “Faced with Losing Their Jobs, Even the Most Hesitant Are Getting Vaccinated.”
NPR, NPR, 7 Oct. 2021, https://www.npr.org/2021/10/07/1043332198/employer-vaccine-mandates-success-workers-get-shots-to-keep-jobs.
U.S. Food and Drug Administration. (2021). Covid-19 vaccines. Covid-19 Vaccines. Retrieved
November 30, 2021, from https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines.
World Health Organization. (2021). Coronavirus. Coronavirus disease (COVID-19). Retrieved
November 30, 2021, from https://www.who.int/health-topics/coronavirus#tab=tab_3.
Understanding Heat Illnesses: How to Stay Safe During Hotter Summers
Miguel A. Perez, Ph.D., MCHES
As the world experiences longer and more intense heat waves, heat illness has become a growing public health concern. From young children playing outdoors to older adults, athletes, and outdoor workers, anyone can be affected by extreme heat. Fortunately, the body has built in systems to regulate and release excess heat, but that mechanism can be easily overwhelmed when temperatures exceed normal parameters. Let’s explore how the body regulate its temperature.
One of the most obvious cooling mechanisms used by the body is sweating. This is the body’s most effective cooling mechanism as sweat glands produce moisture that spreads across the skin. As the sweat evaporates into the air, it carries heat away from the body, lowering core temperature. Evaporation, however, becomes less effective when humidity is high because the air is already saturated with moisture. This is why hot, humid days often feel much more oppressive than dry heat.
A second cooling mechanism used by the body is increased blood flow to the skin. When the body heats up, blood vessels near the surface of the skin widen (a process called vasodilation). This allows warm blood from the body’s core to circulate closer to the skin, where heat can be released into the surrounding air. This is one reason your face or skin may appear flushed during hot weather or exercise.
A third cooling mechanism is faster breathing. Although less significant than sweating, breathing also helps release small amounts of heat and water vapor from the body. Every time you exhale, the body releases warm, moist air. This process removes a small amount of heat and water vapor from the respiratory tract.
When the body temperature begins to rise, breathing rate often increases slightly. By moving a greater volume of air in and out of the lungs, the body can lose additional heat through a process known as respiratory heat loss. While this cooling effect is much less significant than sweating, it serves as an additional way for the body to dissipate heat.
During exercise or exposure to hot environments, the breathing rate naturally increases to meet the body’s increased oxygen demands. This faster breathing also modestly increases heat loss. However, because respiratory heat loss accounts for only a small percentage of the body’s total cooling capacity, it cannot compensate when sweating becomes ineffective or when environmental conditions are extreme.
Certain chronic health conditions can also reduce the effectiveness of this cooling mechanism. People with asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, or other respiratory disorders may not be able to increase their breathing rate as efficiently during heat stress. In addition, high humidity reduces the amount of water that can evaporate from the respiratory tract, further limiting heat loss.
While respiratory heat loss alone cannot prevent overheating, it works alongside sweating and increased blood flow to the skin as part of the body’s integrated thermoregulation system. When all of these cooling mechanisms function properly, they help maintain a stable core body temperature. However, if one or more mechanisms become impaired the risk of heat illness increases.
What Are Heat Illnesses?
Heat illness refers to a group of medical conditions that occur when the body is exposed to more heat than it can safely manage. Under normal circumstances, the human body maintains a core temperature of about 98.6°F (37°C) through the complex temperature regulation system (thermoregulation). This process allows the body to function properly even when environmental temperatures change.
Heat-related illnesses exist on a spectrum ranging from mild conditions that can be treated quickly to medical emergencies requiring immediate care.
Heat Rash
Heat rash, also known as miliaria or prickly heat, is the mildest form of heat-related illness. It develops when sweat becomes trapped beneath the skin because sweat ducts are blocked or inflamed. Instead of reaching the surface and evaporating to cool the body, the trapped sweat irritates the surrounding tissue, leading to inflammation and the characteristic rash.
Heat rash most commonly occurs during hot, humid weather when heavy sweating is combined with clothing or equipment that traps heat against the skin. It can affect anyone but it is especially common in infants, young children, athletes, outdoor workers, military personnel, and individuals who spend long periods in warm environments.
Heat rash symptoms include small red bumps or blisters, Itchy or prickly skin, mild discomfort often seen in skin folds or areas covered by clothing. Heat rash most often appears on the neck, chest, upper back, groin, armpits, elbows, beneath the breasts, and waistline or areas covered by tight clothing.
Treatment focuses on reducing sweating and minimizing skin irritation. Moving to a cooler environment, keeping the skin dry, and wearing loose-fitting clothing may also help. If itching is bothersome, calamine lotion or other soothing skin products may provide relief. In some cases, a healthcare provider may recommend a mild topical corticosteroid for persistent inflammation.
Most cases of heat rash can be prevented by reducing excessive sweating and allowing air to circulate around the skin. Helpful prevention strategies include:
- Staying in cool or air-conditioned environments during extreme heat
- Wearing lightweight, moisture-wicking clothing
- Taking frequent breaks from outdoor activities
- Showering and changing out of sweaty clothing promptly
- Keeping skin folds clean and dry
- Drinking plenty of fluids to support the body’s natural cooling process
Heat Cramps
Heat cramps are one of the earliest and mildest forms of heat-related illness. They are painful, involuntary muscle spasms that occur during or after strenuous physical activity in hot environments. Although they are not usually life-threatening, heat cramps are an important warning sign that the body is struggling to regulate its temperature and maintain its fluid and electrolyte balance.
When large amounts of fluid and electrolytes are lost and not adequately replaced, muscles become more susceptible to abnormal contractions, leading to painful cramping. Muscle fatigue from prolonged or repetitive activity can further increase the likelihood of cramping.
Heat cramps most commonly affect people who exercise vigorously or perform physically demanding work in warm weather, including athletes, construction workers, agricultural workers, landscapers, military personnel, and individuals who are not yet acclimated to hot conditions.
Heat cramps usually develop gradually and are characterized by sudden, painful muscle contractions. Symptoms include painful muscle cramps, heavy sweating, fatigue, and thirst. Unlike heat exhaustion or heat stroke, people experiencing heat cramps typically have a normal body temperature and remain alert and oriented.
Treatment for heat cramps include stopping the activity, moving to a cool place, drinking water or an electrolyte-replacement beverage, and gently stretch the affected muscles. For individuals with heart disease, kidney disease, or those following a sodium-restricted diet, electrolyte replacement should be discussed with a healthcare provider before consuming large amounts of sports drinks or salt-containing products.
Most heat cramps can be prevented with proper hydration, conditioning, and heat safety practices. Helpful prevention strategies include:
- Drink fluids before, during, and after physical activity.
- Replace electrolytes during prolonged exercise or heavy sweating, especially during activities lasting longer than one hour.
- Gradually increase activity over one to two weeks to allow the body to acclimate to hot weather.
- Take regular rest breaks in shaded or cool environments.
- Wear lightweight, breathable clothing.
- Avoid strenuous outdoor activities during the hottest part of the day whenever possible.
Heat Syncope (Heat Fainting)
Heat syncope is a temporary loss of consciousness, or fainting, that occurs when the body is unable to maintain adequate blood flow to the brain during exposure to high temperatures. It is generally considered one of the earlier heat-related illnesses and serves as a warning that the body’s cardiovascular system is struggling to adapt to heat stress.
Although heat syncope is usually brief and not life-threatening, it can lead to serious injuries if a person falls while fainting. It may also be an early indicator that, without intervention, more severe heat illnesses such as heat exhaustion or heat stroke could develop.
Symptoms often develop gradually before fainting occurs, providing an opportunity to prevent loss of consciousness if recognized early. Heat syncope symptoms include light headedness, dizziness, fainting, and temporary loss of consciousness
Heat syncope treatments include lying down in a cool place with legs elevated, drinking fluids, and seeking medical evaluation if symptoms continue. If the person does not quickly regain consciousness, has persistent confusion, experiences chest pain, has difficulty breathing, or sustains an injury during the fall, call 911 immediately. These symptoms may indicate a more serious medical emergency or another cause of fainting.
Many episodes of heat syncope can be prevented by supporting the body’s ability to maintain healthy blood pressure during hot weather. Helpful prevention strategies include:
- Stay well hydrated before spending time outdoors.
- Avoid standing still for long periods in the heat.
- If standing is unavoidable, periodically flex your calf muscles, march in place, or shift your weight from one leg to the other to encourage blood flow back to the heart.
- Rise slowly after sitting or lying down.
- Take frequent breaks in cool or shaded areas.
- Gradually acclimate to exercising or working in hot conditions over one to two weeks.
Heat Exhaustion
Heat exhaustion is a heat-related illness that develops when the body loses excessive amounts of water and electrolytes through prolonged sweating and can no longer maintain its normal cooling processes. It is more serious than heat rash, heat cramps, or heat syncope and should be treated promptly to prevent progression to heat stroke.
Heat exhaustion often develops after prolonged exposure to high temperatures, especially when combined with physical activity, high humidity, inadequate fluid intake, or insufficient opportunities to cool down. It can affect anyone, but it is particularly common among athletes, outdoor workers, older adults, young children, and individuals with chronic medical conditions. Without intervention, the body’s cooling mechanisms become less effective, allowing core body temperature to rise and increasing the risk of progression to heat stroke
Symptoms usually develop gradually over several hours but can worsen quickly if heat exposure continues. Symptoms of health exhaustion include heavy sweating, cool, pale, or clammy skin, headache, weakness or fatigue, nausea or vomiting, muscle cramps, dizziness, rapid pulse, and fainting.
Unlike heat stroke, individuals with heat exhaustion are generally still alert and able to think clearly, although they may feel weak, exhausted, or mildly confused. Their core body temperature is typically below 104°F (40°C).
Prompt treatment is essential to prevent heat exhaustion from progressing to heat stroke.
Move to an air-conditioned or shaded area, loosen clothing, apply cool cloths, sip water, and seek medical care if symptoms last longer than an hour or worsen.
Heat Stroke
Heat stroke is the most severe form of heat-related illness and is a life-threatening medical emergency. It occurs when the body’s temperature-regulating system fails, causing the core body temperature to rise rapidly typically to 104°F (40°C) or higher. At this point, the body’s natural cooling mechanisms are no longer able to keep up with the heat being generated or absorbed.
