Sun Safety

It’s May and we all know what that means: neighborhood pools will be opening soon, and many people will be heading outdoors or to the beach for Memorial Day weekend. That means it’s time for a quick refresher on how to stay safe in the summer sun.

Learning from past mistakes

I recently participated in a Mindful Triathlon (it was awesome – look for one in your area here). It was an outdoor event at a local park from early morning to mid-afternoon. Before I left the house, I applied sunscreen to my face, but since it was still a little chilly, I dressed in layers with most of my body covered and protected from the sun. I knew that I might shed layers as the day warmed up though, so I threw the bottle of sunscreen in my backpack. Around mid-morning when we moved into the yoga portion of the event, I removed my outer layer, but I failed to apply any sunscreen on my chest, back and other exposed areas. I thought about it briefly, but I rationalized that it was still early, and the sun’s rays weren’t that intense.

Wrong. The reddish hint of a minor sunburn later that day reminded me just how powerful the sun is…and why it’s so important to protect our skin. I have had my fair share of sunburns. One of the worst was just after I graduated college and spent the day at a beach volleyball tournament under a blazing hot sun. I applied sunscreen that morning but failed to reapply throughout the day. The result was a nasty sunburn that to this day, I believe has increased my sensitivity to being in the sun. I have also had a few “atypical moles” removed, which had the potential to turn into skin cancer. I know several people who have died from melanoma, so I am recommitting myself to follow these basic recommendations to help protect myself and my family.

Keys to protection

According to the CDC, the sun’s ultraviolet (UV) rays can damage your skin in as little as 15 minutes. One of the best things you can do is avoid being in the sun altogether, but none of us want to hide inside all summer. Instead, follow these recommendations to limit your exposure and reduce your risk when you do spend time in the sun.

  • Seek shade, especially late morning through mid-afternoon. This includes 10 am to 4 pm, during peak spring and summer days. Umbrellas, trees, or other shelters can provide relief from the sun.

 

  • Wear a hat, sunglasses and other clothes to protect skin. Protective clothing can reduce your burn risk by 27%. Sunglasses are essential to protect your eyes from UV radiation. They are also important to wear around surfaces that reflect the sun’s rays, like snow, sand, water, and concrete.

 

  • Use broad spectrum sunscreen with an SPF of 15 or higher to protect any exposed skin. Apply a thick layer at least 15 minutes before going outside, and reapply every two hours and after swimming, sweating, and/or toweling off. For help in choosing safe and effective sunscreens, check out the Environmental Working Group’s Guide to Sunscreens. A quick note about high SPF labels: anything higher than SPF 50 can tempt you to stay in the sun too long. Even if you don’t burn, your skin may be damaged. It is best to stick to an SPF between 15 and 50.

 

  • Remember that sunburns and skin damage can occur even on cloudy or overcast days. Thus, the above recommendations are still relevant even if the sun is not completely visible in the sky.

 

Skin cancer screening

Finally, as hard as we may try to protect ourselves from skin damage, we are human and likely to forget the protective clothing and/or sunscreen now and then. Therefore, being evaluated by a dermatologist once a year and checking your skin regularly are two excellent steps you can take to catch melanoma and other types of skin cancer early. The sooner skin cancer is found, the better the chances are of curing it.

It’s important to be familiar with your skin and report any changes to your dermatologist right away. Get into the habit of checking your skin once a month. Look for new moles appearing that haven’t been there before. You can also use the simple ABC guidelines to monitor for changes that may be of concern:

A is for asymmetry: one half of a mole looks different from the other half.

B is for border: the borders of a mole are uneven, jagged or scalloped.

C is for color: the color of a mole is different from one area to another.

It’s also important to note a mole’s size. If you have a mole larger than about a quarter of an inch across (about the size of a pencil eraser), have it checked. If there is a change in the size, shape, color or height of a mole, or if you develop symptoms such as bleeding, itching or tenderness, that should be evaluated, as well.

Being proactive and following the recommendations to reduce your exposure to the sun will still allow you to enjoy the great outdoors this summer and throughout the year. Be safe, be smart and have fun!

