tramp zone

seen

2008-08-24T04:43:00.000-07:00

yellow finches on Hospital Hill
dumpster with complaining, then apologetic graffiti by the new bike path at Veteran's Field (will have to return with camera)
Forbes Library sprinklers eagerly watering down the iron fences
clumsily lettered 'blueberry thief' warnings on Grove Street. Also, 'housemate room fully furnished, widower'.
Mill River down to a sensible flow after some drier weather
'james drules' mirror-lettered in the dust on the Smith physical plant garage windows

work, then work, then work

2008-07-31T15:48:00.001-07:00

I've begun volunteering here. As you can see the site is horrifically out of date due to some major staffing changes. Projects I'm undertaking:

website

Make a mission statement for the Northampton Board of Health. Explain how the BoH delivers the ten core public health services. (Do they? I'm not sure. It seems like the emphasis has been primarily on enforcement. Restaurant inspections, etc.) I've been looking at other local health department websites for inspiration:

- San Francisco

Way too slick! I'm limited to a plain text entry field for each component of the page. Although buried, this is a short and simple mission statement.

- Amherst, MA

A manageable amount of information. Too much text to read, though... they have the same weird Board of Health / Health Department parallel that Northampton does. It's so confusing. I sat in on the most recent Board meeting here in Northampton and it was both fascinating and obtuse. Of course they were debating the new hookah bar...

- Springfield, MA

They also have a "Department of Health and Human Services" and a separate "Public Health Council". I wonder if this structure is throughout Mass, or New England, or the country... It also seems that their DPH doesn't have responsibility for housing or building inspections, something that seems to be a very big part of Noho's DPH responsibilities.

Health literacy is another objective - can the info on the website be accessible to someone who's not a health professional? Someone who doesn't have a college degree? Someone whose first language isn't English?

I'm excited to see that there is a logo for LPHDs, although it will probably make very little difference in the overall project. Along with the "This is Public Health" campaign maybe one day my family will understand what it is I want to study...

standards

Take part in the National Health Performance Standards Program (CDC). This looks like a huge project and one that might be targeted towards much larger departments than Northampton's. Still, the CDC has provided a helpful checklist which includes getting flip charts and refreshments for the meetings.

Take part in the Profile of Local Health Departments Survey (NAACHO). An exciting find from NACCHO: With an automated Disaster Designer Wizard, creating your next tabletop exercise will be fast, fun and FREE!

regionalization

Connecticut, Georgia, and Utah have already begun offering incentives for local health departments to regionalize. Small towns don't always have the resources to meet the ten core components of public health. Economies of scale and shared resources can make this possible. That's according to the Massachusetts Public Health Regionalization Project (BU), and again, NAACHO. Western Massachusetts stands to gain a lot from regionalization incentives. Noho might be part of a pilot program...

unnatural causes

'Is inequality making us sick?' Well, yeah, but here's a great documentary explaining exactly what this looks like and how communities are addressing health disparities. I've only seen part of the series which aired back in March, but the transcripts are available online and Noho's DPH is hoping to do a screening soon using some of the ideas in the Action Toolkit. One provoking comment from the first episode:

ICHIRO KAWACHI (Epidemiologist, Harvard School of Public Health): Health care can deal with the diseases and illnesses. But a lack of health care is not the cause of illness and disease. It is like saying that since aspirin causes a fever that the lack of aspirin must be the cause of the fever.

Yeah, I've been busy as hell. There's only one way I'm going to get from here to there, though... and it's not by playing Kongai...

butts

2008-06-29T03:45:00.000-07:00

Five weeks ago, I came down with a brief cold. I retreated to my bed; after Robitussin, a Law & Order marathon, and lots of rest, I was fine. But I hadn't had a cigarette in days.

Since then, I've smoked about 40 cigarettes. About 30 of those where while drinking, in the company of other smokers. I'm so! close! to quitting for real. The quit hurdles come in threes, we arbitrarily believe without much evidence. That's fine; 3 hours, 3 days, 3 weeks, and 3 months from now, I don't think I'll care. Where did that notion arise, anyway? I haven't been able to figure out. Maybe some brochure in some clinic somewhere, and it just spread....

In Dundee, a region in Scotland where half of smokers are impoverished, the NHS recently announced they will offer quit incentives[PDF] - about $25 a week which is provided in a pre-paid card. Participants must pass a test which looks for evidence of smoking. The card cannot be used for alcohol or tobacco. (The NHS must know, a strong drink makes me both crave a butt and become susceptible to that craving.) The smokers also receive counseling and nicotine patches. The program is based on "Give It Up for Baby", a similar system targeting pregnant smokers. via BBC

Would you give up smoking if you got paid? Is $25 a week enough to get you thinking about it? If you don't smoke, but could really use $25, do you think this is a little unfair?

