Mr Epidemiology

No, I'm not a skin doctor



The Biggest Public Health Stories of 2013

2013 was a big year for public health. We were thrust to the forefront again with disease outbreaks, and have had to deal with increased skepticism of the nature of what we do from the public. Meanwhile, within the establishment, rifts have been growing between groups, as different professional organizations vie for power and control. Here are my top five public health stories for 2013, presented in no particular order, but I’d love to hear yours in the comments.

1. Polio in Syria
Polio is a crippling disease that has been covered on the blog before. It’s been almost completely eradicated, but is still endemic to certain parts of the word. However, following civil unrest in Syria, polio has started to spread again and has, to date, crippled 17 children. Before the March 2011 uprising, vaccination rates were estimated to be above 90%. However, since then, estimates for vaccination rates hover around 68% – enough to prevent the benefits of herd immunity from kicking in. In order to increase immunization rates, the UN is trying to mobilize a vaccine drive. However, due to political and safety concerns, they are having a hard time ensuring that all children are vaccinated. To quote NPR:

Polio does not stop at borders or military checkpoints. Without a comprehensive response to stop the virus, aid workers fear that the outbreak could become a public health catastrophe.

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Guest Post: Dear (Food) Diary …

Mr Epidemiology: Today, I’m welcoming Natalie Causarano to the blog. You can find out more about Natalie at the end of this post.

The summer is finally on its way, bringing us BBQs, cottages, and …wait for it…the often dreaded BATHING SUIT SEASON! That moment of truth when we must face the effects of our winter hibernation (which might make us want to stay in hibernation).

Vanity aside, the benefits of maintaining a normal weight is a long-championed public health message. Yet the combined effects of increased portion sizes and our increasingly sedentary lifestyle are making it difficult for us to maintain a healthy weight. So, where should we start to lose? The diet industry seems to be growing as fast as the obesity epidemic and the price of weight loss products is even more discouraging.

One inexpensive weight loss strategy is to self-monitor with a food and / or exercise diary, which has been found to be an effective weight loss strategy by numerous studies (1). I know what you’re thinking, there’s no more room in your purse or murse for a food journal!

Fear not, the internet has the solution!

Continue reading “Guest Post: Dear (Food) Diary …”

Guest Post: The Evolution of Sedentary Time

Mr Epidemiology: Today, I’m welcoming Lindsay Kobayashi back to the blog. You can find out more about Lindsay at the end of this post.

How sad.

The negative health effects of sedentary behaviour are a hot topic gaining scientific and popular attention. Any Canadian reading the news should be aware that sitting is killing us – Maclean’s, the Globe and Mail, and the CBC have all recently published on the topic. Given the tsunami-like obesity epidemic that has risen over North America over the past few decades, critical investigation of our sedentary behaviour is highly warranted.

Every time I hear someone talk about how sitting is killing us, I return to the same question – If I was born 50 or 100 years earlier, would I be less sedentary than I am now? In the figure above, I’ve depicted my average 16-hour day (waking hours only). Exemplary of a big question in the sedentary behaviour research domain, I am what you would call an “active couch potato” – I spend 7-8 hours week engaged in moderate-to-vigourous exercise, yet I still spend 50% of my waking hours sitting in front the computer! What does this mean for my health? And yours too – if you are reading this, you are likely somewhat similar to me. Is this sort of sedentary behaviour a new phenomenon of the latter part of 20th and early 21st century? Continue reading “Guest Post: The Evolution of Sedentary Time”

Romance is not a romantic comedy: The importance of good exposure measurement

If you live in Kingston, you may have come across this headline:

Kingston, ON is the most romantic city in Canada

Wonderful you think – after all, Kingston does have that small city charm, with lots of historical buildings, quaint little cafes and restaurants as well as being right on the water. Lots of romantic movie potential, where big city Sandra Bullock moves to a small town only to fall for lovable country mouse Ryan Reynolds.

It's like if you had this movie set in Kingston, instead of Alaska! .... which I wouldn't know because I've never seen it *cough*

And then you read the article more closely, and determine how they measured the “romanticness” of a city:

The online retailer bases its list by comparing sales data of romance novels, sex and relationship books, romantic comedy DVDs and CDs by Canadian crooner Michael Buble since Jan. 1 on a per capita basis in cities with more than 80,000 residents.

Wait, what?

Continue reading “Romance is not a romantic comedy: The importance of good exposure measurement”

How many calories are in that burger?: Do our estimates become more accurate with labelling Recently, there has been a push to mandate labelling in fast food restaurants and stores. In the US, this is a huge initiative, passed as part of the 2010 Health Reform Bill (for another view on this, check out Dr Yoni Freedhoff’s post). This Bill mandated that all restaurants with more than 20 locations nationally had to post nutritional information on their website.

There’s a lot of ammo on both sides: some think that people should be responsible for their food choices, and that restaurants shouldn’t have to put up nutritional information. After all, they don’t *force* you to eat it. On the other hand, others advocate that knowing what is in your food will help you make a more informed decision.

Do you know how many calories are in a regular Big Mac? Take a guess. The answer is at the end of this post.

Regardless of your viewpoint, it all becomes irrelevant if the nutritional information doesn’t actually make a difference; if people don’t read and remember them, then what is the point?

And this is where today’s paper comes in.

