Empowered Health

America has a critical need for more doctors, especially in underserved communities. The American Medical Association estimates a shortage of about 35,000 primary care physicians and 60,000 specialists by 2025. Rural areas will be hit hardest by this, along with inner-city communities, both of which already face additional socio-economic barriers to adequate healthcare. The MAVEN Project is working to connect experienced volunteer physicians to vulnerable health centers to combat these shortages.

COVID-19 has caused many patients to shift from their usual office visits to now-covered telehealth appointments. Virtual visits allow for the ability to remotely manage medical issues during a time when in-person care may not be an option for many. But even in pre-pandemic times, the U.S. has limited access to mental healthcare, while demand for support increases. We explore the mental health app landscape and investigate how effective telepsychiatry really is. We hear from Karan Singh, CEO of Ginger, an on-demand mental healthcare app, on how his platform delivers care. Dr. Lynn Bufka, of the American Psychological Association, discusses if therapy is as engaging over a screen versus face-to-face. Lastly, digital mental health researcher Dr. Jennifer Nicholas helps us understand how to vet mental health apps, addresses privacy concerns, and talks about issues in the space.

Social media allows those living with medical conditions to share health anecdotes and advice to a wider audience, turning many patients into influencers within their condition's community. Healthcare companies, in turn, have increasingly tapped into these networks by partnering with influencers on campaigns. Julie Croner of WegoHealth, a patient influencer talent agency, joins us to discuss the ethical dilemma that advocates face when compensated. We revisit the credibility issues around influencers' sponsored content with journalist Suzanne Zuppello.

Influencers aren't just promoting beauty, lifestyle, and fashion products anymore, they're posting #ads with medical devices, pharmaceuticals, and even testimonials on surgical techniques. But is this ethical? Dr. Sophie Boerman, who studies consumers' understanding of sponsored content, helps us understand why these posts are so influential. Suzanne Zuppello, who has been reporting on the trends in health sponcon, breaks down the ways the government has failed at regulating these ads.

While the coronavirus shutdowns have been difficult for everyone, they weigh especially heavy on single moms who are navigating everything alone. Dr. Marika Lindholm, a sociologist and founder of Empowering Solo Moms Everywhere (ESME), an online community for solo mothers, explains how the pandemic has amplified single mothers' socioeconomic vulnerabilities. Across dozens of ESME-hosted Facebook groups, the moms' posts contain the same undertone: They are scared.

Bladder leakage is not something women have to live with, yet many do. While approximately half of U.S. women over 50 experience urinary incontinence, very few seek treatment. Urogynecologist Dr. Carolyn Swenson breaks down the most common forms of urinary incontinence, addresses leakage during the postpartum period, and lays out treatment options. Dr. Donna Mazloomdoost, director of the NICHD Pelvic Floor Disorders Network, discusses the lack of attention around the condition and shares helpful resources.

With more Americans dying in their homes than in hospitals, end-of-life doulas are stepping in to assist the process. While doulas are mainly associated with the role of supporting mothers through pregnancy, doulas who guide clients through their last moments are rising in popularity. For those with a loved one nearing the end, death can be a taboo topic. The end-of-life doula helps make everyone comfortable with the process, assisting with burials, legacy work, estate planning, companionship and more.

A constant theme on Empowered Health is the importance of advocating for your own health, but what does that exactly mean? Christie VanHorne, a public health consultant, joins us to explain how she helps others understand good patient-provider communication. VanHorne teaches how to best prep for office visits, communicate efficiently during appointments, and understand bias in health care in her various workshops.

Manal Rostom has never let her hijab stop her from excelling at her sport. In 2015, the Dubai-based athlete broke barriers as the first hijabi woman in a Nike campaign, modeling their new sports hijab. Later, she became the first Egyptian woman to run Great Wall of China Marathon marathon—the pharmacist-turned-runner is on track to run all six of the major marathons. Rostom runs Surviving Hijab, a female-only Facebook community, as a space for other veiled women to find support, advice and inspiration.

Dr. Heather Hirsch, who leads the Menopause and Midlife Clinic at Brigham and Women's Hospital, breaks down what women should expect as they go through menopause. We discuss estrogen replacement therapy, hot flashes, changes in metabolism during menopause, and the Women's Health Initiative. Hirsch also explains how cognitive behavioral therapy can be beneficial when dealing with the symptoms that arise during the menopausal transition.

