Last month, the Public Health Committee of the Legislature proposed a bill that could help resolve the issue. S.B. 1285 would create a pilot program for four opioid OPCs in Connecticut beginning in June 2026. This would allow people to use drugs in a monitored setting with access to mental health counseling and medical treatment.

“The advantages of overdose prevention centers is that they create a site where people can not just use drugs safely, but also get medical care, get a square meal, a cup of coffee, use a computer and seek treatment through a referral,” Robert Heimer, professor of pharmacology at the School of Public Health, told the News. “It allows drug users to come together, to talk about their problems, to seek treatment if they are ready for it, to talk to people who successfully managed the transition to medication based treatment. It really saves lives.”

According to Heimer, approximately seven million people in the United States struggle with moderate to severe opioid use disorder, contributing to approximately 700,000 deaths annually. In Connecticut alone, the crisis claims an average of 120 lives each month. Though the rate of opioid overdoses is beginning to go down gradually, New Haven continues to be a hotspot for overdose deaths. And the current rate does not appear to be due to increasing fentanyl supply or due to more people going into treatment.

Currently, there are various frameworks for addressing the opioid overdose crisis in New Haven. The first approach is expanding access to methadone, a medication that reduces withdrawal symptoms and cravings, to help individuals manage opioid use disorder; second, efforts have intensified to distribute naloxone and clean syringes in cities to prevent overdoses and reduce harm; lastly, programs now test drug samples to detect dangerous substances, ensuring users are aware of what they’re consuming. 

However, Heimer points out that accessing these services requires financial resources, awareness, time and personal commitment — barriers that make it challenging for many individuals to get the help they need. OPCs can tackle these barriers.

OPCs provide a safe space for people to use pre-obtained drugs under the supervision of trained staff, without fear of arrest or of overdose. They provide sterile use supplies, answer questions on safer use practices, administer first aid and watch for an overdose. OPCs have sprang up across the world in 14 countries, though in New England, there is only one in Rhode Island. 

Kimberly Sue, assistant professor of internal medicine at the School of Medicine, indicates that what makes OPCs different from treatment centers like the APT Foundation is the lack of direct treatment. At the APT Foundation, individuals can access treatments like methadone and receive primary care; OPCs are for individuals who are trying to use drugs safely.

“If you inject fentanyl, you don’t know how strong it is. You basically could overdose in the span of one minute to 20 minutes, depending on how much you’re doing. So to reverse that overdose, OPCs provide oxygen or even naloxone. So that’s a medication that’ll kick the fentanyl off of opioid receptors, and you can start breathing again, and it saves your life. Time is brain,” Sue said.

These centers do more than just reverse potentially fatal overdoses; it provides a community of medical and mental support. OPCs are associated with better health benefits as they promote cleaner use of drugs and needles through education, reducing transmissions of diseases. Individuals can access medical resources like vaccines and regular wellness care for half the cost. And when they’re ready, they can access substance use disorder and mental health counseling with educational information. For the community, OPCs reduce public drug use and drug debris.

“In addition, OPCs prevent people from having to go to the emergency department or call anyone or ambulances to send them to the hospital,” Benjamin Howell, assistant professor of general medicine, said. “That is where people and the city can save money. OPCs definitely have been shown to be cost-effective in the long run.”

With holistic care, laundry services and computer access, OPCs can serve as vital community hubs, offering social support to drug users who have been marginalized, abandoned and left to struggle alone on the streets.

According to Heimer, OPCs can also reduce the stigma and its impact around drug addicts and drug users. Many individuals may feel demoralized or blamed for their disease and medical problems, when it’s usually a secondary mental health problem that inspired their drug use. And with the stifling stigma of mental health care, many would rather turn to drugs that make them feel better than seek mental health treatment. The stigma around drug use has also led to subpar treatment in hospitals, where they aren’t prioritized for care and forced to go through withdrawals.

In New York, OPCs are frequently used by the same individuals. According to Sue, during an OPC’s first year of operation in NYC, it recorded 48,000 visits and intervened in 636 overdoses. Most of these visitors were registered with the OPC. While Connecticut’s OPCs will likely see fewer visitors, they will also require individuals to register for services.

Last year, the bill was proposed in the state House of Representatives, though it didn’t pull through despite support from psychiatrists and harm reduction activists. One of the reasons why it didn’t pass was because of fears that OPCs will encourage drug use. However, Sue believes that people will find a way to use drugs, especially those physically dependent on them. 

“So there’s two options,” Sue told the News. “One, I’m going to go use a Dunkin’ Donuts bathroom. I’m going to use a needle that I’ve used multiple times before, that is not sterile and has been shared. I could miss my vein and I could overdose and die there. The other option is you go to a place where it’s clean. You can wash your hands. You can use a new sterile syringe. Someone with training who will watch you and make sure that you’re safe.”

In addition, some community members were fearful that construction of these OPCs will increase local crime. However, according to Sue, that’s been proven false in various research articles done at the national and international level. 

Currently, the Public Health Committee has expressed support for this bill. Howell acknowledges that while Connecticut’s opioid crisis is not as severe as in New York or Vancouver, he sees OPCs primarily as an educational tool and a symbol of solidarity rather than just a response to overdose deaths. 

However, Howell believes that the biggest challenge to passing the bill in Connecticut may not be community sentiment but rather the need for strong governmental support — especially given the political climate under the current presidency. Trump is looking to prosecute those who provide a place to use drugs, and Howell is unsure if the state government is ready to take on the federal attention OPCs might bring.

“I mean, don’t get me wrong; OPCs absolutely work. It’s a great public health intervention,” Howell said. “It just takes a lot of courage on the state’s level to pass a bill that might get some fire from the federal government.”

As of 2025, Connecticut residents are more likely to die from unintentional drug overdose than a motor vehicle crash.

The post How overdose prevention centers can change the game in the fight against the opioid epidemic appeared first on Yale Daily News.

These are just some of the effects of the current diaper crisis in Connecticut — even with current initiatives like diaper banks, individuals struggle to provide a consistent supply of diapers for their children. 

However, in late January 2025, Connecticut lawmakers introduced House Bill 6397, aiming to expand Medicaid coverage to include diapers for children from birth to age 3 when deemed medically necessary. The impact this bill has on families across the state, including in New Haven, is transformative.

“Looking at it from a basic needs standpoint, diaper access represents a huge financial burden for many of our families that are on Medicaid,” Dr. Maryallen Flaherty-Hewitt, professor of pediatrics at the School of Medicine, told the News. “This bill will have a long term positive impact on the growth and development of our infants into being healthy toddlers and children. It can also help our families to have some financial freedom to spend money in other ways.”

What is the diaper disparity?

For many families across the country, diapers represent a critical yet overlooked necessity. According to Flaherty-Hewitt, infrequent diaper changes can cause patches of inflamed skin to develop on babies. Additionally, a lack of regular diaper changes increases the risk of urinary tract infections, which affect any part of the urinary system.

The medical ramifications of a lack of diapers affect the mother’s health as well. 

“In 2013, there was a study done that was published in the Journal of Pediatrics that showed the highest correlation between maternal depression and stress in moms and diaper need,” Janet Alfano, the executive director of the Diaper Bank of Connecticut, said. “This is a recurring stressor that’s going to happen every few hours over the first three years of your baby’s life, and it can interfere with what would be normal bonding with one’s child and how you feel about yourself as a parent.”

Diaper disparities also exacerbate economic hardships on a family. Many childcare centers will not accept children whose parents do not provide diapers, even if they rely on subsidized health care. This leads to parents not being able to go to work to care for their children, missing at times four days of work a week. Alfano points out that this leads to an average loss of $6,000 in wages.

To put diaper costs in perspective, most infants need diaper changes every two hours, leading to an average of 10 diapers per day. Most parents need 700 to 1000 diapers a year, waning off each year as the child becomes more independent. That means $60-$100 just for diapers each month. 

For families who earn low incomes or qualify for Medicaid, the cost is a significant barrier for diaper access. Alfano indicates that with costs of the basic needs like diapers rising, the income stagnancy forces families to improvise.

Ella Thomas, a missionary at Mt. Bethel Baptist Church, points out that some individuals are also forced to make harsh economic decisions; some have to decide between buying food and buying diapers or buying gas and buying diapers. 

Across the country, about one in three families struggle with access to diapers. In Connecticut, it’s one in two families. According to Flaherty-Hewitt, the issue of diaper disparity access goes beyond just concerning caregivers and parents.

“I believe this issue is important to everybody, because there’s so many things downstream that diaper disparities can affect,” Flaherty-Hewitt said. “What may seem insignificant, is not insignificant as a lack of access to diapers can have long-term impacts on the growth of that child. It should be, as a group, we want to make sure that our next generation is healthy and developing well. And it may not seem like diapers are associated with that, but they really are.”

