Europe and the United Nations: Clinical Trials, Not Criminal Trials

Conducting clinical trials has never been harder, but it may soon become criminal too, under two dangerously unwise legal initiatives emanating from Europe. Two well-meaning legal texts designed to fight falsified or substandard medicines—one from the Council of Europe (CoE), and another from the UN Office of Drugs and Crime (UNODC) but drafted by the Irish Medicines Board—are so negligently done that they would expose honest researchers and drug manufacturers to prosecution, simply for their involvement in something so basic as a placebo-controlled trial. If clinical trials are not unwittingly to lead to criminal trials, the research community must intervene against these errant legal proposals becoming binding.

Police Killings, Political Impunity, Racism and the People’s Health: Issues for Our Times

“Black lives matter.” “I can’t breathe.” “Racism kills.” These searing statements visibly appear on handwritten placards, on buttons, and on the shirts, hoodies, hats, and even bodies of hundreds of thousands of people who have been participating in protests across the United States, triggered by the recent round of police killings of unarmed black men and, in the case of Michael Brown and Eric Garner, the abject failures of grand juries to call for criminal prosecution for their deaths. Starkly revealing the profound links between racism and the people’s health, these statements also illuminate the flip side of this pain: the fundamental links between social justice and public health.

Capable Guardians

We, HSPH students and faculty, are living in a nation that is not flourishing. To quote Martin Luther King, “We may have come in different ships, but we are now in the same boat.” American democracy is slipping away; eroding in front of us. The most flagrant instance of this impairment is manifest in the lives of African American boys and men. The deaths of Michael Brown and Eric Garner escalate this crisis from one of everyday complacency to collective outrage.

Trends in US Deaths Due to Legal Intervention Among Black and White Men, Age 15-34 Years, by County Income Level: 1960-2010

To inform current national discussions about the deaths of black men due to the police, we present novel data on long-term trends (1960-2010) in deaths due to legal intervention (i.e., deaths due to law enforcement actions) among US black and white men, by county income level. Among the three health studies investigating trends in this outcome, one focused on the total US population for 1962-1993, one documented a marked excess for young adult black as compared to white men for 1979-1997, and the third reported on systematic underreporting of such deaths, overall and by race/ethnicity and age, for 1976-1998; none included socioeconomic data.

HPHR Editorial: Racism Is a Public Health Problem

The killings of Rumain Brisbon, Tamir Rice, Akai Gurley, Dante Parker, Michael Brown, Eric Garner, and many other Black Americans, have brought global attention to racial inequities involving police brutality in the United States. The subsequent non-indictments resulting from the grand juries in Ferguson and Staten Island as well as the bombing outside a NAACP chapter in Colorado have left many Americans outraged. The Editorial Board of the Harvard Public Health Review recognizes that racism has driven health inequities among historically underserved and marginalized populations nationwide, evidenced not only in the extraordinarily disparate rate at which Blacks are killed at the hands of the police compared to Whites, but also through inequities in environmental exposures, limitations in access to health care, and other factors that affect optimal health and well-being. Indeed, Eric Garner died after a police officer violently compressed his neck and chest. This officer’s actions severely limited his ability to breathe, which already had been compromised by asthma, obesity, and hypertensive cardiovascular disease—diseases that occur at substantially higher rates among Blacks than Whites. As the Institute of Medicine (IOM) has noted, the role of racism in undermining Black health is undeniable.

The Key to Changing Individual Health Behaviors: Change the Environments That Give Rise to Them

Over the past four decades, the United States has faced steadily rising rates of obesity and associated chronic conditions. Many of these chronic conditions are rooted in nutrition and physical activity behaviors, and are often referred to as lifestyle diseases. Historically, the prevention of lifestyle diseases has focused on changes in individual behavior and personal choices, and personal responsibilities. However, a growing body of research has demonstrated the strong influence of physical and social surroundings on individuals’ actions.

How America’s Flawed Supplement Law Creates the Mirage of Weight Loss Cures

Dr. Mehmet Oz, “America’s Doctor,” recently testified before Congress on why he was promoting supplements containing Garcinia cambogia, raspberry ketones, green coffee extract and other unproven ingredients as weight loss miracles. He acknowledged that “sometimes they don’t have the scientific muster to pass as fact.” In fact, there is no legal over-the-counter botanical supplement that has demonstrated clinical efficacy as a diet pill. [The only herbal treatment that can lead to modest weight loss is ephedra combined with caffeine, but this cocktail can also cause strokes, heart attacks and sudden death; hence, ephedra was banned in 2004.]

ObamaCare’s 2014 Report Card? Preaching Patience — to Supporters and Opponents

The first open enrollment period under the Affordable Care Act has come and gone. One might be tempted to ask, “How has the law done so far?” — if only that question hadn’t already been asked ad nauseum since the first week of open enrollment in October 2013. As a researcher whose primary interests are insurance coverage and access to care (and as an advisor in the U.S. Department of Health and Human Services), I have frequently been asked this question – by students, by friends and family, and by reporters. Consider this my response.

Addressing Social Inequities to Create a More Just, Fair and Equitable World

The Harvard Public Health Review (HPHR) recently sat down with Dr. Nancy Krieger, Professor of Social Epidemiology in the Department of Social and Behavioral Sciences, and Director of the Interdisciplinary Concentration on Women, Gender and Health, at HPSH. Drawing on her extensive body of research, she outlined how populations ultimately embody their social and ecologic experiences, which, under inequitable conditions—like those related to poverty to global climate change—can result in unfair and unjust distributions of disease and suffering. Far from deeming these distributions a given, Krieger argues that academics, public health professionals, policymakers, and informed constituencies have a right and an obligation to mobilize evidence in their efforts to address heath inequities head on and create a better world for all.

Was Mayor Bloomberg a Nanny?

New York Mayor Michael Bloomberg long sought to address a wide range of public health problems, including those associated with obesity and smoking. A number of his initiatives seem to have been behaviorally informed. Like many experts, he believes that soda is a contributing factor to increasing obesity rates and that large portion sizes are making the problem worse. In 2012, he proposed to ban the sale of sweetened drinks in containers larger than sixteen ounces at restaurants, delis, theaters, stadiums, and food courts. The New York City Board of Health approved the ban, though it was later struck down in court.