Today I read yet another article on the healing power that dogs have for humans who have experienced trauma, in this case sexual abuse. According to a Sept. 23, 2012, story in the Seattle Times (Courthouse dogs calm victims’ fears about testifying), King County Washington’s seven-year-old practice of using assistance dogs to provide comfort to victims in a courthouse setting has been deemed legal in an appeals court ruling. I have previously written about how pets are used in prison settings, leading to better outcomes for both the state and prisoners (see my May 3, 2012, post: Cats behind bars — more proof of how pets bring out our best). I do not think it is a surprise to anyone who is familiar with the value of using therapy dogs that dogs could and should be used to assist young persons who are crime victims. They are commonly used by many people with illnesses and disabilities, like this instance with a college student who has spina bifida.
In this particular case reported by the Seattle Times, a lab-retriever mix named Jeeter helped two female victims of molestation heal and also testify in trial, as a means to alleviate their reported fear and discomfort. The decision deemed the dog to be a neutral agent, not siding with either party in the legal process and being an equal opportunity dispenser of affection. As one of the two females victims told the Seattle Times, “What we want people to know is that they can have a dog to help them, too. We’re not ashamed about what happened. We didn’t do anything wrong.” In fact, the Seattle Times reported the National District Attorneys Association passed a resolution last year supporting the use of courthouse dogs.
As the final report on that gun-related massacre from NIU highlighted, in addition to more than 500 counselors who assisted victims and the campus community, there were dozens of volunteers who assisted by bringing “comfort dogs” to the NIU campus in DeKalb, Ill., after the shootings. The report noted, “many of our students hugged those wonderful dogs and wept openly, some for the first time since the tragedy.”
A wonderful book that I read this summer on the powerful bond between humans and other species called Kindred Spirits: How the Remarkable Bond Between Humans and Animals Can Change the Way We Live, by DMV Allen Schoen, highlights how powerful this connection is, including on the health of humans and the species with whom they interact. Schoen has attracted attention for research and efforts exploring the ways science and larger culture understand how humans interact with their many animal friends. His description of his former golden retriever, who he rescued and who then became his assistant caring for his animal patients, is wonderfully touching. He eventually had to put his beloved assistant down. When I shared this book with a member of my family, she broke down into tears, thinking about her former dog.
Schoen has his own web site and a blog here: http://www.drschoen.com/. His web site notes that he continues to practice what he calls integrative veterinary healthcare, which brings together holistic and natural techniques such as acupuncture and homeopathy along with the best of conventional veterinary medicine to provide animal healthcare services.
There are peer-reviewed journal articles being published about the power of animals, including in the work setting, where an abundance of anecdotal reporting and research has occurred. An Associated Press story from Feb. 9, 2012, described the “growing phenomenon” of dogs in the workplace in America, according to Rebecca Johnson, director of the Research Center for Human-Animal Interaction at the University of Missouri’s College of Veterinary Medicine, in Columbia. “People are realizing we need to do things to reduce stress in the workplace,” Johnson told the AP. She said dogs can build connections among co-workers and create healthy diversions from work. People interacting with dogs have a hormonal reaction that causes them to “feel more relaxed and more positive.”
All I can say is that nothing beats a dog or purr on a bad day. Even the worst day improves the moment there is that amazing interspecies contact.
I love fresh food markets. I had a fruit, vegetable, and fish market near me growing up, the old Market in the Loop, in University City, Mo. To this day I remain a loyal supporter of local food and local businesses that sell fresh fruit and vegetables. Today, these markets are very much at the center of the national health discussion on nutrition, healthy food, obesity, and politics. So I decided to examine this issue using two examples in Seattle–one where I shop and the other where I mostly people watch and occasionally will buy some food. (Please go below for my photo essay of both venues.)
For the last decade, the public health community increasingly has been focussing on how to increase fruit and vegetable consumption by Americans, improve Americans’ nutritional intake, and address the complex systems that are making this country the fattest on earth. Research has shown that Americans still do not consume the recommended amounts of fruits and vegetables, and government research is showing that lower-income consumers eat fewer fruits and vegetables than higher-income consumers do.
According to research by public health experts, communities that lack full-service grocery stores and neighborhood food markets have less access to fresh fruits and vegetables. Since 2009, the CDC, in its list of strategies to reduce obesity, has called for making healthier food choices available in “public service areas.” Specifically, the CDC says local governments can make healthier foods accessible through policy choices and offering vouchers that can be redeemed for healthy food choices. This is happening nationally at farmers markets, where technology to read food stamps, or EBT, cards (known today as Supplemental Nutrition Assistance Program, or SNAP), is being made available to merchants so they can serve lower-income consumers.
