Public Health On Call

Thanks to policies like tobacco taxes, clean indoor air acts, and legislation to ban flavor additives, tobacco use is declining around the globe. But there's still an enormous burden of death and disease from smoking, and rates of use are still particularly concerning among key groups like youths and Black Americans. Joanna Cohen, director of the Institute for Global Tobacco Control, talks with Stephanie Desmon about where the US stands on major policies like banning menthol, how New Zealand's efforts to launch some of the most stringent policies in the world have fared under a new administration, and ongoing battles against tobacco industry lobbying tactics.

Tuesday, February 6 is the International Day of Zero Tolerance for Female Genital Mutilation/Cutting. Dr. Michele Decker, founding director of Johns Hopkins Center for Global Women's Health and Gender Equity, and Dr. Nicole Warren, a nurse and an expert on the harmful practice of female genital cutting talk with Stephanie Desmon about the practice and its cultural roots, challenging long-standing cultural norms, and why this year's Day of Zero Tolerance puts an emphasis on how collective action is needed to end the practice.. They also discuss the launch of the Center for Global Women's Health and Gender Equity and the work the center hopes to accomplish in priority areas like eliminating gender-based violence and harmful practices like child marriage through research, training, and translation. Learn more: https://publichealth.jhu.edu/center-for-global-womens-health-and-gender-equity

How are updated COVID vaccines performing against severe and long COVID? What have we learned about COVID transmission that could help people calculate their risk in certain situations? Do we know more about when people might be most infectious? What's the latest evidence on seasonality? And do we have any new answers about long COVID? Katelyn Jetalina, aka Your Local Epidemiologist, returns to the podcast to talk about what's new in COVID research. Learn more here: https://yourlocalepidemiologist.substack.com/

Professor Nancy Glass of the Johns Hopkins School of Nursing studies violence against women and girls in humanitarian settings and conflicts around the world. She speaks with Dr. Josh Sharfstein about key themes from this difficult work and how they apply to reports of the rape, mutilation, and murder of Israeli women and girls during the Hamas attacks on October 7, 2023. They also discuss what comes next for survivors. *Please note: This podcast was recorded several weeks ago. Earlier this week, the United Nations announced it was sending a team to Israel to investigate these reports. Also, please note that this is a difficult conversation that discusses sexual violence including rape.

With more widespread use of cannabis has come an uptick of reports of related psychotic symptoms, especially among youths and young adults. Dr. David Wolinsky, a psychiatrist at Johns Hopkins, talks with Stephanie Desmon about cannabis and the risk of psychosis and what is known (and not known) about how cannabinoids interact with our bodies. They also discuss who might be most at risk and some takeaways people can consider about cannabis use when the field of research is still so lacking about the benefits and risks.

More than 85,000 participants attended the 28th Conference of the Parties to the UN Framework Convention on Climate Change in Dubai, better known COP28, which ended in December. The big news: a call to governments to speed the transition away from fossil fuels. Susan Joy Hassol, author and climate change communicator, tells Stephanie Desmon that the final agreement is a hollow disappointment misaligned with the urgency of the climate crisis. They discuss the "minefield" of the growing climate emergency and what global leaders should be doing to put meaningful action behind commitments to addressing it.

Ketamine prescriptions for chronic pain and mental health are increasing, but what is known about the safety and effectiveness for off-label use? And how are doctors prescribing a drug approved as an anesthetic in clinical settings for outpatient use? Dr. Caleb Alexander returns to the podcast to talk with Lindsay Smith Rogers all about ketamine.

Rural communities have unique challenges and opportunities when it comes to health. Cara James, president and CEO of Grantmakers in Health, a philanthropic organization that supports rural health foundations, talks with Dr. Josh Sharfstein about some of the unique facets of small communities including economic disparities and struggling health care systems. They also discuss addressing misinformation and the role that foundations can play in connecting people with much-needed services.

