Put the “Comprehensive” Back in Sex Education

For some late teens and young adults, engaging in the “hookup culture” is part of growing up. Instead of turning a blind eye and hoping our kids aren't part of it, we should get serious about educating people about the issues that come with the behavior, like sexually transmitted infections (STIs), sexual  assaults, rape and harassment.

Many of our college campuses have been and continue to do just that, helping students lead healthier, happier and safer lives, including Macalester. There are numerous talks and campaigns that are embracing the fact that college students are having sex, and are trying to encourage safer sex practices rather than shying away from the fact. However, what are high schools doing to ensure that these students come into college equipped to deal with the stresses like college, where casual sex is a prevalent practice?

Young people (ages 15-24) are particularly affected, accounting for half (50 percent) of all new STIs, although they represent just 25 percent of the sexually experienced population,” according to a 2013 CDC report. Abstinence only education isn’t realistic at all. To ensure that these kids don’t end up pregnant or contracting STDs, comprehensive, age appropriate sex education is important. The world these kids live in is a lot more complicated and dangerous than people want to believe.

According to the American Public Health Association, “Experts in the fields of adolescent development, health, and education recommend that sexuality education programs as part of a comprehensive health education program assist young people in developing a positive view of their sexuality, provide them with information necessary to protect their sexual health, and help them acquire skills to make informed decisions, both now and in the future.”

Morally and ideologically justifying why or why not the “Hookup culture” exists, isn’t going to help anyone. In the end, everyone should have youth's best interests at heart. These students are going to enter the world, unprepared to deal with the variety of issues related to sex, including pertinent issues such as rape, sexual assault, and harassment. Thus, comprehensive sex education should aim to address these issues.

Posted in Education | Related Topics: K-12 education  Curriculum  Public Health 

Mental health and College

College is a time of self discovery and trying to carve a place for yourself in the world. It is stressful not just because of higher academic expectations but also, because of the many social pressures of college life. Learning how to be truly independent for the first time and also experiencing immense personal and intellectual development contributes to the stress. In turn, many academic problems stem from “mental health and personal problems.”

According to the American Psychological Association (APA) anxiety and depression are some of these common problems seen on college campuses, and these issues are some of the more severe psychological issues. Many studies have indicated that visiting a counselor can do great things for academic success and as well as personal stability.

Colleges, like the University of Minnesota, Bemidji State University and Macalester College, are seeing an uptick in the number of students that are seeking counseling help. It’s because the problems that these students are experiencing have increased ten fold as well. There is a dire need to address these issues urgently. 

The “work hard, party hard” motto, prevalent on college campuses, could end up suppressing mental health issues and in the long term could end up hurting students rather than helping them. It’s no secret, that abuse of drugs occurs on campus, with a wide variety of stimulants purchased by students. These kids often look for a quick fix, rather than the healthier, and more effective long term solution. For full time students, there is simply no time to think about long term health. Some experts believe that there might not necessarily be many more mental health issues compared to past generations. Rather, there are different ways to cope with these issues.

Thus, colleges and individuals need to address these issues better. NAMI (National Alliance on Mental Illness) says that students need and want suicide prevention programs, peer-run student run organizations, mental health campus events, and individual counseling services. Destigmatization of mental health and creating a supportive community is another important factor to consider. National organizations like Active Minds, committed to opening up the conversation and not trivializing the conversation on mental health has opened up a lot of chapters on Minnesota college campuses and is striving to help student with get the help that they need to overcome their mental health issues.

According to a 2011 MPR article, “Mental health officials at Minnesota colleges say to deal with the increase in students seeking care, they'll have to be creative.” Changing priorities and increasing funding for students in the clinic is key to helping to helping students have rewarding college experiences. Colleges don’t seem to have enough funding for treating mental health issues. The main point, is that better counseling services need to be provided for students, and support needs to be given to students to pursue off campus counseling services.

Posted in Health Care | Related Topics: Higher Education  Mental Health 

Video: Unfinished Business for Disability Advocates

Hundreds of people rallied at the capitol this week in support of a wide range of issues that concern Minnesotans with disabilities. Advocates called on state legislators to address a number of unfinished priorities from the last legislative session, including raising funding for in-home and community based services to the elderly and people with disabilities.

Posted in Health Care | Related Topics: Minimum Wage  Working / Middle Class Issues 

MNsure’s Bright Spots

As MNsure nears the end of its first open enrollment period, one thing’s for sure: it’s been an interesting ride. Little has come easily over the past six months.