The Food Research Action Center (FRAC) has called for increasing participation in SNAP; improving those benefit levels so lower-income persons can afford adequate diets, including healthier foods; promoting fruit and vegetable purchases with SNAP benefits, which is taking place; and boosting the access to healthy and affordable foods in “underserved communities.” To that end, the CDC is making available more than $100 million (chump change, really, when you compare that to funding made available to corporate farms through the U.S. Farm Bill) to promote policy, systems, and environmental change through Community Transformation Grants (CTG). This is designed to “to reduce chronic diseases such as heart disease, cancer, stroke, and diabetes” — all major health issues that are also bankrupting our health care system and treasury.
A 2010 White House report on childhood obesity notes that in the last three decades, prices for fruits and vegetables rose twice as fast as the price of carbonated drinks, and a bump in the cost of fruits and vegetables relative to less healthy foods can reduce consumers’ desire to buy fruits and veggies, leading to unhealthy Americans. Pricing is of course a key issue impacting purchasing decision of lower-income consumers, among other factors. U.S. Department of Agriculture (USDA) research found that a 10% discount in the price of fruits and vegetables would increase the amount purchased by 6-7%.
So, yes, price matters a lot, along with access. Where I live (Seattle), the Farmers Market Alliance claims “the vast majority” of the fruits, vegetables, herbs, and berries are the same price or less expensive at farmers markets, especially with organics, than at conventional grocery stores (QFC, Fred Meyer, Safeway, etc.). The organization further claims that the quality and variety of its produce exceeds the quality sold at the chain grocery stores. The farmers market movement is truly national in scope, and a network of nonprofits like the Philadelphia based Food Trust is partnering with local farmers to promote farmers markets in underserved areas.
The Atlantic in May 2011 published an article noting that farmers markets were less expensive than supermarkets and provided better food. The article challenges the criticism that farmers markets catered to mostly wealthy white snobs who drive Subarus and Prius’s, and it argues that no formal research supports “this widely accepted contention, and the few studies that have been conducted call its veracity into question.” Of course the movement to support “local food production” and farmers markets has both national and local critics, including conservative bloggers, who call it a trendy cause. Some have blasted the use of electronic EBT card readers as a wasteful expense ($1,200 to purchase, $50 to lease).
The closest market to my home, about one mile away, called the Ballard Farmers Market, most definitely is more expensive than grocery stores and independently owned produce and grocery stores where I also shop in Seattle. Its clientele, based on my many trips there, is decidedly and stereotypically upscale, white or Asian (I’d say 90% white, 5% Asian, 5% other), and professional. I haven’t conducted a poll to actually verify this, but this corner of Seattle is not that diverse, and it is close to a neighborhood where homes fetch $600,000 and where condominiums are sprouting on many major intersections. No, I can’t afford to buy anything there, with the exception of a good bargain, like beets today ($3 a bushel of three). I have bought a few apples and heads of lettuce and other veggies in the past, but not much else — not salmon, not herbs, nothing. For my part, I grow some of my own food, pick some (like berries or tree fruit that abounds in Seattle), and wish I caught salmon like I did in Alaska.
I don’t begrudge the vendors there for selling produce at a higher price point, which shuts out low-income persons like me. (I may have a few university degrees, but I am by all measures very low-income now.) As one food blogger and jam-making blogger from San Francisco notes: “People selling at the markets have priced their products according to a wide range of criteria. First, many of the farmers who sell at markets are smaller operations than those who sell to grocery stores. Maybe they have 10 acres of land compared to 60 or 100 or 200 acres and rely almost exclusively on markets for income.”
I try to support my favorite produce store in Seattle, called McPherson’s Fruit and Produce, in Seattle’s Beacon Hill neighborhood. First, their selection is usually excellent–fresh but not organic food in season. I find their produce is fresher than most grocery stores. Their vegetables and fruits are always cheaper than any grocery store I visit, including stores with hefty supply chain advantages like Costco. They cater to a full spectrum of clients, and that clientele is more low-income and more ethnically diverse than what is found in Ballard. (Beacon Hill is much more diverse ethnically.) I’m as likely to see Hispanic, African American, immigrant, and Asian-American shoppers as I am those who look like me (white). However, McPherson’s is located about seven miles by car from my home, while the Ballard Farmer’s Market is a mile away, making it impossible for me to bike to Beacon Hill, and there are some serious hill and traffic issues. So I drive there, but usually combining outings and errands with a stop. I have been shopping at McPherson’s for years, during my previous and current stays in Seattle. I do not know if their model can be replicated in other cities–unique private owners, a great location on well-travelled road, proximity to distributors, an ability to attract shoppers with and without cars.
