Public Health On Call

In this bonus episode, Johns Hopkins Professor Thomas Burke joins Dr. Sharfstein to talk about the risk to residents following the train derailment and toxic release of chemicals in East Palestine, Ohio— the knowns, the unknowns, and where to go from here. Dr. Burke is a former environmental official for the state of New Jersey and a former science adviser of the Environmental Protection Agency

Mark Miller, the executive vice president of health care at Arnold Ventures joins Dr. Josh Sharfstein to talk about the impact of the Inflation Reduction Act for Medicare patients this year, as well as two areas of future work to bring down the cost of prescription drugs. They discuss patent reform and opportunities to increase transparency for pharmaceutical benefit managers.

Amany Qaddour, regional director for Syria Relief and Development, a nonprofit humanitarian organization on the ground in Syria, joins Dr. Sharfstein They discuss the enormous challenge of responding to a natural disaster in a part of the world that has suffered from conflict, displacement, and crisis for years. To make a contribution to the organizations mentioned in the podcast, see https://srd.ngo/ and https://www.whitehelmets.org/en/ .

Today, guest host Shelley Hearne, director of the Lerner Center for Public Health Advocacy brings us to the south lawn of the White House for a conversation with Catherine Flowers, environmental justice advocate and a MacArthur Genius Award winner. Flowers talks about working with grassroots advocates, celebrities, politicians, and influencers of all kinds to raise awareness around serious sanitation issues in US cities that we usually associate with underdeveloped nations.

The average life expectancy in the United States has dropped precipitously during the pandemic—and COVID-19 is not the only culprit. Dr. Josh Sharfstein, who leads the Bloomberg American Health Initiative at Johns Hopkins, talks to co-host Stephanie Desmon about a new report on how we can halt U.S. life expectancy declines by focusing on major causes of the declines: COVID, opioids, gun homicides and suicides, motor vehicle crashes, heart disease, diabetes, and stroke. This report sets out ten feasible ideas for reversing the decline and setting the nation on a path of greater equity and health.

The Stoop Storytelling Series and Johns Hopkins Bloomberg School of Public Health partnered last fall to present a night of storytelling by scientists, activists, and community members sharing personal stories about urgent public health issues. In part 1, Carolyn Sufrin, an obgyn and medical anthropologist, tells her story of how she began working in reproductive health care in prisons, and Cicely Franklin, an overdose prevention specialist with the Baltimore City Health Department, talks about the dual dynamic of working in harm reduction and having a family member with substance abuse issues. These stories were recorded on September 22, 2022 at the Enoch Pratt Free Library in Baltimore.

In a two-part conversation that begins while facing down a tiny yet fierce migratory bird on the coastal plain of the Arctic National Refuge to a celebration on the south lawn of the White House, guest host Shelley Hearne, director of the Johns Hopkins Lerner Center for Public Health Advocacy, and David Kieve, president of the Environmental Defense Action Fund, discuss why the new climate bill is so critical, what it took to get this massive piece of legislation to the finish line.

Astronomer Andy Rivkin led the team at the Johns Hopkins Applied Physics Laboratory that sent a rocket into space last year to change the trajectory of an asteroid. Stephanie Desmon talks to him about how this proof of concept launch could one day aid in the ultimate public health mission: To save humans from the fate of the dinosaurs.

Roughly 10 percent of long-term care workers have left their careers since the start of COVID-19. The shortage in staffing has led to nursing homes turning patients away, left caregivers at home struggling for help, and ultimately put patients at risk in the hands of workers who have been stretched thin. Tradeoffs host Dan Gorenstein talks about a San Fransisco non-profit home health agency looking to make changes in this sector and how providing long-term care workers with new career pathways could be part of the solution. If you like this episode, check out the Tradeoffs podcast at www.tradeoffs.org.

Howard Sklamberg, a former deputy commissioner of the U.S. Food and Drug Administration, talks to Dr. Sharfstein about legislation passed at the end of 2022 to improve the safety of cosmetics. On the agenda for discussion: inspections, manufacturing standards, recalls, and the answer to the trivia question of whether a combination of antiperspirant and deodorant is considered a cosmetic or a drug.