Unlike the earlier stages of heat illness, heat stroke is not simply an extension of dehydration or fatigue. It represents a breakdown of the body’s ability to regulate its internal temperature. Without immediate treatment, heat stroke can cause permanent damage to the brain, heart, kidneys, liver, muscles, and other organs. In severe cases, it can be fatal.
As body temperature continues to rise, the brain becomes especially vulnerable. Swelling and inflammation within the brain can impair normal function, leading to confusion, altered behavior, seizures, and loss of consciousness. If not treated immediately, heat stroke can progress to multi-organ failure and death.
There are two types of heat stroke: exertional heat stroke and classic (non-exertional) heat stroke. Although anyone can develop heat stroke under extreme conditions, certain groups including those 65 and older, infants and young children, and people with some chronic diseases face a significantly higher risk.
Symptoms of heat stroke include body temperature of 104°F (40°C) or higher, hot, red skin, confusion, slurred speech, loss of consciousness, seizures, rapid, strong pulse, and sweating may or may not be present. Contrary to popular belief, a person with heat stroke may still be sweating, especially if heat stroke developed during strenuous physical activity. The absence of sweating is not required to diagnose heat stroke. Changes in mental status including confusion, unusual behavior, or loss of consciousness are among the most important warning signs.
Heat stroke represents the complete failure of the body’s cooling system. By the time confusion, seizures, or loss of consciousness develop, the body’s organs are already being exposed to dangerously high temperatures. Every minute counts. Immediate recognition, rapid cooling, and emergency medical care are essential to improve survival and reduce the risk of permanent disability. Call 911 immediately. While waiting for emergency responders, move the person to a cooler location and cool them with cold water, ice packs, or wet towels. Do not delay emergency medical treatment.
Health Illnesses and Chronic Diseases
Several chronic health conditions can affect sweating and temperature regulation. Because these conditions can make it more difficult for the body to stay cool, people living with chronic illnesses should take extra precautions during hot weather. Drinking adequate fluids (when medically appropriate), staying in air-conditioned environments, avoiding strenuous activity during the hottest part of the day, and paying close attention to early symptoms of heat illness can significantly reduce the risk of serious complications.
Diabetes: People with diabetes may develop damage to the autonomic nerves (autonomic neuropathy), which control involuntary body functions, including sweating. As a result, some individuals sweat less than normal, making it harder for the body to cool itself. Diabetes can also impair circulation and increase the risk of dehydration, both of which further reduce the body’s ability to regulate temperature.
Heart Disease. To cool the body, the heart must pump additional blood to the skin so heat can be released into the environment. People with heart disease may have reduced cardiovascular reserve, meaning their hearts cannot increase blood flow as efficiently during extreme heat. This places additional strain on the cardiovascular system while reducing heat loss.
Kidney Disease. Healthy kidneys help regulate the body’s fluid and electrolyte balance. Chronic kidney disease can make it more difficult to maintain proper hydration, and some individuals are advised to limit fluid intake. These factors can increase the risk of dehydration, reducing sweat production and making heat illness more likely.
Neurological Conditions. Conditions such as Parkinson’s disease, multiple sclerosis (MS), spinal cord injuries, and certain forms of autonomic nervous system disorders can interfere with the nerves that control sweating. Some people with these conditions produce very little sweat, while others may have abnormal sweating patterns that do not adequately cool the body.
Obesity. People with obesity often generate more body heat during physical activity and may have greater difficulty dissipating heat. The body must work harder to cool itself, and insulation from excess body fat can slow the release of heat.
Thyroid Disorders. An overactive thyroid (hyperthyroidism) increases the body’s metabolic rate, causing it to generate more heat. Although sweating may increase, the additional heat production can still make it difficult to maintain a normal body temperature, particularly during hot weather.
Medications Can Also Reduce Sweating.In addition to chronic medical conditions, certain medications can interfere with the body’s cooling system. These include
- Diuretics (“water pills”), which increase fluid loss and can contribute to dehydration. Some blood pressure medications, including beta-blockers, which may reduce the heart’s ability to increase blood flow during heat stress.
- Antihistamines, which can decrease sweat production.
- Certain antidepressants and antipsychotic medications, some of which interfere with sweating or temperature regulation.
- Anticholinergic medications used to treat bladder conditions, gastrointestinal disorders, Parkinson’s disease, and other medical conditions, which commonly reduce sweating.
Anyone with a chronic medical condition should discuss heat safety with their healthcare provider, especially if they take medications that affect hydration, sweating, or circulation.
California Is Taking Heat Illness More Seriously
Recognizing the growing risks of extreme heat, California is strengthening public awareness efforts.
Governor Gavin Newsom signed Assembly Bill 1653 on July 13, 2026. It requires the next revision of California’s Health Education Framework to consider including instruction on recognizing and responding to the signs and symptoms of heat illness. While the law does not immediately require new classroom instruction, it directs the Instructional Quality Commission and the State Board of Education to evaluate incorporating heat illness education into future health education standards.
California has also introduced CalHeatScore, (https://calheatscore.calepa.ca.gov/?utm_medium=email&utm_campaign=WhatMatters&utm_source=31&utm_source=ActiveCampaign&utm_medium=email&utm_content=New%20heat%20rules%20limit%20when%20utilities%20can%20cut%20off%20your%20power&utm_campaign=WhatMatters) a statewide heat-risk forecasting tool developed by the California Environmental Protection Agency’s Office of Environmental Health Hazard Assessment (OEHHA).
Unlike a standard weather forecast, CalHeatScore estimates how dangerous upcoming heat conditions may be based on both weather and health risk factors. The tool provides ZIP code-specific information to help Californians prepare before extreme heat arrives.
By translating weather data into understandable health information, CalHeatScore helps individuals, schools, employers, and communities make informed decisions before temperatures become dangerous.
In conclusion
Extreme heat is becoming a significant public health challenge. Fortunately, many heat-related illnesses are preventable through education, preparation, and early recognition.
Understanding the different types of heat illness can help you recognize warning signs early, respond appropriately, and keep yourself, your family, and your community safe throughout the summer.
With California encouraging schools to consider teaching students about heat illness through Assembly Bill 1653 and providing innovative resources like CalHeatScore, residents have more tools than ever to stay informed and protect themselves during periods of extreme heat.
Refences
Bauman, J., Spano, S., & Storkan, M. (2024). Heat-Related Illnesses. Emergency medicine clinics of North America, 42(3), 485–492. https://doi.org/10.1016/j.emc.2024.02.010
CalEPA. (n.d). calHeatScore. https://calheatscore.calepa.ca.gov/?utm_medium=email&utm_campaign=WhatMatters&utm_source=31&utm_source=ActiveCampaign&utm_medium=email&utm_content=New%20heat%20rules%20limit%20when%20utilities%20can%20cut%20off%20your%20power&utm_campaign=WhatMatters
California Department of Public Health. (2025). Tips for preventing heat-related illness. https://www.cdph.ca.gov/Programs/EPO/pages/bi_natural-disasters_extreme-heat_tips-for-preventing-heat-related-illness.aspx
Centers for Disease Control and Prevention. (2026, Mar 3). Heat-related illnesses. https://www.cdc.gov/niosh/heat-stress/about/illnesses.html
Centers for Disease Control and Prevention. (2025, July 25). About heat and your health. https://www.cdc.gov/heat-health/about/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fextreme-heat%2Fabout%2Findex.html
Cheshire W. P., Jr (2016). Thermoregulatory disorders and illness related to heat and cold stress. Autonomic neuroscience : basic & clinical, 196, 91–104. https://doi.org/10.1016/j.autneu.2016.01.001
Gagnon, D., Schlader, Z. J., & Jay, O. (2026). The Physiology behind the Epidemiology of Heat-Related Health Impacts. Physiology (Bethesda, Md.), 41(1), 0. https://doi.org/10.1152/physiol.00012.2025
Gauer, R. L., MD, McNutt, R., MD, & Bryan, K., MD (2026). Heat-Related Illnesses. American family physician, 113(4), 369–381.
Gardner, J., Caley, L., Poche, M., & Trammell, S. (2024). Heat-related illness. Nursing, 54(7), 16–23. https://doi.org/10.1097/NSG.0000000000000029
Hasan, F., Marsia, S., Patel, K., Agrawal, P., & Razzak, J. A. (2021). Effective Community-Based Interventions for the Prevention and Management of Heat-Related Illnesses: A Scoping Review. International journal of environmental research and public health, 18(16), 8362. https://doi.org/10.3390/ijerph18168362
John Hopkins Medicine. (2026). Heat-related illnesses (health cramps, heat exhaustion, heat stroke). https://www.hopkinsmedicine.org/health/conditions-and-diseases/heatrelated-illnesses-heat-cramps-heat-exhaustion-heat-stroke
Maung, Z., & Tustin, A. W. (2020). The Heat Death Line: Proposed Heat Index Alert Threshold for Preventing Heat-Related Fatalities in the Civilian Workforce. New solutions : a journal of environmental and occupational health policy : NS, 30(2), 138–145. https://doi.org/10.1177/1048291120933819
National Weather Service. (n.d.) Heat cramps, exhaustion, stroke. https://www.weather.gov/safety/heat-illness
Occupational Safety and Health Administration. (n.d.). Heat. https://www.osha.gov/heat-exposure/illness-first-aid
O’Connor F. G. (2025). Heat-Related Illnesses. Annals of internal medicine, 178(7), ITC97–ITC112. https://doi.org/10.7326/ANNALS-25-01958
Sorensen, C., & Hess, J. (2022). Treatment and Prevention of Heat-Related Illness. The New England journal of medicine, 387(15), 1404–1413. https://doi.org/10.1056/NEJMcp2210623
Tustin, A., Sayeed, Y., Berenji, M., Fagan, K., McCarthy, R. B., Green-McKenzie, J., McNicholas, J., Onigbogi, C. B., Perkison, W. B., Butler, J. W., & ACOEM Work Group on Occupational Heat-Related Illness (2021). Prevention of Occupational Heat-Related Illnesses. Journal of occupational and environmental medicine, 63(10), e737–e744. https://doi.org/10.1097/JOM.0000000000002351
World Health Organization. (2026). Heat and health. https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health
The importance of continuing education for public health professionals
Introduction
Ongoing professional development strengthens core competencies, reinforces best practices, and empowers public health professionals to adapt their skills in an increasingly complex health landscape. As public health challenges grow more complex and interdisciplinary, ongoing learning ensures that the workforce remains knowledgeable, adaptable, and equipped with current evidence-based approaches.