Perhaps instead of throwing all of our support into the farmers market craze, more can be done to help smaller businesses and producers. This would require the proverbial “upstream intervention.” For instance, our government tells people to eat five servings of fruits and vegetables a day, but is not providing the supports through federal legislation to make that possible. The White House Task Force on Childhood Obesity notes that by 2020, the country needs to boost the availability of fruits and vegetables by 70%, or 450 pounds per person a year (that’s an enormous pile of food by the way). It is not doing that now because of our dated, bloated Farm Bill.
Such upstream actions, to grow the intake of healthy food consumption, in a policy sense, have the biggest bang for the buck, compared to downstream actions. Many wise and smart persons who follow food and nutrition issues have long said that the pork-laden, decades-old Farm Bill needs to be overhauled to create true change. New York Times food blogger Mark Bittman notes “agricultural subsidies have helped bring us high-fructose corn syrup, factory farming, fast food, a two-soda-a-day habit and its accompanying obesity, the near-demise of family farms, monoculture and a host of other ills.” The farm bill, up for renewal in 2012, offers an agriculture subsidy worth $30 billion, $5 billion of which is direct payments to farmers. Conservative groups like the Heritage Foundation even blast this.
Bittman suggests that a revised Farm Bill–which I believe no one involved in policy-making believes can occur in the current political climate–should support farmers who at the moment now grow unsubsidized fruits, vegetables, and beans, while giving incentives to “monoculture commodity farmers to convert some of their operations to these more desirable foods.” This is food that would make us healthier compared to factory raised meat fed on subsidized grain, which is what our current system promotes. Bittman also calls for incentives to help medium-sized farms, those big enough to supply local supermarkets but small enough to care what and how they grow, compete better with corporate agribusiness.
Personally, I would love to see both farmers markets and McPherson’s in most neighborhoods in most cities. Right now, I’m going to stick with shopping primarily at McPherson’s, despite the inconvenience. And I’ll keep growing a garden where ever I live, too.
First, scroll straight to the bottom to see the photos (I really like these) if you don’t want to read this long-winded introduction, but I think this background gives these photos context.
In February, I worked on a community health assessment project in Kent, Wash., one of the most diverse cities in the state, if not the United States. Located in South King County, the suburb community of 92,400 residents is a lot like other suburban cities that are now the melting pots for immigrants and recently arrived residents to the United States. During my visit to Kent a day ago, I saw Sikhs, Somalis, Latinos, Ukrainians, Burmese, a diverse mix of South Asians, Cambodians, Vietnamese, and more, and that was just at a local lake where I was photographing a swim race.
Today, more than 130 languages—from Afrikaans to Yoruba—are spoken in the Kent School District, the 4th largest in Washington State. Kent has become a prototypical “melting pot suburb.” Nationally, minorities now represent 35% of all U.S. suburban residents. And many new suburbanites come from abroad. According to a 2010 report by King County, a full fifth of King County residents identify as “foreign born,” and many are choosing to locate in South King County communities like Kent. Today, only 56 percent of residents are white, the rest all other minorities, the largest being Latinos/hispanics.
In terms of urban design, Kent is like many other exurb or suburb towns—entirely and slavishly devoted the internal-combustion engine. Decades of development in Kent have created pockets of cul de sac streets and multifamily units, as well as a pattern of major thoroughfares 4-6 lanes wide, literally preventing people from moving safely across the street or getting out by foot or bike. It’s incredibly hostile to anyone who isn’t in a vehicle, and unsafe (lots of deadly crashes here). A prevalent design feature is the strip mall, which caters to the car. One is Benson Plaza, at a main intersection in the city’s East Hill on SE 104th Ave, which reflects the city’s true diversity. Punjab Sweets, owned by local leader Harpreet Gill, is de facto hub on East Hill for many south Asian residents and many other residents. Harpreet also helped launched Kent’s annual International Festival. If you visit Kent’s East Hill, be sure to stop in her shop and buy some Indian sweets. (They also serve dinner.)
The photographs were taken at Benson Plaza on Aug. 17, 2012. I’ve never eaten Indian pizza. I may have to go back and try one.
A now-deceased doctor friend of mine who dedicated his life to serving the Native community in the Indian Health Service used the expression a lot describing where he worked in New Mexico and Alaska. It is a legal term, codified in treaty rights, federal regulations, and court decisions. Indian country can be a physical place, associated with customs and cultures of the continent’s first peoples. It is also a state of mind. You literally know you are in Indian country when you go there. There are place names and of course the people. I grew up in St. Louis, Mo., which sits on the mighty Mississippi River (Ojibwe for “great river”), and I felt connected to Indian country there because of the great muddy and the phenomenal Cahokia Mounds just east of the city in Illinois. I knew I was living on historic Indian land even as a kid.