Guest host Shelley Hearne, director of the Lerner Center for Public Health Advocacy, brings us eight miles above the Arctic Circle to talk with Bernadette Demientieff, council member for the Arctic Refuge Defense Council and member of the Gwichyaa Zhee Gwich'in Tribe. They discuss the very real impacts of climate change on her community in their day-to-day lives and our global interconnectedness, including why it matters to all of us what's happening in a remote corner of the world.

Years of masking and distancing during the COVID-19 pandemic protected many of us from the common cold and flu, and isolation protected children from respiratory illnesses like RSV. So, why are so many kids getting sick this winter? In this episode, Stephanie Desmon talks to Dr. Mike Rose, a pediatric resident at the Johns Hopkins School of Medicine about a concept called 'immunity debt' and why it could explain the recent increase in pediatric illness and hospitalizations.

After years of using a ZERO COVID strategy in China, which led to many lockdowns and economic questions, the country has dropped all COVID restrictions in recent weeks. Dr. Amesh Adalja of the Johns Hopkins Center for Health Security joins Stephanie Desmon to discuss what has happened in China, what the consequences are now and what they will be in the future. Adalja says both policies were destined to fail and we could see China in 2023 look a lot like the United States in 2020.

Environmental health wasn't always part of the public health portfolio but in recent years "science caught up to the obvious." Dr. Howard Frumkin, former head of Environmental Health Operations at the CDC and currently senior vice president at Trust for Public Land, talks with Shelley Hearne about the evidence base behind environmental impacts on our health, the political and cultural changes required for the CDC to adopt programs around climate and environment, and why hope for tackling climate change is not only a worthy strategy, there's empirical evidence behind it.

Dr. Roger Mitchell, the former chief medical examiner of the District of Columbia, and current chief of pathology at Howard University speaks with Dr. Sharfstein about how deaths in custody are classified. Dr. Mitchell has observed that when it comes to understanding the reasons for these deaths, the usual rules of autopsies and death investigations don't always seem to apply. He's leading the charge to understand more about what's happening.

As we enter the fourth year of the COVID-19 pandemic, Dr. Mike Osterholm, a leading expert from the University of Minnesota, talks to Stephanie Desmon about why hundreds of people in the U.S. continue to die each day from COVID and tens of thousands are newly hospitalized. They discuss the question he gets asked most often, "Is this pandemic ever going to end?", as well as coming variants, the massive outbreaks in China, and the lack of demand for vaccines and treatments that are effective in preventing death and severe disease.

Our guest is Judge David Tatel, who recently took senior status on the U.S. court of appeals for the DC circuit after joining the court in 1994. He was appointed to fill the seat created by the appointment of Justice Ruth Bader Ginsburg to the Supreme Court. Judge Tatel speaks with Dr. Sharfstein about West Virginia v. EPA, in which the Supreme Court announced a major new doctrine for judging actions by health agencies to protect the public.

In this episode, Dr. Elizabeth Letourneau, director of the Moore Center for the Prevention of Child Sexual Abuse at the Johns Hopkins Bloomberg School of Public Health, speaks with Dr. Josh Sharfstein about sexual abuse prevention means for youth serving organizations, and for children themselves. More about the Moore Center is here.

Today, guest host Shelley Hearne, director of the Lerner Center for Public Health Advocacy talks with former EPA leader and inaugural White House National Climate Advisor Gina McCarthy about why climate change is a people and public health problem, not a planetary problem.

A report from the Select Subcommittee on the Coronavirus Crisis sheds light on disturbing instances of the Trump administration's politicization of science during the COVID-19 public health emergency. Subcommittee member Congressman Bill Foster (D-IL) talks with Dr. Josh Sharfstein about what's in the report, how to better protect agencies like the CDC from political interference, and lessons learned to prepare for the next pandemic.

Since the reversal of Roe v. Wade, there's been a flurry of activity at the state levels to protect, significantly restrict, or ban abortion. Legal and public health expert Joanne Rosen returns to the podcast to talk with Dr. Josh Sharfstein about how removing the "constitutional guardrails" is playing out in courtrooms across the country, the "chilling effect" much of this has on practitioners, and how the recently passed Respect for Marriage Act could have implications for protections at the federal level. Referenced in this episode: https://jamanetwork.com/journals/jama/article-abstract/2798214.