The media has been dominated with stories about MNsure’s failures. Some of those critiques are certainly deserved. As a Navigator, I’ve encountered some serious issues, particularly with delays or errors in processing my clients’ applications. There have also been challenges with MNsure’s leadership, budget, IT structure… you name it, it’s been tough. My optimism has wavered at times. But I don’t think the news reports have given as much as attention to the bright spots—and there certainly are some. As we close in on March 31, here’s some of the good news:

Things are getting better for customers. The website is more functional. Call-center hold times are drastically lower. At least in my anecdotal experience, applications seem to be getting processed more quickly and accurately. There is certainly still a lot of room for improvement, but there’s progress.

Enrollment is picking up. Though we don’t have the full numbers just yet, the latest word was that MNsure is enrolling 1,000 people a day. They may actually hit the initial enrollment target (135,000 people), though with more people enrolled in public plans than anticipated.

Consumers are saving money. To me, this is the most significant high point so far. Most of my clients are very happy with the plan cost and coverage they find on MNsure. Some are able to afford health insurance for the first time in years. Others had prior coverage, but their new plans will save them hundreds, or even thousands, of dollars a year (this is even true for many enrollees who aren’t receiving any financial assistance).

Of course, it remains to be seen whether or not these affordable insurance rates will remain just as affordable next year. No one can say for certain who the new enrollees are, what medical care they will use, or how much that care will cost. Will better access to insurance lower healthcare costs long-term? We hope so, but we may not see the full downstream effects for years. The Affordable Care Act represents an enormous change to the healthcare market, and it may take a while for things to settle out.

There’s still room for improvement. MNsure still faces significant challenges in several areas, and the news about newly-affordable insurance still hasn’t reached everyone. This is the beginning of the road, not the end. I hope that we can all withhold final judgment until we get a little further down this path.

Posted in Health Care | Related Topics: Health Insurance Exchange 

More to Medical Marijuana Opposition

While the fate of the medical marijuana bill remains uncertain, discussions of its continued opposition by law enforcement have illuminated the importance of another set of indirectly related bills – those pertaining to the state’s civil forfeiture laws.

Recently, Rep. Carly Melin, who is sponsoring the medical marijuana bill, stated that beyond law enforcement’s legitimate public safety concerns about medical marijuana, their staunch opposition (even in the face of Melin’s many concessions to their demands) makes it “pretty obvious that something else is going on here.” Awhile back, I discussed the possibility that this opposition might be rooted at least in part in concern over the potential loss of proceeds from civil forfeiture, since a significant portion of those proceeds is likely related to marijuana.

Civil forfeiture laws currently allow police to seize any assets (such as cash and cars) they believe to be connected with a crime. Upon seizure, these items become the property of the state, and anyone wishing to recoup them must enter a lawsuit against their own property within 60 days. Although some states require proof “beyond a reasonable doubt” that the property seized is actually connected to a crime, in Minnesota “clear and convincing” evidence of a connection is sufficient.

Critics take issue with several facets of Minnesota’s application of civil forfeiture law – especially because law enforcement agencies in Minnesota get to keep the majority of the proceeds derived from asset seizure. According to a recent report on civil forfeiture, these agencies netted almost $30 million through civil forfeiture between 2003 and 2010, during which time forfeiture revenues grew 75%. The report’s authors argue this system “creates perverse incentives for law enforcement to pursue profits rather than prosecute perpetrators.”

These profits aren’t being generated from huge seizures; rather, the average value of forfeited property is $1,000 (in many cases, property kept by law enforcement is worth $400 or less). Lee McGrath, an attorney who co-authored the report, told me people don’t usually bother trying to recover their seized property because its value is often exceeded by the costs of hiring a lawyer and filing a claim.

In an effort to ameliorate the administration of civil forfeiture in Minnesota, two bills are being advocated by several organizations, including the ACLU, MACDL, and the Institute for Justice: HF 1081/ SF 873 would make it possible for spouses and other innocent owners to raise claims when their assets are seized in connection with someone else’s criminal activity, and HF 1082/ SF 874 would make a conviction in criminal court a prerequisite for forfeiture.

These amendments would help to eliminate the clear conflict of interest that arises when law enforcement is given an incentive to “police for profit.” Given that many law enforcement officials perceive the wholesale legalization of marijuana as the inevitable outcome of legalizing medical marijuana, the potential for reductions in federal crime-fighting funds and civil forfeiture revenues may strike them as significant. If the impetus for low-level drug arrests is lessened, law enforcement agencies can direct their attention toward matters that actually compromise public safety, rather than those that may impact finances.

Posted in Health Care | Related Topics: Courts & Justice 

“Aug” fats are never good for you

There has been a steady diet of academic studies from the University of Minnesota and other research universities in recent decades on the importance of raising food literacy in America.

I can almost pinpoint when it started. That was when food companies began labeling ingredients, including contents that had little meaning for the general public. A woman once called me when I was covering food and ag issues for the Pioneer Press to say she was reading a label and wanted to know "if ‘aug’ fats were good or bad for me.”