From meeting credentialing and licensure requirements to strengthening core competencies and leadership skills, continuing education supports professionals in delivering effective programs designed to address emerging community needs. By prioritizing professional development, organizations and individuals help sustain a high-quality public health workforce capable of driving meaningful and lasting improvements in population health.
Continuing education is a requirement for those holding the Certified or Master Certified Health Education Specialist Credential (CHES/MCHES) as well as for those Certified in Public Health (CPH). The continuing education required for retaining credentialing denotes a professional commitment to lifelong learning, ethical practice, and effective public health impact. Many young professionals struggle to identify continuing education opportunities.
In general, there are many free and accessible options such as CDC TRAIN. University-based certificate programs offer structured learning and credentials that can enhance teaching portfolios or research relevance, but they often come with a higher cost and time commitment. Finally, regional training centers can be especially useful for academic staff involved in teaching community-engaged practice or workforce development, linking academic theory with public health practice.
The following table provides an overview of paid and free opportunities for continuing education for those holding the CHES/MCHES or CPH certifications. It is not meant to be a comprehensive list, but it is a good start for those looking for continuing education opportunities.
| Provider / Cost | Program Offerings | Ideal For | Strengths | Limitations |
| CDC TRAIN (CDC Training & Continuing Education) Mostly Free | Self-paced online courses/trainings | Public health professionals wishing to stay current on public health practice updates | Large catalogue of public health topics Free and accessible On-demand options so you can learn at your own pace | Not always academic-level depth |
| American Public Health Association (APHA) Free or discounted membership pricing | Annual meeting. APHA Now Courses. | Academic staff involved in professional networks or teaching | Reputable source with quality content | Best value often for members only |
| Society for Public Health Education (SOPHE) Free or discounted membership pricing | Annual Meeting Center for Online Resources & Education (CORE) | Academic staff involved in professional networks or teaching | Offers CE credits via journal reading & events Discounts for members | Best value often for members only |
| Drexel University Dornsife Continuing Education Paid | Graduate certificates, workshops, micro-credentials | Academics building advanced skills or credentials | Academic-level content Certificates can enhance faculty portfolios | Tuition/fee based |
| University of Washington CE Programs Paid | Online & in-person Professional certificates & training | Faculty seeking deeper technical or leadership skills | University-backed certificates Wide range of topics & formats | More expensive than free offerings |
| Indiana University “Public Health and You” Initiative Free/Paid | Online | Public health workers wanting topical professional development | High-quality free courses on pressing public health issues May appeal to faculty for content ideas | Free offerings limited to select topics |
| University at Buffalo Public Health CE Free/Paid | Online & in-person | Public health professionals involved in workforce training or credential maintenance | CE units available for credentialing Practical, workforce-oriented | May be more applied than theory focused |
| University of Minnesota School of Public Health Free/Paid | Live webinars, trainings, self-paced e-learning and games | Public health professionals engaged with community practice | Self-paced online modules Excellent for foundational topics | Limited range compared to larger providers |
| Public Health (Regional) Training Centers Mostly Free | Online, webinar & workshops | Public health professionals engaged with community practice | Practical, workforce-focused courses | Coverage varies regionally Not all trainings offer CE credits |
| NCHEC list Mostly free | Online, webinars & workshops | Public health professionals engaged with community practice and teaching | Offers an updated list of CE opportunities for those holding the CHES/CHES | There may be a lag in program offerings. |
| CPH Mostly free | Online, webinars & workshops | Those holding the CPH credential | A wide variety of courses on topics | There may be a lag in program offerings. |
Practical recommendations about CEUs.
Match Your Credentialing Needs. Check with your credentialing body before enrolling in continuing education opportunities.
Think Beyond Cost. While free options are attractive, often paid courses offer deeper engagement, expert instruction, and recognized certificates that can boost your resumé.
Blend Formats. A mix of webinars, self-paced modules, and formal certificates lets you satisfy requirements while gaining actionable skills.
Be Strategic About Continuing Education. Don’t wait until your renewal cycle is nearly over. Instead, plan CE activities early and spread them out over time. You should also choose opportunities that strengthen areas in need of development. This approach helps you build meaningful expertise rather than just “checking boxes.”
Engage with Professional Organizations. Membership in organizations such as SOPHE, APHA, or your state public health association can provide regular CE opportunities, access to current research and practice tools, and also network with experienced public health professionals.
Stay Informed Through Trusted Sources. Make a habit of following reliable public health outlets such as the CDC, NIH, and WHO. Read peer-reviewed journals and public health newsletters. Setting aside even 15–30 minutes a week can make a big difference.
Learn From Practice and Reflection. Some of the most valuable learning happens on the job. As we being a new year it is recommended that you reflect on programming outcomes and community feedback, seek constructive feedback from supervisors and colleagues, and document lessons learned for future improvement. These experiences complement formal continuing education and deepen your impact as a public health professional.
Conclusion
Staying current as a public health professional is not just about maintaining certification but also denotes a commitment to the field. By investing in continuous learning, building strong professional relationships, and staying curious, you set the foundation for a fulfilling and impactful career.
Take Care of Yourself
We live in a culture that often rewards output and frowns upon pause. In fact, modern society places constant demands on our time and attention, from ever-increasing work expectations to the need to be socially and electronically connected. There is pressure to “always be on,” as society rewards success even when it comes with a hefty personal price tag.
Recently, I was forced to really slow down. At the beginning, I tried to “push through,” but my body eventually enforced an often-forgotten rule: rest isn’t optional. Many friends and colleagues showed their concern with the phrase “take care of yourself” leading me to ask: what does that actually mean?
The quest for an answer led me to concept of self-care which is defined as “the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and to cope with illness.” During my body-enforced downtime, I found myself with time to reflect on the role of self-care and the reasons we neglect it. After much consideration, I have come to realize that while most of us say self-care is important, we don’t place it in the top three priorities in our lives. As I spoke with friends and read on the subject, I realized that there are multiple barriers (both external and internal) that prevent self-care including believing that time spent resting is time wasted, cultural messaging that glorifies overwork and often dismisses rest as laziness, and internal resistance perhaps out of fear of falling behind or confronting emotions we might want to avoid.
In 1955, Northcote Parkinson postulated that “work expands so as to fill the time available for its completion.” It seems that a society we have truly adopted this approach at the risk our wellbeing. Research consistently shows that chronic stress, lack of rest, and poor self-care are directly linked to burnout, lower productivity, and long-term health issues. It also shows that self-care strategies like mindfulness, sleep, and social connection significantly reduce stress and improve performance. In this context, self-care is not a luxury, but rather a necessity. It allows for recovery and it reminds us that we are human, not machines. In an era when anxiety, depression, and burnout are on the rise, the phrase “take care of yourself” expresses a crucial counterbalance to the chaos and speed of modern life.
Reflecting on self-care, I’ve come to understand it as a deeply personal act. Self-care is about intentionally taking time to meet our needs regardless of the approach we take (e.g., rest, healthy food, connection, movement, or solitude). It’s not indulgence; it’s maintenance. Without self-care, stress accumulates, burnout becomes inevitable, and relationships begin to deteriorate. To care for oneself in a world that demands constant output is a quiet form of resistance. It’s saying: I matter, even when I’m not productive.
I’m writing this not as someone who has it all figured out, but as a gentle reminder to myself and other that being well is more important than being constantly available. I’m writing this not from a place of perfection but from a place of humility. Illness stripped away the illusion of invincibility. It reminded me that productivity without recovery is unsustainable; self-care is not a reward to be earned, but rather a fundamental act of responsibility; and sharing vulnerability can normalize rest.
As an educator, I can’t conclude without sharing some micro-adjustments each of us can take each and every day to “take care of yourself”:
- Set a regular bedtime and wake-up time consistent with the recommendations for your age group.
- Incorporate more physical activity into your daily routine. Take walking meetings, stretch between calls, and take short walks after meals, no need to run a marathon every weekend unless that is what you want.
- Promote balanced meals, decreased processed sugar, and aim for one nutrient-rich snack a day.
- Incorporate “pause points” throughout your day to check in how you are feeling and explore ways to effectively deal with those feelings.
- Stay connected with those important to you. Put down your phone and instead of texting each other while in the same room, talk, smile, and tell them how much you love each other.
- Don’t be afraid to say “my well-being matters” and set do not disturb hours in your calendar and especially your devices.
My recent illness taught me not to confuse rest with laziness, not to tie my self-worth to productivity, and more importantly to avoid waiting for illness or crises to begin taking action. Moving forward, I aim to treat self-care not as something I earn, but as something I deserve by virtue of being human. I hope to build routines and boundaries that protect my well-being and remind myself and hopefully others that taking care of ourselves is a foundation for everything else we do. To those of you who said “take care of yourself” thank you for the bottom of my heart. Listen to the advice you gave me and rest before you’re forced to.
#SelfCare #Wellbeing #WorkLifeBalance #PersonalGrowth
Seasonal Affective Disorder
Photo by Pixabay
As the days grow shorter and the air gets chillier, many of us find ourselves craving warm blankets, cozy drinks, and longer nights of rest. But for some, the change in seasons brings more than a preference for comfort—it triggers a deeper emotional shift that can significantly impact daily life. This condition is known as Seasonal Affective Disorder (SAD), a type of depression linked to seasonal changes.
What Is Seasonal Affective Disorder?
SAD is a form of depression that typically occurs during the fall and winter months when there is less natural sunlight. The lack of sunlight can disrupt our circadian rhythms, which affects our mood and can lead to cravings for carbs and weight gain.
It is estimated that about 10 million of US adults suffer from SAD, but it’s not just adults who experience it; kids and teenagers can also be affected. Unfortunately, many people don’t realize they have it and think it’s normal to feel down when the seasons change. A short source of information about SAD is provided by the National Institutes of Mental Health.
The exact cause isn’t fully understood, but it is believed to be influenced by a combination of biological and environmental factors, such as:
• Reduced sunlight: This can disrupt your body’s internal clock (circadian rhythm) and lower serotonin levels, affecting mood.
• Melatonin imbalances: The longer nights can lead to overproduction of melatonin, which regulates sleep and mood, making you feel more sluggish.
• Vitamin D deficiency: Less exposure to sunlight can result in lower vitamin D levels, which are crucial for mental health.