How the diaper disparity is currently being addressed

One of the ways New Haven is addressing this need is through the hospital’s diaper distribution programs. Flaherty-Hewitt told the News that pediatricians and nurses at the Yale New Haven Hospital will keep a supply of diapers for patients and their families in their offices. Physicians also hold diaper drives across the hospital and the School of Medicine twice a year to drive up diaper supply.

Another way the city is addressing the growing need is through the expansion of diaper banks. The Diaper Bank of Connecticut partners with over 100 shelters, social service agencies and health clinics to distribute free diapers to families. The Diaper Bank helps nearly 7,000 families access diapers. One of the bank’s partners is Mt. Bethel Missionary Church in New Haven, which serves more than 200 babies every fourth Saturday of the month. 

“It’s the role of the church to do anything that we can,” Thomas said. “That’s one of the things we believe we are commissioned to do, was to help somebody. So if there’s a need, we’re supposed to address it as a church.”

According to Alfano, the bank only serves 7 percent of the diaper needs in the state. In her opinion, the most effective way to address the diaper care disparity is through enacting state-wide policies. Currently though, the only “policy” available is $75,000 from the state budget to an array of organizations, from faith-based to family resource centers, that act as diaper banks for their communities. Also, state Medicaid already provides diapers to children above the age of 3 for medical conditions.

However, Flaherty-Hewitt points out that local initiatives to expand diaper access are only short-term solutions to a systemic problem. According to Thomas, the demand for diapers increases each year, as more and more families come to the church for diapers. Additionally, the cost of other essentials like diaper wipes and creams adds another layer of financial strain for struggling families.

“They’ll look at a baby and say, Oh, she’s cute, or he’s cute, but they don’t think that that baby might be in need. People, to me, don’t see children as people,” Thomas said. “They’re not little people, they’re people within themselves, and they have to be taken care of.”

The bill

In past years, there were bill proposals inspired by community organizations like the Diaper Bank meant to democratize access to diapers. Initially, these organizations tried to allow everyone on Medicaid to receive diapers from the state; however, that was simply too costly for some lawmakers.

The new bill proposal filed by the Human Services Committee is more conservative. The bill states that for families on Medicaid to access diapers, a doctor needs to determine whether or not the diaper is medically necessary. This includes when the child is having a persistent diaper rash or if there’s a neurological condition that inhibits a child’s ability to use the restroom normally. 

“We [The Diaper Bank of Connecticut] had some discussions with the Department of Social Services to get this bill to happen,” Alfano said. “We’re only scratching the surface with this bill but we’re happy we at least get some language from policymakers they’re interested in this issue.”

Alfano is relieved that the diaper disparity in Connecticut is receiving more attention and that there is more support among the bill than last year. Lawmakers in Connecticut and the Centers for Medicare and Medicaid are especially interested in enacting this bill. 

However, as Alfano suggests, this bill does not provide preventative care as the state only assumes responsibility if a medical condition already arises. It does not address the root cause of the diaper need itself. Thomas and Flaherty-Hewitt believe there should be no medical necessity requirement for diapers, as the diapers represent a medical necessity on their own. 

“Pediatrics, as a field, has been focused on trying to be less reactionary and more preventative,” Flaherty-Hewitt said. “I would hate for the medical necessity to be, ‘this baby has a really bad diaper rash because they didn’t have enough diapers, and now we can give them more diapers.’”

In addition, with the federal government threatening to make cuts to Medicaid, Alfano is worried that the bill might fail to pass for a third consecutive year. The estimated annual cost for the state is $119.9 million; and with federal reimbursements from Medicaid, the state’s share could be reduced to only $59.9 million.

Alfano told the News that to help move this bill forward, lawmakers may need to understand the specific impacts of diaper disparities in their communities.

“Throughout the legislative session up until June, hearing from folks in the community about why this is critical and what it means to your community, whether you have children or not, is incredibly important,” Alfano said.

The Mt. Bethel Missionary Baptist Church is located at 100 Webster St.

The post How a proposed bill can increase access to diapers in Connecticut appeared first on Yale Daily News.

These are the words that Yale experts told the News as they grapple with the implications of Robert F. Kennedy Jr.’s federal appointment.

Robert F. Kennedy Jr. has long been a vocal critic of pharmaceutical companies and public health institutions. Now, as the new Secretary of Health and Human Services, he is in a position to reshape national healthcare policy.

Kennedy’s tenure at HHS marks a significant shift in federal health policy. His Make America Healthy Again — MAHA — movement focuses on preventing chronic disease, reducing corporate influence on public health policy and removing chemicals from food and water. However, his long standing skepticism toward vaccines and distrust of regulatory agencies such as the CDC and FDA have raised alarms among public health experts, who warn that his policies could weaken institutional trust, reduce immunization rates and hinder evidence-based policymaking.

“My biggest fear – like many of my colleagues – is that he will continue to promote an anti-

science rhetoric that undermines our most critical public health efforts and our incredibly talented

biomedical science workforce,” Nicola Hawley, professor of chronic disease epidemiology at the School of Public Health, wrote to the News. “Doing so would more than offset any potential gains from addressing chronic diseases.”

The state of U.S. healthcare and Kennedy’s diagnosis 

The United States spends more on healthcare per capita than any other country, yet it ranks poorly in life expectancy, maternal health outcomes and chronic disease rates. According to the Commonwealth Fund, the United States spends more than twice the average of other high-income nations but sees higher rates of obesity, diabetes and preventable deaths.

In New Haven, one in five adults over 65 has diabetes. In Connecticut, nearly 33 percent of adults have high blood pressure, and heart disease is the leading cause of death. 

Kennedy attributes these issues to a healthcare system that prioritizes expensive treatments over prevention and wellness. He contends that corporate interests — particularly those of pharmaceutical and vaccine companies, industrial agriculture and processed food manufacturers — have shaped public health policies in ways that encourage chronic disease rather than prevent it.

His MAHA movement seeks to address chronic disease at its root, through food policy changes, corporate transparency, and vaccine skepticism. However, experts caution that Kennedy’s ideological learnings may interfere with legitimate policy solutions. 

“When we look at a HHS Secretary, we want someone who’s a healthy skeptic who’s willing to ask experts what the evidence is behind new technologies, behind how we should actually do healthcare,” Reshma Ramachandran, professor of general medicine, told the News. “But my worry is that RFK’s record does not reflect somebody who’s a healthy skeptic, but someone who has the kind of ideological views that he puts before science.”

Addressing the debacle of processed foods

One of Kennedy’s primary concerns is the rising prevalence of chronic diseases such as diabetes and heart disease. To address this, his administration has proposed banning ultra-processed foods in schools, nursing homes, jails and other institutional settings where food is provided. 

According to Hawley, foods such as frozen vegetables and canned tuna are minimally processed — the more troubling foods are the ultra-processed. Chips, pretzels, sodas and breakfast cereals, for example, are processed by breaking down whole foods and adding chemicals and additives to make them look appealing.

Such foods are cheap, widely available and highly palatable, leading to overconsumption. Research has consistently linked high sugar, fat and calorie content in ultra-processed foods to obesity, heart-disease and metabolic disorders. Children consume the majority of their daily calories from these foods, making school food policies a critical area for reform. 

Hawley agrees that many children, who get the majority of their daily meals at school, eat ultra-processed foods throughout the day. She suggests that removing ultra-processed foods from school cafeterias and providing access to healthy, affordable food alternatives will have a positive impact. 

However, where Hawley doesn’t agree with Kennedy is his promotion of unsubstantiated beliefs around nutrition practices. According to Hawley, though some of his statements do have good intentions, Kennedy asserts misinformed science to back his claims. For example, Kennedy has suggested that food dyes, which Hawley does believe we should avoid, causes ADHD. Hawley also believes that RFK’s support of all natural alternatives will bring more harm than good. This includes the promotion of raw milk, which has been shown to induce foodborne illnesses.

In addition, RFK seems to have a bit of a narrow focus when it comes to addressing nutrition disparities.

“There is certainly evidence to suggest that our exposure to processed foods and environmental toxins has increased alongside chronic disease prevalence, and some studies are beginning to make causal links,” Hawley wrote. “What is problematic about his narrative though is the lack of attention to the more far-reaching structural issues that are also major contributors to chronic disease. ”

Kennedy’s focus on processed foods as the primary driver of chronic disease fails to address deeper systemic issues that make it easy to consume these foods in the first place. Low-income communities and communities of color face higher rates of obesity and diabetes, often due to limited access to fresh food, unsafe neighborhoods, and unstable housing. 