I have lived the last 16 years of my life in what I definitely consider to be Indian Country, Alaska and Washington State. Alaska felt much more like Indian country to me. Anchorage, my home for six years, is very much a Native city in terms of population (about 16 percent). I rarely feel that connection in modern, congested, urban Seattle. But I recently took a four-day trip to the hot, upper plateau of central Washington, from the Methow Valley to Omak, and indeed felt I had landed four-square in Indian country again.
-All land within the limits of any Indian reservation under the jurisdiction of the United States government, notwithstanding the issuance of any patent, and including rights-of-way running through the reservation;
-All dependent Indian communities within the borders of the United States whether within the original or subsequently acquired territory thereof, and whether within or without the limits of a State; and
-All Indian allotments, the Indian titles to which have not been extinguished, including rights-of-way running through the same.
Indian country also implies U.S. federal recognition of tribal bands as sovereign on their lands and capable of enjoying rights that are government to government. As one source notes, recognized tribes “possess absolute sovereignty [that] are completely independent of any other political power,” but also which is shared with other jurisdictions (local, state, and federal).
In Washington state, federal definitions of “Indian country” apply to state law, in addition to provisions acknowledging tribes non-taxable status in some commerce, such as the sale of tobacco products to tribal members on their reservation. In Seattle, there is still a band, the sparsely populated Duwamish, who have lost their sovereign status and failed to win legal recognition in the city’s limits, on some of the choicest real-estate on the West Coast. Another nearby tribe, the Snoqualmie, regained their status in 1999 and promptly built a casino and became an economic and political player.
The decades-long fight over treaty-protected fishing and subsistence rights by the tribes culminated in the historic 1974 ruling in the landmark U.S. v. Washington case (the Boldt Decision) that unequivocally affirmed 19 federally-recognized tribes’ fishing rights to salmon and steelhead runs in western Washington. That decision gave the tribes rights to half of the salmon, steelhead, and shellfish harvests in the Puget Sound. It was a major game changer, and its impacts are still felt today–particularly legal squabbles if the decision should still be applied to land-use decisions impacting salmon habitat.
Yet, even as I gaze out on the beautiful Puget Sound, I am hard-pressed to think that I am on historic Indian lands, that I live in Indian country, where there are 29 federally-recognized tribes, in all corners of the state (see tribes and locations here). But this is very much Indian country in a historic and cultural sense.
In fact, more than half of the state was outright taken by military force, illegal land seizures, and treaties (which also provided fishing and resource rights to tribal members) from the 1850s to the 1890s. Many stories of the exploitation of Native tribes come to mind, notably the hanging of Yakima warrrior Qualchan (also called Qualchew) by the reportedly violent Col. George Wright, in his campaign that defeated five tribes in Washington in the eastern half of what is now is the state.
On Sept. 25, 1858, Qualchan had surrendered with a white flag and was hung within 15 minutes. That was followed with the hanging of six Palouse warriors the next day. Such incidents typified the period of conquest in my home state. Exploitation of tribal rights followed the signing of treaties. The Colville Tribes, for instance, had their lands stolen without their consent, setting off decades of legal battles that continued to the 1930s and ended in historic settlements returning hundreds of thousands of stolen acres of land. Salmon and steelhead runs in the state were decimated by commercial fishing interests that harmed tribal groups in the upper and lower Columbia River basin. The runs were further extinguished by the dams built on the Columbia River. Only with the Boldt Decision in 1974 did the tide turn, but with numbers that no where near compared to the great runs of 100 years earlier.
Again, all of this is very academic and abstract to me and most Western Washington residents. Only when I traveled to the “World Famous Omak Stampede” rodeo and suicide race, with Native riders who charge down a 200 foot hill on horseback every second weekend of August, did I again realize I was truly in Indian country. Omak, in north central Washington, lies partially in the 1.4 million-acre Colville Reservation, in sparsely populated Okanogan and Ferry counties. The Confederated Tribes of the Colville Reservation number less than 10,000. I found the area to be amazingly beautiful. It’s hot in the summer, and bitterly cold in the winter. During my visit to Omak for the Stampede, the mercury hit 100 F.
Outside of agriculture (on non-tribal lands), there is little industry in this part of the state, but there is gold mining, forestry, and a limited personal use salmon fishery for tribal members. Forestry is the mainstay for generating tribal revenues. Gaming is also a big moneymaker at the tribes’ three casinos. If you can believe it, the casinos are attracting acts like blues legend Buddy Guy and rock has-beens like Foreigner and Joe Walsh in the next few weeks. I think it’s a bit sad that even stalwart Canadians are driving south from British Columbia to spend their loonies at the tribal gaming tables, but come they do.