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Keeping Your Eye on the Prize

For most of my adult life, walking has been my “go to” exercise – whether it be walking with family and friends outside or taking advantage of my treadmill and/or various walk at home DVDs when the weather isn’t conducive to exercising outdoors. Like many walking enthusiasts, I jumped on the pedometer bandwagon in the early 2000s. After all, I needed to know if I was achieving the recommended 10,000 steps a day to help maintain good health. As an added incentive, the company I worked for offered a walking challenge as part of the employee wellness program and I could earn prizes based on my steps.

I recall becoming frustrated with the pedometer over time. I had the simple kind that just hooked on to your pants, but this posed a problem if I wore a dress or some other outfit without a place to attach the pedometer. Even if I wore pants, the pedometer often slipped off. And there was always the question of what to do with it when needing to use the rest room so as not to lose said pedometer down the toilet. Eventually, I gave up and stopped wearing one altogether.

Wearable fitness trackers: friend or foe?

Fast forward about a decade to the introduction of wearable fitness trackers. I recall a friend owning one of the earliest products, which was technically still a clip-on device, but it did more than just measure steps. These new products could also track and monitor calories burned, sleep activity, and floors climbed. I’ve never really been an early adopter when it comes to technology, so I took a wait and see approach. As the technology and design improved, I finally jumped in a few years ago and purchased one of the more popular band-style fitness trackers. (Note: I am not going to name which brand I use as I am not endorsing or criticizing any particular device or company.)

At first, I was enamored by the wealth of data this device could supply. The accompanying app was user-friendly and the dashboard was customizable, so I could set it up to include as much or as little information as I wanted. My primary interest was in steps taken, minutes of exercise, calories burned and sleep. I have to admit it was fun at first, monitoring my progress and hoping to see green icons at the end of the day, meaning I had met my goals. I invited friends to participate in step challenges, so that we could hold each other accountable with a little friendly competition.

Wearing the device has definitely made me more aware of my level of activity and it has helped me achieve some health goals. But recently, I have started to question whether the fitness tracker is as beneficial as I first believed it to be. For example, I aim to get 10,000 steps per day. On average, my normal daily activity typically adds up to about 5,000 steps and then with at least 30 minutes of exercise, I can usually make it to my goal. However, I sometimes find myself “gaming the system,” if you will. I use the feature that reminds me to get up and move each hour if I have been inactive…except more and more lately, I find myself ignoring the notification and staying put in my seat. Then, later in the day when I realize I am behind on steps, I may find myself pacing the halls to get to 10,000 steps before bed. This is not helping me sit less during the day, and it often drives my husband crazy when I pace the bedroom trying to get in those last 500 steps or so.

The other feature that I have started to second guess is the sleep tracker. At first, I was excited to have this information at hand to get a better sense of the quality and quantity of my sleep. I typically aim to get about seven and a half hours of sleep per night during the week and maybe a little more on weekends. I have never really had a problem with sleep. I usually fall asleep quickly and often wake up before my alarm even goes off. I am an early riser as I meditate and exercise in the morning before going to work. Because of my schedule, it’s important for me to get to bed at a decent hour. So, I aim to have lights out no later than 10pm and wake up around 5:15am, giving me between seven and seven and a half hours of sleep.

When I started looking at the sleep data, I was surprised to find that I was often getting less than that according to the tracker. Most days I was lucky to be getting six to six and half hours per night, and sometimes it was even less. In looking at the breakdown of sleep stages, it indicated that I was often awake for an hour or more overnight. I realized over time that seeing these numbers was actually stressing me out about not getting enough sleep…when in reality, nothing had changed about my sleep patterns. For the most part, I was not waking up for significant amounts of time during the night and I usually felt refreshed and alert when I woke up. It took me a while to come to the conclusion that having this sleep data was doing more harm than good, so I recently made the decision to stop wearing the device at night (it was never really comfortable to me anyway) and I removed the sleep data from my dashboard. It is the best decision I have made in a while.

A ha moment

I have been having mixed feelings about my fitness tracker for some time now, but the “a ha” moment happened last weekend when I was in the middle of Nia class. I glanced at the tracker to see how many steps I had and found myself disappointed that it was less than I expected. Then it hit me – I had totally lost sight of my true goal. The bottom line is I exercise to maintain good health so I can enjoy life. The most important thing is that I am active and that I enjoy the activities I engage in. Whether or not I get 10,000 steps a day is really irrelevant. I had taken my eyes off the prize: being active because it feels good and is good for me.