In the last episode of Season 6, Lindsay Smith Rogers talks with co-hosts Dr. Josh Sharfstein and Stephanie Desmon about 2022: how it started, what happened, and how it's going now. They reflect on the changing COVID response, listener feedback, standout episodes, notable guests, looking ahead to topics for 2023 and more. This episode was recorded in person as a video and can be viewed on the @johnshopkinssph YouTube channel. Please vote for the podcast in the Signal Listener's Choice Awards! Info here: https://bit.ly/PHPodVoting

Last week, hundreds of public health leaders and scholars gathered in Philadelphia for the annual Bloomberg American Health Summit and to discuss critical topics ranging from gun violence and environmental justice to food policy and preventing overdose. This special episode of Public Health On Call features three panels from the main plenary session: Extreme Risk Protection Orders, Innovations in Harm Reduction, and Youth Suicide Risk in Latinx Communities. You can watch the full sessions here. Please vote for the podcast in the Signal Listener's Choice Awards! Info here: https://bit.ly/PHPodVoting

Dr. Shaun Truelove, an infectious disease epidemiologist, returns to the podcast to talk with Dr. Josh Sharfstein about the latest models for the COVID-19 Scenario Modeling Hub. They discuss the possibility of another COVID surge this winter as well as what models can tell us about other respiratory diseases like flu and RSV, and factors like the flu and bivalent vaccines. Please vote for the podcast in the Signal Listener's Choice Awards! Info here

For the first time, the WHO released a report of fungal "priority pathogens" that are causing invasive diseases in humans and are becoming more prevalent and more resistant to treatment. Dr. Hatim Sati, technical leader of the report, talks with Stephanie Desmon about why fungi pose such a threat to human health, the lack of diagnostics and treatments, and how better research and surveillance can help.

Guest host Bilal Khan, a Johns Hopkins public health student who recently worked as an advisor to senior public health leaders in Pakistan, talks with Dr. Rabika Fatima, a Karachi-based doctor volunteering at medical relief camps near the floods, about what's happening on the ground in the aftermath of Pakistan's devastating floods. Organizations working on the front lines include: JDC Foundation, Al Khidmat Foundation, IMI Pakistan, and The Indus Hospital.

Unintentional injuries like auto and firearm accidents, drownings, and poisonings, are the leading causes of death in US children over age 1. Dr. Sadiqa Kendi, Division Chief of Pediatric Emergency Medicine at Boston Medical Center and a Bloomberg Fellow, talks with Lindsay Smith Rogers about her work on the Mass PIER project and some insights they've gained from reviewing pediatric injuries. Learn more about the project findings here.

COVID-19 infections may look different in 2022 than they did in 2020, thanks to vaccines, infection-induced immunity, and new treatments—but that doesn't mean we can rest easy. Dr. Paul Sax, clinical director of infectious diseases at the Brigham and Women's Hospital and editor-in-chief of the Journal of Clinical Infectious Diseases talks with Dr. Josh Sharfstein about the overall state of COVID-19 treatments and vaccines, what we still don't know about this virus, and why it's important to stay vigilant.

Medications to treat opioid use disorder in pregnant people can decrease the chances of an infant being born too early and reduce risks of maternal overdose and death. But with a fractured and underfunded system of OUD treatment, as well as stigma around drug abuse in pregnancy and siloed maternal health care, how can pregnant people access this lifesaving care? Dr. Stephen Patrick, pediatrician and former senior policy advisor at the White House Office of National Drug Control Policy, returns to the podcast to talk with Lindsay Smith Rogers about a new report that lays out suggestions for lifting barriers to OUD treatment for pregnant people. Read the report here.