Congress banned most surprise medical bills back in 2020, with one major exception: ambulance rides. Can lawmakers find a fix? Guest host Dan Gorenstein of the Tradeoffs podcast investigates. Learn more: https://tradeoffs.org/2023/11/09/surprise-ambulance-bills/

Substance use disorder is recognized as a disability and therefore protected under antidiscrimination laws. But stigma persists, even in health care settings where people who use substances may be denied necessary care. Rebekah Joab, senior staff attorney at the Legal Action Center, talks with Lindsay Smith Rogers about LAC's litigation and advocacy efforts to combat SUD-based discrimination and the details of a major lawsuit against a hospital that allegedly denied critical care to a patient. Learn more about LAC's work: https://www.lac.org/

Anopheles stephensi, a species of mosquito native to Southeast Asia, is finding its way to Africa. Unlike Anopheles gambiae, the species native to Africa, Anopheles stephensi can breed in tiny amounts of water year-round and has made a comfortable home in urban areas. It's also a remarkably adept spreader of malaria in places and to extents not normally seen in places across the continent. In an extended episode of Malaria Minute, a podcast from the Johns Hopkins Malaria Research Institute, guest host Thomas Locke discusses how researchers are tracking stephensi and how the invasive species could complicate efforts to control the disease in Africa. Learn more: www.who.int/teams/global-malaria-programme/prevention/vector-control/global-databases-on-invasive-mosquito-vector-species

Just because we can do something medically, should we? A new podcast from the Johns Hopkins Berman Institute of Bioethics explores some unintended consequences of advancing technology and medicine. Bioethicist and playing god? producer Jeff Kahn talks with Stephanie Desmon about the podcast and some of the topics they cover, including ethics around buying and selling organs, fertility, and more. Learn more: https://bioethics.jhu.edu/research-and-outreach/the-dracopoulos-bloomberg-bioethics-ideas-lab/projects/playing-god/

Are you one of the millions of people who experience dry skin and itchiness when the weather becomes colder? Dermatologist Dr. Shafat Hassan talks with Dr. Josh Sharfstein about what happens to our skin in the wintertime and how we can take care to reduce redness, chapping, and other dermatological issues. Spoiler alert: It's also important to apply sunscreen, even on blustery, cold days.

Known risk factors for suicide, such as gender and race, are too general to pinpoint who might be in imminent danger. Johns Hopkins psychiatrist Dr. Paul Nestadt talks with Stephanie Desmon about "psychological autopsies," or investigations of suicides to better understand who is at risk—and where there might be opportunities for interventions. Learn more: https://magazine.jhsph.edu/2023/looking-for-why Please note that this podcast contains mentions of self-harm and suicide. If you or someone you know is struggling, there are ways to get help. Call 988 for free, confidential crisis counseling and referrals available 24/7.

An increased prevalence of firearms and a lack of public denouncement of violence are escalating the risks of violence in places critical to political participation. Tim Carey, law and policy advisor at the Johns Hopkins Center for Gun Violence Solutions, talks with Stephanie Desmon about a new report from the Center that lays out gun policy and communication recommendations to ensure that the places in which democracy plays out—legislatures, election offices, public demonstrations and more—remain safe. Learn more: https://publichealth.jhu.edu/2023/preventing-armed-insurrection-firearms-in-political-spaces-threaten-public-health-safety-and-democracy

Dr. Paul Spiegel, a physician, epidemiologist and the director of the Center for Humanitarian Health at the Johns Hopkins Bloomberg School of Public Health, has worked in humanitarian emergencies for the last 30 years. In a bonus episode, Dr. Spiegel talks with Dr. Josh Sharfstein about his recent deployment to Cairo, Egypt as a strategic advisor to the United Nations Relief and Works Agency for the health response in Gaza.

Since 2020, New Yorkers have lost around 4.6 years of overall life expectancy—and up to 5.5 years for Black and 6 for Latino residents. NYC's Health Commissioner Ashwin Vasan talks with Dr. Josh Sharfstein about Healthy NYC, an initiative building on the momentum of the pandemic to claw back these losses and improve the overall health of the population. They discuss the goals of the initiative, how success is measured, and specific tactics to address some of the greatest threats to health and life in the metropolis. Learn more: https://www.nyc.gov/site/doh/about/about-doh/healthynyc.page

In the last episode of 2023, Lindsay Smith Rogers talks with co-hosts Dr. Josh Sharfstein and Stephanie Desmon about 2023. This year saw a rise in non-COVID topics, including Supreme Court cases, malaria, RSV, antitrans health legislation, climate emergencies, artificial intelligence, and more. They also talk about what topics they're thinking about for 2024. Learn more about another one of our projects, the Expert Insights newsletter: http://publichealth.jhu.edu/subscribe

In September of this year, routine testing turned up the presence of a microscopic parasite called cryptosporidium in Baltimore's water supply. Johns Hopkins environmental health scientist Natalie Exum returns to the podcast to speak with Lindsay Smith Rogers about what the parasite's presence means for the larger water system, and why it's critical to repair and replace aging infrastructure throughout the US. Note: This podcast was recorded in November. Since then, President Biden has proposed a new plan to remove all lead water pipes across the country. Learn more about another one of our projects, the Expert Insights newsletter: http://publichealth.jhu.edu/subscribe

The Geneva Convention sets out specific protections of health care in war dating back to the 1860s. Len Rubenstein, interim director of the Johns Hopkins Center for Public Health and Human Rights and author of the book Perilous Medicine: The Struggle to Protect Health Care from the Violence of War talks with Dr. Josh Sharfstein about the core elements of these laws and how they apply in the current conflict.