You may be conscientious of the ingredients—or even the macronutrients—in the meals you eat, but what about the chemicals used during crop production of your food? For the past two decades, journalist Carey Gillam has covered American agriculture. Her book "Whitewash" chronicles what happens when agribusinesses place corporate interests over public safety. Gillam explains the potential health hazards of glyphosate, one of the most widely used herbicides, which is most commonly found in the weedkiller Roundup.

After altering her diet to fix her own health problems, psychiatrist Dr. Georgia Ede became fascinated by how what we eat affects our physical and mental health. Ede helps her patients reduce or eliminate their need for psychiatric medications using nutritional strategies. She will also explain how to thoroughly examine nutrition studies, specifically taking a look at EAT-Lancet's plant-based recommendations and unpacking its inconsistencies.

Metformin, most commonly used to treat type two diabetes, is one of the most prescribed medications in the United States. We talk to Cindi Morshead, whose research found metformin has sex-dependent effects on brain repair in mice. In recent years, metformin’s off-label benefits have become an area of interest, with some even deeming it a miracle drug. We were curious about the adverse effects of the drug, so Adam Konopka joins us to explain his study looking at how metformin blunts the effects of exercise.

After watching the Sandy Hook tragedy unfold on the news, Shannon Watts knew she needed to do something. She went on to found Moms Demand Action for Gun Sense in America, a non-partisan grassroots movement working to end gun violence. We talk to Watts about the power of organized mothers, the organization's main initiatives, how Moms Demand Action gets major retailers to listen, and the pushback she gets from oppositional groups.

Human trafficking is a major public health crisis in the United States. While most cases remain unreported, we know that women and children are often the victims of the modern day slavery. Dr. Hanni Stoklosa, an emergency medicine physician at Brigham and Women's Hospital and executive director of HEAL Trafficking, breaks downs what human trafficking consists of and clears up misconceptions. Stoklosa explains how clinicians are in a unique position to help trafficked persons due to how frequently they access health care.

TIME'S UP, a movement against sexual harassment and discrimination in the workplace, launched affiliate TIME'S UP Healthcare in March 2019 to create more equitable conditions for female healthcare professionals. The healthcare industry is dominated by women, they make up 80 percent of the workforce, yet they only hold 20 percent of leadership roles. We speak to TIME'S UP Healthcare's new executive director, Dr. Lauren Powell, to hear what she hopes the organization can accomplish.

The new year is often accompanied by the desire to change whatever feels stagnant in our lives. For some, that change may be a pivot in their career path. But what does switching industries entail? Melini Jesudason, who is currently a yoga teacher and influencer, explains how she had to start over from scratch after leaving a successful career in investment banking. Pivoting expert Wendy Sachs shares some of the tricks of the trade from her book “Fearless and Free: How Smart Women Pivot and Relaunch Their Careers."

In the first part of our mammogram series, we unpack the doubts regarding mammography’s effectiveness. In this episode, Dr. Daniel Kopans, a retired radiologist, explains why he thinks women should get mammograms. We break down how statistics surrounding screening can be manipulated and why you should be aware of your absolute risk. These opposing opinions can leave women feeling confused, so we ask ob-gyn Dr. Jenn Conti how she advises her patients in their decision-making process.

If breast cancer is detected early, it is very responsive to treatment—but the choice to get screened via mammogram, an x-ray picture of the breast, is an area of heated debate. Different governing bodies offer conflicting guidelines on when and how often to get a mammogram. In part I of our two-part series on mammography's effectiveness, former breast cancer surgeon and current epidemiologist Dr. Mette Kalagar explains the impact of mammography overdiagnosis, which is when mammograms find tumors that wouldn’t turn into harmful cancer if left undetected. Dr. Anthony Miller discusses the findings from his large randomized control screening trial, which followed almost 90,000 women for 25 years. The study concluded that annual mammograms did not cause a difference in breast cancer mortality for the mammography and control arms of the study.