So, does this mean I am tossing out my fitness tracker? No, at least not yet. I do believe there are benefits to wearing it and monitoring the data, but I won’t allow the data to stress me out or dictate how I spend my time. I am also going to take breaks from it now and then so I don’t feel so tethered to this little device on my wrist. Unfortunately, it seems that fitness trackers have become one more piece of technology that we can become addicted to, so it’s good to unplug from them every now and then. Take it off, then go walk, run, swim or play…just for the fun of it.

Allergy Season: The Dreaded Yellow Haze

Itchy, watery eyes. Sneezing. Nasal congestion. Yep, it’s that time of the year again: spring allergy season. I stepped outside yesterday to grab the morning newspaper and our cars were coated with a yellow sheen. Pollen – ugh.

Those of you based in the mid-Atlantic or southeastern part of the United States know what we are in for – several weeks of this yellow haze, making it difficult to be outdoors just as we are yearning to bust outside after a long, drawn out winter. We were finally getting over a rather nasty flu season and now we have to deal with this? Doesn’t seem fair.

Prevention: Limiting exposure to allergens

Fret not as there are some things you can do to lessen the blow of seasonal allergies. After all, no one wants to be stuck inside as spring finally awakens, beckoning us to come play outside and bask in the sunshine and warm breeze. The Asthma and Allergy Foundation of America recommends the following actions to help reduce allergic reactions to pollen:

  • Limit your outdoor activities when pollen counts are high. This will reduce your exposure to pollen and other allergens and reduce your symptoms. Your local newspaper and/or TV news station website usually have the daily pollen counts or you can visit the Weather Channel and use their Allergy Tracker.

 

  • Keep windows closed during pollen season and use central air conditioning with a HEPA filter attachment. This applies to your home as well as your vehicle. Removing as much of the allergen as possible is key to preventing or reducing your symptoms.

 

  • Start taking allergy medicine before pollen season begins. Most allergy medicines work best when taken this way. This helps prevent your body from releasing histamine and other chemicals that cause your symptoms. Consider it a preemptive strike and one of your best defenses against the offending allergens.

 

  • Bathe and shampoo your hair daily before going to bed. This will remove pollen from your hair and skin and keep it off your bedding. If you typically shower in the morning or prefer not to wash your hair every day, then consider at least brushing or combing your hair before bed (away from your bedroom) to reduce the pollen that does make it onto your bedding. You may also want to shake out clothes worn during outdoor activities if you don’t want to run a load of laundry every day.

 

  • Wash bedding in hot, soapy water once a week. This will help remove any pollen that does make it onto your sheets. And whether washing your sheets or your normal laundry for the week, be sure to dry items in a dryer, not on an outdoor line. The goal is to eliminate exposure to pollen, especially during peak blooming season.

 

  • Wear sunglasses and a hat. This will help keep pollen out of your eyes and off your hair. This can help you avoid having to wash your hair every day. Just be sure to brush off your hat outside to avoid bringing pollen indoors.

 

  • If you have pets that spend a lot of time outdoors, be sure to brush them or even give them a quick rinse to help remove pollen and other allergens before they come inside for the night.

 

Treatment: When prevention isn’t enough

Preparation and prevention are the best approaches to surviving allergy season, but if you do find yourself suffering, there are several over-the-counter and prescription medicines that may help reduce your symptoms. Note: Please be sure to read all medication packaging and/or consult with your health care provider before taking any new medications, either prescription or over the counter.

Antihistamines come in pill, liquid or nasal spray form. They can relieve sneezing and itching in the nose and eyes. They also reduce a runny nose and, to a lesser extent, nasal stuffiness. They include over the counter options such as Claritin, Allegra and Zyrtec as well as prescription options such as Xyzal and Clarinex.

Decongestants are available as pills, liquids, nasal sprays or drops. They help shrink the lining of the nasal passages and relieve nasal stuffiness. Decongestant nose drops and sprays should only be used on a short-term basis though as they can have a rebound effect and cause more congestion. Some common over the counter decongestants include Afrin (nasal spray) and Sudafed (pill).