Medications like Ozempic, Wegovy, and Mounjaro show lots of promise for treating obesity but scientists still don't understand exactly how they work. There's also a lack of data to show whether these medications are safe to take long term. Dr. Sameer Khan, a Johns Hopkins fellow in gasteroenterology, talks with Dr. Josh Sharfstein about what these medicines are and what they can do, the questions that remain, and why it's a challenge for clinicians to prescribe them and for patients to actually obtain them. Learn more about another one of our projects, the Expert Insights newsletter: publichealth.jhu.edu/subscribe

The CDC's newest center, a "national weather service for public health threats," is up and running! Dylan George, director of the center, returns to the podcast to talk with Dr. Josh Sharfstein about the center's mission, what they're working on, and how this year's viral respiratory season might stack up against last year's tripledemic.

Tuberculosis is one of the oldest diseases on earth—taking more than 1 billion lives throughout history. Dr. Richard Chaisson, director of the Johns Hopkins Center for Tuberculosis Research, talks with Dr. Josh Sharfstein about how TB continues to be a significant threat to global public health, what progress is being made in treatment and prevention, and why research will be needed until the day the last case is treated.

After two World Wars and the Holocaust, the adoption of the Universal Declaration of Human Rights of 1948 was a milestone for humanity. But 75 years later, the document remains both an inspiration and a measure of failure. Zeid Ra'ad Al Hussein, former UN High Commissioner for Human Rights, talks with Dr. Josh Sharfstein about the origins of the document, its role in "stating the obvious," and why the world has fallen woefully behind in upholding it. Learn more: https://research.un.org/en/udhr75

Peacebuilders work to help solve violent conflicts and rebuild societies through nonviolent means. Michael Shipler, vice president of Search for Common Ground, an international peacebuilding NGO, talks with Dr. Josh Sharfstein about the remarkable work the organization has done amidst some of the most intractable conflicts around the world. They discuss what factors drive violent conflict, the goals and processes of peacebuilding as a practice, and how everyone can adopt a peacebuilding mindset.

A mysterious respiratory disease is affecting dogs across the country, in some cases causing serious illness and even death. Veterinarian Dr. Meghan Davis returns to the podcast to talk with Stephanie Desmon about what we know and don't know about these cases so far, and how data collection and surveillance will be key to learning more. They also discuss One Health, a public health approach bridging human, animal, and environmental health for surveillance against novel threats.

Stimulant medications can significantly increase the quality of life for kids with attention-deficit/hyperactivity disorder. Johns Hopkins psychiatrist Dr. Rheanna Platt talks with Dr. Josh Sharfstein about how a shortage of these meds is impacting patients and their families. They discuss what's behind the shortages and address questions about whether overuse of these drugs among adults is a contributor.

PEPFAR, or the President's Emergency Plan for AIDS Relief, was initiated by President Bush in 2003 is credited with saving 25 million lives over the past 20 years and remains the largest commitment to a single disease in history. But the global bipartisan program is now at the mercy of American politics. Dr. Chris Beyrer, director of the Duke Global Health Institute and a member of the scientific advisory board for PEPFAR, returns to the podcast to talk with Stephanie Desmon about why PEPFAR's reauthorization is in jeopardy and what the failure of reauthorization could mean for global health.

An alarming rise in sexually transmitted infections like chlamydia, gonnorhea, and syphilis in the US calls for new prevention and treatment tactics. Dr. Matthew Hamill, a Johns Hopkins clinical researcher specializing in HIV and STIs, talks with Stephanie Desmon about DoxyPEP, or the use of antibiotic doxycycline after sexual contact. They discuss its effectiveness and availability, use in the context of antibiotic resistance, and why DoxyPEP isn't a silver bullet in the prevention of STIs.

Our individual health is shaped by the environments we live in. So what does that mean for the more than 280 million people worldwide who have moved across country borders from the place of their birth? Johns Hopkins Health Policy and Management assistant professor Catherine Ettman, who recently edited the book Migration and Health, talks with Stephanie Desmon about the many factors that impact the health of migrants, including whether they've moved by choice or to escape conflict or natural disaster.