Despite the flow of revenues, health issues remain a problem, as they do throughout Indian country. A June 9, 2012, story republished in the New York Daily News about Tribal Councilman Andy Joseph, Jr., profiles his efforts to address Native health funding issues. The story notes his tribal members and others nationally “are dying of cancer, diabetes, suicide and alcoholism. They are dying of many diseases at higher rates than the rest of the population. And instead of those rates getting better, they’re getting worse.” Joseph is the tribes’ representative to the Northwest Portland Area Health Board, which serves 41 tribes in Washington, Oregon, and Idaho, and is that group’s delegate to the National Indian Health Board, which speaks for all 566 federally-recognized tribes in the country. The story notes that, nationally, tribal members die an average of five years earlier than the rest of the U.S. population and are six times more likely to die of tuberculosis or alcoholism, three times more likely to die of diabetes, and also twice as likely to be killed in an accident. What’s more, they are also twice as likely to die from homicide or suicide. Pretty grim data indeed.
According to Joseph, the major health issues associated with diet and nutrition have occurred as a result of conquest and cultural assimilation: “‘Joseph holds up a jar of canned salmon sitting on his desk. ‘Our people crave this,’ he said. ‘It was taken away from us when they put Grand Coulee Dam in.’ He reaches for a string of dried camas root. ‘It’s what our bodies were raised with for thousands of years. Now, we have Safeway and Albertsons and Walmart.'”
In Omak, I got a taste of Native pride during the Omak Stampede Parade, which mainly featured local businesses, rodeo princesses, groups like firefighters, Republican office holders or candidates, and less than half a dozen Indian floats. (I saw no Latino groups in the parade, despite their large presence picking fruit and in agriculture–they “officially” number about 15 percent of Omak’s residents.)
The Stampede features a tribal encampment with teepees and a performance area where tribal members perform traditional dances and song in gorgeous costumes. It reminded me a lot of Alaska, particularly the many gatherings I saw there, including the largest conference called the Alaska Federation of Natives Annual Convention. Yup, I was definitely in Indian country.
My only real, true regret was that I missed the Suicide Race, which features some of the state’s finest Native horseman who charge down the steep hill and swim across the Okanogan River on their way to the finish inside the Omak Stampede stadium. You can watch it on YouTube, and note some times, yes, horses have died in this race.
Seattle’s annual Seafair, which culminates in noisy and popular Blue Angels fly overs and hydroplane races on Lake Washington the first week and weekend of August, is a month-long potpourri of community events, health fairs, ethnic festivals, parades big and small, and very slick corporate and U.S. military glad-handling. Just about any community event within 50 miles is somehow branded under Seafair’s giant umbrella. Overall, most Seattle area residents love it, particularly the Navy jets that break the sound barrier over the city, shutting down traffic on our floating bridges for several hours at a time over several days.
Seafair also features micro celebrations of the city’s diversity and neighborhoods. This has been the norm ever since I first moved to Seattle in 1987 (I have now lived here on four separate occasions). This is the part of Seafair I enjoy the most. And I really like the diversity that is showcased, including by the Filipino community (see photos below).
Though Seattle is 70 percent white, the all-inclusive and equally non-descriptive “Asian American” racial category represents 14 percent of the city’s population (and that diversity is even greater in south King County). Filipinos fit into that mix, and they number well over 30,000 of the city’s residents.
Filipino immigrants have been arriving in Seattle in successive waves since the 1880s, and have a strong presence in the community, thought not entirely represented proportionally in political offices. However, I once worked with the first Filipino-American lawmaker elected to the Washington State Legislature, former Representative Velma Veloria, when I was employed by the House Democratic Caucus in Olympia, for two legislative sessions more than a dozen year ago.
The Filipino celebration that takes place during Seafair is called Pista Sa Nayon, and it was held the last weekend of July in Seattle’s Seward Park. I caught the Filipino Youth Activity Drill Team during a rehearsal on the shores of Lake Washington. They were one of many performing groups that entertained residents on July 29, 2012. I have seen this group many times before – and they are always entertaining and beautiful to watch in their colorful Filipino costumes. (I am a huge fan of the Philippines, having travelled there in 2003, and I hope to get back there one day soon.) So here are a few shots taken with my new digital Nikon camera that I converted to black and white. I really enjoyed watching these ladies practice. If you are in Seattle, be sure to visit their Facebook page and see them around town.