Nasal corticosteroids are a type of nasal spray. They reduce inflammation in the nose and block allergic reactions. They are the most effective medicine type for allergic rhinitis because they can reduce all symptoms, including nasal congestion, and have few side effects. There are several options available over the counter including Flonase, Nasacort, and Nasonex.

Leukotriene receptor antagonists block the action of important chemical messengers (other than histamine) that are involved in allergic reactions. The most common option is Singulair, but it does require a prescription.

Some people with pollen allergy do not get complete relief from medications. They may be candidates for immunotherapy, or long-term treatment that can help prevent or reduce the severity of allergic reactions. The most common treatment is allergy shots; however, there are newer therapies including tablets that are placed under the tongue for 1 to 2 minutes and then swallowed.

For those who prefer a more natural approach to dealing with sinus symptoms, consider a nasal irrigation system such as a Neti pot. The basic explanation of how the Neti pot works is that it thins mucus and helps flush it out of the nasal passages. It involves the use of a saline mixture that you pour into one nostril, that flows through your nasal cavity and out the other nostril. In studies, people suffering from daily sinus symptoms found relief from using the Neti pot or other nasal irrigation system daily. Neti pots are available over-the-counter at many drug stores, health food stores, and online retailers.

If you are not sure what the best treatment approach is for your allergy symptoms, make an appointment to discuss it with your health care provider. Although seasonal allergies may be a part of life, they don’t have to stop you from enjoying the beauty of spring and its outdoor pleasures.

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Tobacco Cessation

I saw a statistic the other day that made me do a double take. There was an article in the local paper that referenced health research related to tobacco use and it stated that worldwide, tobacco use causes nearly 6 million deaths per year. Wow. That was a shock for me. I think with all the progress we’ve made here in the US in the last decade around creating smoke-free environments in schools, hospitals, restaurants, and so forth, I was under the false impression that tobacco use had declined greatly and just wasn’t a big problem anymore. Clearly, I was wrong.

The public health profession has made great strides in battling “Big Tobacco” at both the policy and individual levels. Overall, there has been a downward trend in cigarette use among students and adults. Data from 2015 indicate that many adults want to quit smoking and/or tried to quit in the past year.  That is great news. On the other hand, we are seeing an increase in the use of e-cigarettes, particularly among young adults, who may believe that they are a safer alternative to traditional cigarettes or smokeless tobacco products. E-cigarettes do not contain tobacco, but according to the CDC, they are not considered a safe alternative to tobacco use.

If you use any form of tobacco products or e-cigarettes, the best thing you can do for your health is quit. If quitting completely seems like too daunting a challenge for you, then consider reducing your use gradually until you are ready to quit. The nicotine available in these products is what causes the addiction and the craving to smoke or use other forms of tobacco. The good news is that there are many tools, resources and medications available today that help make quitting easier than ever. You don’t have to do it alone. In fact, social support is an important factor for anyone who is trying to reduce or stop using tobacco.

If you are thinking about quitting or are ready to make a change now, consider the following resources and strategies to help you on your journey to stop using tobacco:

Talk to your doctor: S/he can talk to you about medications to help you quit and put you in contact with local resources.

Call a quitline: Talking to someone about quitting smoking can be the support you might need to see it through. All states have quitlines with counselors who are trained specifically to help smokers quit. Call 800-QUIT-NOW (800-784-8669) to connect directly to your state’s quitline.

Contact your employer or health insurance company about resources for quitting: Many employers offer free tobacco cessation programs to help employees quit. If you are not working, inquire with your health insurance company as they often have trained specialists available by phone and/or may offer free or low-cost nicotine replacement products. Even Medicare Part B (Medical Insurance) covers up to 8 face-to-face visits with an approved provider in a 12-month period.

Consider behavioral therapy or coaching: This involves working with a counselor or a health coach to find ways not to smoke or use other forms of tobacco. Together, you’ll identify your triggers (such as emotions or situations that make you want to use tobacco) and make a plan to get through the cravings.

Whether you decide to quit cold turkey or use a combination of options to help you on this journey, know that the first few days are the toughest. You’ll probably feel irritable, depressed, and tired, especially if you’re quitting cold turkey. Identify your support system beforehand, whether it be a good friend, a colleague and/or a quitline specialist, and use them in times of need. Once you get past those first days, you’ll begin to feel more normal and your cravings should begin to decrease.