More after this word from our sponsors … (click read more)

Continue reading “How many calories are in that burger?: Do our estimates become more accurate with labelling”

Don’t call kids “obese”: Parental preferences for what you call their child Obese youth are often stigmatized by society, and this stigmatization can have drastic, and long lasting consequences ranging from decreased self esteem to increased suicidal ideation. And for those youth who remain obese into adulthood, they also face worse employment, educational opportunities and even stigmatization by healthcare professionals.

Knowing that obese youth face this sort of discrimination, and the toll this can take on parents, you have to wonder what effect Pediatricians can have. Given that parents put a lot of trust in pediatricians, and often pediatricians form the first port of call for parents concerned about their child’s weight, the words they use and the policies they promote can make a lot of difference to those concerned about their weight.

The Rudd Center for Food Policy and Obesity is a world leader in obesity stigma research

This led to a study being conducted Dr Rebecca Puhl and colleagues at the Rudd Center for Food Policy and Obesity at Yale University, where they asked parents what terms they would like pediatricians to use when talking about a child with a higher than ideal weight, and also what action they would take if their doctor used stigmatizing language. As I’ll talk about later, the article caused a bit of a firestorm online.

Continue reading “Don’t call kids “obese”: Parental preferences for what you call their child”

Attitudes to Publically Funded Obesity Treatment and Prevention In countries where healthcare is funded by taxpayers, concerns over whether or not obesity treatment should be included under the umbrella of national healthcare is an ongoing concern. While this is also a concern in countries with private healthcare, in the public healthcare system the cost may be borne by society as a whole.

Perhaps the biggest issue in supporting obesity treatment programs is *not* whether or not there is a need for treatment: it’s obvious these people need help. The underlying issue is whether or not there is *public support* for treatment. Skim through the comments section on any CBC or Globe and Mail piece on obesity, and it is clear that this is a very contentious issue.

Hospital's can provide treatment for obesity. But is there public support for extreme measures such as surgery?

Prejudice and discrimination against the obese is not new, and last year the Canadian Obesity Network, along with partners, hosted the 1st Canadian Summit on Weight Bias and Discrimination (for more information, see the executive summary.) Knowing this prejudice exists, researchers in Denmark set out to investigate public support for obesity treatment, and to identify predictors of this support.

Continue reading “Attitudes to Publically Funded Obesity Treatment and Prevention”

Do cartoons affect child attention spans?

This post was chosen as an Editor's Selection for

EDIT 27/09/11: This piece was selected by Jason Goldman in his weekly roundup! Thanks Jason!

I was on the phone with my mom recently, and she told me about a recent study she saw on CTV stating that watching SpongeBob Squarepants was bad for children. I scoured the internet, and found the research article in question. While searching, I also found reference to the study in the media. The headlines were … disturbing. They ranged from the factual “SpongeBob may impair 4-year-olds’ brains” and “Young Attention Spans Impaired by SpongeBob and Rapid Games, Study Says” to the more controversial “So your four-year-old can’t concentrate? He’s probably been watching SpongeBob” and finally throwing all logic and reason out of the window and claiming “Study says SpongeBob makes kids stupid.” (Those are all the actual headlines) As you can imagine this just made me more interested in the actual paper itself – in particular if I would be able to use the line “Researchers call SpongeBob Stupid” and cite it.

A threat to your child's intelligence?

As someone who watched a fair share of Tom and Jerry, Looney Tunes and Teenage Mutant Hero Turtles  as a kid, I wanted to see how such claims were made, and what the actual study was. And yes, it was Teenage Mutant HERO Turtles. In the UK they changed the word Ninja to Hero, as Ninja had violent connotations. True story.

More after this word from our sponsors … (click read more)

Continue reading “Do cartoons affect child attention spans?”

Using Video Games to Model Real Life Outbreaks

Those of you who know me know that I’m a video game nerd. And comic book nerd. And just nerdy nerd in general. So when I read an article that used World of Warcraft to model disease outbreaks, I jumped on it.

World of Warcraft is a MMORPG (Massively Multiplayer Online Role Playing Game) and forms the butt of many jokes in shows like Southpark, The Simpsons and others. I’ve never played it myself, but I lived with a guy who did so picked up a few things. Basically, you pick a player class (barbarian, wizard etc) and then join a “guild” and do quests together. These vary from the mundane to the epic (“kill this dragon”). It is, allegedly, a lot of fun. And a lot of that fun comes from being in a group of 50-60 like minded people, all playing out their fantasies as an elf, warlock, goblin etc.

World of Warcraft (WoW) has a very intricate world that has grown up around it. Gold provides an in-game economy, and treasures you gain from slaying foes give people items to trade. And since it is based around the actions of people, each quest can be very different from the last. Sometimes this can result in inadvertently hilarious consequences; the video below shows a guild meticulously planning their attack. However, when a player decides that he’s had enough, he runs in screaming his name (“LEEEEROOOOYYYYY JENNNKINNNSSSSS”). This results in his team panicking, and all their planning going to waste. To quote Robert Burns: “The best-laid schemes o’ mice an’ men / Gang aft agley.” I’m pretty sure he was talking about WoW when he wrote that.

So you have this society with thousands of players all logging on regularly, heavily invested in their characters, spending anywhere upwards of 40-60 hours a week in the game. What happens when a “virus” is introduced into the game?

More after the loading screen … (click read more)

Continue reading “Using Video Games to Model Real Life Outbreaks”

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