I think the notion of being drug tested for smoking is interesting, a little odd to contemplate - it puts cigarette addiction in the same realm as 'harder' drugs like opiates. And I wonder, would smoking tests end up in CVS, next to the pot and opiate tests? Don't bother with the breath mints and Febreze, Mom is going to test me when I get home anyway.

(This tests for the 5 most commonly abused prescription drugs as well as Ecstacy. It's About Prevention.)

A Philadelphia study of the effects of incentives on quitting seemed to show that incentives work, but only for the short-term... relapse rates were about the same whether the participants received money or not. Maybe the problem with paying folks to quit is that once they quit, the reinforcement disappears. I know that once I recovered from my cold and was well enough, I wanted to go right back to smoking, even though I had passed the 3 hours, 3 days mark.

I'll remind myself about the evils of Big Tobacco, though, and find my own incentives there... until I have a cocktail, at least.

thoughts on abuse

2008-06-14T06:52:00.000-07:00

I've been meaning to write about these for a while now...

First, the Massachusetts Dept of Public Health has issued an advisory following a significant spike in deaths due to domestic abuse. I didn't realize that the DPH would issue advisories on a 'social' epidemic - after all, you can't catch domestic violence from an infected tomato or tainted bag of spinach. The numbers are definitely startling - so far this year, there have been 24 deaths in the state attributed to domestic violence. That's much higher than the 15 recorded in all of 2005. Our governor speculates that the rise might be due to the economic pressures affecting so many families. Some questions I had...
- 5 "domestic violence-related suicides" were included in the 2008 figures. What are the criteria for determining the relationship between a suicide and DV?
- What are the nation-wide figures - have other states' DPH released similar advisories?
- Was there anything notable about MA's decision to identify this trend as a public health problem, and more than just 24 isolated, tragic incidents? I'm in full agreement that DV is a form of structural and systemic violence. Is this recognition by public health officials anything new or noteworthy?
- What are some other reasons for the increase? Some hypothetical suggestions...
- a decrease in funding for domestic violence hotlines and shelters
- increased overall population (what are the rates of DV deaths per 1000 MA residents? How does that rate compare with previous years)?
- a demographic shift towards groups more likely to suffer from DV. This one makes me nervous but I have to bring it up. I know that DV affects folks from all walks of life, all ethnicities, all backgrounds. Are certain groups less likely to report DV, or seek help? Are police in certain communities less likely to pursue DV reports? Are shelters in certain communities too stretched to service all clients? I hate to fall on stereotypes, but I think these questions have to be asked before they can be discarded. I remember when working at a local shelter for DV that so many women and families had to be turned away due to lack of space, or shuttled to other agencies.
- improved reporting / recording methods? For example, were DV-related suicides counted in previous years figures?

Second...
A media and advertising group in Singapore has released these simple ads, intended to illustrate the real damage of verbal abuse. I can't find much about this campaign from the actual company, only on various blogs which have noted the ads' disturbing quality. I'd like to know what organization hired Saatchi to create these, and what context they'd be used - on the side of a bus? As a series of print ads in a major newspaper? Would there be a call to action - for abusers or victims? It's hard to evaluate these ads without knowing more. Could you imagine seeing these ads here in the US? Maybe I'm just cynical, but I think too many folks would want to censor a similar campaign for being too explicit in their violence.

And third...
I still don't know what to say about this ad depicting the horror of sexual abuse. It's incredibly creepy and disturbing. I literally had to shower after watching it. But damn, does it stick with you.

Well... that's all been pretty depressing. In other news, Cuba, on the socialized-health-care radar after Sicko, is now including sex-change operations as part of the free services included in the state-sponsored health care system. Homos and commies! In cahoots - I knew it! Just kidding. Interesting to learn that Fidel Castro's niece, Mariela, is spearheading the movement for GLBT rights in Cuba.

And if that's not enough, this guy should cheer you up (via Getty).