Finally, be sure to build in ways to reward yourself. What you’re doing isn’t easy. When you achieve the smaller milestones on your way to quitting, treat yourself with something you want or enjoy.  Or another idea is to save the money you would have spent on cigarettes/tobacco products and donate it to a favorite charity. This is a win-win situation – you are helping yourself and others at the same time.

Quitting isn’t easy, but 50 million ex-smokers in the United States are proof that it’s possible.  What step can you take today to move you closer to the goal of quitting?

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Complementary Approaches to Health

As I mentioned in a recent post, the outer ring of the Wheel of Health focuses on Professional Care, which may include both conventional and complementary approaches to healthcare. A primary goal of integrative medicine is to erase the distinction between conventional and complementary approaches and instead encourage the use of the most effective, evidence-based modalities across the continuum.

 As a public health professional, I absolutely believe in the importance of prevention and primary care services that are typically obtained through more traditional or “Western medicine” practices. However, I also believe in, and have experienced firsthand, the benefits of more complementary approaches, many of which are grounded in more “Eastern medicine” traditions. I have had conversations with many individuals who are skeptical about the effectiveness of complementary approaches. My belief is that if you are open to these approaches and believe they can help you, they will. Whereas if you are skeptical and doubtful of their effectiveness, they likely won’t work for you. I feel fortunate that we all have a choice when it comes to deciding what treatments we seek to help us achieve and maintain our health and wellbeing.

Firsthand experience

I’d like to share my experience with some complementary approaches I have used to help manage anxiety. I have dealt with anxiety since I was a young child. One of the ways my anxiety manifested itself was through a nervous habit of biting the inside of my cheeks. I would chew away as I ruminated on my many worries about school, family, fitting in and all the other concerns of an adolescent trying to find her place in the world. I didn’t think much of it as a kid, but I became more self-conscious about it as I matured. I imagine I looked pretty silly with my mouth contorted to one side or the other. When my husband gently inquired about this habit, it made me realize it was noticeable to others and not something I could keep hidden.

I knew I wanted to break this habit but felt powerless to do so. As anyone who has tried to stop a long-standing habit knows, it can be incredibly difficult to change the behavior. I tried chewing gum to keep my mouth occupied. I tried that bitter tasting chemical that is supposed to help you stop biting your finger nails. I decided to try therapy, to address the underlying issue of anxiety. It helped manage the anxiety to some degree but didn’t break the habit. I eventually decided to see a psychiatrist and try anti-anxiety medication, which to me was a last resort. I try to avoid prescription medications unless absolutely necessary. I started taking a relatively low dose of an SSRI (selective serotonin reuptake inhibitor, a class of drugs commonly used to treat depression and generalized anxiety disorder). I would say it took the edge off a little, but it wasn’t solving the problem I wanted to fix which was the cheek biting. I weaned off the medication after about two years, as it wasn’t doing enough, and I did not feel like trying different medications.

At that point, I felt stuck and resigned myself to living with this habit. Then one day my husband came back from a weekend of camping with some friends and shared some interesting news. A couple of the guys had shared that they were working with a local shaman to help resolve some physical and mental health issues – and that this shaman was essentially a miracle worker, curing their ills. I was somewhat taken aback as these gentlemen are well-educated, highly respected professionals…and the first image conjured up in my mind when I heard the word shaman was “witch doctor.” My curiosity was piqued. My husband gently suggested that perhaps this shaman could help with my cheek biting. I was skeptical at first but willing to try anything to get some relief.

I went for my first visit with the shaman and left feeling like a new person. I had not really experienced energy work before, but I felt like he literally wiped away all negative energy that had been present in my body. It took about three or four sessions to kick the habit, but I did stop biting my cheeks. It felt like a huge weight had been lifted from my shoulders. I did experience an occasional relapse, but I would go in for a booster session and be good as new. The only downside to the experience was the cost – it was several hundred dollars per session and not covered by insurance. For me, it was worth every penny, but I realize I was fortunate that I could afford to seek his services.