While Kennedy’s push for dietary reform is well-intentioned, experts caution that his policies must be paired with efforts to address food insecurity and socioeconomic disparities—or they risk being ineffective.

Attacking corporate influence in public health agencies

One of Kennedy’s most contentious stances is his criticism of public health institutions. He has accused agencies such as the CDC, FDA, EPA and NIH of being influenced by corporate interests and failing to protect Americans from harmful products. 

Some of his claims are based in fact. 

According to Yusuf Ransome, professor of social and behavioral sciences at the School of Public Health, corporate agencies can influence federal agencies in various ways. This includes lobbying for favorable regulations, funding research to support their interests. For example, companies like Monsanto have influenced the EPA to downplay the risks of widely used pesticides. Coca-Cola has built relationships with the CDC to resist sugar regulations. According to Xi Chen, professor of health policy at the School of Public Health, some pharmaceutical industries have even altered experimental data on dementia treatment. 

Howard Forman, professor of health policy at the School of Public Health, also highlighted the issue of the revolving door, where individuals move between leadership roles in regulated industries and positions within government agencies, like the FDA. While industry expertise can be valuable in agencies, the concern arises when former regulators use their government connections to benefit private interests.

“Corporate influence can create conflicts of interest, where the primary focus of federal agencies shifts from protecting public health to advancing corporate profits,” Chen said. “This can then exacerbate health inequities by prioritizing interventions and policies that benefit wealthier populations or specific industries, while neglecting the needs of marginalized and underserved communities.”

Chen believes that Kennedy should investigate corporate influence and bring about some transparency to the regulation and actions of federal agencies; he suggests Kennedy does this by creating a committee with scientists who can provide unbiased analysis of the corporate influence. 

However, the way that Kennedy is currently “cleaning up” federal agencies has been up for contention. 

Forman cautioned that while corporate influence in public health policymaking is an ongoing concern, dismantling agencies outright could have serious consequences.

“[Kennedy’s] rhetoric could weaken confidence in federal health guidance, making it harder to implement critical public health measures,” Forman said.

Chen mentions that Kennedy’s oversight of the purging of federal agency employees does more harm than good. Laying off professionals won’t reduce corporate influence; instead, it would make it more difficult to develop unbiased, evidence-based public health recommendations. This would impact efforts in chronic disease prevention, maternal mortality and other critical health issues.

The danger of anti-vaccine rhetoric

Kennedy’s stance on vaccines remains one of his most controversial positions. While he has not called for an outright vaccine ban, he has consistently opposed mandates and questioned vaccine safety. His claims that vaccines cause autism, that COVID-19 vaccines alter DNA, and that people of color should be on a different vaccine schedule than white individuals solely on race have all been debunked. 

There is the potential of serious side effects of vaccines, like blood clotting issues with the Johnson & Johnson COVID-19 vaccines and neurological disorders with the flu vaccines. However, these side effects are rare. And though RFK propagates the harm of vaccines, his own family is vaccinated, including from COVID-19. 

Chen warns that loosening vaccine mandates could lead to declining immunization rates and the resurgence of preventable diseases. This will lead to a higher healthcare burden as medical resources will be strained on cases that could’ve been prevented. In addition, lower vaccination rates break down herd immunity, placing vulnerable populations who can’t take vaccines-like the elderly-at risk. Already, there are reports of measles outbreaks in Texas as childhood vaccination rates drop below herd immunity thresholds. 

“Look, we’re down to 93 percent vaccination rates for childhood vaccines at the kindergarten level in this country,” said Forman. “That’s below the herd immunity rate for measles. There’s a consequential measles outbreak in under-vaccinated communities in Texas, and it’s already spilled over into a county in New Mexico.”

Currently, Kennedy is using his pseudoscientific beliefs of vaccines to promote vaccine skepticism. For example, he has ordered the CDC to half the flu vaccination ad campaigns. And though he promised to uphold existing vaccine schedules, Kennedy has announced plans to review these schedules. 

A polarizing future for U.S. health policy

Experts have reached a general consensus that Kennedy has some innovative ideas that can improve the health of the country.  However, his ideologies and deprioritization of scientific evidence will make it difficult for him to achieve those goals.

Chen points out that Kennedy is not a medical professional and has no experience leading a public health institution, much less one as large and influential as the HHS department. His lack of medical knowledge showcased itself in his Senate confirmation hearing, when he couldn’t explain the difference between Medicaid and Medicare. 

“Despite his stated intentions about addressing these key issues, it just doesn’t seem like he’s the right person for the job,” Ramachandran told the News. “You want someone who’s willing to look at their agencies that are staffed with scientists, clinicians and engineers. You want him to say ‘I’m not going to be an expert at everything, because health is a huge topic, but I’m going to be willing to listen to people and talk to them about it.’ He’s not that.”

Chen notes that there are already gaps between scientific understanding of various public health issues and the public perception of these issues. Kennedy’s actions and beliefs can not only worsen the gap, but also worsen the trust many Americans have in federal agencies. 

Though there’s grave concern about what Kennedy will do, he will be America’s HHS secretary for the next four years. Ramachandran suggests that those in Congress who have the power to stand up to Kennedy and keep him accountable should do just that. Others, like Hawley, hopes that Kennedy can begin to change his ways.

“I would urge him to center his health platform on interventions with robust scientific backing and to fulfil his promise of transparency and accountability without undermining the scientific consensus,” Hawley wrote to the News.

On Feb. 13, RFK Jr was sworn in as the 26th Secretary of the Department of Health and Human Services.

The post ANALYSIS: RFK Jr.’s health revolution: reform or risk? appeared first on Yale Daily News.

This month, per President Donald Trump’s executive orders, the CDC is trying to eliminate any association with diversity, equity and inclusion, or DEI, on its website. The scrubbing of data — which includes topics like gender and racial identity and accessibility — has led to the disappearance of various CDC web pages that feature keywords such as “disability” and “women.” This data loss raises concerns — it not only prevents researchers from providing more accurate analyses and medical information, but it could also have widespread negative impacts on public health. 

“The first step to understanding the health challenges that the public faces is to be able to study and understand some of the social determinants of health,” Michael Capello, department chair of epidemiology at the School of Public Health, said. “So for the government to attempt to scrub information about some of the various populations within our society is in itself an effort to further marginalize some of the more vulnerable populations in our country. And that is an incredibly regressive decision on the part of our government.”

The CDC’s shift on DEI

According to Mayur Desai SPH ’94 GRD ’97, the associate dean for DEI at the School of Public Health, the CDC is the premier public health organization in the U.S. and one of the key agencies in the Department of Health and Human Services. One of the main tasks of the CDC is to collect various data sets about the nation’s health, ranging from the Nutrition Examination Survey to the Health Interview Survey. The CDC usually collaborates with local health departments and universities to collect the data, but they also have their own scientists who conduct research.

Researchers and medical professionals look to the CDC for data about epidemiology, patient outcomes, health disparities and more. Desai points out that the data collected is funded by taxpayer dollars to benefit the American people’s health and is meant to be freely accessible to any researcher around the world.

“The information and data that is present on the CDC is something a lot of us access on a regular basis,” Sona Jasani, assistant professor of OBGYN at the School of Medicine, told the News. “For example, the best guidance for treating certain infections, like STD (sexually transmitted diseases) management. When a patient comes in and tests positive for something, you can just look at the CDC and point to the recommended guidance for a certain patient population.”

However, the CDC recently decided to limit DEI influence in their data due to the Trump administration’s pushback on DEI. This decision has led to websites like the Agency for Toxic Substances and Disease Registry’s Social Vulnerability Index vanishing. It has led to the replacement of words on the website and CDC-funded research data like “gender” to “sex.” It has led to the removal of complete sentences, courses and articles that have to do with equity or diversity. It has even led to the removal of the CDC mission on the website, at least temporarily. 

Federal judge overturns CDC decision

Although a federal judge ordered the CDC to reverse its actions on Tuesday, some of the websites with DEI content are still down and accessing the data is difficult. Jasani told the News that it takes her longer than usual to pull up data, as she had to go to different parts of the website to find information; at times the data won’t download properly. In addition, the CDC states that the website is being modified to comply with Trump’s executive orders, with many sentences and words still not being restored. 

“These observations seem to suggest that ‘restoration’ may not mean complete restoration,” Jasani wrote to the News. “It may mean that some of the words including ‘gender’ or DEI information may not be restored despite the federal court order. The lack of transparency for an end-user like myself to know what will and will not be restored is somewhat alarming and frustrating.” 