Symptoms of SAD
The symptoms of SAD can range from mild to severe and often mimic those of major depression. They may include:
• Persistent sadness or low mood
• Loss of interest in activities once enjoyed
• Fatigue or lack of energy
• Difficulty concentrating
• Changes in sleep patterns (oversleeping is common in winter SAD)
• Weight gain or changes in appetite, often craving carbohydrates
• Feelings of hopelessness or worthlessness
Who Is at Risk?
SAD can affect anyone, but certain factors may increase the risk:
• Geographic location: People living farther from the equator are more likely to experience SAD due to longer winters and reduced sunlight.
• Gender: Women are more likely than men to be diagnosed with SAD, though men may experience more severe symptoms.
• Family history: A history of depression or other mood disorders in the family can heighten the risk.
• Existing depression or bipolar disorder: Those with these conditions may find their symptoms worsen seasonally.
Coping with and Treating SAD
The good news is that there are effective ways to manage SAD. Here are some common approaches:
1. Social support
Many people suffer in silence when they don’t have to. Connecting with friends can help combat feelings of isolation, a simple coffee date or a group activity can really lift your spirits, even in the dead of winter. What’s important is that you do not need to suffer and silence and there’s no shame in seeking support.
2. Light Therapy
Also known as phototherapy, light therapy involves sitting near a light box that mimics natural sunlight for 20–30 minutes a day. This can help regulate your circadian rhythm and boost serotonin levels.
3. Medication
In some cases, antidepressants may be prescribed, particularly selective serotonin reuptake inhibitors (SSRIs).
4. Psychotherapy
Cognitive-behavioral therapy (CBT) has proven effective in helping individuals identify and change negative thought patterns associated with SAD.
5. Vitamin D Supplements
If a vitamin D deficiency is contributing to symptoms, supplements can help restore balance.
5. Lifestyle Changes
• Spend time outdoors during daylight hours, even when it’s cold or cloudy.
• Exercise regularly to boost endorphins and improve mood.
• Maintain a healthy diet rich in whole grains, fruits, vegetables, and lean proteins.
Breaking the Stigma Around SAD
One of the challenges of dealing with SAD is the misconception that it’s just “the winter blues” or a minor inconvenience. SAD is a legitimate medical condition that can significantly impact quality of life. Educating others, seeking professional help, and fostering open conversations about mental health are key to breaking the stigma.
Looking Forward to Brighter Days
While SAD can feel isolating, it’s important to remember that you’re not alone, and brighter days—both literally and figuratively—are ahead. With the right treatment and support, managing seasonal affective disorder is possible, and the transition from one season to the next can become more hopeful and less overwhelming.
If you suspect you or someone you know may have SAD, reach out to a healthcare professional for guidance. Your mental health is worth prioritizing, no matter the season and remember that while SAD is most common during the Fall and Winter seasons, it can also, less commonly, occur in the spring or summer.
Sources
Chen, Z. W., Zhang, X. F., & Tu, Z. M. (2024). Treatment measures for seasonal affective disorder: A network meta-analysis. Journal of affective disorders, 350, 531–536. https://doi.org/10.1016/j.jad.2024.01.028
Dollish, H. K., Tsyglakova, M., & McClung, C. A. (2024). Circadian rhythms and mood disorders: Time to see the light. Neuron, 112(1), 25–40. https://doi.org/10.1016/j.neuron.2023.09.023
Galima, S. V., Vogel, S. R., & Kowalski, A. W. (2020). Seasonal Affective Disorder: Common Questions and Answers. American family physician, 102(11), 668–672.
Mayo Clinic. (2024). Seasonal affective disorder. https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651
Galima, S. V., Vogel, S. R., & Kowalski, A. W. (2020). Seasonal Affective Disorder: Common Questions and Answers. American family physician, 102(11), 668–672.
National Institutes of Mental Health. (2024). Seasonal affective disorder. https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder
NHS. (2022). Overview – Seasonal affective disorder. https://www.nhs.uk/mental-health/conditions/seasonal-affective-disorder-sad/overview/
Psychology Today. (2024). Seasonal affective disorder. https://www.psychologytoday.com/us/conditions/seasonal-affective-disorder
Happy & Healthy Holiday Season!
Miguel A. Perez, Ph.D., MCHES
Interim Associate Dean
College of Health and Human Services
As December rolls in, it’s easy to overlook our health with all the holiday festivities. The hustle and bustle can make it challenging to stick to healthy routines and who can overlook all the delicious treats that seem to pop up everywhere during this season.
Here are some strategies to help you manage your cravings during the holidays.
Moderation
Moderation is key to enjoying the holidays, therefore, portion control should be followed during this time of the year. For instance, allow yourself a small serving of food that appeal to you, instead of going all in. It is also important important to stay mindful while eating. Sometimes we just eat out of habit, not because we’re truly hungry. Being present during meals can help us enjoy our food more and recognize when we’re satisfied.
Physical Activity
With the colder weather, it can be tempting to hibernate indoors. Remember, incorporating fun winter activities can really help your physical and emotional health. Things like ice skating or even a brisk walk can keep us moving. Plus, outdoor activities can boost your mood during the darker days of winter.
Mental/Social Health
It is also important to take care of our mental health during this time. Holiday stress can creep up on us. Setting aside time for self-care is crucial. Whether it’s reading a book, meditating, or just taking a quiet moment for yourself.
Also, don’t forget to connect with friends and family. Sometimes just chatting with someone can lift your spirits. Social connections can be so beneficial for our mental well-being, especially during the holidays when loneliness can be common.
Hydration
It’s easy to forget to drink water when we’re sipping on holiday beverages. Staying hydrated helps with energy levels and can even curb some of cravings for “adult beverages.” An article by the Centers for Disease Control and Prevention can be useful as you attempt to determine your water intake.
In conclusion
The holidays are a busy time of the year so will keep this post short. I hope these tips help you enjoy the holiday season while taking care of your health.
Mosquito-borne diseases
Miguel A. Perez, Ph.D., MCHES
Interim Associate Dean
College of Health and Human Services
As summer comes to an end in the United States, many people nostalgically look back to the great memories made during the summer months and prepare for the new opportunities the fall season will bring. Unfortunately, thoughts of mosquitoes and the diseases they carry will be part of that process. Therefore, we want to explore three diseases that might catch people’s attention as they watch the news.
Eastern Equine Encephalitis
Eastern Equine Encephalitis (EEE) is a rare but severe disease (only 4 cases in the US as of 8/27/24) that can impact both humans and animals, including birds, reptiles, and amphibians (CDC, 2024a). While it affects people of all ages, those under 15 years and those over the age of 50 are at greater risk for complications from this disease. Symptoms related to this disease can range from mild, including chills, fever, joint pain, muscle pain, stick neck, and lack of energy, to more severe symptoms, including headaches, confusion, drowsiness, vomiting, loss of appetite, fever, higher than 104 degrees, and brain inflammation (encephalitis). According to the Centers for Disease Control and Prevention (CDC, 2024b), “30% of people with eastern equine encephalitis die, and many survivors have ongoing neurologic problems.” It’s important to note that it is possible to contract the disease and have no symptoms, underscoring the need for vigilance. In the US, Triple E, as it is also known, is most prevalent in eastern and Gulf Coast states.
Your role in preventing mosquito-borne diseases, including EEE, is crucial. The Commonwealth of Massachusetts and the CDC recommend avoiding outdoor events during peak mosquito hours, wearing long-sleeve clothing, and using DEET, Picaridin, IR3535, oil of lemon or eucalyptus, Para-methane-diol, or 2-undecanoate for personal protection (CDC, 2024c; Commonwealth of Massachusetts, 2024). Standard mosquito prevention strategies are also effective, including removing standing water and keeping pools properly chlorinated. Your vigilance and proactive measures can significantly contribute to mosquito control efforts. It should be noted that currently, no vaccines prevent EEE.
West Nile Virus
West Nile Virus is a mosquito-borne pathogen (disease-causing organism) that can infect birds, humans, and horses (California Department of Health, 2024). Exposure to the virus can result in West Nile Virus Disease (New York State, 2024b), with higher infection rates during the late summer and early fall. In addition to being transmitted by mosquitoes, the virus may also be contracted from contact with infected animal tissues or blood.
According to the World Health Organization (2024), although it can be fatal to humans, 80% of those infected with West Nile Virus Disease show no symptoms. The most common symptoms of this disease are fever, headache, tiredness, body aches, high fever, stupor, convulsions, and paralysis. Mild flu-like symptoms include fever, headaches, body aches, skin rash on the trunk of the body, and swollen lymph glands. More severe symptoms can include high fever, impaired consciousness, convulsions, and paralysis (John Hopkins, 2024).
According to the World Health Organization (2024) “In the absence of a vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus.” The WHO (2024) recommends that educational messages should focus on the following:
- Reducing the risk of mosquito transmission. Efforts to prevent transmission should first focus on personal and community protection against mosquito bites through the use of mosquito nets, personal insect repellent, by wearing light coloured clothing (long-sleeved shirts and trousers) and by avoiding outdoor activity at peak biting times. In addition community programmes should encourage communities to destroy mosquito breeding sites in residential areas.
- Reducing the risk of animal-to-human transmission. Gloves and other protective clothing should be worn while handling sick animals or their tissues, and during slaughtering and culling procedures.
- Reducing the risk of transmission through blood transfusion and organ transplant. Blood and organ donation restrictions and laboratory testing should be considered at the time of the outbreak in the affected areas after assessing the local/regional epidemiological situation.
Oropouch Virus
A lesser-known virus in the United States is the Oropouch Virus (OROV), also known as the Sloth virus. It is an important emerging pathogen in tropical and subtropical regions of Central and South America, especially in Brazil, Peru, and Cuba (Rebello Moreira et al, 2024; (Romero-Alvarez & Escobar, 2018; WHO, 2024b). OROV affects humans but can also affect a range of vertebrate hosts, including sloths and birds. It is transmitted primarily by biting midges and by mosquitoes. The virus poses significant public health concerns due to its ability to cause large-scale outbreaks, leading to an illness known as Oropouche fever.
In early August, the Pan American Health Organization issued an epidemiological alert for this virus, given its increasing infection rates in the Americas (PAHO, 2024). The CDC has also issued a health advisory advising high-risk individuals, including pregnant women, to avoid traveling to areas with high infection rates (CDC, 2024d; Morrison et al., 2024). Transmission occurs predominantly in urban and suburban areas, often affecting densely populated regions where vector control is challenging.
