Mailman School Scholars Advance Knowledge at APHA

The scene was set in New Orleans last week for the biggest stage in public health, where more than 13,000 took part in the American Public Health Association Conference—including over 40 Mailman School faculty, students and alumni, who explored everything from motor vehicle safety and sexual risk to occupational health and the ethics of fear-based interventions.  

Buckle Up in the Back Seat

In close to half the country, it’s the law to wear a seatbelt no matter where you sit in a car. And for good reason. Looking at data from fatal car accidents, alumnus Eli Ranses (MPH ‘14), a student of Joyce Pressley, professor of Epidemiology, reported that not belting up in the back seat is associated with a threefold increased risk of death. In fact, it’s safer to be in the front seat wearing a seatbelt than in the backseat without one, according to a presentation by MPH student Nicholas Moloci, another of Pressley’s students. In other road-related research conducted with Professor Guohua Li, doctoral student Victor Puac-Polanco found baby boomers are dying in motorcycle accidents at higher rates than other birth cohorts, and not only because of their advanced age.

Sexual Risk: Alcohol, Porn, and Hate

In examining HIV in the United States and globally, researchers want to know what behaviors increase risk for infection. Professors Victoria Frey and Eric Schrimshaw in Sociomedical Sciences looked at what might lead men who have sex with men to refrain from using a condom. Frey found racial and sexual discrimination was a factor. Schrimshaw reported that while watching online porn was common, it didn’t clearly lead to unprotected sex.

Globally, partner behaviors mattered: Sanyukta Mathur, researcher in Population and Family Health, explained that young Ugandan women whose partners used alcohol and had unprotected sex had elevated risk of HIV. In Pretoria, South Africa, intention played a role: Doctoral student Justin Long found that among men who have sex with men who intended to use a condom, alcohol increased the likelihood of unprotected sex.

Spirited Anthems

This year saw the passing of major milestone in the annals of APHA history—the 100th anniversary of the section on occupational health and safety. In a rousing keynote address, Professor David Rosner spoke about a longstanding tension over “who should bear the risk of the new industrial workplace that was emerging during this time.” One view saw workers to blame and job-related illness the result of carelessness; another emerging view demanded business assume responsibility.

Rosner illustrated his talk with a number of highs and lows from that contentious history, including the 1930 Gauley Bridge Disaster in which many hundreds of African-American workers were killed on the job due to acute silicosis from breathing construction dust without protective equipment. Rosner led the audience in several labor anthems, including “Silicosis Blues” which memorializes the disaster with the line, “Didn’t know I was digging my grave/Silicosis eating my lungs away.”

Fear-Based Campaigns

Another session took a retrospective look at the role of fear in public health. Merlin Chowkwanyun, a Robert Wood Johnson Foundation Scholar who will join the department of Sociomedical Sciences next year in the Center for History and Ethics, argued that fear both fueled and clouded the debate around nuclear power.

Longtime Center faculty Ronald Bayer and Amy Fairchild reviewed the history of fear-based advertising campaigns—which went out of fashion after World War II only to return in the 1990s. Still, there was considerable debate about whether such techniques further stigmatize groups they purport to help.

In Socratic fashion, Bayer wondered if graphic cigarette labels and other appeals to fear cloud judgment or create new opportunities for informed choices.

“Do we have a duty to use the most effective techniques we have to protect [vulnerable groups] from the consequences of their social marginalization?” asked Bayer. “And if we do not act in the most effective way, have we condemned them to the suffering and death and short lives from behaviors that are not individual behaviors but are socially structured?”

The theme of the 2014 conference was Healthography, a nod to the geographic determinants of health. At its conclusion, participants, sated with research findings, returned to their respective homes. Until it begins again at next year’s conference in Chicago.