What makes the situation more complicated for researchers and medical professionals is the general uncertainty; many do not know what else will constitute the CDC’s response to Trump’s executive orders and whether or not they’ll be struck down. 

Capello believes the CDC’s next steps are uncertain because of the lack of clarity on the ultimate intention of the CDC’s actions. 

“It’s a very unsteady and uncertain moment in which we’re trying to grapple with these changes that are made, and then, in some cases, within hours today are reversed,” Capello told the News. “I think that’s a very important point for people to understand that uncertainty makes it extremely challenging for my colleagues in the School of Public Health and the School of Medicine to be able to do their work when they are reliant on publicly available databases.”

According to Capello, the restriction of the availability of public health data is not new; the political implications of HIV/AIDs in the late 1900s and firearm injury and death in the 2010s made published data not as clear. However, this is the first time that general health information, like the rates of influenza and rates of cancer, is being restricted as data on certain sectors of society are being reworded. To Capello, this doesn’t seem rational.

Desai told the News that he wasn’t surprised about the Trump administration’s actions as he made clear on the campaign trail what his priorities were; however, the speed by which these changes are taking place is what shocks him.

“I think there’s an effort on the part of the administration to look past these inequities,” Desai said. “For them to negate their existence.”

The impact of the CDC’s actions

According to Jasani, the most comprehensive data set is one that’s routinely updated and represents diverse groups. With 80 percent of health outcomes associated with the social determinants of health of where one lives, eats, learns and works, medical factors can impact different groups differently because people live in different environments. 

For example, structural racism plays a role in health outcomes for people of color as black women face higher rates of maternal mortality than white women. It was by recognizing the differences between demographics that researchers realized that some biological instruments like pulse oximeters measure oxygen saturation levels differently across various skin tones. Removing data on these social differences can lead to drastic deficiencies in addressing health.

This lack of data doesn’t only affect minority groups, it has the potential to impact everyone.

“The COVID-19 pandemic and other infectious disease outbreaks that have occurred should make us all understand that what affects the health of one of us has the potential to affect the health of all of us,” Capello said. “It’s less about sort of targeting specific groups, then this broad-based effort to limit the flow of information and the potential it has to harm all of us.”

According to Capello, the impact CDC data scrubbing has on society is boundless. The New Haven Health Department relies on federally provided health data to inform policies that address public health issues and disparities. Without accurate data, it’ll be more difficult to enact impactful interventions that promote the health of New Haven residents. 

“If we don’t have reliable research based on current and accurate data, we can’t develop policies that can target particular groups to improve their health, whether that group is a particular marginalized group, a racial or ethnic group, or the health of the entire country,” Capello said. “Policy can only be based on well collected, accurate, up to date and reliably analyzed data.”

To Jasani, science is about discovering the truth, and the scientific process is meant to reduce as much bias as possible during data collection and analysis. The introduction of bias in the form of data revokement can result in skewed, inaccurate and biased conclusions of public health situations.

Capello believes that the CDC’s actions erode the agency’s credibility; it will be harder for public health professionals to trust the data the CDC produces because of the uncertainty it has “injected” into its data. Even with some of the data being restored back to the website, Jasani is now worried about the issue of accountability in the CDC for it’s still unclear who will make sure that the revoked information is being restored.

Rebuilding lost data

In response to the growing threat of the loss of data, a number of academic and nonprofit organizations are recreating removed data sets based on archived websites. According to Jasani, the American College of Obstetricians and Gynecologists provided some resources on CDC information; the Internet Archive also provided some data archived from the CDC website.

However, these second-hand websites aren’t as transparent, accessible or user-friendly when trying to utilize such data. Websites host disorganized data entries that make it difficult to find exactly what one is looking for in a timely manner. Jasani suggests that, at times, relying on data from the state and city governments or local institutions could actually provide more accurate data on local issues than federal data. This could potentially reduce the impact of the CDC’s actions

“Sometimes the most accurate data is either your local data, or your institutional data, depending on what the topic that you’re studying is,” Jasani said. “I would hope that some of these other data sets that we have here, locally or state-based, haven’t been affected. However, not every location in the United States can say that with certainty.”

According to Desai, the School of Public Health’s message to faculty is to continue to link science and society, helping to improve the health of the masses. He believes that it’s even more important that the school continue to do its vital work and be a trusted voice in public health. 

Jasani believes that Yale should work to optimize their own data collection, making sure its data collection process and results are accessible and transparent to everyone, including the patient. 

Capello points out that one of the things that patients, agencies and the general public can do to push for change is to contact elected representatives, especially in Republican districts, to let them know how the CDC’s actions can impact general health. Pressuring members of Congress to advocate for stronger public health policies and increased transparency in data reporting can help ensure that agencies like the CDC remain accountable.

The CDC was founded in 1946.

The post ANALYSIS: Loss of CDC data is impacting public health appeared first on Yale Daily News.

Since early December, Connecticut has seen a historic surge in norovirus cases and hospital visits, leaving the Yale community battling with the virus’s relentless symptoms and ease of transmission. Though cases are currently low, it is unclear when exactly they may peak this year. Therefore, health officials are urging students to take preventive measures to curb the spread.

“In December, we had a limited outbreak among undergraduates in the period leading up to and including exams,” Madeline Wilson, the chief campus health officer, wrote to the News. “Since returning to campus, we have seen a few isolated cases at Yale Health but not at the level we were seeing prior to winter break. That said, it is the nature of norovirus that we don’t always know about cases because many do not seek care.”

According to Albert Ko, a professor of epidemiology at the School of Public Health, norovirus is a gastrointestinal viral infection. Though it’s not a respiratory disease, consuming contaminated food or water, touching contaminated surfaces and being in close contact with an infected person increases the risk of infection. Symptoms range from nausea to diarrhea and vomiting, but some may experience illness without visible symptoms.

Norovirus infects cells in the gut that help absorb nutrients from food. The infection triggers inflammation in the gut and leads to stomach irritation, making it harder to absorb water. This causes the various symptoms seen in norovirus patients.

“It’s highly transmissible because it doesn’t take a lot of virus particles to infect people, probably less than 10 or 100 virus particles,” Ko said. “People can get exposed to it very easily.”

The disease usually causes symptoms for less than 48 hours, Ko said, but those infected can transmit the disease to others for longer. 

Due to its symptoms that cause constant water loss, those infected with the disease should drink lots of fluids and take time to rest and recover. 

Though it can cause complications like severe dehydration, norovirus is very rarely fatal. However, for young children, the elderly and those with weakened immune systems, symptoms can be worse.

According to Craig Wilen, associate professor in immunobiology at the School of Medicine, there are currently no drugs, antivirals or vaccines for norovirus. Moreover, the understanding of norovirus is relatively limited compared to other viruses, and there has been relatively little funding for norovirus research.

Norovirus outbreaks usually occur almost every year, especially during the winter, like most other infectious diseases. However, the waning immunity that COVID-19 public health mandates has made this year’s case surge higher than normal. And though experts don’t know the exact number of cases, they can base their evidence on the increase in hospital visits.

“We have seen, based on evidence from hospitals and emergency rooms, that cases have been going up, starting in December and extending through January right now,” Ko told the News. “However, it is not a public health emergency. What we’re seeing now is something expected.”

Sebastian Reyes ’27 told the News that he was not aware of the norovirus before he contracted it in December. Because Reyes switched his medication as he began to exhibit symptoms, it took days before he realized the symptoms were not side effects.

“It definitely took at least two or three days to ramp up fully,” Reyes said. “It was a fever, which got up to either 103 °F or 104 °F. It remained there for like a day or two. There was a lot of GI discomfort, we’ll leave it at that, and then some body aches.”

Reyes could not pinpoint when he contracted the virus, recalling a doctor telling him it was very likely that he contracted the virus through contaminated food.

Though it isn’t a public health emergency and Yale isn’t experiencing an outbreak, Wilen believes that everyone should play their part in reducing the spread. Without vaccines, Yale Health’s main intervention in preventing an outbreak is education, as seen in the various messages placed in restrooms that detail steps to take if symptomatic and how to prevent transmission.

According to Wilson, everyone should wash their hands with soap and water, instead of using hand sanitizers, after using the restroom. Students should also clean high-touch surfaces like classroom desks with bleach-based cleaners. 

If students do get sick, they should stay at home for 48 hours after symptoms resolve and talk to their college dean if they need any accommodations. If symptoms worsen, they should come to Yale Health to receive treatment.

Around 1 in 15 people in the U.S. get norovirus annually.

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“I wanna talk about how [my condition] makes me feel,” she told Yale researchers, “not rehearse my diagnosis.”

Katie Wang, associate professor of public health, led a study at the School of Public Health this month revealing the discrimination faced by people with disabilities like Pam when seeking mental healthcare. 