I stayed free from my nervous habit for a couple of years but then started to experience more relapses. At this point, our financial situation had changed and we did not have as much disposable income to spend on these services. I sought some less expensive opportunities involving energy work, but they were not as effective at stopping the cheek biting. I felt resigned again to just live with it but knowing that it was possible to break the habit made me continue to seek other options. One day I was doing some internet research about cheek biting and stumbled upon individuals who had success with hypnosis. I was intrigued but skeptical again, as all I knew about hypnosis was the Vegas-style shows where some volunteer from the audience gets hypnotized and does silly things on stage to entertain the crowd. As I read more, I realized that hypnosis was different than that and many people have used it to help stop smoking or to lose weight.

I was hesitant to take the leap until I found a local practitioner who also happened to be a fellow graduate of the Duke health coaching program I attended. This connection gave me the courage to reach out and make an appointment. Once again, it took a few appointments to completely kick the habit. However, in the past year or so since I first underwent hypnosis, I have only had a couple of minor relapses that were easily fixed with a one-time booster session. The cost of hypnosis is much more reasonable and since I sought the services to help address a health issue (anxiety), I have been able to use our Health Savings Account to cover the cost.

I will readily admit that I don’t know exactly how the energy work and the hypnosis helped me break this habit. When I questioned the shaman about how his therapy works, he really couldn’t explain it. His response was basically “if it fixed your problem, does it really matter how it works?” He’s got a point. From what I have read about hypnosis, it is a way to access a person’s subconscious mind to help implement the desired change. The hypnotist serves as a guide, using suggestions that can help you modify your behavior and achieve your goals. Regardless of how these approaches work, I am grateful that they have helped me when conventional healthcare couldn’t. I encourage you to consider exploring complementary approaches if you are not achieving the results you desire through more traditional means.

Quality vs. Quantity – A New Approach to Weight Loss?

I wanted to take a moment to highlight a new study that was released last week in The Journal of the American Medical Association (JAMA) that challenges the traditional notion that weight loss is only possible through calorie reduction (i.e., counting or restricting the number of calories you eat). In the DIETFITS study, researchers found that participants who cut back on added sugar, refined grains and highly processed foods while focusing on eating plenty of vegetables and whole foods — without counting calories or limiting portion sizes — lost significant amounts of weight over the course of a year.

The study was a randomized clinical trial that included 609 overweight adults, who were assigned to either a healthy low fat (HLF) or a healthy low carb (HLC) diet group. Members of both groups attended classes with dietitians where they were educated about eating nutrient-dense, minimally processed whole foods, preferably cooked at home. A key difference in this study is that it did not set restrictive limits on the amount of carbohydrates, fats or calories that participants could eat. Rather, the researchers emphasized that participants focus on eating whole or “real” foods and as much as they needed to avoid feeling hungry. The emphasis was on the quality, not quantity, of food that was consumed.

The researchers also wanted to test the hypothesis that some people are predisposed to do better on one diet over the other depending on their genetics and their ability to metabolize carbs and fat. A growing number of services offer people personalized nutrition advice tailored to their genotypes. (See this previous post about my experience with one of these genetic testing services). Somewhat surprisingly, they found that participants’ genotypes did not appear to influence their responses to the diets. This is something to keep in mind if you are thinking about pursuing genetic testing for guidance on nutrition.

The general outcome of the study was that after one year of focusing on food quality, not calories, both groups lost substantial amounts of weight. On average, the members of the low-carb group lost about 13 pounds, while those in the low-fat group lost almost 12 pounds. The good news is both groups also saw other health improvements such as reductions in their waist sizes, body fat percentage, and blood sugar levels.

It is important to note that there was variability among the participants – some people gained weight, and some lost as much as 50 to 60 pounds. One key finding though is that the people who lost the most weight reported that the study had “changed their relationship with food.” For example, they no longer ate in their cars or in front of the television. They also started cooking more at home and sitting down to eat dinner with their families. To me, this demonstrates that how we eat is just as important as what we eat.

As with any research study, there are limitations. This was only one study involving a relatively small number of participants. Repeat studies with larger sample sizes should be conducted to see if results can be replicated. This study also just focused on initial weight loss. Maintaining weight loss can be as hard, if not harder, than losing the weight in the first place. Future studies may want to follow participants over time to see if they can maintain a healthy weight following the same approach of focusing on quality, not quantity.

I hope that this study is just one of many that will show that traditional dieting, where people make themselves miserable by counting or restricting calories, is not the best or most sustainable way to attain and maintain weight loss.  Rather, if we shift our focus to the quality of foods we eat and take time to enjoy and savor our meals, we will change our relationship with food and reap the many health benefits that come along with eating a well-balanced diet.