Fortunately, a colleague had left a snack pack of something on the desk. There, in big, bold type, the makers proclaimed, “0g trans fat.” I was able to help her, to a point.

We are back to fighting “aug” fats all over again. Minnesota farmers and food companies are caught in the middle of what looks like no-win but costly battles in the food industry. It proves again why independent, or pure research from our land grant research universities is imperative for consumers to understand and make good choices about what to eat.

A case in point: Mike Hughlett reported in the Star Tribune on March 2 that locally-based General Mills and Cargill are among food manufacturers and processors being sued by groups over the use of the term “natural” on labels.

The Food and Drug Administration doesn’t have a formal definition of what “natural” means; consumers must define it for themselves.

But wait. The New York Times had a February article with even more disturbing news about food literacy and how millions of dollars are spent annually to heighten consumers’ confusion. In “Rival Industries Sweet-Talk the Public,” Eric Lipton documents the millions being spent in rival campaigns pitting the Corn Refiners Association and its members against the Sugar Association and its members over the health and safety of sweetener products.

It cites court documents showing one health expert doing research on sweetener health issues was on a $41,000-a-month retainer from one of the groups. One doesn’t need a sweetener buzz to question the independence of this research.

We Minnesotans should care for both health and economic reasons. Minnesota farmers and the state’s huge food and ag industries are caught up in these food fights.

Starting at the farm level, nearly all Minnesota sugarbeet farmers are also corn farmers. Thus, costly battles between sugar and high-fructose corn syrup pits one of the farmer’s pockets against the other. The same can be said for Cargill, a major corn processor and a sugar marketer whose products include Minnesota made and processed beet sugar.

Consumers ultimately pay for legal battles and political battles in the food chain. It just might be cheaper over time for consumers to pay for pure, non-special interest scientific research at our land grant universities that would contribute to our collective food literacy.

Posted in Health Care | Related Topics: Agriculture  Nutrition 

1 Comment ->

Video: Low Wages Increase Poor Health

Low income and poor health go hand-in-hand. Working two to three jobs, many low-wage workers don't have the time to take care of their bodies. Wellness visits, a healthy diet, exercising and getting the proper amount of rest are luxuries they really can't afford. Most workers hardly have the time to spend with the families they work so hard to support.  

Posted in Economic Development | Related Topics: Minimum Wage  Public Health  Poverty 

Possible Medical Marijuana Compromise Reframes Legalization Debate

The crusade to legalize medical marijuana in Minnesota has come up against tough resistance from law enforcement officials, who characterize marijuana as a harmful gateway drug. But this resistance may be wavering as lawmakers consider alterations to medical marijuana legislation this session.

The changes would see a narrowing of the bill to include marijuana consumption by pill or liquid, rather than through smoking/inhalation. The leaders of several law enforcement agencies have indicated tentative openness to this possible new approach. John Kingrey, Executive Director of the Minnesota County Attorneys Association, stated that his organization would not be opposed to an extract “if you can distill some of [the 150 compounds in marijuana] and it does not include the THC component and if it is effective to treat certain illnesses…”

This willingness to accept a “purified” version of marijuana for medicinal use illustrates the assertions made by Jeremy Daw in an article that appeared on salon.com last month. In “The racist roots of America’s marijuana policy,” Daw argues that American drug policy is rooted in a medical/recreational dichotomy that has long privileged the narcotic preferences of white, middle-class patients (i.e. for morphine) while criminalizing those of immigrants (i.e. for opium).

According to Daw, the acceptance of drugs with single active ingredients and the rejection of those featuring uncertain chemistry marks a distinction that continues to inform drug policy – including debates over medical marijuana. This explains why we are seeing growing approval for cannabis extracts with “surprise—a known and reproducible chemistry featuring a single active ingredient,” and continued aversion toward the far more accessible and affordable herbal version. The “low-cost alternative to an expensive pharmaceutical system” remains criminalized in this scenario, which impacts “the medical options of needy patients.”

Changing the bill will not only increase the costs of medical marijuana – it will also likely limit the number of conditions for which it can be prescribed. For these reasons, the new approach may not sit well with some medical marijuana advocates.

But Governor Dayton has gone on record several times stating that he will not sign a medical marijuana bill into law in the absence of support from law enforcement, and there is a precedent to suggest he means it: Governor Pawlenty refused to sign a similar bill that passed in the House and Senate in 2009 largely because law enforcement officials opposed it.

Medical marijuana advocates could hold out in the hope that if the bill manages to pass in the Legislature, law enforcement officials might change their stance, or that Dayton may elect to disregard it if they don’t – but neither of these scenarios is likely. A compromise bill that proposes the legalization of a marijuana derivative for medical purposes may represent the only real chance for medical marijuana to be legalized in Minnesota this year – not least because it insulates us from having to confront the problematic roots and continued impacts of America’s drug policy.