According to interviews with disabled individuals, ableism causes and exacerbates the disparities in mental health care.

Mental health care is a sector that Wang believes especially typifies discrimination people with disabilities face. She hopes that her research inspires changes in mental health practices that prioritize treating individuals no matter their disabilities.

Healthcare settings are commonplace for people with disabilities to face discrimination. Previous research has indicated that disabled individuals experience higher rates of mental health distress, including depression and anxiety, and are usually left unsatisfied with their care. Wang wanted to understand why this was the case and what barriers people with disabilities were facing when trying to access psychotherapy services.

Wang and her team interviewed 20 adults in the United States with disabilities in fall 2022 about their experiences with the American mental health care system. The interviewees came from various backgrounds, including race, gender and sexual orientation. They also had a range of disabilities, ranging from physical to mental.

The team asked the individuals about the barriers that they experienced when seeking mental health care as well as if they experienced ableism when talking to their providers. 

“They showed a lot of resilience and shared deeply personal stories and were brave about it,” Sarah Fodero SPH ’23, a co-author of the study, told the News. “We asked a lot of really direct questions about their experiences and how providers treat them. But I think folks were happy to share the negative experiences. Many articulated that they wanted to participate in the study in order to help other people.” 

Interviewees expressed annoyance with psychologists either overemphasizing or ignoring the role their disability played in their mental health. One participant with autism trying to access mental health care was redirected to disability services even though her main concern was not related to her autism. Participants in the study also felt that providers frequently invalidated their experiences and needs.

“One of the most difficult barriers to remove is the attitude of people towards people with mental disabilities,” Carmen Correa-Rios, the operations director of the CT Center for Disability Rights, told the News. “We have people walking in when they’ve been accused of different things, and they feel everything is in their head. It’s not only in their head.”

Instances of interpersonal ableism between patients and psychologists, uncovered by the study, included various microaggressions directed toward people with disabilities — for example when psychologists addressed the family members instead of the patients themselves. According to Joan Ostrove, professor of psychology at Macalester College and co-author of the study, this can make patients feel unsafe, unseen, invalidated and frustrated.

Systemic ableism refers to the institutional barriers that make it difficult for people with disabilities to access mental health care. 

Some hospitals’ harsh cancellation policies negatively impact people with disabilities, for example, because they might need to cancel appointments at the last minute due to unpredictable disability conditions.

Another example of systemic ableism, according to the study, is the use of telehealth.

“The lack of universal design features or accessibility features are in a lot of the telehealth software people are using,” Wang told the News. “Telehealth software really does need to be accessible, both for screen reader users and for people. But there are others who have disabilities that make it more difficult to use telehealth altogether.” 

Lastly, some people with disabilities experience compounding discrimination because of their race or sexual orientation. They found it difficult to not only find providers who understood what it is like to live with both identities but also couldn’t understand if the discrimination they received was based on their disability or their other identities.

Though the study did not interview many individuals with intellectual disabilities or those above the age of 60, Wang believes that her research clearly lays out various ways that people with disabilities experience ableism in their mental health care.

According to Fodero, who’s also visually impaired, hearing the stories of these individuals was not only sad but deeply validating, as she could relate to the many experiences of the individuals she interviewed.

Fodero shared that some people with disabilities believe that the current U.S. medical system is not geared to treating individuals with disabilities, which exacerbates the problem. The system sees people with disabilities as a medical anomaly more than a minority population. This creates a lack of disability competency training among physicians, a lack of flexible health insurance plans and other systemically ableist policies.

Addressing the problem 

According to Correa-Rios, one of the easier ways to address ableism in mental health care is by increasing disability competency training in the standard curriculum of medical students and psychologists. Exposure to topics they might not understand helps professionals to see people with disabilities as not incompetent or medical phenomena but as actual patients who need mental health care. 

Roger Jou, an instructor of clinical child psychiatry at the School of Medicine, also believes this shouldn’t be a one-and-done; physicians should learn about disabilities throughout their careers.

“[Physicians] need to understand it’s not always one size fits all,” Correa-Rios said. “You can have two people with the same disability who need a completely different approach. So by asking ‘How can I help you?’ the person will in one way or another let you know what is the best way to help them.”

Wang believes that increasing the number of psychologists who have disabilities themselves — through recruitment and ensuring workplace accessibility —  “will do wonders” in reducing ableism in the mental health care experience.

She also suggested that healthcare institutions should be more flexible with appointment and cancellation procedures. 

It could also mean further community-based participatory research to continue to uncover deeper analysis of ableism in the mental health space.

Further community-based participatory research on ableism and other forms of discrimination is needed, Ostrove believes. 

However, during Donald Trump’s presidency, Fodero fears it will be harder for people with disabilities to gain equal access to mental health care in various ways.

Trump’s removal of diversity, equity and inclusion programs at various agencies will make it harder for clinics and institutions to hire psychologists with disabilities. The possible removal of certain research funding may make it difficult to conduct more research into ableism in the future. 

By providing a voice to people with disabilities, Fodero hoped to inspire conversations about the needed structural changes.

“First seek to understand, then to be understood,” Jou wrote to the News when asked what psychologists can do to fight ableism in mental health care. “Apologize and commit to doing better. Quoting Maya Angelou, ‘Do the best you can until you know better. Then when you know better, do better.’”

According to the CDC, adults with disabilities report experiencing frequent mental distress almost five times as often as adults without disabilities.

The post ‘Not in My Head’: Addressing ableism in mental health services for people with disabilities appeared first on Yale Daily News.

That’s why, this month, in one of his final policy recommendations, Murthy has called attention to the cancer risks associated with alcohol and urged Americans to reduce their consumption. He also proposed adding cancer risk warnings to alcoholic beverage labels as one strategy to address this issue. And while Yale experts agree with the recommendation, some believe the relationship between alcohol and cancer is more complex than the surgeon general suggests.

“I don’t disagree with putting the warning label on alcohol,” said Vasilis Vasiliou, co-chair of the T23 Translational Alcohol Research program and professor of environmental health sciences, “However, I want people to be informed and make educated decisions regarding this. If you are a smoker and you drink a lot [of] alcohol, you are at a higher risk, that’s for sure.”

The research behind the federal recommendation

Alcohol consumption has been linked with various negative side effects. According to Xi Chen, associate professor of health policy at the School of Public Health, alcohol has been linked with dehydration, nausea, impaired judgment and other conditions.

According to Vasiliou, alcohol can cause cancer in various ways. It can damage DNA, alter the normal levels of estrogen — increasing the risk of breast cancer — and potentially cause a greater absorption of other carcinogens such as tobacco smoke.

“During the alcohol’s metabolism, you have the generation of reactive oxygen species,” Vasiliou told the News, “If you don’t have antioxidants from a very well-balanced diet, you can increase your oxidative stress, raising the risk for cancer.”

Research has shown that alcohol increases the risk of cancer for at least seven sites, ranging from the liver to the mouth to the throat to the breast in women. If a man consumes seven drinks every week, his risk of developing alcohol-related cancer increases from 10 percent to 11.4 percent; for women, the increase is more drastic, from 16.5 percent to 19 percent. 

Though the increase in cancer risk seems marginal, associate professor of psychiatry Lisa Fucito believes at the population level, they are huge. In the United States, alcohol use contributes to nearly 100,000 cancer cases and about 20,000 cancer deaths annually. 

The recommendations for action

More than 50 percent of Americans don’t know that alcohol consumption increases cancer risk. And in a state such as Connecticut — ranking in the top 20 states with the most alcoholics — spreading the knowledge about the cancer risk of alcohol is of even more importance. According to Chen, the lack of sufficient public health messaging about alcohol’s cancer risk has led to the information disparity.

“Though there have been some beliefs that alcohol has some benefits, the Surgeon General wants to correct that message,” Chen told the News. “There’s no benefit to drinking. Since it’s not a necessary consumption, if you can avoid drinking on some occasions, try to do that.”

Younger generations are drinking alcohol at lower rates than older generations. Though a cause to be hopeful, Marcella Nunez-Smith, director of community engagement and health equity at the Yale Cancer Center, believes that more work needs to be done to change the narrative around alcohol at a mass level. In her view, the Surgeon General’s recommendations can do just that. 

Warning labels

One way to educate the public about the cancer risks of alcohol is through updating the health warning labels on alcoholic drinks. According to Nunez-Smith, the last update to these labels was in 1988. Since then, the labels have only briefly mentioned potential health risks and addressed birth defects related to pregnancy and impaired driving. 