As Maryland's Public Defender, Natasha Dartigue's office sees 90% of criminal cases in the state. In addition to the mission of representing individuals with criminal charges, there are new efforts underway to keep young people from getting into trouble in the first place. She speaks with Dr. Josh Sharfstein about the office's new outreach and collaborations to close critical gaps for families and help young people thrive.

Former Surgeon General Jerome Adams talks about his new book, "Crisis and Chaos, Lessons From the Front Lines in the War Against COVID-19" with Dr. Josh Sharfstein. On the topic list: his compelling personal story, the "emotionally jarring" experience of leading during a highly politicized pandemic, and his efforts to advocate for health as a bipartisan priority.

Overdose prevention sites—places where people can use illicit drugs under supervision—are extremely controversial and many cities are opposed to them because of the belief that they'll invite disorder and crime to the communities where they're operating. Dr. Brandon del Pozo, assistant professor of medicine at the Warren Alpert Medical School at Brown, talks with Dr. Josh Sharfstein about a new study that put this question to the test and what they observed in the areas around two OPCs in New York City. Read the JAMA paper here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811766

In the wake of last month's Lewiston shootings in Maine, the state's "yellow flag" law has come under scrutiny. Josh Horwitz of the Johns Hopkins Center for Gun Violence Solutions talks with Stephanie Desmon about red flag laws, or Extreme Risk Protection Orders, and why Maine's hybrid approach is so ineffective. They also discuss the constitutionality of red flag laws and a number of other effective policies that can help prevent all kinds of gun violence.

RSV—respiratory syncytial virus—is a common infection that causes cold-like symptoms but can become very severe in young children and is the leading cause of hospitalization for babies under 1. Dr. Ruth Karron, director of the Johns Hopkins Vaccine Initiative, talks with Dr. Josh Sharfstein about two new products, a vaccine for pregnant people and an antibody treatment for babies, that could substantially lower the rates of severe infections among children. However, the rollout has been slow and people may still have a hard time getting them for their children as RSV season kicks into gear.

The holiday season can be intense for anyone, but especially those who are living with grief—whether it's recent or decades old. Eleanor Haley, who has a master's in counseling psychology, and Litsa Williams, a clinical social worker, are co-founders of What's Your Grief, an online community for grieving people and grief support professionals. They talk with Lindsay Smith Rogers about ways to approach celebrations or rituals, the importance of communication with loved ones, and the need to make room for flexibility, honesty, and maybe even a little joy. Learn more: https://whatsyourgrief.com/

Many lawsuits against employers for requiring COVID-19 vaccines remain in U.S. courts. Dawn Solowey, a partner in the labor and employment practice of Seyfarth Shaw, talks with Dr. Josh Sharfstein about these court cases, the rise in public discourse around religious and medical exemptions, and implications for other workplace issues like diversity training and protections for LGBTQ individuals.

The Johns Hopkins Center for Communication Programs was established to develop and research creative ways to boost the use of modern family planning around the world. Today, as the center marks its 35th birthday, Dr. Joshua Sharfstein speaks to CCP's new executive director Debora Freitas Lopez about the program's continued mission to inspire and enable people around the world to make healthy choices about everything from contraception to COVID-19 to climate action.

Dr. Ashish Jha, former White House COVID-19 response coordinator under President Biden, helped the country move out of the acute phase of the pandemic—and learned a lot in the process. Dr. Jha talks with Dr. Josh Sharfstein about what surprised and disappointed him during his federal experience, what it was like to feel responsible for the health of 300+ million people, and why he's concerned about respiratory virus season this year, and every year. Plus: listen to the end to hear a little history about Dr. Jha and Dr. Sharfstein.

The U.S. is home to some of the widest streets and driving lanes in the world—and that's not something to brag about. Shima Hamidi, director of the Johns Hopkins Center for Climate-Smart Transportation, talks with Stephanie Desmon about a new report from the Bloomberg American Health Initiative that challenges the notion that wider lanes are safer. They also discuss how altering roads could not only help with safety, but our physical health and climate change adaptations. Learn more here: http://narrowlanes.americanhealth.jhu.edu/

Ringworm, athletes foot, and jock itch are all names for a fungal infection of our skin, hair, and nails. Dermatologist Dr. Avrom Caplan talks with Dr. Josh Sharfstein about tinea, the actual name of the infection, and how people can get it, how it's treated, and why there are global concerns about new strains that may be much harder to treat.

