You Need to Slow Down
Three Things Thursday
Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week. And this week I feel like I’ve been hit (and subsequently crushed) by a tidal wave of information/news.
The floods in Texas and the missed opportunities for prevention/early warning that cost so many their lives, the (first round of) fallout from the passage of the big, beautiful bill, HHS cutting a program that monitors the safety of birth control, and RFK Jr canceling a meeting of the U.S. Preventive Services Task Force (scheduled for today). Additionally, the number of measles cases in the US is highest it has been in 30 years. COVID vaccines for children have been officially approved by the FDA, but can only be given to kids who are at increased risk for severe disease. And RFK Jr is preaching that the key to being healthy is to purchase a wearable and eat these $7 per person ready-to-go meals, which are high in sugar, sodium, and saturated fats (read: NOT healthy).
In this moment, when it all feels so heavy and I can barely keep up with the headlines that are posted —
I need to remind myself to slow down.
I need to pause and not allow the news and social media posts to consume me. And I need to ask myself what is important in this moment. What do I need to know (or do) now to create healthy communities?
This week’s Three Things Thursday highlights three things we need to do to be healthy and create healthy communities for all.
Hoping this post helps to educate and empower you
to be healthy and create healthy communities.
Be Grateful
From a health perspective, there is a lot to be grateful for right now. COVID-19 levels remain low. Wastewater levels of the SARS-CoV-2 virus remain low.
All of the early indicators for COVID are below the levels we were seeing this time last year (before our August 2024 wave of disease).
There is little influenza spreading in our communities.
And while we are seeing record numbers of measles cases for the year, only 4 new cases were reported last week, a significant decline from 20+ new cases each week in June.
Check Your Healthcare Coverage
As I noted last week, Trump’s Big, Beautiful Bill is going to gut healthcare. The Bill presents a clear and present danger to each of us (regardless of the type of healthcare coverage we have). Now that the bill has passed, please check in with your health insurance company, especially if you are on Medicaid or secured your insurance through the ACA Marketplace (like the Pennie Program in Pennsylvania). Here are some of the questions you should be asking —
What paperwork do I need to complete to re-enroll for next year?
One of the stipulations of the bill is that individuals who are currently insured will NOT be automatically insured each year beginning in 2028. Individuals must re-enroll. Ask your insurer when you need to start completing renewal paperwork NOW — do not wait.What requirements (like employment) do I need to meet?
Medicaid will begin requiring individuals to complete 80 hours of community engagement to stay enrolled in the program. Ask your insurer what qualifies as “community engagement,” when the rule goes into effect, what documentation is needed, and if there are exemptions, etc.Do alternative insurance policies exist? What options are out there?
And please, please, please —
Plan for your healthcare costs to increase (regardless of what insurance you have).
And inform and help your friends and family.
According to a national poll —
“Only 8% of all Americans name Medicaid cuts as a detail of the bill they have heard about.”
The Bigger Picture
As I wrote last week — when people lose their health insurance, those of us with insurance end up paying more. When people lose their health insurance, hospitals go out of business because individuals cannot pay for emergency room care. When people lose health insurance, disease spreads more readily (because people are unwilling to pay for preventive care or treatments). When people lose their health insurance, mortality rates go up, suicide rates go up, loneliness increases, and the overall health of our communities declines.
And this is just the tip of the iceberg.
Cuts in the budget would eliminate cancer prevention programs, tobacco control efforts, and diabetes prevention programming. And these cuts will only increase healthcare costs in the future. When we invest $1 in tobacco control, it saves $155 in future healthcare costs. Invest $1 in TB prevention/treatment, and the savings will be ~$30-45 in the future.
Cutting the healthcare budget does NOT eliminate healthcare problems.
From a public health perspective, nothing has changed — we still have a chronic disease epidemic, a loneliness epidemic, an epidemic of gun violence, uncontrolled spread of infectious diseases, and declining vaccination rates.
RFK Jr is peddling quick fixes — expensive meals delivered to your door and a smart watch — that he claims will make America healthy again. What is needed is a global, coordinated, well-funded plan to address all of the health problems facing our communities. If the pandemic has taught us anything, it is that when our health is threatened, everything is impacted. Financial markets collapse. Schools are closed. Loneliness sets in. Frustration grows. Violence increases. People die. Opportunities are missed. We spent too much time at our desks. We miss visiting with friends and family.
Health is so connected to everything that without health, everything else is nothing.
We need to think of health as a system (or a word with endless definitions) — a health(eco)system. Take a moment to imagine a forest (I’m imagining Fangorn from The Lord of the Rings, but the Redwoods are a good image, too).
Imagine that we are each an individual tree (I’m a blooming cherry tree).
I would argue (strongly) that in our forest of HEALTH, we all need to have strong, deep roots in the soil of PREVENTION.
I want (and would argue we all should) to prevent disease before it occurs. I want vaccines that prevent severe illness. I want clean water to prevent the spread of cholera (and other waterborne diseases). I want clean air to prevent asthma attacks from occurring. I want amazing sex education to prevent disease and violence. I want healthcare providers who talk to patients about the dangers of smoking, vaping, drugs, and too much screen time before addiction begins. I want clinics built in communities that lack access to health care. I want a healthcare system that values a healthy individual more than it values someone who is sick.
Like trees in a forest, we each must grow out of a strong foundation of PREVENTION.
We each must strive to be healthy.
But we also must realize that we are just one tree in a vast global forest.
In that forest, lightning could strike a very healthy tree, igniting a forest fire that could kill trees for miles around. A fungus could spread from tree to tree, causing disease and death. Or a tree that is unhealthy could suck the life out of the trees surrounding it.
The health of the forest is measured by the health of the soil, health of individual trees, health of groups of trees, the health of the environment in the forest (too much brush/tinder could result in a bigger fire), and the ways (healthy or not) in which the forest is used by others.
Health is not a singular thing.
Everything in the forest ecosystem is connected. Shifts and changes in one part of the ecosystem will impact all areas of the ecosystem.
And so it is with health.
We are all connected.
When someone is unhealthy, it could lead to others becoming ill. Or healthcare costs could increase. Or premature death could occur, leaving children without parents. Or someone is unable to go to work to do their job — teachers are unable to teach, doctors are unable to care, bus drivers are unable to transport us. Being sick is not just an individual problem. Illness is a health(eco)system problem.
We do NOT solve health problems by cutting the budget, recommending a meal delivery system, or encouraging people to wear a smart watch.
We create healthy communities by taking care of each other
and the places where we work, learn, eat, play, and pray.
“The fight for public health and health equity will be a lifelong one. But for the next few years, we can look to our families, our communities, and our cities to help us stay healthy. We should not waver in the demand for safe and healthy communities as well as for evidence-based health information. Love each other, protect each other, and get vaccinated!”
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Epi(demiology) Matters is written by Dr. Becky Dawson, PhD MPH — an epidemiologist, teacher, mom, wife, and dedicated yogi. She is a tenured professor at Allegheny College, Research Director at a community hospital, and an exclusive contributor (all things health & medicine) at Erie News Now (NBC/CBS). Her goal is to create healthy communities for all. She writes Epi Matters — first & foremost because epidemiology does matter (to all of us), and she hopes that each post will help to educate and empower readers to be healthy and create healthy communities.
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Much needed advice during turbulent times :)