“Warning labels have been a tremendous success globally for communicating the risks of tobacco use at the population level and changing population risk perceptions about tobacco use,” Fucito wrote to the News. “Applying labels directly to products is important because they provide a continuous reminder and public health messages communicated via other ways may be missed.”

However, according to Nunez-Smith, some New Haveners aren’t as comfortable with trusting health information from outside sources. To work around this, Nunez-Smith believes that community leaders can partner with public health professionals and raise awareness about the link between alcohol and cancer effectively, potentially through workshops or town hall meetings.

Fucito also suggested that healthcare professionals need to learn how to interact with patients about the cancer risk of alcohol. This can mean doctors and nurses learning to assess alcohol use, providing alcohol treatment resources and connecting patients with effective interventions. 

“The rule is, not just for this advisory, but for everything in public health, is that we provide people with information to make informed decisions,” Nunez-Smith said, “The information must be high quality, and that they receive it from trustworthy sources. But after that people will be armed with the information to make their individual choice.”

Complexities

However, the surgeon general’s recommendation has various nuances that need to be considered. 

According to Vasiliou, though there is a consensus that more alcohol leads to higher cancer risk, the precise amount of alcohol that elicits its various health repercussions — including cancer — is not known. 

Additionally, Vasiliou pointed out that most of the findings the surgeon general concluded are based on questionnaires given to cancer patients asking them about their alcohol behavior. This leads to bias and a lack of evidence-based conclusions. He believes more clinical evidence must be collected, including blood measurements. 

“We have a lot of gaps in our knowledge that need to be filled with further research,” Vasiliou told the News. “We need our epidemiology to be mostly based on clinical biomarkers showing that alcohol is the driving force of cancer, not just a contribution. We also need mechanistic studies, using human models to show the direct relationship between cancer and alcohol.”

According to Nunez-Smith, though reducing alcohol intake or removing alcohol from one’s diet will reduce the risk of cancer, it won’t completely remove it. Every individual has their own unique genetic and social factors that make it easier or harder for them to get cancer. Though at the population level, it is the consensus that drinking less alcohol will significantly reduce the risk for cancer, the individual risk varies.

“The issue is, at the individual level, people may have some healthier behavior to offset the harm generated by consuming alcohol,” Chen said, “Those who exercise can offset some of the risks that alcohol provides, but what we observe is the net impact.” 

According to Chen, it’ll also be difficult to turn the surgeon general’s recommendations into law. A majority of Congress will have to agree with the recommendation. With the large lobbying efforts of the alcohol industry in Congress and Health and Human Services, it’ll be difficult to change the opinions of many. 

Additionally, there are various other risk factors for developing cancer, such as obesity, and it’s important to highlight these are preventable causes of cancer risk. According to Chen, having a holistic approach when raising awareness about cancer risk is key to spreading the correct information. 

Vasliliou hopes that talking about cancer will serve as a conversation starter for cancer education, making individuals more informed about cancer risk in general. According to him, alcohol use disorder is a major problem in society and can wreak havoc on the individual body. Though the cancer risk of alcohol may need more evidence-based clarification, he encourages moderate drinking of alcohol due to its other negative effects.

This spring, the School of Public Health is hosting the 5th International Conference on Alcohol and Cancer.

The post Unmasking alcohol: Yale experts debate alcohol’s cancer risk and labeling implications appeared first on Yale Daily News.

Based out of the School of Nursing, the clinic annually provides free vaccines to uninsured and under-insured individuals in New Haven during October. This year, in addition to administering flu vaccines, they supplied COVID-19 vaccines to New Haveners for the first time. The clinic has provided more than 130 vaccines over five Saturdays of the month. 

“Vaccine inequities are a part of the troubling, long-standing social determinants of disparate and inequitable health,” Dr. Jeffery Bender, professor of cardiovascular medicine at the School of Medicine and medical advisor of NHP, told the News. “However, NHP provides a way for us to reduce those inequities through the vaccine clinic. People often have questions about the vaccine like, do you think this is important, are the vaccines safe? The nursing students, as well as student volunteers, can spend time communicating and answering their questions, providing vaccine education and access.”

The hosts of the vaccine clinic

The vaccine clinic is part of the broader organization of the NHP, a graduate student-run clinic. Created in 2003, the clinic offers a range of free services to the New Haven community, from blood pressure checks and healthcare counseling to providing sexual health supplies like menstrual products. The clinic also serves as an education center for community members, providing resources and information for where and how to access further medical care.

NHP is directed and staffed by graduate students from the School of Medicine, School of Nursing, School of Public Health and the Physician Associate Program. Advisors from the School of Nursing and School of Medicine oversee the development of the clinic; at least one advisor is present at NHP events. However, according to Bender, the students are the operators and drivers of the clinic. There’s an emphasis on recruiting as many different voices in health as possible with the inclusion of students with different health interests. According to Ryan Sutherland SPH ’20 MED ’26, NHP’s community outreach director, this approach creates different opportunities for specialized information. 

“Every good health decision starts with a conversation,” Sutherland told the News. “A lot of these patients don’t really want to come to clinics. They may have an issue with transportation. They might have an issue with discrimination. Our model is meeting individuals in their community where they need care the most.” 

One of the impactful community partnerships that NHP has formed has been with Loaves and Fishes, an organization dedicated to providing an equitable food system in New Haven. The organization provides culturally appropriate and nutritious foods, clothing and access to various services. Loaves and Fishes runs its operations every Saturday, including during the holidays, between 8 a.m. and 10:30 a.m. at the Episcopal Church of St. Paul and St. James.  

Excluding holidays and school breaks, the NHP holds its services at the church at the same time Loaves and Fishes run their operations. According to Sutherland, this is because Loaves and Fishes is an established organization that already knows how to reach community members. Many of the individuals who come to Loaves and Fishes don’t have insurance for health care and don’t have routine care with primary care physicians. NHP sees it as an opportunity to go to where patients are already present to provide education and health advice.

According to Lorrice Grant, the executive director of Loaves and Fishes, the partnership with NHP is wonderful because people come for food and clothes and leave with healthcare advice and connections to health resources. 

“They already have a relationship with people at Loaves and Fishes,” Grant told the News. “They trust us, so therefore they start to develop a trust with medical providers. A lot of people are afraid to go to the doctors, but because NHP is right in the space that they’re already familiar with, people’s guard is down and they’re already comfortable, and they’ll say, ‘Yeah, I’ll let you test my blood pressure, or, you know what, I do need COVID vaccine or a flu shot’”

As of 2022, 40 percent of New Haven residents have decided to remain unvaccinated as a result of misinformation. According to Sutherland, the vaccine misinformation is partly due to the historical legacies of racial discrimination in healthcare that have left many individuals not trusting healthcare systems. He believes that the NHP is helping to create a new health legacy in New Haven by providing thoughtful community collaborations that are consistent with what the community needs. 

Additionally, Christina Pantzer NUR ’25, the co-director of NHP’s vaccine clinic, told the News that the privilege of attending and being a part of an institution like Yale with its resources and education comes with the need to give back. This allows students like Pantzer to apply what they learn in the classroom and build healthier relationships with the New Haven community.

“NHP provides people with science-based evidence and knowledge about vaccines, disease, healthcare and even nutrition,” Grant said. “This is important because sometimes people don’t have time to kind of go research those things on their own. Now, they will take good information back home with them, rather than things that they hear on social media or the news or in passing or from their friends because it’s a place where they already feel like they can trust people.”

What the vaccine clinic provides

The vaccine pop-up clinic, held only in October, is one of the many NHP services provided at Loaves and Fishes. According to Pantzer, holding the clinic in October works because it’s late enough for volunteers to get settled into the semester and early enough before the winter. This best protects individuals from the peak of flu and COVID-19 season in the winter.

Led by Pantzer and Ezra Otto NUR ’26, the vaccine clinic usually employs nursing students to volunteer at the vaccine clinic. According to Sutherland, this is because nursing students are provided with a National Provider Identifier that certifies them to provide vaccines.

“Nurses are often overlooked as leaders in the healthcare system,” Pantzer said. “The nursing perspective is valuable because we’re trained to view someone as a holistic person with social, environmental and developmental factors. Nurses are also resourceful because we’re used to working in care settings and we can apply what we know in care to the vaccine clinic.”

The clinic accesses the vaccines through the Connecticut Department of Public Health, which allows medical institutions to provide vaccines to uninsured or underinsured individuals. The clinic orders the vaccines from a government portal and they are usually stored at the Yale Health Pharmacy. According to Pantzer, the clinic uses the NHP budget to then buy other necessary supplies for the day, including hand sanitizer, alcohol swabs and needles.