Oropouche fever, the disease caused by OROV, manifests with symptoms that closely resemble those of other arboviral infections, such as dengue and chikungunya. Common symptoms include high fever, headache, myalgia (muscle pain), arthralgia (joint pain), photophobia, and a maculopapular rash. The disease is typically self-limiting, with symptoms lasting for about 3 to 7 days. However, sometimes, patients can experience prolonged fatigue and other symptoms that persist for weeks. While the disease is generally not fatal, it can significantly impact the quality of life and productivity, particularly in outbreak settings (Vernal et al., 2019).
Prevention of Oropouche virus infection relies heavily on controlling its vectors. This includes reducing breeding sites for midges and mosquitoes, such as standing water and implementing community-wide vector control measures. Insecticide spraying, the use of larvicides, and environmental management can help reduce vector populations. Personal protective measures, like wearing long-sleeved clothing and using insect repellent, are also necessary, especially during peak biting times. Public health education campaigns can be crucial in raising awareness about the disease and promoting preventive behaviors in affected communities (VDCI, Mosquito Management, 2024).
Mosquito-borne diseases are common throughout the world. By practicing the strategies described in this article, you can decrease your chances of contracting these diseases.
Sources
California Department of Health. (2024). West Nile Virus. https://westnile.ca.gov/
Centers for Disease Control and Prevention. (2024a). About eastern equine encephalitis.” https://www.cdc.gov/eastern-equine-encephalitis/about/index.html
Centers for Disease Control and Prevention. (2024b). Eastern Equine Encephalitis Virus: Current Year Data (2024). https://www.cdc.gov/eastern-equine-encephalitis/data-maps/current-year-data.html
Centers for Disease Control and Prevention. (2024c). Preventing Mosquito Bites. https://www.cdc.gov/mosquitoes/prevention/index.html
Centers for Disease Control and Prevention. (2024d). Oropouche virus disease among U.S. Travelers – United States, 2024. https://www.cdc.gov/mmwr/volumes/73/wr/mm7335e1.htm
Cleveland Clinic. (2024). Eastern Equine Encephalitis. https://my.clevelandclinic.org/health/diseases/21187-eastern-equine-encephalitis-eee
Commonwealth of Massachusetts. (2024). EEE (Eastern Equine Encephalitis. https://www.mass.gov/info-details/eee-eastern-equine-encephalitis
John Hopkins. (2024). West Nile virus. https://www.hopkinsmedicine.org/health/conditions-and-diseases/west-nile-virus
Morrison A, White JL, Hughes HR, et al. Oropouche Virus Disease Among U.S. Travelers — United States, 2024. MMWR Morb Mortal Wkly Rep. ePub: 27 August 2024. DOI: http://dx.doi.org/10.15585/mmwr.mm7335e1
New York State. (2024). Eastern Equine Encephalitis. https://www.health.ny.gov/diseases/communicable/eastern_equine_encephalitis/
New York State. (2024b). West Nile Virus. https://www.health.ny.gov/diseases/west_nile_virus/fact_sheet.htm
PAHO. (2024). Epidemiological alert oropouche in the region of the Americas – 1 August 2024. https://www.paho.org/en/documents/epidemiological-alert-oropouche-region-americas-1-august-2024
Rebello Moreira, F.R., Rodriguez Ditra, J.V., Barbosa de Carvalho, A.H., Rezende Reis, C., Hickson Rios, J.S., Oliveria de Ribeiro, M., Barcllos Arruda, M., Alvarez, P., Pedra Souza, R.,
Romero Alvarez, D., & Escobar, L.E. (2018). Oropouche fever, an emerging disease from the Americas. https://www.sciencedirect.com/topics/medicine-and-dentistry/oropouche-virus
Vernal, S., Martini, C. C. R., & da Fonseca, B. A. L. (2019). Oropouche Virus-Associated Aseptic Meningoencephalitis, Southeastern Brazil. Emerging infectious diseases, 25(2), 380–382. https://doi.org/10.3201/eid2502.181189
VDCI Mosquito Management. (2024). What is oropouche virus, and how does it spread? https://www.vdci.net/vector-borne-diseases/oropouche-virus/
Volouch, C., Gomes Zauli, D.A., & Santana Aguiar, R. (2024). Oropouche virus genomic surveillance in Brazil. The Lancet Infectious Diseases. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00558-9/fulltext
World Health Organization. (2024a). West Nile Virus. https://www.who.int/news-room/fact-sheets/detail/west-nile-virus
World Health Organization. (2024b). Oropouche virus disease – Cuba. https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON521
Optimizing Adolescent Health: Encouraging Parents on the Importance of HPV Vaccination
By Dilpreet Sekhon and Hermelinda Guzman
What is HPV?
HPV is Human Papillomavirus, a common sexually transmitted infection (Centers for Disease Control and Prevention (CDC), 2023). HPV was first associated with cervical cancer on February 12th, 1985, by Dr. H. Zur Hausen of the University of Heidelberg in Germany (Yousefi et al., 2022). He found that papillomaviruses are a large group of non-enveloped double-stranded DNA viruses that constitute the papillomavirus genus of the Papillomaviridae family (Yousefi et al., 2022).
The HPV virus can stay in the skin and cause the formation of genital warts, which are tiny bumps or growths that show up in the genital area (CDC, 2023). Having genital warts can raise the chance of getting cervical cancer (CDC, 2023). In two years, 9 out of 10 HPV infections go away; however, certain infections last longer and lead to cancer of the throat, cervix, and other sexual parts (CDC, 2023). The CDC states that in both men and women, there are around 36,000 HPV cases in the United States (2023).
Importance of HPV Vaccination
Source: BC Women’s Hospital
To ensure optimal protection, the CDC recommends that children receive two doses of the HPV vaccine between the ages of 11 and 12 (CDC, 2023). However, the vaccine can be given as early as 9. In the case where the first dose is administered before the child’s 15th birthday, only two doses are needed (CDC, 2023). Individuals who receive their first dose on or after their 15th birthday will require three doses (CDC, 2023). It is important to note that the HPV vaccine is most effective when administered before an individual is exposed to the virus (CDC, 2023).
There is hesitancy against the HPV vaccine among parents of adolescents, and in 2018, only 54% of women had completed the HPV vaccine series (Szilagyi et al., 2020). Szilagyi and other researchers (2020) found that among parents of adolescents, 23% reported hesitancy against the HPV vaccine. Nguyen and other associates (2021) discovered that parents who are hesitant towards vaccination are from a lower educational and income level, with the mothers being more hesitant.
Kamolratanakul and associates (2021) concluded in their study that the rate of cervical cancer amongst vaccinated and unvaccinated women was 6.7 versus 11.3 per 100,000 women. Those with the HPV vaccine faced lower rates of cervical cancer, emphasizing the effectiveness and importance of the vaccine. The study highlights the importance of early vaccination since young women who were HPV seronegative faced a higher HPV vaccine efficacy (Kamolratanakul et al., 2021).
How to Obtain the HPV Vaccine
To promote the increase of HPV vaccines in adolescents, Sonawane and other associates (2021) found that parents are more likely to initiate vaccinations for their children if healthcare providers make the recommendations. Although recommendations alone won’t significantly boost vaccine acceptance, healthcare professionals should include motivational interviewing and confidently suggest vaccinations when dealing with hesitant individuals.
Source: Maryland Department of Health
Intervention strategies are another way to encourage vaccinations. According to Spencer and associates (2020) interventions such as call reminders for vaccinations, school-located vaccinations, and quality improvement visits to primary care clinics increased the number of vaccinated individuals. They found that applying either one of these interventions can effectively increase HPV vaccination rates.
The CDC’s Vaccinate with Confidence framework (2019) and The Increasing Vaccination Model are other beneficial methods that aid uptake (Brewer et al., 2021). The Vaccinate with Confidence framework focuses on protecting communities who do not have access to vaccines, empowering families through effective vaccine conversations, and stopping misinformation that hinders public trust in vaccines. In contrast, the Increasing Vaccination Model is derived from behavioral and social drives, which include thinking and feeling, social processes, motivation, and practical issues.
Tips for Healthy Living Tips
Prevention plays a critical role in safeguarding against HPV, making it essential to prioritize vaccination as the initial step towards healthy living. The vaccine offers a safe and effective shield against HPV-related cancers and infections. Following immunization, it is also essential to practice safe sex. This involves limiting the number of partners and consistently using condoms during intercourse. Additionally, for sexually active individuals, regular check-ups with a healthcare provider are crucial. Screenings such as Pap smears and HPV tests can detect HPV exposure early, leading to a better prognosis for individuals.
Equity
Addressing equity in HPV prevention ensures that all individuals, regardless of their socioeconomic status, have equal access to vaccines and screenings. This can be done by providing education and raising awareness of HPV to marginalized communities. Providing access to vaccines at a low cost or free of charge is another way to reduce HPV disparities. In a study by Mohammed and associates (2018), individuals residing in rural areas were less likely to be aware of HPV and the HPV vaccine than their urban counterparts. Among those who were aware of HPV, rural individuals were less likely to believe that HPV can cause cervical cancer and that HPV can be transmitted through sexual contact (Mohammed et al., 2018). Racial disparities are also present with the uptake of the HPV vaccine and its correlation with one’s knowledge, attitudes, and beliefs. Ojeaga and associates (2019) found that racial/ethnic differences exist in HPV knowledge/awareness and cancer communication preferences. HPV awareness and knowledge that HPV causes cervical cancer was significantly lower among Blacks; additionally, there were significant disparities in awareness of the HPV vaccine, with only 25% of Black women indicating that they or a family member was recommended the HPV vaccine by a healthcare professional (Ojeaga et al., 2019).
While knowing and being aware of cancer screenings and vaccinations might not be enough to encourage people to get them, it is still a way to focus on helping those in rural areas become more aware of HPV and the cancers it can cause.
Conclusion
HPV is a common virus known for causing health issues such as genital warts and certain cancers. Fortunately, getting vaccinated, getting regular screenings, and practicing safe sex can lower the chances of HPV infections. It is crucial that everyone understands the risks of HPV and takes steps to minimize them. Additionally, it is important to address obstacles to accessing prevention measures and promote fairness in HPV prevention efforts to ensure everyone has an equal chance to protect themselves against HPV-related health problems.
