Health Policy, Equity, and the Lead Poisoning Crisis: A Conversation with Dr. Mona Hanna-Attisha

Dr. Mona Hanna-Attisha delivered the 33rd Annual Herbert Lourie Memorial Lecture on Health Policy on Thursday, September 23, 2021. This year\u27s lecture was titled, Health Policy, Equity, and the Lead Poisoning Crisis: A Conversation with Dr. Mona Hanna-Attisha Mona Hanna-Attisha, MD, MPH, FAAP, is founder and director of the Michigan State University and Hurley Children’s Hospital Pediatric Public Health Initiative, an innovative and model public health program in Flint, Michigan. A pediatrician, scientist, activist, and author, Dr. Hanna-Attisha has testified three times before the United States Congress and was awarded the Freedom of Expression Courage Award by PEN America. She was named one of Time magazine’s 100 Most Influential People in the World and recognized as one of USA Today’s Women of the Century for her role in uncovering the Flint water crisis and leading recovery efforts, and most recently, received the 2020 Fries Prize for Improving Health. A frequent contributor to national media outlets, including the New York Times and Washington Post, Dr. Hanna-Attisha has appeared on CNN, MSNBC, BBC and countless other outlets championing the cause of children in Flint and beyond. She is the founding donor of the Flint Child Health and Development Fund (flintkids.org). A Covid-19 survivor, Dr. Hanna-Attisha has donated her convalescent plasma several times while continuing to advocate for health and racial equity. With concentrations in environmental health and health policy, Dr. Hanna-Attisha received her bachelor’s degree and Master of Public Health degree from the University of Michigan. She completed her medical degree from Michigan State University College of Human Medicine and her residency at Children’s Hospital of Michigan in Detroit, where she was chief resident. She is currently a Charles Stewart Mott Endowed Professor of Public Health and an associate professor of pediatrics and human development at Michigan State University College of Human Medicine. Dr. Hanna-Attisha is the author of the widely acclaimed and bestselling book What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City. For more information on Dr. Hanna-Attisha, please visit www.prhspeakers.com

High tensile steel as normal reinforcement in concrete

The use of high tensile steel as normal reinforcement in concretemembers necessitates the study of the behaviour of such members under theaction of static, fatigue and sustained loading. The present state ofknowledge of the effects of the type of steel and the type of loading onthe serviceability and strength of concrete members has been reviewed. Froma comparison of structures reinforced with ordinary and high tensile steels,it has been indicated that by increasing the permissible steel stresses greatsavings can be obtained, but the deflection and cracking become more pronounced,especially when the effects of long-term loading are considered. Limitedinformation has been reported on the effect of the static cyoles, subsequentto the first cycle, on these two limit states. In view of the above, theapplicability of the limit state design, and the study of the recommendationsof codes of practice of several countries, it was felt that an experimentalinvestigation was required to study the behaviour, in cracking and deflection,of concrete members reinforced with hiEýi tensile steel and subjected to static,fatigue and sustained loading.A programme of an experimental investigation was designed to study thebehaviour of reinforced concrete beams

Retrospective assessment of a collaborative digital asthma program for Medicaid-enrolled children in southwest Detroit: reductions in short-acting beta-agonist (SABA) medication use

Background Real-world evidence for digitally-supported asthma programs among Medicaid-enrolled children remains limited. Using data from a collaborative quality improvement program, we evaluated the impact of a digital intervention on asthma inhaler use among children in southwest Detroit. Methods Children (6–13 years) enrolled with Kids Health Connection (KHC), a program involving home visits with an asthma educator, were invited to participate in a digital self-management asthma program (Propeller Health). Patients were provided with a sensor to capture short-acting beta-agonist (SABA) medication use, and given access to a paired mobile app to track usage. Patients’ healthcare providers and caregivers (“followers”) were invited to view data as well. Retrospective paired t-tests assessed change in mean SABA use and SABA-free days (SFD) over time, and regressions explored the relationship between followers and medication use. Results Fifty-one patients were assessed. Mean program participation was nine months, and patients had on average 3 followers. From the first to last participation month, mean SABA use decreased from 0.68 to 0.25 puffs/day (p\u3c0.001), and mean SFD increased from 25.2 to 28.1 days/month (p\u3c0.001). 76% of patients had an increase in the number of SFD. There was a positive, but non-significant, relationship between the number of followers and reductions in SABA inhaler use. Conclusions We observed a significant reduction in SABA inhaler use and an increase in the number of SABA-free days among Medicaid-enrolled children enrolled in a multi-modal digital asthma program

Duty to Protect: Enhancing the Federal Framework to Prevent Childhood Lead Poisoning and Exposure to Environmental Harm