NHP volunteers set up tables in the church’s basement at 7:30 am. For the vaccine clinic, there’s one table for admitting the COVID-19 vaccine and another table for the flu vaccine. Two nursing students are stationed at each table with Pantzer and Otto supervising proceedings. Before New Haveners can get in line for food and clothing, there are various tables with health services, including the vaccine clinic. 

When an individual wants to get a vaccine shot, the volunteers for the vaccine usually ask about their insurance status. After confirming their eligibility, the volunteers will provide them with a screening form in either English or Spanish and information about the vaccine. The information includes the side effects and the procedure of providing a vaccine. 

According to Pantzer, the COVID-19 vaccination in particular should occur yearly because COVID-19 still poses a direct threat to health. Some people do not get the vaccine and are completely fine. But for community health as a whole, unvaccinated individuals can raise the risk of infection for vaccinated vulnerable populations, including the immunocompromised. However, Pantzer believes that individuals should know about the unlikely yet unpleasant reactions to the vaccine, from fever to pain in the arm. 

“We never say, ‘You have to get it or use scare tactics or anything like that,’” Pantzer said. “We’ll just say, ‘This is what the CDC recommends. It’s to prevent the COVID infection. These are symptoms that can happen if you get COVID, this is why we recommend the vaccine.’ But if they say no, we don’t push too hard after that.”

According to Pantzer, the reason why the clinic, and NHP as a whole, decide to focus on uninsured and underinsured individuals is because they have the hardest time accessing healthcare services, and paying out of pocket could mean more than $100 for each vaccine. This can create a financial burden that makes individuals unable and not interested in receiving care. 

Additionally, being able to speak Spanish breaks the language barrier that leaves many individuals on the periphery of medical care. Having a Spanish-speaking provider allows some individuals to receive vaccine education in their own language and be encouraged to take it since they know more about it. 

“[Non-English-speaking] populations often have less trust in the healthcare system because of the history of not being treated as well within the healthcare system, or not feeling understood, or having difficulty communicating within the healthcare system,” Pantzer said. “If you don’t speak English, it’s probably a lot more difficult to understand different factors of being enrolled in a new healthcare system.”

This semester has been a memorable one for the clinic, as they were able to encourage many people to take the COVID-19 vaccine for the first time. According to Pantzer, through constant interaction and encouragement, many individuals who didn’t know much about the vaccine were open to learning more and receiving one. 

This year, the NHP administered 133 vaccines, averaging around 15 to 20 vaccine provisions every Saturday. In the future, Pantzer hopes that the vaccine clinic will continue to thrive as it will be passed down to the next cohort of directors and volunteers in 2025. Through continued support from Loaves and Fishes, the Connecticut Department of Public Health and Yale Health Pharmacy, the vaccine clinic will continue to provide an even greater impact in the New Haven community.

Loaves and Fishes is located at 57 Olive St.

The post Through vaccine education and provision, NHP’s Vaccine Clinic tackles  health disparities in New Haven appeared first on Yale Daily News.

However, before the 2024 presidential election, Robert F. Kennedy Jr. posted on social media that if up to him, he would advise all U.S. water systems to remove fluoride from public water systems. And now, with President-elect Donald Trump picking Kennedy to be the next secretary of the Department of Health and Human Services, Kennedy’s beliefs highlight the growing debate of whether or not fluoride should be in U.S. water.

Some health professionals and scientists believe that the complete removal of fluoridation in water is an idea based in misguided science that could cause more harm than good. However, others, citing evidence that suggests that fluoridated water does have legitimate harmful outcomes, believe that some changes need to be made.

“The public benefits of fluoride and fluoridation of drinking water are clear and well-established,” Dr. Nicole Deziel, associate professor of epidemiology at the School of Public Health, wrote to the News. “[However] there is some evidence of links between fluoride overexposure and neurological and cognitive effects. While not yet conclusive, this evidence combined with the availability of fluoride in other products, has prompted some reexamination of whether the recommended fluoride concentrations and the maximum limits in drinking water should be lowered to maximize public health benefits.”

The history and benefits of water fluoridation

U.S. water fluoridation was implemented to help prevent tooth cavities and dental caries, an infectious bacterial disease in a tooth’s enamel surface that can lead to the loss of tooth structure. This results in crippling pain and bacterial infection, forcing the loss of tooth function and tooth extraction. During the first half of the 20th century, dental caries were prevalent across the country. 

Fluorosis, or the extreme mineralization of tooth enamel caused by excessive fluoride ingestion, was identified as a prevalent oral condition in America as well. However, the Dental Hygiene Unit at the National Institutes of Health discovered that dental caries among children was lower in areas with more fluoride in community water supplies.

“In 1945, cities like Grand Rapids, Michigan, began to conduct field studies for dental caries prevention by increasing the fluoride levels in water,” Dr. Ashley Malin, an assistant professor of epidemiology at the University of Florida, told the News.

Surveys conducted over 13 to 15 years found that caries were reduced by 50 percent to 70 percent among children in communities with fluoridated water. This study also inspired a recommended range of fluoride concentration in water from 0.7 to 1.2 ppm. Cities across the United States in the second half of the 1900s adopted the public health measure as a way to prevent dental caries, leading to a decline in their prevalence. Additionally, fluoride delivery began to take the form of oral health care products like toothpaste, gels and mouth rinses around this time.

According to the CDC, with the introduction of fluoridated water, tooth decay has decreased by at least 40 percent in children and tooth loss by at least 40 percent in adults. Additionally, school children in communities with fluoridated water have 2.25 fewer decayed teeth compared to children who do not have access to fluoridated water. 

According to Deziel, the enhancement of oral health leads to cardiovascular benefits as well, since poor oral health is linked to heart diseases caused by bacteria spreading through the bloodstream. Additionally, children who undergo tooth decay experience pain, have difficulty concentrating in class and experience social stigma. Fluoridation of water helps prevent these problems. 

“Fluoride reduces the ability of the bacteria, a major cause of cavities to make acid,” Dr. Vasilis Vasiliou, chair of the environmental health sciences department at the School of Public Health, told the News. 

Fluoride also reverses or stops tooth decay by placing minerals back into the teeth. This makes the teeth more resistant to acid and stronger.

According to Vasiliou, fluoridation of water is important because it improves oral health care for all, including those who find it hard to access dental care. Some fluoridated products like toothpaste and dental care are not accessible to everyone, but public water systems can reach everyone in communities with fluoridated water. This allows for the reduction of disparities in dental insurance and access to dental care.

The ineffectiveness and possible risks of water fluoridation

According to Malin, water fluoridation’s implementation led to one to two teeth saved on average. After 1975, however, the dental health benefits of water fluoridation diminished, as now there’s only an average of a quarter of a tooth being saved due to fluoridation. 

“When fluoride was first implemented decades ago, its benefits were profound,” Deziel told the News. “The current benefits are still present, but are more modest, due to the presence of fluoride in toothpaste and other oral hygiene products. However, good dental care is not accessible and affordable to all.”

Additionally, high levels of fluoride can have dangerous outcomes. According to Vasiliou, this can happen from the combination of using dental products and drinking water from a private well that has elevated levels of fluoride. This leads to dental fluorosis, which leads to weaker enamel, brittle teeth and other severe dental issues.

Additionally, studies are coming out that showcase at least some correlation between elevated levels of fluoride in water and slowed neurological development. A study that Malin helped conduct this year also suggested that fluoride exposure could cause harm to the brain development of a fetus during pregnancy. This could be in the form of reduced IQ or brain damage.

“They determined a moderate confidence that fluoride exposure is consistently associated with reduced child IQ at a minimum for those living in regions with water fluoride concentrations of 1.5 milligrams per liter or higher,” Malin told the News.

The CDC recommends 0.7 mg per liter of fluoride in drinking water.

According to Malin, there hasn’t been enough evidence that proves these neurological effects occur below 1.5 mg/L. However, the NTP also didn’t completely rule out the risk of neurological development harms at lower levels due to a lack of information. 

According to Vassiliou, the CDC, the American Dental Association and the American Academy of Pediatrics all support water fluoridation. The CDC has said they haven’t found convincing evidence that has linked community water fluoridation with any potential adverse health effects or disorders, including in neurological development but also immune disorders, bone fractures or allergic reactions.

However, according to Vasiliou, the CDC hasn’t provided a public statement related to the NTP 2024 study of slow neurological development in children.

“There was also a recent ruling in a federal trial where the EPA [U.S. Environmental Protection Agency]  was being sued by a consumer group to end fluoridation because the plaintiffs were concerned that it was negatively impacting child neurodevelopment,” Malin said. “The EPA has been ordered to mitigate that risk and create more of a margin of safety between the level of 1.5 milligrams per liter that’s consistently associated with reduced child IQ and the current recommended level of 0.7 mg/L.”