For the first time in 20 years, locally transmitted cases of malaria have been reported across three US states. Scientists are trying to piece together why and how malaria is appearing in places where it's no longer endemic. Guest host Thomas Locke talks with Jane Carlton, the new director of the Johns Hopkins Malaria Research Institute, about her work decoding the genomes of the parasites that have infected individuals in Maryland to determine their lineage. They also discuss the role of climate change in malaria infections, the global fight against the disease, and the extent to which the public is at risk.

National Prescription Drug Take Back Day is coming up, and Dr. Caleb Alexander joins the podcast to help you clean our your medicine cabinet in preparation. Dr. Alexander talks with Lindsay Smith Rogers about the history behind the day and its roots in response to the opioid epidemic, what kinds of drugs and equipment require safe disposal, where you can find a Take Back drop-off in your community on the 28th, and how to safely get rid of unused prescription drugs year round. Learn more: https://www.dea.gov/takebackday NOTE: In this episode we discuss medical equipment, such as syringes or "sharps" as they're called. Most DEA drop-off locations will not accept these as part of Take Back day, but you can take them to pharmacies, health clinics, police stations, and many other locations.

Humans are using up groundwater—or water stored in naturally occurring aquifers underground—at a dangerous pace. Kellogg Schwab, the Abel Wolman professor in water and public health at the Johns Hopkins Bloomberg School of Public Health, talks with Dr. Josh Sharfstein about why groundwater is being depleted so quickly, what needs to happen to ensure the world doesn't run out of this precious resource, and how water conservation could bring people together across state and country borders.

Opill, the over-the-counter birth control pill recently approved by the FDA, marked a major win for access to contraceptives. But, in the wake of SCOTUS's Dobbs decision, some have called for codifying the right to contraceptive access in federal law. Dana Singiser, cofounder of the nonprofit Contraceptive Access Initiative and senior advisor to Americans For Contraception, talks with Stephanie Desmon about Opill, the overwhelming bipartisan voter support for contraception, and her work advocating for access as a federal right.

The Aedes aegypti mosquito transmits deadly viruses like Zika, chikungunya, and dengue, but doesn't actually get sick from the diseases it carries. George Dimopoulos of the Johns Hopkins Malaria Research Institute talks with Stephanie Desmon about a new discovery of a protein, Argonaute 2, that plays a key role in the mosquito's immune system, and how genetically modifying mosquitos could make them vulnerable to the viruses they carry. They also discuss how much of an impact killing off large numbers of mosquitos would have, both on the burden of disease and larger ecological balance.

The Surgeon General issued an advisory about the epidemic of loneliness and isolation in the U.S., saying there are serious physical and mental health impacts of loneliness. Dr. Maulik Joshi, president and CEO of Meritus Health, talks with Lindsay Smith Rogers about Care Callers, an innovative volunteer program aimed to combat loneliness among Meritus patients. They discuss the incredible impacts these phone calls can make, and Dr. Joshi's own experience as a Care Caller himself.

Just back from a trip to Kyiv, Human rights expert Len Rubenstein talks with Dr. Josh Sharfstein about what things are like on the day to day right now. He recounts meetings with officials and health care workers, and their stories ranging from some degree of normalcy and routine health care delivery to brutal attacks on facilities and workers. They also discuss the status of war crime prosecution, the critical need for sustained international support, and the presence of an unwavering sense of hope and optimism among Ukrainians. Content warning: this episode contains depictions of violence and torture.

Registered dietitians with huge social media followings are getting paid to promote sugar, supplements, and other products and messages that clash with evidence-based recommendations—at times without proper disclosure. Sasha Chavkin, a reporter with The Examination, talks with Dr. Josh Sharfstein about the food industry's stealthy tactic to exploit the power that influencers can have on social media, and how this raises questions for the ethics of professional dietitians. Read The Examination's report here: https://www.washingtonpost.com/wellness/2023/09/13/dietitian-instagram-tiktok-paid-food-industry/

Nipah virus is a lethal zoonotic disease that passes from bats to humans in what are called "spillover events." But it's still not known for sure how outbreaks happen, which makes prevention difficult. Epidemiologist Emily Gurley, who has studied Nipah outbreaks in Bangladesh for nearly 20 years, talks with Lindsay Smith Rogers about her work tracking the virus's transmission and the enormous amount of multi-disciplinary resources and complexity required to investigate spillover events.