Sexual Assault Nurse Examiners, or SANEs, are specially trained advocates and care providers for survivors of sexual violence in ERs and other clinical settings. In addition to providing medical care and counseling, they can collect forensic evidence at the critical moment following a sexual assault. Oregon SANE Savannah Powell talks to Lindsay Smith Rogers about the important role SANEs play in survivors' healing and the unique challenges the field faces in the context of the nation's nursing crisis and post-Roe policies. This episode was co-produced by intern Hannah Bennett.

Thanksgiving dinner can bring tension alongside turkey and this year may feel especially stressful given a highly polarizing political environment. Dr. Consuelo Amat, an expert in peace building at the SNF Agora Institute at Johns Hopkins, talks with Dr. Josh Sharfstein about some ground rules for peace-building and dialogue, and how to meaningfully engage in difficult conversations with people we love.

During the midterms, Oregon voters passed Measure 114 which restricts magazine capacity for firearms and requires purchasers to obtain a permit which includes a background check and safety training. Cass Crifasi, co-director of the Johns Hopkins Center for Gun Violence Solutions, talks with Lindsay Smith Rogers about why this measure is a lifesaving win not only for gun violence solutions and public health, but also for evidence-based advocacy. They also discuss where the measure falls in the context of the Supreme Court's Bruen Decision and what Crifasi hopes to see happen next.

Today's episode is all about the liver. Thelma Thiel, founder and chair of The Liver Health Initiative, talks with Dr. Josh Sharfstein about this "silent organ" that, among many roles, removes toxins from what you eat, breathe, and absorb through your skin. They also discuss Thiel's efforts in advocacy and education—including her talking about the "football-sized" liver with an NFL team.

For the first time, a physician—Dr. Rahul Gupta—is directing the White House's Office of National Drug Control Policy. Dr. Gupta talks with Dr. Josh Sharfstein about the national strategy to address addiction and overdose, emphasizing treatment and harm reduction, not criminalization.

New CDC data shows that during the pandemic, gun-related homicides and suicides surged to record highs. Ari Davis, a researcher at the John Hopkins Center for Gun Violence Solutions, talks with Stephanie Desmon about the spikes, some possible contributing factors, and effective public health solutions. ‌

As advocates from around the world gather at the International Conference on Family Planning in Thailand this week, what's the state of global reproductive rights? Megan Christofield, a project director and advisor at JHPIEGO, talks with Stephanie Desmon about the accessibility and prevalence of contraceptive use worldwide, where gains have been made and where things have been stagnant or even backslid in the last decade, and some game-changing new contraception options that could help avert many more millions of unintended pregnancies, unsafe abortions, and maternal deaths.

Coming into the third year of the pandemic, we now have more data about how COVID affects people in the long term. Dr. Ziyad Al-Aly, Chief of Research and Education Service at Veterans Affairs in the St. Louis Health Care System returns to the podcast to talk with Stephanie Desmon about a new study of 150,000 people with COVID-19 that found higher incidence of headaches, seizures, sleep problems, strokes, and other neurological symptoms following even mild or asymptomatic infections. Read the study here.

First we had alpha, beta, and delta, and now we have hundreds of sublineages just from omicron alone. Virologist Dr. Andy Pekosz returns to the podcast to talk with Dr. Josh Sharfstein about how experts are keeping track of so many variations of SARS-CoV-2, which advantageous mutations most lineages are picking up to help them spread, the clinical impacts on treatments and vaccines, and why COVID-19 is not yet seasonal.

First declared in January, 2020 and renewed every 90 days since, the federal COVID-19 public health emergency allows for key flexibilities and funds in response to the pandemic. With the declaration due to expire in January, what are the implications for things like Medicare/Medicaid coverage, and cost and access to vaccines and tests? Jennifer Kates, Senior Vice President and Director of Global Health & HIV Policy at the Kaiser Family Foundation, talks with Lindsay Smith Rogers about the PHE and potential fallout for ending it too soon. Read Kates' coauthored article here.

Disappointing rates of child and adolescent vaccination for COVID are colliding with an intensifying seasonal storm of viral illnesses including flu and RSV. ERs and pediatric ICU beds are already filling up in some areas and many more kids will miss precious school time on top of pandemic learning loss. Pediatrician Dr. Megan Tschudy talks with Stephanie Desmon about the importance of vaccination in prevention and protection, a worsening child and adolescent mental health crisis, and why the pandemic's lingering aftershocks are far from over.

