The World Health Organization recently published an interactive map (click the image below) based on their “Global Urban Ambient Air Pollution Database,” which contains data on the concentration (micrograms per meter cubed) of particles less than 10 microns in diameter (1/7th the diameter of human hair) around the world, also known as PM10. Since major sources of these particles include motor vehicles, wood burning stoves/fireplaces, construction/agricultural/landfill dust, waste burning, and industrial sources, PM10 concentration is a good proxy for pollution level.
Apart from China, which has made news on repeated occasions for air pollution, I was particularly struck by the levels of pollution in Saharan Africa, the Persian Gulf, and within India. I can only imagine the human health health and ecosystemic effects of contaminated air in these regions. Of note, however, the vast majority of activities that result in PM10 production are tied in some way or another to economic productivity. Innovation at the level of technology, business, and governmental policy is clearly in need to enable less environmentally deleterious means of economic productivity in these regions of the world.
After four exciting and formative years, I finally graduated from Harvard Medical School a few weeks ago. Aside from the abundance of bedside manner, physiology, pathophysiology, and procedural skills that I learned, here are the top four life lessons that I took away from the experience:
Never be afraid to ask questions.
Maintain balance between work and life — it makes both much more enjoyable.
Stay plugged into your supports (faith, family, and friends).
If you’re like me, election season brought forth my curiosity about U.S. healthcare spending in the past. One of the most user-friendly interfaces for this is the Kaiser Family Foundation’s “Health Spending Explorer,” a simple yet powerful tool for learning about healthcare spending in the U.S. since 1960. Not only does this living infographic utilize National Health Expenditure Account data, but it also will continue to incorporate new data upon release.
It goes without saying that healthcare expenditure in the United States has increased dramatically since 1960. In a healthcare system where fee-for-service prevails, there is little incentive for physicians to abandon the approach of ordering excessive laboratory and imaging tests as well as performing procedures in what seems to be perhaps the least parsimonious, efficient way possible. Over the past few decades, however, multiple healthcare organizations began to focus on the quality and cost-effectiveness of healthcare provided. After all, expensive imaging tests, labs, and procedures are not only expensive for the healthcare institution providing them, but they also serve as a major financial burden to patients. By incentivizing physicians to increase the quality of the healthcare they provide while also practicing efficient medicine to improve patient outcomes and satisfaction, the rapid growth in U.S. healthcare expenditures may hopefully start to slow.
Data is an integral element of the world in which we live. Innovative companies analyze user-collected data to improve the efficiency of daily tasks like searching the Internet, navigating a city, and finding the best place to eat. Similarly, healthcare is an incredibly data-drive field. On a daily basis, physicians and medical students like myself integrate patient data with findings from large studies published in major medical journals to provide the best care possible. To this end, there are numerous collective databases that exist among groups of medical professionals such as transplant surgeons, oncologists, radiologists, and even plastic surgeons which enable larger sample sizes and thus more accurate determinations of health outcomes and the effect of various interventions among patients of a variety of backgrounds.
As a fan of open-source data, I was pleased to recently discover website healthdata.gov, one of the most powerful ventures by the United States Department of Health and Human Services in my opinion. I had forgotten just how much information the United States government collects through the services it funds such as hospitals, Medicare, Medicaid, and other national and state-based organizations. Whether digging through a geotagged database of toxic chemical spills in the United States or analyzing a database of cancer outcomes in low income elders, I can’t wait to delve into the plethora of eye-opening information that this website offers.
The information we need to make change already exists. It’s our job to put that information into action.
Let’s face it, major social issues often take a back seat in the immediate aftermath of natural disasters. One unfortunate example of this is the systemic gender discrimination and rampant violence against women that continues to occur in Haiti (now 6 years after the colossal earthquake in 2010). The non-profit organization Human Rights Watch recently made a submission to the United Nations Committee on the Elimination of Discrimination Against Women regarding the systemic problems that contribute to the marginalization of women in Haitian society.
More specifically, this HRW submission to the UN provides eye-opening insight into the impact of gender-based violence and widespread lack of rights to fresh water and sanitation on women’s’ access to healthcare and education in Haiti. Perhaps most apparent is the direct infectious health risks that result from poor sanitation. Less obvious, however, is that the absence of easily accessible fresh water (a problem that was greatly exacerbated by the widespread destruction that occurred during the 2010 earthquake) is forcing countless girls and women alike to put themselves at risk of rape and other violence in order to retrieve water while also foregoing empowering activities such as education and entrepreneurship.
Simply put, systemic injustice at the level of government and society are responsible for perpetuating, if not creating, the large amounts of suffering among marginalized groups in countries like Haiti that have recently suffered major catastrophes. While it is undoubtedly difficult to eliminate these systemic issues overnight, the work of organizations like Human Rights Watch and the UN to raise awareness about the issues and their systemic causes is an important first step toward progress.