Posted in Health Care | Related Topics: Government Policy  Courts & Justice 

Supporting the ACA - In Simple Terms

The Affordable Care Act is definitely at the forefront of the news, especially after the recent CBO report. It has come up in almost every political conversation of late and while most conversations seem to be a verbal sparring of facts and anti-facts (thank you FoxNews), I find few individuals are swayed in this way. Instead, let's look at it from a different perspective, and I'll tell you in plain words why I (and you should) support it...

I support it for Clark.

Clark was a kid that lived down the dirt and gravel road from me growing up, and was just a few years behind me in school. Every day on the 45 minute bus ride to and from school, I watched with fascination (and a little fear) as Clark would prick himself with a needle, look at a readout, and then calmly put everything back into an old lunchbox that served as a carrying bin. You see, Clark had Type 1 diabetes. For him that meant constant monitoring of his glucose levels, but to his parents that meant something more - a huge financial strain. Sure they had health insurance, but at the time Type 1 diabetes was considered a "pre-existing condition" and wasn't covered.

According to the American Diabetes Association, average annual medical costs for an individual with the disease can reach $13,700. Clark's parents weren't immune to this burden yet to my knowledge, they shouldered it without complaint, as any parent would to keep their child healthy. The real tragedy happened in Clark's early teenage years. It was about that time he started to realize the financial strain he put his parents under and felt guilty for it. You could see it in his eyes on the bus every day - it hurt him to know that he was the center of his parent's financial stress.

Fast forward to today. Here in Minnesota 290,000 Minnesotans struggle with diabetes (type 1 & 2) everyday. However, thanks to the Affordable Care Act, children will no longer have to shoulder the burden of their family's financial predicament like Clark did because no child will have their diabetes used to deny them or their family's coverage.

We can debate all day about changes that need to be made with the law. I personally don't think it went near far enough to address our rising cost structure in healthcare, but that is another discussion and something we can fix without scrapping it and starting over as some would have us do. We made a great leap in this country with the ACA. It helped Clark and his family and it will help approximately 1.2 million Minnesotans who have been diagnosed with a "pre-existing condition."

So when asked if I think the ACA is a good thing, I calmly reply "No... It's a great thing." We have a long ways to go Minnesota, but for Clark and his family, this changes their life for the better.

Posted in Health Care | Related Topics: Children's Health  Health Care Reform  Preventative Care 

1 Comment ->

Good Health is Created, Not Purchased

Health equity has become one of the pressing issues in our world today. Growing up in India, I have seen pernicious manifestations of health inequity with people I’ve known personally due to lack of basic health care access.

Minnesota consistently ranks in surveys as one of the country's healthiest states, bolstered by strengths like low prevalence of obesity and premature death. But not all Minnesotans share this distinction. Vulnerable populations, which include “disadvantaged racial and ethnic minorities,” often bear the brunt of receiving the worst care and “experience poorer health outcomes than other groups,” according to a 2012 Commonwealth Fund report. African Americans typically have lower life expectancy and higher rates of premature births, according to this and other studies.

Recently, the Minnesota Department of Health published an informative report detailing how Minnesota has failed to address the needs of these vulnerable populations. It noted “increased access” to healthcare and “targeted grants” wouldn't alone solve such great healthcare disparities. Mainly because they arise from generations of structural and institutional racism built into all the systems that contribute to overall health. 

In order to help disadvantaged, vulnerable populations, a “comprehensive solution” is urgently needed. It must account for the interconnectedness of healthcare to other spheres of life such as, transportation, economic opportunity, housing, criminal justice and education. These multiple factors are what researchers call the “social determinants of health,” and without addressing disparities in these individual factors, one can never achieve and attain complete health.

Thinking about the factors that create or limit opportunity will help policy makers work toward achieving health equity in Minnesota. If you think about it closely, it makes sense: if someone falls into the lower income bracket, educational opportunities are limited, that then affects their diet, the activities they partake in, and hence their overall health and wellbeing. 

“Health is created, not purchased,” according to the MDH report.

Long before this report, Minnesota began to recognize its public health short comings in certain communities.  In 2009, the University of Minnesota launched the NIH-sponsored Center for Health Equity, focused on the “elimination of disparities with the goal of achieving equity.” 

As we move forward from this report, multiple organizations, not just the Minnesota Department of Health or the U, should pledge to improve the lives of Minnesotans who need help. Individual philanthropy is one thing, but systemic change will have lasting and beneficial effects to better the lives of all our residents.

Posted in Health Care | Related Topics: Racial Inequalities  Public Health 


Next Page