Mark Twain, my favorite writer, in Life on the Mississippi, wrote of the transformation that occurred when he, the majestic pilot of the paddleboat, no longer saw the magic and wonderment in the beautiful world outside the pilot’s cabin:
But as I have said, a day came when I began to cease from noting the glories and the charms which the moon and the sun and the twilight wrought upon the river’s face; another day came when I ceased altogether to note them … . No, the romance and the beauty were all gone from the river. All the value any feature of it had for me now was the amount of usefulness it could furnish toward compassing the safe piloting of a steamboat. Since those days, I have pitied doctors from my heart. What does the lovely flush in a beauty’s cheek mean to a doctor but a ‘break’ that ripples above some deadly disease. Are not all her visible charms sown thick with what are to him the signs and symbols of hidden decay? Does he ever see her beauty at all, or doesn’t he simply view her professionally, and comment upon her unwholesome condition all to himself? And doesn’t he sometimes wonder whether he has gained most or lost most by learning his trade?
And it is with these words, etched in my head, that I began to realize that I had become a zombie. To be precise, I had become a fully credentialed (MPH) public health zombie.
When I attend big festival type events, I no longer experience pure fun and enjoy the carnival atmosphere in a pure form. I look at how healthy or, rather, how unhealthy the food sold is. Is it loaded with transfat and sodium? Is it industrially raised meat with potential risks of carrying e-coli?
Instead of people watching for pleasure, I will study the crowd through a public health lens. And are those attending a celebration, like Seattle’s annual Fremont Fair, smoking and drinking excessively? (And they were at the Fremont Fair in June this year – I guessed nearly one in five attendees smoked, and I counted at least four outdoor beer gardens, with people imbibing booze as early as noon on a summer day.)
Did people drive to this event, or did they use a healthy form of active transportation like biking, walking, or perhaps a bus?
I also recently visited a middle school in Snohomish County, and was looking at the school entirely as an environment where public health interventions were or were not working. Were kids walking and biking to school? No, they had to bus. The school was located off a busy highway, and there were no sidewalks anywhere near the school. I could go on and on and on. The visit actually was driving me nuts because of all the built environment issues I was seeing that was preventing the kids from being more active than they could be.
For its part, the CDC has, to my delight, decided to poke fun at its earnest seriousness protecting the public’s health by launching a “zombie preparedness” campaign to prepare for a “zombie apocalypse.” The was a surprisingly successful tongue-in-cheek awareness campaign on how to prepare for disasters. It received a lot of coverage. Was this a sudden dash of entrepreneurial social media savvy by the organization dedicated to protecting the health of the nation that tens of millions of Americans know little or next to nothing about?
As much as I hate seeing people eat incredibly unhealthy food, and smoke cigarettes in any form, and get drunk on beers in the midday sun, and drive their cars everywhere, I wish I could now just turn off my own “public health zombie.” Now I often ponder if I have succumbed to Twain’s curse of the riverboat pilot, contemplating what I have gained against what I have lost by learning this trade. The good news is, I have my next Halloween costume already planned: a zombie public health inspector.
On June 14, Tom Paulson’s insightful blog, Humanosphere, put the spotlight on U.S. military initiatives underway in Africa as part of a grander strategic focus the U.S. Government is placing on Africa, through the U.S. Africa Command called Africom. He raised concerns about the dual efforts of the U.S. Government. On one hand, it was expanding its covert operations, purportedly to root out so-called terrorism networks and promote and training activities in Africa by building bases stretching from Djibouti to Ouagadougou, Burkina Faso, while at the same time trying to stomp out malaria, which kills about 600,000 Africans a year. According to a U.S. Department of Defense (U.S. DOD) press release, “Africom incorporates malaria prevention into much of its theater engagement, distributing mosquito nets and teaching new diagnostic techniques during training events throughout Africa.”
I think few could argue with the humanitarian goals of this type of health intervention, at least with some basic metrics. But in reality, health-related assistance usually has a broader function. Combining “hard” and “soft” power is nothing new to geopolitics or the U.S. Government and its diplomatic, development, and military branches. The two often go hand in hand. Closer to home for most Americans, but still far away in the U.S. Arctic in communities along coastal Alaska, the U.S. Coast Guard has spent four years expanding its training activities and capacities in the Arctic to prepare for offshore oil drilling by Shell Oil Co. Production is scheduled to begin in the summer of 2012 in the U.S. portions of the Beaufort Sea, just north of one of America’s largest oilfield, Prudhoe Bay. Oil would then be shipped down the aging and half-empty Trans-Alaska Pipeline System (TAPS).