References
BC Women’s Hospital. (2018, September 20). Prevent cancer with the HPV vaccine. http://www.bcwomens.ca/about/news-stories/stories/prevent-cancer-with-the-hpv-vaccine
Brewer N. T. (2021). What Works to Increase Vaccination Uptake. Academic pediatrics, 21(4S), S9–S16. https://doi.org/10.1016/j.acap.2021.01.017
Centers for Disease Control and Prevention. (2023, February 10). Human papillomavirus (HPV) infection. https://www.cdc.gov/hpv/parents/about-hpv.html
Centers for Disease Control and Prevention. (2019, October 30). Vaccinate with Confidence. https://www.cdc.gov/vaccines/partners/vaccinate-with-confidence.html
Kamolratanakul, S., & Pitisuttithum, P. (2021). Human Papillomavirus Vaccine Efficacy and Effectiveness against Cancer. Vaccines, 9 (12), 1413. https://doi.org/10.3390/vaccines9121413
Maryland Department of Health. (n.d.). Maryland Department of Health. HPV: Don’t Wait. Vaccinate! https://health.maryland.gov/phpa/cancer/Pages/HPV.aspx
Mohammed, K. A., Subramaniam, D. S., Geneus, C. J., Henderson, E. R., Dean, C. A., Subramaniam, D. P., & Burroughs, T. E. (2018). Rural-urban differences in human papillomavirus knowledge and awareness among US adults. Preventive Medicine, 109, 39–43. https://doi.org/10.1016/j.ypmed.2018.01.016
Nguyen, K. H., Santibanez, T. A., Stokley, S., Lindley, M. C., Fisher, A., Kim, D., Greby, S., Srivastav, A., & Singleton, J. (2021). Parental vaccine hesitancy and its association with adolescent HPV vaccination. Vaccine, 39(17), 2416. https://doi.org/10.1016/j.vaccine.2021.03.048
Ojeaga, A., Alema-Mensah, E., Rivers, D., Azonobi, I., & Rivers, B. (2019). Racial Disparities in HPV-related Knowledge, Attitudes, and Beliefs Among African American and White Women in the USA. Journal of cancer education : the official journal of the American Association for Cancer Education, 34(1), 66–72. https://doi.org/10.1007/s13187-017-1268-6.
Sonawane, K., Zhu, Y., Lin, Y. Y., Damgacioglu, H., Lin, Y., Montealegre, J. R., & Deshmukh, A. A. (2021). HPV Vaccine Recommendations and Parental Intent. Pediatrics, 147(3), e2020026286. https://doi.org/10.1542/peds.2020-026286
Spencer, J. C., Brewer, N. T., Trogdon, J. G., Weinberger, M., Coyne-Beasley, T., & Wheeler, S. B. (2020). Cost-effectiveness of Interventions to Increase HPV Vaccine Uptake. Pediatrics, 146(6), e20200395. https://doi.org/10.1542/peds.2020-0395
Szilagyi, P. G., Albertin, C. S., Gurfinkel, D., Saville, A. W., Vangala, S., Rice, J. D., Helmkamp, L., Zimet, G. D., Valderrama, R., Breck, A., Rand, C. M., Humiston, S. G., & Kempe, A. (2020). Prevalence and characteristics of HPV vaccine hesitancy among parents of adolescents across the US. Vaccine, 38(38), 6027-6037. https://doi.org/10.1016/j.vaccine.2020.06.074
Yousefi, Z., Aria, H., Ghaedrahmati, F., Bakhtiari, T., Azizi, M., Bastan, R., Hosseini, R., & Eskandari, N. (2022). An Update on Human Papillomavirus Vaccines: History, Types, Protection, and Efficacy. Frontiers in immunology, 12, 805695. https://doi.org/10.3389/fimmu.2021.805695.
The hidden link: How BPA exposure may contribute to childhood obesity
By Lori Hayes and Grant Mendoza
Photo taken from Microsoft Word Stock Images.
Healthy People 2030 – Childhood Obesity
Childhood obesity is a growing concern in the United States. According to the Healthy People 2030 initiative, reducing the proportion of children and adolescents with obesity is a top priority. The NWS-04 target aims to reduce the percentage of children and adolescents aged 2 to 19 years with obesity. The baseline data from 2013-16 indicates that 17.8 percent of this population had obesity, while the most recent data from 2017-20 shows an increase to 20 percent, indicating an upward trend (Office of Disease Prevention and Health Promotion [ODPHP], n.d.).
Obesity in children and adolescents can lead to various health problems, including high blood pressure, high cholesterol, diabetes, asthma, anxiety, and depression (CDC, 2022). Furthermore, obesity can have long-term effects, as children with obesity are more likely to have obesity as adults. Additionally, children with obesity are more likely to be bullied, which can have a negative impact on their mental health (CDC, 2022).
Changes in policy and school curriculums can also help reduce childhood obesity. For instance, schools can offer healthier food options and ensure that students have access to safe and enjoyable physical activities. There have been several policy changes implemented to reduce childhood obesity in recent years. One of the most significant changes is the Healthy, Hunger-Free Kids Act of 2010, which updated the nutrition standards for school meals. This policy requires schools to provide healthier food options, including more fruits, vegetables, and whole grains, while reducing the amount of sodium and unhealthy fats in school meals. Furthermore, policies can be implemented to limit the marketing of unhealthy foods to children.
Overall, reducing childhood obesity is crucial for promoting healthy lifestyles and preventing chronic diseases. A multifaceted approach, including behavioral programs and policy changes, is required to create a healthier environment for children and adolescents (CDC, 2022).
The Link Between Childhood Obesity and BPA
Childhood obesity is a significant public health concern, with a prevalence increase of 47.1% between 1980 and 2013 (Hoepner et al., 2016). It is defined as having a body mass index greater than or equal to the 95th percentile for both age and sex. Childhood obesity has been linked to various health complications such as cardiovascular disease, diabetes, digestive system metastasis, and mental health ailments. Recent evidence suggests that Bisphenol A, an endocrine-disrupting chemical, plays a role in obesity along with traditional risk factors (Vrijheid et al., 2020). Bisphenol A is an obesogen that can be found in food packaging, drinking water, and incidental dermal exposure. Dietary ingestion is the primary exposure path for most people in the United States (Gajjar et al., 2022; Guo et al., 2020).
Robles-Aguilera and colleagues (2021) conducted a study to investigate the correlation between Bisphenol A exposure and anthropometric measures in Spanish children. They found positive correlations between total dietary exposure to Bisphenol A and being overweight or obese in female children but no significant correlation between dietary exposure to BPS and BMI (Robles-Aguilera et al., 2021). The study suggests that environmental toxicants may significantly impact adolescents more during their rapid growth and development than adults and previous studies on animal models have reported gender disparities in the relationship between BPA exposure and obesity due to variations in BPA metabolism, estrogenic receptor expression, and gender-related variations in BPA exposure through dietary intake and energy expenditure (Robles-Aguilera et al., 2021).
The study conducted by Guo et al. (2020) aimed to explore the potential association between maternal and child bisphenol A exposure and adiposity measures in children. The researchers measured the bisphenol A concentrations of spot urine samples in mothers and their children at ages three and seven. The study found that maternal urinary bisphenol A concentration was positively associated with the waist circumference of seven-year-old children, indicating that exposure to bisphenol A during the prenatal phase could potentially increase the circumference of the waist in children and lead to more weight gain in school-age girls (Guo et al., 2020).
A study by Vrijheid and colleagues (2020) investigated the correlation between different environmental risk factors during early life and early childhood obesity. The study found that smoking on the mothers’ side was associated with higher child BMI and child blood levels of copper and cesium were also correlated with increased BMI. On the other hand, organochlorine pollutants, cobalt, and molybdenum levels were linked with decreased BMI. Overall, the study highlighted several factors that positively correlate with increased child BMI (Vrijheid et al., 2020).
Resources for Parents
There are a number of resources available for parents seeking information about childhood obesity and BPA. Here are a few:
1. The Centers for Disease Control and Prevention (CDC) offers a range of resources related to childhood obesity, including information on healthy eating habits, physical activity guidelines, and tips for parents to help their children maintain a healthy weight. Additionally, the CDC has information about BPA and its potential health effects, as well as ways to reduce exposure.
Please visit https://www.cdc.gov/obesity/childhood/index.html for more information.
2. The American Academy of Pediatrics (AAP) provides guidance for parents on preventing childhood obesity, including recommendations on healthy nutrition, physical activity, and screen time. The AAP also has information on BPA and other environmental toxins, as well as resources for reducing exposure.
Please visit https://www.aap.org/en/patient-care/institute-for-healthy-childhood-weight/ for more information.
3. The Environmental Working Group (EWG) offers a range of resources on BPA and other environmental toxins, including a guide to BPA-free products and information on how to reduce exposure.
Please visit https://www.ewg.org/news-insights/news/2022/06/are-food-and-consumer-product-chemicals-contributing-our-obesity-crisis for more information.
Conclusion
Bisphenol A is an obesogen and endocrine-disrupting chemical that has been associated with childhood obesity (Guo et al., 2020; Mustieles et al., 2019; Robles-Aguilera et al., 2021). Globally, about 340 million children are estimated to be overweight/obese (Mustieles et al., 2019). An increasing public health concern is childhood obesity, leaving the child at risk for cardiovascular disease, type 2 diabetes, certain digestive cancers, and mental health issues (Vrijheid et al., 2020). Vafeiadi and colleagues (2016) found that children aged 2-7 years old with a higher urinary concentration of BPA were more likely than not to have a more extensive body mass index, skinfold thickness, and waist circumference. Robles-Aguilera and colleagues (2021) found a positive correlation between exposure to dietary ingested bisphenol A and being diagnosed with overweight/ obesity in a population of female children. Regulations restricting the possible exposure of BPA to children should be considered to protect children from the side effects of BPA.