Scientific evidence indisputably demonstrates that lead poisoning causes permanent neurological damage and numerous co-morbidities for children and adults. Exposure to lead hazards irreversibly harms individuals and, left unchecked, can devastate communities into the future. In recognition of these threats, the President\u27s Task Force on Environmental Health Risks and Safety Risks to Children (Task Force) was established by Executive Order in 1997. The original Task Force created the first coordinated federal response to eliminate childhood lead poisoning in the United States and set an ambitious ten-year timeline to achieve its goals of prevention, treatment, research, and progress management. However, the most recent Task Force retreated from these bold goals. Rather than eliminating lead poisoning, in 2018 the Task Force sought merely to reduce it. This Article provides a comprehensive overview of the dangers of lead exposure, details the federal government\u27s evolving response to lead poisoning, and, for the first time, disseminates previously unpublished comments on Drafting a New Federal Strategy to Reduce Childhood Lead Exposures and Impacts, submitted to the Task Force in 2017, ahead of its most recent report. By providing these comments publicly, this Article creates a record of critical recommendations to the Task Force, provides best practices for the federal government\u27s response to lead poisoning, and encourages federal policymakers to take the necessary steps to meet the original goal of eradicating lead hazards and protecting children from lead poisoning

Health Justice Strategies to Eradicate Lead Poisoning: An Urgent Call to Safeguard Future Generations

Despite over a century of evidence that lead is a neurotoxin that causes irreparable harm, today, lead continues to pervade children\u27s environments and remains a constant threat to health and wellbeing. One in three homes across the United States housing children under the age of six has significant lead-based paint hazards that place occupants at risk of permanent neurological harm and lifelong poor health risks. Federal, state, and local governments must use a range of primary prevention strategies in order to fully eradicate the risks and protect children from lead poisoning. This Article provides a comprehensive examination of best practices for addressing lead poisoning and proposes urgent reform measures at the local and state levels. Successful interventions ultimately prioritize health justice strategies and rely on community ownership and cross-sector participation; dedicate significant resources and funding to completely eliminate lead in the environment; and prioritize primary prevention practices that identify lead-based paint hazards before children are exposed

Duty to Protect: Enhancing the Federal Framework to Prevent Childhood Lead Poisoning and Exposure to Environmental Harm

Scientific evidence indisputably demonstrates that lead poisoning causes permanent neurological damage and numerous co-morbidities for children and adults. Exposure to lead hazards irreversibly harms individuals and, left unchecked, can devastate communities into the future. In recognition of these threats, the President\u27s Task Force on Environmental Health Risks and Safety Risks to Children (Task Force) was established by Executive Order in 1997. The original Task Force created the first coordinated federal response to eliminate childhood lead poisoning in the United States and set an ambitious ten-year timeline to achieve its goals of prevention, treatment, research, and progress management

A Search for WIMPs with the First Five-Tower Data from CDMS

We report first results from the Cryogenic Dark Matter Search (CDMS II) experiment running with its full complement of 30 cryogenic particle detectors at the Soudan Underground Laboratory. This report is based on the analysis of data acquired between October 2006 and July 2007 from 15 Ge detectors (3.75 kg), giving an effective exposure of 121.3 kg-d (averaged over recoil energies 10--100 keV, weighted for a weakly interacting massive particle (WIMP) mass of 60 \gev). A blind analysis, incorporating improved techniques for event reconstruction and data quality monitoring, resulted in zero observed events. This analysis sets an upper limit on the WIMP-nucleon spin-independent cross section of 6.6$\times10^{-44}$ cm$^2$ (4.6$\times10^{-44}$ cm$^2$ when combined with previous CDMS Soudan data) at the 90% confidence level for a WIMP mass of 60 \gev. By providing the best sensitivity for dark matter WIMPs with masses above 42 GeV/c$^2$, this work significantly restricts the parameter space for some of the favored supersymmetric models.Comment: 5 pages, 4 figures, submitted to PRL 28 March 200

Low-threshold analysis of CDMS shallow-site data

Data taken during the final shallow-site run of the first tower of the Cryogenic Dark Matter Search (CDMS II) detectors have been reanalyzed with improved sensitivity to small energy depositions. Four ~224 g germanium and two ~105 g silicon detectors were operated at the Stanford Underground Facility (SUF) between December 2001 and June 2002, yielding 118 live days of raw exposure. Three of the germanium and both silicon detectors were analyzed with a new low-threshold technique, making it possible to lower the germanium and silicon analysis thresholds down to the actual trigger thresholds of ~1 keV and ~2 keV, respectively. Limits on the spin-independent cross section for weakly interacting massive particles (WIMPs) to elastically scatter from nuclei based on these data exclude interesting parameter space for WIMPs with masses below 9 GeV/c^2. Under standard halo assumptions, these data partially exclude parameter space favored by interpretations of the DAMA/LIBRA and CoGeNT experiments' data as WIMP signals, and exclude new parameter space for WIMP masses between 3 GeV/c^2 and 4 GeV/c^2.Comment: 18 pages, 12 figures, 5 table