The Coast Guard preceded its Arctic ramp-up with a much heralded health and logistics outreach, called Operation Arctic Crossroads, starting in 2009, to Alaska’s western coastal communities, such as Barrow and Kivalina. These were welcomed by the mostly Native residents and received high marks from nearly all quarters in Alaska. The Coast Guard is perhaps one of the most celebrated institutions in Alaska because of its humanitarian work saving countless lives and vessels, year after year, and because of the stellar reputation it has earned, demonstrated by its outstanding safety and rescue record. (I am a huge fan of the Coast Guard, if you cannot tell, having reported on their helicopter rescues numerous times as a reporter in Sitka, Ak., in 1993.) But the Coast Guard also has noted these outreach events in Alaska have been ultimately tied to the much larger issue of energy security and defense. The U.S. DOD reported “the Arctic has economic, energy and environmental implications for national security. Coast Guard missions there are increasing because Shell Oil Co. has permits to drill in Alaska’s Chukchi and Beaufort seas beginning this summer.” The U.S. DOD further notes, “Shell will move 33 ships and 500 people to Alaska’s North Slope, and will helicopter some 250 people a week to drilling platforms.”
All told, Shell spent some $2.2 billion for offshore leases alone, not to mention millions in legal wrangling, government relations, PR, advocacy in Alaska and in DC, and much more since the mid-2000s. The New York Times estimates Shell spent $4 billion in its quest for one of the biggest oil prizes in North America outside of the Athabascan oil sands of Alberta and shale oil finds in North Dakota. (Shell also is drilling for natural gas in the Chukchi Sea this summer also.) The issues framing a stronger U.S. commitment in the Arctic are natural gas and oil resources and a so-called “race for resources,” as it has been described by some, which concerns rights to those resources on the Arctic Ocean seabed floor.
The U.S. Energy Information Agency claims that nearly a quarter of untapped oil and natural gas resources are in the Arctic basin, which explains the significant interest by the major multinational oil exploration companies in the shallow Arctic waters off Alaska’s North Slope. Companies like Shell and ConocoPhillips and others have been staking out their claims for years by buying controversial offshore drilling leases that have been sharply contested in protracted legal fights with environmental groups and Native Alaskan residents of the North Slope Borough (the Inupiat). The Inupiat residents, who, while mostly supporting onshore development, are concerned about the threat an oil spill or blowout in pristine Arctic waters, similar to BP’s spill in the Gulf of Mexico in 2010. Some Inupiat resident say that would harm their subsistence hunting of migratory bowhead whales, which have been hunted and eaten by these historic Arctic residents for thousands of years.
What is clear is that interventions premised on health care will likely be part of a larger strategic framework of nations as powerful as the United States. Those actions, no matter how well-intentioned to improve health care from Kivalina to Kenya, must be understood in a much larger context of any nation’s political and economic interests. This is particularly true regarding access to and the development of natural resources, wherever those resources may be.
To celebrate the completion of my public health studies at the University of Washington School of Public Health, I celebrated on June 2, the way I always do at the end of long journeys or the start of new chapters—I had a salmon barbecue with good friends. This time I added Alaskan ling cod to the menu.
I love salmon. The fish I bought, Copper River sockeye, was very fresh, and the ling cod was amazingly delicious (have to eat more of this). In the past, I have always marked major milestones of my life with salmon. This includes moving, changing my name, celebrations with friends, and other good reasons to cheer. My last night in Alaska, in August 2010, also involved salmon. Times I have left Seattle for journeys abroad have included salmon. In many ways I am following historic traditions of the tribes of coastal British Columbia and their potlatch celebrations.
Salmon has long held a special place in the traditions of West Coast Native peoples, from the Salish all the way up to the Alaska among nearly all Native groups in the Great Land (what Alaskans call their home state). Salmon provided food to support both the health and culture of many tribal bands.
Rich in vitamins A and D and omega-3 fatty acids, which reduce the risk of heart disease and stroke, wild salmon is extremely healthy food. Its intake has traditionally been much higher among many Natives because of their subsistence lifestyle. In Alaska, the Yup’ik people, of the Yukon-Kuskokwin region (including the Yukon River), often eat 20 times more fish oil than other people, and they appear to be protected from ill health effects of junk food and obesity with such a diet. However, epidemiologists still assess risk with salmon intake because of potential mercury contamination.
In Alaska, epidemiologists recommend people eat fish at least twice a week, and they say wild Alaska salmon of any species can be eaten in unlimited amounts by women and children, but other species should be eaten less, because of mercury and other toxic contaminants that could be found in fish.
As a former Alaskan, I was spoiled by an abundance of fresh fish.