However, the judge noted that it’s unclear whether or not the recommended level of 0.7 mg/L causes slowed neurological development; he also didn’t specify the exact steps that the EPA needed to take.

Kennedy’s impact

Kennedy believes water fluoridation has various possible dangerous health effects, citing not only neurological development but also arthritis, bone cancer and IQ loss. And although organizations like the American Academy of Pediatrics found no valid evidence to support his claims that fluoride causes possible health harms outside of neurological development, Kennedy believes that there should be no fluoridation in water in America. In an interview with NBC, President-elect Donald Trump said “It sounds okay to me,” referring to Kennedy’s wish to remove fluoride from water.

However, according to Deziel, the decision to fluoridate water is a local one. Elected officials or the public, through open voting, set the policy of water fluoridation. And not everyone needs to fluoridate water. 

“In part, some areas may have relatively high background naturally occurring levels of fluoride in the water already and therefore do not need to supplement it,” Deziel told the News. In other places, voters have decided against fluoridation.

Though Kennedy can’t control local laws, his words have a significant impact. Some cities like Winter Haven, Florida, are already deciding to remove fluoride from water, according to Malin; one commissioner on the panel has based his claims on Kennedy’s statement on the issue. 

Avenues for Resolution

Though Vasiliou says there are possible dangers of fluoride, he believes that the benefits significantly outweigh the harms. Reducing the risk of slowed neurological development by lowering the target amount of fluoride and other actions is up for discussion. However to remove fluoride entirely from drinking water could reignite disparities in oral health across the country. 

According to Malin, the issue of water fluoridation inspires some disagreement between medical professionals and some environmental professionals like herself. She believes that environmental public health is now starting to become more concerned about the systemic adverse health effects of fluoride exposure. But, she doesn’t see water fluoridation as a political issue and believes it shouldn’t be. 

“I don’t think it needs to be politicized,” Malin said. “I think this is more of a human issue, and one that people should really focus on the state of the existing science in forming their opinions about. Hopefully, as science evolves, we all can come and work together to determine what the best course of action for the most people may be.”

Though most of Kennedy’s claims about the negative health effects of fluoride in water are unsubstantiated, Malin believes that this is a legitimate area of focus and discussion that he’s bringing to the table. And this doesn’t have to mean the complete removal of fluoride from water. This could instead translate to more dedicated research on the harms of fluoridated water at the recommended levels so there’s more information and evidence available for policymakers to use. 

According to Deziel, the Connecticut Department of Public Health, or CTDPH, requires public water systems serving 20,000 or more people to add fluoride to drinking water to a fluoride level of 0.55 to 0.85 ppm.

The post How the lack of water fluoridation could impact communities across the US appeared first on Yale Daily News.

A study released last month by the School of Public Health and School of Medicine revealed just how much havoc climate change can wreak on the bodies of young adults. In the study, researchers found that short-term exposure to high temperatures could substantially increase the risk of stroke for adults aged between 18-64, especially for women. 

“We have seen that over the past decades, the stroke instances in younger adults have been increasing in the United States,” Kai Chen, co-director of the Yale Center on Climate Change and Health and co-author of the study, told the News. “So we decided to determine whether temperature could be a risk factor correlated with higher stroke instances among young adults. And it does.”

Context and inspiration

Stroke is a condition where a blood clot in the brain blocks blood supply to the organ. It is usually correlated with being overweight or obese, chronic hypertension hypertension, smoking and diabetes. 

According to Dr. Adam de Havenon, associate professor of neurology at the School of Medicine, stroke risk factors are becoming more prevalent in younger age groups, because fewer young people have access to healthy food or have time to be physically active. Conditions like Type II diabetes, which is caused by a dysregulated metabolic process, are starting to appear in people in their 30s and 40s.

The climate change crisis has led to higher temperatures all over the country where there’s been a 2.5 degrees Fahrenheit increase in temperatures. According to Chen, this has had various devastating results, including the deaths of more than 30 people a year from the extreme heat in Connecticut. And in places like Phoenix and Houston, where temperatures regularly reach triple digits in the summer, effects could even be more devastating.

“Climate change is associated with risks for infectious diseases like tick-borne diseases, Lyme disease, mosquito-borne diseases,” Daniel Carrion, associate professor of epidemiology at the School of Public Health, told the News. “There are also many health outcomes associated with extreme temperatures, including cardiovascular, renal, respiratory diseases, psychiatric outcomes and there’s even some evidence that extreme temperatures can increase the risk of overdose deaths.”

According to Chen, there have been many studies that have found associations between air pollution — an environmental risk factor — and higher incidences of stroke. But it’s only been recently determined that high temperatures are also correlated with an increased presence of stroke. 

“In terms of biological mechanism, the extreme heat could lead to what we call hyper vicious blood,” Chen said. “When we are exposed to high temperatures, we sweat a lot and get dehydrated. This makes your blood and heart work harder to cope with the heat stress. This can then increase the risk of blood clots, which leads to an increase of stroke risks.”

Recent studies have shown that extreme temperatures, including extreme cold, can lead to a higher risk of stroke for adults above the age of 65. However, with the advent of more young people experiencing a stroke, the researchers wanted to focus on the overlooked population of adults aged between 18-64. 

According to Chen, determining this correlation for young adults will allow them to not overlook the danger that high temperatures present to their bodies as well. 

Additionally, young adults are more prone to be outside due to work, entertainment, and other purposes, placing them at a unique risk for the damaging effects of high temperatures, including stroke.

Disparities in the results

According to Chen, the researchers found that there is an increased risk for young adults having a stroke if you are exposed to higher ambient temperature or the outside air temperature. They also found that women had a higher risk of experiencing stroke due to high temperatures than their male counterparts. He reasons, though not confirmed, that this is due to their different physiological conditions, such as pregnancy and hormonal changes. 

Additionally, though not as statistically significant, they found that non-Hispanic Black individuals and neighborhoods of low socioeconomic status are more likely to experience a high stroke risk due to increased temperatures. 

According to Carrion, this can be due to various reasons. One reason is the presence of urban heat islands in cities like New Haven, where people of color experience more heat exposure and higher overall temperatures than other neighborhoods in the area; this is because they have lower access to adaptation strategies like regular air conditioning. 

“Another reason is residential segregation,” Carrion said. “Neighborhoods that are segregated with more black and brown folks tend to have less green space, have more concrete and asphalt and tend to be more urbanized surfaces. This leads to higher systemic exposures to these temperatures.”

Avenues of application

According to Carrion, various interventions are already in place to reduce the impact of extreme temperatures. The National Oceanic and Atmospheric Administration, or NOAA, will put out alerts on phones whenever there are extreme temperatures for a particular day that recommend drinking water and staying indoors. There are cooling centers where people can go if they don’t have access to AC.

Other interventions that Carrion believes could be geared to young people most at risk for exposure to extreme temperatures include the Low Income Home Energy Assistance Program; some states are using the program to support people to help keep themselves cool during the extreme heat of the summer. Another possible avenue is using Medicaid dollars to pay for getting AC in the home; this provides a better incentive to stay at home during times of extreme heat. 

Temperatures throughout the year aren’t usually at an extreme number. However, even relatively moderate exposure to heat has been shown to increase the risk of stroke among young adults. 

“We should not only focus on these extreme heat days,” Chen warned. “So, for example, let’s say we have a heat wave for only three days in the summer. We should not only focus on those three days, because there are many other very hot days and we still have an increased risk. I think we should make it clear to the public so that they know that if there’s no heat warning, that doesn’t mean you will have no risk.”

Chen also makes it clear that there needs to be a societal approach to reducing the risk of stroke. Some people won’t be able to go to cooling centers for cultural reasons or traffic access. The individual responsibility of keeping oneself from the dangers of extreme heat is valid; however, the government needs to take the lead in reducing the environmental risks of stroke in a community that creates disparities in health.

However, according to de Havenon, he doesn’t believe that high, extreme temperatures don’t have that much of an impact on young adults’ stroke risk as compared to other risk factors like hypertension and diabetes. He believes that even small improvements in smoking, physical inactivity and addressing obesity outweigh the benefit of the individual and society addressing the temperature-related risk of stroke. 

“We can all agree that, like, we shouldn’t expose people to dangerous levels of heat, and certainly that is happening in the United States, and this can lead to higher risks for stroke,” de Havenon said. “But I would argue that extreme heat provides a higher risk of cardiovascular mortality more than stroke, in my opinion. So for stroke risk, I would rather focus on getting patients to control their blood pressure.”

According to the National Institutes of Health, 10 to 15 percent of strokes that occurred in the United States during 2021 were among adults aged between 18 and 50.

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