References
CDC. (2022, July 27). Childhood Obesity Facts | Overweight & Obesity | CDC. Centers for
Disease Control and Prevention. https://www.cdc.gov/obesity/data/childhood.html
Gajjar, P., Liu, Y., Li, N., Buckley, J. P., Chen, A., Lanphear, B. P., Kalkwarf, H. J., Cecil, K. M.,
Yolton, K., & Braun, J. M. (2022). Associations of mid-childhood bisphenol A and
bisphenol S exposure with mid-childhood and adolescent obesity. Environmental
Epidemiology, 6(1), e187. https://doi.org/10.1097/EE9.0000000000000187
Guo, J., Zhang, J., Wu, C., Xiao, H., Lv, S., Lu, D., Qi, X., Feng, C., Liang, W., Chang, X.,
Zhang, Y., Xu, H., Cao, Y., Wang, G., & Zhou, Z. (2020). Urinary bisphenol A
concentrations and adiposity measures at age 7 years in a prospective birth cohort. Chemosphere, 251, 126340. https://doi.org/10.1016/j.chemosphere.2020.126340
Hoepner, L. A., Whyatt, R. M., Widen, E. M., Hassoun, A., Oberfield, S. E., Mueller, N. T.,
Diaz, D., Calafat, A. M., Perera, F. P., & Rundle, A. G. (2016). Bisphenol A and
Adiposity in an Inner-City Birth Cohort. Environmental Health Perspectives, 124(10),
1644–1650. https://doi.org/10.1289/EHP205
Mustieles, V., Casas, M., Ferrando-Marco, P., Ocón-Hernández, O., Reina-Pérez, I.,
Rodríguez-Carrillo, A., Vela-Soria, F., Pérez-Lobato, R., Navarrete-Muñoz, E. M., Freire,
C., Olea, N., & Fernández, M. F. (2019). Bisphenol A and adiposity measures in peripubertal boys from the INMA-Granada cohort. Environmental Research, 173, 443–451. https://doi.org/10.1016/j.envres.2019.03.045
Pérez-Bermejo, M., Mas-Pérez, I., & Murillo-Llorente, M. T. (2021). The Role of the Bisphenol
A in Diabetes and Obesity. Biomedicines, 9(6), 666.
https://doi.org/10.3390/biomedicines9060666
Robles-Aguilera, V., Gálvez-Ontiveros, Y., Rodrigo, L., Salcedo-Bellido, I., Aguilera, M.,
Zafra-Gómez, A., Monteagudo, C., & Rivas, A. (2021). Factors Associated with
Exposure to Dietary Bisphenols in Adolescents. Nutrients, 13(5), 1553. https://doi.org/10.3390/nu13051553
Vrijheid, M., Fossati, S., Maitre, L., Márquez, S., Roumeliotaki, T., Agier, L., Andrusaityte, S.,
Cadiou, S., Casas, M., De Castro, M., Dedele, A., Donaire-Gonzalez, D., Grazuleviciene,
R., Haug, L. S., McEachan, R., Meltzer, H. M., Papadopouplou, E., Robinson, O., Sakhi,
A. K., … Chatzi, L. (2020). Early-Life Environmental Exposures and Childhood Obesity:
An Exposome-Wide Approach. Environmental Health Perspectives, 128(6), 067009.
Sexually Transmitted Infections (STIs) Among Young Adults
By: Mariana Aldana, Andrew G. Gatz, and Courtney K. Yang
Image source: https://pixabay.com/vectors/relationship-love-couple-boy-2747387/
Introduction
More than 30 different types of sexually transmitted infections (STIs) are caused by bacteria, viruses and/or parasites that can be passed from one person to another through sexual contact like vaginal, anal and oral sex (WHO, 2023). Today, STIs are still a major health issue concerning health professionals. As of 2022, the U.S. has accumulated more than 2.5 million STI cases (CDC, 2024). For example, in 2022, there were over 200,000 cases of Syphilis; nearly 650,000 cases of Gonorrhea; and 1.6 million cases of Chlamydia (refer to figure 1) (CDC, 2024). It is important to take into consideration that any person who engages in sexual relations could be at risk for an STI and become asymptomatic or have minor symptoms. However, certain individuals are at a higher risk of STIs compared to others: individuals between the ages of 15 through 24; pregnant women; sexually unbiased and homosexual men; and specific racial and ethnic minority groups (e.g., Black, American Indian/Alaska Native, Hispanic) (Boyer et al., 2021).
Figure 1: Table of STI Cases in U.S (CDC, 2024)
The ongoing rise of STIs is a serious public health concern that requires immediate attention. The STI epidemic influences the wellbeing of individuals physically and socially, while presenting an extremely high cost on the U.S. healthcare system. In 2018, the cost of treatment concerning STIs in the U.S. was almost 16 billion (Chesson et al., 2021). Additionally, untreated STIs can prompt long term medical issues, such as: pelvic pain; infertility; and poor birth outcomes, including increased infant mortality rates (HHS, 2022). Moreover, STIs can lead to other serious health problems, beyond the actual infection itself. For instance, mother-to-child transmission of STIs may result in stillbirth, low-birth weight, congenital deformities, neonatal death, increased risk of HIV acquisition, cause cancer, and more (WHO, 2023). While STI treatment and prevention efforts continue, infection rates disproportionately rise. The CDC reports that rates of syphilis among young and pregnant women are increasing (HP30-a, n.d.). Young men and adolescent males are also exhibiting increased rates of gonorrhea (HP30-a, n.d.). Therefore, with undeniably high rates of STI infections among young individuals, there is a need to foster and support opportunities for sexual health education and prevention promotions, medical care access, testing, and treatment (Boyer et al., 2021).
Health Equity
Since the findings and resulting actions of the deplorable Tuskegee Syphilis Study, the U.S. has strived to accomplish health equity for all people living in the 50 states. The Belmont Report of 1979 introduced “ethical principles [of] respect, beneficence, and justice” for human research subjects; principles that continue to influence health care standards in public health policy and practice today (HHS, 2021).
Healthy People is the result of decades of dedication toward health equity. Each decade, since the “Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention” of 1979, Healthy People provides a framework for U.S. health objectives in order to advance its mission of “improving the health and well-being of all people” (HP30-c, n.d.). Yet, each year, health disparities emerge among groups of Americans, and are often disproportionately evident in minority and underrepresented groups.
Healthy People 2030 and STIs
Healthy People 2030 is actively addressing the declining sexual health of young adults and adolescents. Human papillomavirus (HPV) vaccinations among 13–15-year-olds increased by 10% from 2018 to 2021; HPV vaccination is a proven method of reducing cervical cancer and genital warts, including herd reductions among unvaccinated individuals (HP30-d, n.d.; Patel, et al, 2018). By highlighting the success of HPV vaccinations, Healthy People 2030 provides health professionals with resources of successful framework for youth vaccination programs, while linking HPV vaccinations to other Healthy People 2030 objectives: reducing cancer related deaths, and increasing cervical cancer screenings (HP30-e, n.d.). Highlighting health promotion success is important to reinforce continued campaigns of improvement, but Healthy People also highlights declining health outcomes.
Presenting health declines raises awareness for issues that require more work in order to make an impact. Healthy People 2030 highlights sexual health issues that are not improving or stagnant among young adults and adolescents: gonorrhea in males and new HIV infections (HP30-a). Research suggests, since 2021, that limited healthcare access, due to COVID-19 and limited health facility availability, contribute to the increase in STI’s among young adults and adolescents, specifically and disproportionately among black youth (Mena, 2023). The importance of highlighting this issue, and the disproportionate groups affected, enlightens researchers and policy makers of how and where to focus their resources in order to improve the health of the people who are suffering the greatest.
Prevention of STIs
Rates of STIs are increasing among people. Young adults and adolescents, ages 15 through 24 years old, make up about half of all new STI cases annually (Shannon and Klausner, 2018). Educational awareness is an effective method to utilize for teaching young adults (Arakawa, 2021). In the role of health education specialists, it is always encouraged to influence communities on health prevention. The use of an educational approach may reduce the rates of STIs in young adults because they will gain knowledge about STI screening, prevention, and the different types of STIs. Healthy People 2030 provides evidence-based methods of prevention resources for healthcare professionals and young adults, including: prophylaxis training; screening and testing; best practice recommendations; and behavioral counseling (HP30-b, n.d.).
Any adolescent who is thinking about or decides to engage in sexual activity should consider the best practices to avoid transmission of STIs. Because of the behavior and biological perspectives of adolescents, it is more common for them to consider high-risk sexual behavior compared to other populations (Arakawa, 2021). To stay protected, one should practice abstinence, reduce the number of sex partners, and use proper applications of protection (CDC, 2023). By practicing abstinence, a person decides to not participate in having any form of sex (e.g., anal, vaginal, or oral) to avoid the possibility of infection (CDC, 2023). Moreover, teaching adolescents how to properly use a condom and how to inspect if it is expired can prevent the condom from failing (Arakawa, 2021).
Diagnosis and Treatment of STIs
STIs positive persons are not always aware of infection. Often, people are not aware that they have an STI because there are little-to-no presentable symptoms (WHO, 2023). To get tested for an STI, there are many resources that adolescents can refer to, such as: planned parenthood; college university student health centers; primary doctor; and local clinics that offer free testing, etc. To diagnose STIs, health professionals rely on a blood, urine, and anatomical sample/biopsy, or a rapid test (WHO, 2023).
When an STI is diagnosed, the type of treatment depends on whether the disease is bacterial or viral. For example, chlamydia, gonorrhea, and syphilis are known as a bacterial infection, which can be cured with the use of antibiotics (WHO, 2023). But in other circumstances, herpes and HIV must be treated using antiviral drugs and are not curable (WHO, 2023). Providing additional patient education to viral-infected STI individuals is also encouraged in order to prevent the spread of STIs among potential future sex partners.
Conclusion
Young adult and adolescent sexual health concerns shine a spotlight on disproportionate health disparities. Even more, addresses the mission of public health professionals to confront health equity. Addressing youth health not only improves the immediate health of that population, but also fosters health behaviors, and lowers risk factors throughout life. Healthy People 2030 is a useful resource for health professionals, researchers, and policy makers to utilize to address recent health data trends and increasing/decreasing rates of disease incidence and prevalence. Treatment, education, routine health appointments, and preventative measures will be necessary to lower the rate of STIs among this increasingly affected population.