'fertility is not a disease'

2008-05-24T07:10:00.000-07:00

The Office of Population Affairs is the government entity we've entrusted to enforce Title X. Susan Orr, appointed to head the OPA last year by Bush, just resigned. I hadn't heard of her before this but she is practically a caricature of the right's approach to public health:

'Orr applauded a Bush proposal to stop requiring all health insurance plans for federal employees to cover a broad range of birth control. "We're quite pleased, because fertility is not a disease," said Orr, then an official with the Family Research Council.' (WP)

As bootstrap analysis points out, this is so flawed - "neither is pregnancy, but we manage to cover that with insurance". And of course, I'd rather turn to the World Health Organization than to the lobbyists at the Family Research Council for a definition of health:

'Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.' (WHO)

Orr's professional degrees are from the university founded by Pat Robertson. It's no surprise that she's involved in abstinence-only sex ed. But this was the clincher, for me, which makes me both laugh at this absurdity and shudder at the power given to this woman: "Real Women Stay Married".

Ask Health and Human Services Secretary Mike Leavitt (Orr's former boss) to preserve access to birth control options for low-income Americans - hopefully Orr's short term in power will not have any lasting effect on Title X.

WILI 98.3

2008-05-17T22:54:00.000-07:00

it goes back to mariah carey, "dreamlover". whitney houston, "i will always love you". aerosmith, with alicia silverstone. apparently this one radio station, this one summer, they got bought out, damn there is never going to be anyone else who was quite as impressionable in quite that town at quite that time.

Tyranny of the Body

2008-05-17T21:26:00.000-07:00

It starts like any Taco Bell ad. Three girls on barstools, giggling, gossiping. The girls start to get intimate. Bikini wax? Me either. I would never! Really, I'm not a shaver. The word 'bush' is tossed out there.

And this one friend, actually had to do that. Waxer. Yeah, one time this like, seriously eight month pregnant woman came in and she was like - really - really? You're about to give birth and you want to get your butt crack waxed?

Well, maybe she was in pregnant porn.

You guys know, right, like there's every kind of porn out there, and since someone's into really pregnant girls, she's in porn. And, you know, the whole - like - porn look. The clean shaven thing, that's really all because of that porn look. So, even if she's in pregnant porn, she has to get waxed. Right?

Yeah, on her resume she's got a good three, four months, "pregnant - employed in porn". All explaining awkwardly the gap in employment.

And afterwards, she still has to go back to work, after being a pregnant porn star.

No actually! She could be in lactation porn while she's breastfeeding.

Lactation, like how there's already a porn for everything normal. Whatever floats your boat.

I don't know, really - you really want to know? OK. Regular heterosexual porn is, you know, all about the guy - and all about the money shot. Right? OK. So, lactation porn is really just the same.

Well in general it's really hard to capture female pleasure, like how women squirting porn is sort of a thing. Because it's a way to see, visually, a woman's pleasure, whatever, ejaculating. And that's what lactation porn is all about. Well, not really a woman's pleasure - but the body, the body doing something visual. It's like the money shot, except.

And porn is about sex, and sex is about babies, and babies nurse. And everywhere there are these bodies, hairy packages of all kinds of goop and milk. And even though sometimes bodies are gross, and hurt, and make it so easy to be hurt - all kinds of surprising unfamiliar pleasurable things happen in bodies, too.

mass meatia

2008-05-06T18:20:00.000-07:00

Ok, ok, ok. I'm pretty excited.

I'm savoring the last night of a 5-day vacation from my 9-5. A couple years without any real holiday made it that much sweeter, although it took me at least 48 hours to actually start to relax and release. Unfamiliar places and people are threatening to me, sheltered here in familiarity.

Before this vacation, I had been making a lot of noise about Science. Hot off my GREs and with my chart of debt noticeably improving, grad school is becoming a tangible reality. Maybe I'm lazy or too sheltered these days, but I really can't see quitting my job to work as a PCA or volunteering overnights at a local shelter. These examples seem conveniently extreme, so I can 'sensibly' rule them out - and I'm left with my BA from a mediocre state U and the best years of my life that I've wasted at the aforementioned 9-5. How will I ever become a public health educator? Or a community activist? Yeesh. I better start thinking about Science. Maybe biostatistics really is more up my alley, or epidemiology. It might pay better. It's less messy. And taking the GREs reminded me how number crunching might fit me better than granola crunching.

And in Boston, too, technology and Science and my little-kid wide-eyed self amazed at everything around me. So I've totally got myself convinced that I should leave the 'softer' side of public health to the real brave folks, the fighters, the ones who can speak Spanish and who have actually spent some time Educating. Maybe I really belong in a lab, maybe I'm one of the many who realized that social science BA is really not going to take me anywhere unless I've got the street-wise experience to back it up. I mean, really? I'm terrified of taking the T and I think I'm going to handle some kind of global health initiative?