Alaskan residents are still allowed to dipnet and catch fish as subsistence users in the Kenai River and other areas depending on the runs. During my years there, I would dipnet on the Kenai River for sockeye.
The fish I caught would last me through the spring. Here in Seattle, I spent $18 a pound for Copper River salmon. As a just graduated MPH student, that is beyond my budget. My classmate and I once joked when a nutrition professor asked if students ate fish twice a week. Maybe the professor forgot to check what the tuition price was as the University of Washington. Lentils and rice still keep me going. I forever dream of salmon now.
Here in the United States, promoters of biking and various groups attempt to rally public awareness around the health, environmental, cost, and multiple other benefits of biking by having “bike to work month” and “bike to work day.” This is important, because these activities can turn the attention of a chaotic media landscape for a brief moment on the incredible versatility and value of biking.
The down side is, once the day, week, or month passes, the next worthwhile cause takes the spotlight, and the public’s attention quickly turns away from biking, and without sustained interest, meaningful policy work and political momentum fizzles. Luckily, I live in a Seattle that at least has a critical mass of cyclists and some more “advanced” infrastructure to help keep cyclists somewhat safe from the perils of sharing roads with vehicles. To Seattle’s credit, it is getting ready to update its bicycle master plan. (For anyone who is from Seattle and who has not taken the survey, please do so.) And nationally, many advocates are working hard to sustain a national movement one community at a time.
As a highlight of “bike to work day” on May 18 in Seattle, a portion of the Ballard neighborhood was closed to vehicle traffic. Bikers were able to lock their bikes to makeshift bike locks. This is a scene we seldom see in this country because too few businesses and governments support and pay for basic infrastructure to make cycling more doable — such as having secure areas to lock bikes and accommodate them. (This is not the case in every community, and cycling advocates throughout the country are working to ensure new developments accommodate bikes with the right bike racks.)
I remembered my travels to Germany. Even back in the 1980s, I found hundreds of bikes locked outside, in large bike parking areas, that were used during every month of the year, including winter months. I long for the day when bike racks are common in front of every building, and every rack is occupied by a locked bike.
This week, a physical education columnist with the New York Times named Gretchen Reynolds was all over the radio. In 48 hours I heard her interviewed by Terry Gross of Fresh Air and then interviewed by the BBC World Service. She has published a book with a catchy title called The First Twenty Minutes. It appears to be catching fire.
I liked a lot of the things she was saying, and how she communicated. Reynolds is a communicator attempting to take peer-reviewed journal articles, which to nonscientists are impenetrable with graphs and meaningless numbers and confusing P values and unconnected to their lives, and make them fit into the larger problems this country faces with the obesity and overweight epidemic. I applaud her for calling attention to this problem that is bankrupting our medical system and leaving tens of millions of Americans unable to live more productive, happier lives.
I caught most of her interview with Gross, and while upbeat, I found some of the discussion on the health benefits of activities like standing up often while sitting to be out of touch with larger systemic issues causing the health crisis that led to two-thirds of this country to become obese or overweight. Encouraging people to do minor things is not asking anything resembling sacrifice or commitment, which is what is required both in a personal sense and a larger policy sense. It is as if we have completely dumbed down all of our messaging to the lowest denominator. But then again, Reynolds is someone making a living as a writer and health expert — and selling a popular message as a product is critical to success.
Instead of the media talking to experts about whether 30 minutes of exercise is good enough to keep us healthy, media should be talking about the primary reasons why people aren’t exercising—the overconsumption of TV and screen use, the built environment that promotes the utter dominance of the internal combustion engine, and the failure of each individual to take ownership for their health from the food they eat to how much they move their bodies. (And, yes, I know it is more complicated than this, especially for many minorities and lower-income Americans, but these factors matter a lot).
I was delighted, however, that Reynolds praised the health benefits of walking. She rightly called walking the single best exercise that exists on the planet and what humans are built for. She is right. It reduces your risk for heart disease and diabetes, and it apparently increases memory capacity in mammals (makes sense, blood flow stimulates oxygen and chemicals produced by the body to be delivered to the brain). As for me, there is no better exercise in the world than walking. A walk anywhere, anytime, in any weather, beats sitting on my butt and not walking at all. I feel healthy, happy, and more level-headed after a walk. I just wish more Americans could embrace walking and voted to support measures that promote walking – sidewalks in neighborhoods, parks and trails – and support politicians who want to change how we deal with public transportation funding in this country. Even one of the biggest promoters of lopsided transportation priorities, the car- and petroleum-friendly federal government, notes that a tiny sliver (0.7%) of federal transportation funds are spent on improving pedestrian facilities.
Maybe we need what Scotland has, the right to roam about in a responsible way (yeah Scotland).