References
Arakawa, S. (2021). Education for prevention of STIs to young people (2021 version) Standardized slides in youth education for the prevention of sexually transmitted infections-for high school students and for junior high school students. Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy, 27(10), 1375–1383. https://doi.org/10.1016/j.jiac.2021.05.008
Boyer, C. B., Agénor, M., Willoughby, J. F., Mead, A., Geller, A., Yang, S., Prado, G. J., & Guilamo-Ramos, V. (2021). A Renewed Call to Action for Addressing the Alarming Rising Rates of Sexually Transmitted Infections in U.S. Adolescents and Young Adults. Journal of Adolescent Health, 69(2), 189–191. https://doi.org/10.1016/j.jadohealth.2021.05.002
Centers for Disease Control and Prevention (CDC). (2021). STI prevalence, incidence, and cost estimates. Centers for Disease Control and Prevention. https://www.cdc.gov/std/statistics/prevalence-incidence-cost-2020.htm
Centers for Disease Control and Prevention (CDC). (2023). How You Can Prevent Sexually Transmitted Diseases. Centers for Disease Control and Prevention. https://www.cdc.gov/std/prevention/default.htm
Centers for Disease Control and Prevention (CDC). (2024). Sexually transmitted infections surveillance, 2022. Centers for Disease Control and Prevention. https://www.cdc.gov/std/statistics/2022/default.htm
Chesson, H. W., Spicknall, I. H., Bingham, A., Brisson, M., Eppink, S. T., Farnham, P. G., Kreisel, K. M., Kumar, S., Laprise, J. F., Peterman, T. A., Roberts, H., & Gift, T. L. (2021). The estimated direct lifetime medical costs of sexually transmitted infections acquired in the United States in 2018. Sexually transmitted diseases. https://pubmed.ncbi.nlm.nih.gov/33492093/
Healthy People 2030 (HP30-a). (n.d.). Sexullay transmitted infections: overview and Objectives. CDC. Healthy People 2030. Retrieved February 10, 2024, from https://health.gov/healthypeople/objectives-and-data/browse-objectives/sexually-transmitted-infections
Healthy People 2030 (HP30-b). (n.d.). Sexually transmitted infections: evidence-based Resources. CDC. Healthy People 2030. Retrieved February 10, 2024, from https://health.gov/healthypeople/objectives-and-data/browse-objectives/sexually-transmitted-infections/evidence-based-resources
Healthy People 2030 (HP30-c). (n.d.). Healthy people 2030 Framework. CDC. Healthy People 2030. Retrieved February 10, 2024, from https://health.gov/healthypeople/about/healthy-people-2030-framework
Healthy People 2030 (HP30-d). (n.d.). Increase the proportion of adolescents who get recommended doses of the HPV vaccine. CDC. Healthy People 2030. Retrieved February 10, 2024, from https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-proportion-adolescents-who-get-recommended-doses-hpv-vaccine-iid-08
Healthy People 2030 (HP30-e). (n.d.). HPV Vaccination. CDC. Healthy People 2030. Retrieved February 10, 2024, from https://health.gov/healthypeople/tools-action/browse-evidence-based-resources/hpv-vaccination
Mena, Leandro. (2023, April, 11). U.S. STI epidemic showed no signs of slowing in 2021 – cases continued to Escalate. CDC. Received February 10, 2024, from https://www.cdc.gov/nchhstp/newsroom/2023/STD-Surveillance-Report-2021-media-statement.html
Patel, C., Brotherton, J. M. L., Pillsbury, A., Jayasinghe, S., Donovan, B., Macartney, K., & Marshall, H. (2018). The impact of 10 years of human papillomavirus (HPV) vaccination in Australia: what additional disease burden will a nonavalent vaccine prevent? Euro Surveill, 23(41). https://doi.org/10.2807%2F1560-7917.ES.2018.23.41.1700737
Shannon, C. L., & Klausner, J. D. (2018). The growing epidemic of sexually transmitted infections in adolescents: a neglected population. Current opinion in pediatrics, 30(1), 137–143. https://doi.org/10.1097/MOP.0000000000000578
U.S. Department of Health and Human Services (HHS). (2021, April 22). The U.S. public health service untreated syphilis study at Tuskegee: Research Implications. CDC. HHS. Retrieved February 10, 2024, from https://www.cdc.gov/tuskegee/after.htm
World Health Organization. (2023). Sexually transmitted infections (stis). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
Social Connectedness
Miguel A. Perez, Ph.D., MCHES
Professor of Public Health
Chair, ad interim, Department of Public Health
The need to connect is an innate human need and is recognized as one of the multifaceted components of health. While it is normal to occasionally feel alone, loneliness can impact individuals even when they are around others. In 2023, the US Surgeon General declared loneliness and social isolation an epidemic in the US, given their impact on US adults and profound impact on a person’s health (US Surgeon General, 2023).
Source: CDC, 2024
The CDC defines loneliness as “feeling alone or disconnected from others. It is feeling like you do not have meaningful or close relationships or a sense of belonging. It reflects the difference between a person’s actual and desired level of connection.” (CDC, 2024). Loneliness is a complex and distressing emotional response to perceived isolation. It is different from simply being alone, and it involves feeling disconnected or alienated from others, even when surrounded by people. Loneliness can affect anyone regardless of educational background, gender, social status, or age (Cacioppo & Cacioppo, 2018; Ozawa-de Silva & Parsons, 2020), although more profound impacts are observed among older adults.
Scientists have identified at least two types of loneliness: emotional loneliness and social loneliness. The first is characterized by missing an intimate relationship or close emotional connection with a partner or best friend, and the second includes the lack of social networks or groups of friends, which can lead to feeling left out of social activities.
The perception of being isolated or disconnected is more critical than the actual number of social contacts. Loneliness is not the result of the quantity, but rather the quality of our connections. Someone can have many acquaintances, but still fell lonely without meaningful connections. This may lead to emotional distress manifested in feelings of sadness, emptiness, and longing for social connections.
The major causes of loneliness in individuals worldwide include life transitions such as moving to a new place, starting a new job, or losing a loved one. Loneliness can also be the result of social circumstances, including our social skills, living alone, or being part of a minority group. Mental health issues like depression and anxiety can both contribute to and be the result of loneliness. It should be noted that “Feeling lonely isn’t a mental health problem. But having a mental health problem can increase feelings of loneliness.”
It is important to address loneliness, especially in older adults, as it can have significant negative effects on both the mental and physical health of the individual. Figure 1 summarizes some of the most salient impacts of loneliness on the health status of individuals. :
Addressing loneliness through social connections, therapy, community involvement, and lifestyle changes is crucial for improving overall well-being and reducing severe negative results from loneliness. Perhaps the most important step we can take to eliminate the insidious negative impact of loneliness is to eliminate the perception that it is a sign of weakness or self-pity. Loneliness is not something a person chooses and can discard at will. Instated, loneliness is a reflection of the circumstances being experienced by the individual.
We can all benefit from recommendations designed to reduce loneliness. A quick online search will produce many sites with recommendations for dealing with loneliness. I have chosen to include recommendations from two sites I find particularly useful.
The UK’s National Health Service makes the following recommendations for dealing with loneliness:
- try talking about your feelings to a friend, family member, health professional, or counselor.
- consider joining a group or class that focuses on something you enjoy; you could ask to go along and just watch first if you’re feeling nervous
- consider visiting places where you can just be around other people – for example, a park, the cinema or a café
- consider peer support, where people use their experiences to help each other.
- get practical tips and advice to help with loneliness on Every Mind Matters
- try the 6 ways to feel happier, which are simple lifestyle changes to help you feel more in control and able to cope
- find out how to raise your self-esteem
- listen to free mental wellbeing audio guides
Collier (2020), writing for the Harvard Health Blog, suggests some principles that may help individuals and their loved ones deal with loneliness.
- Connect meaningfully with family and friends. Although technology can help foster connections, it is imperfect: social media, for example, has actually been linked to increasing loneliness. Connect in a way that works best for you, whether by phone, via video chat, through a mobile application, or even by talking with your neighbors across the fence or in a park.
- Be thankful. Loneliness can lead people to focus on themselves and their hardships. Aim to express appreciation toward friends, family, and strangers.
- Focus on what you can change. Spending time dwelling on your current situation can perpetuate loneliness; rather, focus your attention on something within your control and work at it.
- Enjoy being busy. Complete a chore, spend time writing, find a new hobby, or just allow yourself to delve into a new activity. Let your creativity shine!
- Remove negativity. Surround yourself with people and activities that bring you joy. Consider taking a break from the news, or at least limiting your consumption.
- Data suggest that just the act of smiling can make you feel better.
- Be kind, understanding, and patient. Work on treating yourself and others with compassion. Engaging in pleasurable interactions can also help those around you, and may result in deeper connections.
- Develop a routine that provides balance and familiarity. Create a daily plan that includes physical activity, time for connecting with loved ones, a project or hobby, and a relaxing pleasure.
Loneliness can affect anyone at any time. The first step is acknowledging its existence, and the second is seeking help when needed.
References
Cacioppo, J. T., & Cacioppo, S. (2018). The growing problem of loneliness. Lancet (London, England), 391(10119), 426. https://doi.org/10.1016/S0140-6736(18)30142-9
Centers for Disease Control and Prevention. (2024). Health Effects of Social Isolation and Loneliness. https://www.cdc.gov/social-connectedness/risk-factors/index.html
Collier, S. (2020). How can you help a loved one suffering from loneliness? https://www.health.harvard.edu/blog/how-can-you-help-a-loved-one-suffering-from-loneliness-2020090420855
Erzen, E., & Çikrikci, Ö. (2018). The effect of loneliness on depression: A meta-analysis. The International journal of social psychiatry, 64(5), 427–435. https://doi.org/10.1177/0020764018776349
National Health Service. (2022). Feeling lonely. https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/feeling-lonely/
Ozawa-de Silva, C., & Parsons, M. (2020). Toward an anthropology of loneliness. Transcultural psychiatry, 57(5), 613–622. https://doi.org/10.1177/1363461520961627
Qualter, P., Vanhalst, J., Harris, R., Van Roekel, E., Lodder, G., Bangee, M., Maes, M., & Verhagen, M. (2015). Loneliness across the life span. Perspectives on psychological science : a journal of the Association for Psychological Science, 10(2), 250–264. https://doi.org/10.1177/1745691615568999
Tiwari S. C. (2013). Loneliness: A disease?. Indian journal of psychiatry, 55(4), 320–322. https://doi.org/10.4103/0019-5545.120536
US Surgeon General. (2023). Our epidemic of loneliness and isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf
Wendling A. E. (2023). On Health and Loneliness. AMA journal of ethics, 25(11), E850–E854. https://doi.org/10.1001/amajethics.2023.850
Yanguas, J., Pinazo-Henandis, S., & Tarazona-Santabalbina, F. J. (2018). The complexity of loneliness. Acta bio-medica : Atenei Parmensis, 89(2), 302–314. https://doi.org/10.23750/abm.v89i2.7404
Recent Comments
 | Samantha Perez on HIV Among Injection Drug User… |
 | Kendalyn on Improving the Health and Welln… |
 | Brenda Hartman, MPH,… on Healthy Living with Asthm… |
 | Anabel Jayme on Healthy Living With Diabe… |
| Anabel Jayme on Physical Activity and COV… |
Global Public Health 