Then, the last day of vacation, I come home. I catch up on some blogs. And I read about the Zombie Squad. To be fair, I found them through this blog, which does a great job of explaining how their methods are more than just a geeky meme and a relatively new form of public health education. (By framing the message in a scary or funny analogy which is familiar to the target audience, this group can effectively get the consumer to buy the product where product = disaster preparedness, blood donations, etc. Just like those really freaky PSA with the hairy arm. I'll explain it some other time.)

And I'm off - to DC, to reading all I can about social marketing (not to be confused with viral marketing, hurr).

And damn it, I can finally start to see the narrative. The 9-5 falls into place - hey, I know more than I ever thought I would about online marketing, web design, project management. So does that damn cultural anthropology degree - yeah, I get that you have to find the myths and stories that resonate with your audience (zombies, duh, I know). What about my idea for a MySpace PSA that envisions your "top 8" - how many of them statistically have been abused? Raped? How many of them will die in accidents? In easily preventable diseases? How does that ad change given the super-detailed data that advertisers want to collect to target ads to individuals - if I perform lots of searches on Google for water bottles, I'll get recommendations of water bottle retailers in my Gmail and Google Reader. What happens when I search for UTI? Pee after sex? Cigarettes and the pill? Oh my gosh. I gotta go. I promise promise promise to flesh this out soon.

greens

2008-02-29T16:21:00.001-08:00

Every now and then it feels so easy to eat green things. Of course, it's easiest when greasy pale things aren't around.

Me and a thousand other bloggers have read "The Advantages of Closing a Few Doors". The article probably speaks to the digitally inclined most of all, those of us with a million feeds, literally chowing away at the trough of the intertubes. It's gross like pate when I think about it that way, my brain fat with Britney photos and Bizrate surveys and shocking discoveries and slander.

It's easier to buy the spinach instead of the Ore-Ida's - when it's dinner time the choice is clear. The challenge is how to censor myself deliberately, so when I sit down at this machine I don't binge and come away glazed and tired. A nutritional pyramid for my brain, I guess. 5 servings of Mother Jones for 1 serving of TMZ, I guess.

And I guess I need to be a little more forceful with myself, if I'm ever going to learn how to write again.

By the way, that forceful link took me to The Cat and Mouse Act which banned force feeding suffragettes in the UK - essentially allowing women to enter a cycle of hunger strikes, force feeding, release, and reincarceration; women weren't allowed to die for the cause. Now where on the food pyramid is that? I guess it depends on how I cook it up. This little tidbit.

Google Gift

2008-02-10T14:55:00.000-08:00

I'm a QGAP. So far, this has only given an extra layer of legitimacy to my web design firm, and as I was one of the first 500 to get certified, I got a Google baseball cap and Google ballpoint pen. This was back in 2004 or so. The cap was too large and I only use rollerballs, which I expected the folks at G to know somehow. I was excited by the certification (it's not often I get to get paid to take multiple-choice quizzes) and nonplussed by the swag.

I buried the cap with the rest of my ill-fitting, mismatched, or itchy accessories. I lost the pen immediately.

Then, 6-8 weeks ago, the Google Customer Insights Team emailed me a survey link. Sweet. Surveys are almost as good as quizzes - less satisfying, of course, cause there's no reward for giving the right answer (24-30, female, college degree, use the internet multiple times a day, have an account at Metafilter, have made an online purchase in the past 30 days).

So I participate in AdWords Advertiser Feedback 2007. Yes, I would recommend AdWords; No, I don't plan on increasing my budget at this time; I think I wrote a suggestion that an AdWord Rep be available for smaller accounts, too.

Score! My old Nalgene was stubbornly speckled with mold, so the Camelbak was exactly what I needed. G must have finally noticed my search history:

- remove mold nalgene

- vinegar smell nalgene

- nalgene bottle cleaner

- bleach safe nalgene

etc.

The past week has been full of watery freshness. The only qualm I have is with Camelbak's other products, like...

Magnum Force gloves - "reinforced with Kevlar for knuckle protection"

Demon concealment pack - "designed to carry a handgun, an extra single or double stack magazine, tactical light or folding knife in its secure, but easy-access concealment compartment. High-quality, civilian design and color choices help operators blend into the crowd"

I can't help my flight reaction when I come across objects like these that are created with violent ends in mind. Still, if I had to choose, I would take the Demon in Cranberry; it would match my Better Bottle in Red just so.

sssh. the little hater's taking a nap. lemme get this in while I can.

2008-02-10T14:44:00.000-08:00

Eventually, I figured out that messing with the font, or the color palette, or even the domain forwarding means I'm avoiding the Tramp Zone.

Where's that?

You're standing on it.

Then when?

It's now, and tomorrow, and the day after.

This inaugural address is dedicated to my little hater and Browner.