While completing her undergrad at the University of Michigan, Dr. Julie Foucher-Urcuyo craved the community she felt as a high school athlete. She rediscovered that feeling after joining a local Crossfit affiliate. Foucher-Urcuyo went on compete in the Crossfit Games–some of which she was in medical school during– and became an influential member of the Crossfit world. Emily and Foucher-Urcuyo talk goal-setting, overcoming perfectionism and personal fulfillment. They also discuss why she went into family medicine and how she incorporates what she learns in the Crossfit world into her practice.

Four days after publication, journalist Jennifer Block's op-ed “Doctors Are Not Gods” was retracted from Scientific American after severe backlash. The piece critiqued doctors who come across as all-knowing, specifically targeting influential ob-gyn Dr. Jen Gunter, who doesn't hold back when informing Twitter users about evidence-backed medical advice for women. Block argues that Gunter's dismissal of alternative treatments may invalidate women's lived experiences. The debate continued on Twitter where many, Gunter included, felt that it was a hit piece. Emily asks Block: why did you write this piece?

Each year, about 32 million American women travel solo, according to the Travel Industry Association. For female solo-travelers, safety is always top of mind. Erika Weisbrod, director of security solutions for International SOS, is an expert in travel risk management. Weisbrod breaks down the factors women should consider when traveling, what are the necessary precautions they should take and how to approach different situations overseas. Diana Edelman, who spent many years as a travel blogger living in various countries, discusses the pros and cons of the ex-pat lifestyle compared to vacationing. Edelman explains her realization that she was "running away" via travel instead of traveling to explore, which can happen when we feel feel depressed or anxious or lonely or stuck.

In October 2019, Jessica Nabongo became the first black woman to travel to every country in the world. Not only is NaBongo an expert traveler, but she has a wealth of knowledge on international tourism and development. Between her Master’s degree from the London School of Economics, being employed by the UN, starting two tourism-focused companies, and hitting all 195 counties in the world, Nabongo is going to give us the scoop on how to be the ultimate female jetsetter.

Did you know there is a connection between mental health and medical disorders like cardiovascular disease or Alzheimer's disease? Clinical neuroscientist Jill Goldstein, a professor of psychiatry and medicine at Harvard Medical School and the executive director of the Innovation Center on Sex Differences in Medicine, explains why women are disproportionately affected by these co-occurences. They have twice the risk of developing a co-occurrence of heart disease and depression than men do. Goldstein explains how links between the heart and brain can be traced back to prenatal development.

Progesterone, a hormone that helps prepare the uterus to receive a fertilized egg, plays a huge role in fertility. Pregnancy is made difficult by having low levels of the hormone progesterone, a fact many women are unaware of. After experiencing IVF for her first child, Amy Beckley, a scientific researcher with expertise in hormone signaling, wondered if there was an easier way to conceive. She began to track her progesterone at home, discovering she had low levels. After using supplements to level herself out, she delivered a second baby without IVF. Beckley wants to help other women trying to conceive – who may have low progesterone and not even know it – so she invented Proov, an at-home five-minute test to track progesterone.

Approximately 6.1 million women in America struggle to get pregnant every year, according to the CDC. This leads many couples to explore assisted reproductive technologies, most commonly in-vitro fertilization. In part I of our infertility series, we explain what women need to understand about infertility, what the process of IVF is like, and how much emotional and physical labor is involved. Reproductive endocrinologist Dr. Alan Penzias of Boston IVF discusses the most common infertility issues, what the typical treatment process involves and how significant egg quality and quantity are. Penzias also addresses how often men are the cause of infertility issues and how age plays a role in fertility.

More women are dying from childbirth today than when our moms had babies. Pregnancy and childbirth are complex and tech companies are hoping to help make these experiences safer. There has been little innovation in this space since the 1970s. The need for creative solutions to fix maternal problems is clear, so we wanted to know what the tech companies were doing to help make pregnancy and childbirth more safe. Mahmee is an app designed to improve postpartum care for both mom and baby, led by mother-daughter duo Melissa and Linda Hanna. Nuvo, which is awaiting FDA approval, developed a practitioner-facing device that monitors uterine activity and both maternal and fetal heart rate, which the doctor analyzes and communicates back to the patient. Bloomlife also monitors contractions, but reverses Nuvo’s structure by giving mothers their information first as a tool to bring into their doctor’s office.