Social determinants of health—such as access to appropriate housing, health care, and transportation—drive massive health disparities in the US, and many are underpinned by politics and policies. Professor and author Daniel Dawes talks with Dr. Josh Sharfstein about his new book which looks at the role of politics and health, why the "moral case" alone can't advance change, and how the health of the democratic process is key to a healthier and more equitable future.

Traditional after-deathcare in the US carries a huge environmental toll from burying toxic embalming chemicals to the carbon footprint of cremation. Samuel Cline Perry, a licensed mortician, professor of mortuary science, and a deathcare educator at Southern Illinois University Carbondale talks with Lindsay Smith Rogers about how the funeral industry is evolving with more options for "green burials." They also discuss new legislation around human composting and why social justice is a key aspect of the larger conversation of green deathcare.

Conversations about death and dying between physicians and patients or patients and loved ones are difficult but important. Dr. Jillian Tullis, a professor in Communication at the University of San Diego, talks with Lindsay Smith Rogers about why these conversations are important to dying well, some tools for starting the conversation (especially with loved ones who may be resistant to the topic), and some important things to consider when inquiring about someone's wishes. They also discuss how COVID-19 created an "accumulation of death experiences" that may influence how our society thinks about grief, bereavement, and "a good death" going forward.

Climate change is an urgent existential threat to public health, so why is it still considered a separate issue and how can public health take on more problem solving to address it? "Problem Solver for Public Health" Dr. Judy Monroe, president and CEO of the CDC Foundation, talks with guest host Dr. Shelley Hearne, director of the Johns Hopkins Lerner Center for Public Health Advocacy about lessons learned from tobacco battles, why engaging in politics—but not partisanship—is a crucial asset, and how public health can "make some noise" when it comes to climate change advocacy.

Dr. Raegan McDonald Mosley, an obstetrician-gynecologist and CEO of Power to Decide, returns to the podcast to talk with Dr. Josh Sharfstein about the state of reproductive health care 3 months after the overturning of Roe v. Wade. They discuss barriers to access to abortion services, interference with the care of pregnancy, and the challenge posed to US medicine and the health care system.

In June 2020, Dr. Dale Bratzler stepped in to serve as the Chief COVID Officer for the University of Oklahoma. He talks with Dr. Josh Sharfstein about making controversial health and safety decisions in a charged atmosphere, his transition from primary care to public health, and his views on COVID as a long-term issue with far-reaching impacts.

The disastrous water infrastructure issues in Flint, Michigan, and Jackson, Mississippi are not outliers. Looming failures across water, energy, and transportation systems are threatening dozens of cities. Dr. Marccus Hendricks, director of the Stormwater Infrastructure Resilience and Justice Lab at the University of Maryland, talks with Dr. Josh Sharfstein about these emerging challenges.

Across the country, kids who fall into the foster care system are getting stuck in hospitals and institutions because there's nowhere for them to go. Molly Tierney, the leader of child welfare work at Accenture, talks with Dr. Josh Sharfstein about these heartbreaking scenarios and how change starts with redefining the challenges, as well as what individuals can do in their own communities.

The unprecedented floods in Pakistan that have killed more than 1,600 people and directly affected 33 million are the result of years of planning failure coming head to head with climate change. In a two-part conversation, Dr. Josh Sharfstein talks with Dr. Debbie Guha, the head of the Center for Research on the Epidemiology of Disasters at the Lovain School of Public Health in Belgium about the scale of the disaster and contributing factors, and then to Dr. Ben Zaitchik, a Johns Hopkins Professor of Earth and Planetary Sciences about the role of climate change and why these floods are a warning to all of us.

It's a difficult time for public sector workers—health departments, social workers, sanitation staff, and more are burned out from doing so much with so little during an intense pandemic. Beth Blauer, associate vice provost for public sector innovation at Johns Hopkins, talks with Josh Sharfstein about contributing factors to the burnout, where there is innovation happening, and ways for public officials to embrace "the chutzpah of leadership."