Be the Change You Wish to See

Gun violence. For some it may seem like an odd subject for a health and wellness blog. I debated whether to post about this topic, given the controversy and sensitivity around the 2nd Amendment. In my heart I knew I had to address it, especially in the wake of the latest school shooting in Parkland, Florida. It hurts so much to type those words. How are we here, AGAIN, facing more unnecessary loss of precious lives? Didn’t we say “enough” after Sandy Hook? Charleston? San Bernadino? Orlando? Las Vegas? I know there are other events I’m missing as the Parkland tragedy was reportedly the 18th gun incident involving a school or university since January 1, 2018. Wow – we’re only 54 days into the new year. Something must change.

I grew up around guns – primarily hunting rifles – as my dad, uncles, and brothers were all outdoorsmen who enjoyed the sport.  We had a healthy respect for guns in our house though. My dad kept them unloaded and locked up in a safe place. The only time I ever saw them was when they went on a hunting trip. I preferred it that way as I was never really comfortable around any type of firearm – and I’m still not. Even passing an armed police officer on the street makes me nervous. I think it’s fear of the damage that can be done with such a small piece of equipment.

In my ideal world, there would be no guns. If no one has them, no one has to worry about shooting someone else or being shot. Problem solved. Realistically, I know it’s not that easy. So, if guns aren’t going away, then we need to find some way to address the issue of gun violence and the destruction it causes in this country. As a public heath professional, I am excited to see momentum growing behind the idea of using a public health approach to reducing gun violence in this country. What would that look like? In a nutshell, it would involve using a social-ecological model to better understand violence and the effect of potential prevention strategies.

If there is one thing we have learned in the public health arena, it is that it we are usually more effective trying to change the environment than trying to change people. There are many, many people who just refuse to give up their guns. Not to mention the lobbying power of the NRA and the power it holds over Congress. I mean, if the near fatal shooting of former Representative Gabby Giffords wasn’t enough for her fellow legislators to turn down contributions from the gun lobby or to propose stricter laws around access to assault weapons, I am not sure what will be.

Given these circumstances, many health professionals are proposing that the United States use the same harm reduction approach to gun violence that it uses to treat other public health threats, like car crashes, air pollution and even tobacco use – using a wide variety of methods to reduce the problem. You can learn more about these approaches here:

https://jamanetwork.com/journals/jama/fullarticle/1556167#qundefined

https://gunresponsibility.org/solution/public-health-research

https://www.hsph.harvard.edu/news/features/public-health-gun-violence-vegas

One solution that has been proposed in the last few days is arming teachers and other school personnel so that they can respond in the event of an active school shooter or other threat. I am whole-heartedly against this approach. These learning institutions should not have to spend one iota of their time or resources thinking about how to defend against an armed intruder or other violent event. For those who think it is just a reality of modern times, I say we can and must do better than that. That is a band-aid approach to a more systemic problem. Let’s be proactive rather than reactive and figure out how to reduce or even eliminate the possibility of such threats by focusing on common-sense gun laws and improving access to mental health services for those in need.

I have struggled this past week with how to be part of the solution to this problem. I am encouraged by the actions of individuals – like this gentleman who turned in his assault rifle and more so, the young adults who survived the Parkland shooting and are making their voices heard at the national level. As the title of this post suggests, we must each take steps that will help achieve the outcomes we want for this country, our communities and our families. For me, it will mean donating my time and money to organizations like Moms Demand Action that support common-sense gun laws. It will also mean making my voice heard at the polls this fall and voting for candidates that support a proactive approach to this national epidemic. I must admit that I do not know if any of the state or national candidates I have supported in the past accept money from the NRA. I do know that I will have this information before I vote this fall and I will not support any candidate, regardless of political party or my previous support for their election, if they do. These are just some of the first steps that come to mind for me. I will continue to follow the discussion about gun violence and determine additional steps that I can take to help keep our children and our communities safe.

Addressing gun violence is probably one of the greatest challenges this country will face. I have faith that we can and will succeed, but it will take every one of us reaching into our hearts and finding a way to take action, so that we can finally say – and mean – never again.

What small step will you take today to move us toward that goal?