The Pan-Mass Challenge's (PMC) annual bike ride fundraiser broke records with this year's $63 million donation to the Dana-Farber Cancer Institute in Boston. The PMC, led by Billy and Meredith Starr, has exclusively raised $717 million for Dana-Farber over its 40-year history. Dana-Farber president and chief executive Dr. Laurie Glimcher explains how the funds impact patient care and research. Over 150 Dana-Farber employees participated in the last ride, including Dr. Katherine Janeway, who was a cancer patient at the hospital herself.

What do you feed your children at snack time? Fruit snacks? Kid’s yogurt? Gatorade? So many of us don’t realize how much sugar is in these foods, which are often marketed as healthy options. With over two decades of experience as a pediatrician, Dr. Shakha Gillin noticed how many health issues could be solved by a better diet. She realized to fix kid’s eating habits, she needed to educate parents and the school system, the main sources teaching kids the right way to take care of themselves.

Louisiana, Mississippi, and Alabama are among states that have passed laws challenging Roe v. Wade's ruling. With the possibility of states overturning the Supreme Court's decision, we looked at how being denied an abortion affects women. The Turnaway Study, led by Diana Foster Greene, compares the outcomes of women who received an abortion with women who were denied an abortion. OB-GYNs Dr. Jenn Conti and Dr. Erica Cahill further explain the challenges of abortion providers face in the current climate.

When you need help who do you turn to? Instagram? Facebook? Online advice can come loaded with judgment and inaccuracies, but it is accessible and relatable and that makes it potent. We talk to Dr. Margaret Quinlan and Bethany Johnson, the authors of "You’re Doing it Wrong! Mothering, Media, and Medical Expertise", on how mothers face criticism for their choices, from the historical medical expertise of the nineteenth century to the newsfeeds of today.

Even with decades of experience as a cardiology nurse, Kristin O'Meara initially dismissed her own warning signs of a heart attack, relying on the fact she was healthy and active. Hours later, O'Meara would find herself in the emergency room recovering from a heart attack caused by a condition many otherwise healthy women suffer from: spontaneous coronary artery dissection, commonly referred to as SCAD. Many patients, paramedics, and even doctors are unaware of the condition, leaving them to associate heart attack symptoms with less dire ailments, like panic attacks. Cardiologists and SCAD experts Dr. Malissa Wood of Massachusetts General Hospital and Dr. Sharonne Hayes of the Mayo Clinic enlighten us on the rare but acute condition, which causes 40 percent of heart attacks in women under age 50. 

Back in '96, Shannon Miller led the Magnificent Seven to the gold at the Summer Olympics, earning the first-ever gymnastics win over Russia for the U.S. In 2011, Miller announced that she had been diagnosed with ovarian cancer. Following recovery, Miller went on to advocate for others with ovarian cancer. She discusses cancer's aftermath and how it caused her perspective to shift. Miller also talks on her experience growing up as an athlete in comparison to the pressure of youth sports today.

In 1989, a team of anthropologists studying Hadza hunter-gatherers in northern Tanzania noticed how hard one particular group was working: the grandmothers. “They were well into their sixties and their productivity was just as great as the women who are still in the childbearing years,” Kristen Hawkes, one of the anthropologists involved, tells Emily. Historically, women’s primary contribution to society was to give birth– implying post-menopausal women offered no value. We now have scientific evidence to prove that wrong.

From the late reproductive stage to the final menstrual period, the female body goes through a great deal of change. The spikes in estrogen during menopause cause an unpredictability that makes the transition particularly difficult. Unlike the pattern of stocking up on tampons and Advil every 28 days, women are thrown for a loop when their hormones become erratic. Dr. Jan Shifren and Dr. Nancy Woods go in-depth about memory function, feeling unstable, and what women need to be aware of during menopause.  

Hormone therapy has a complicated history. We’ve heard hormone therapy causes cancer and we’ve heard it is perfectly safe. This episode sets the record straight. We unpack the Women’s Health Initiative and why it has been so widely misunderstood, why poor methods led to misleading analysis and how the misinformation has resulted in widespread confusion. Emily asks the country’s top perimenopause and menopause experts.  Dr. Jan Shifren is the director of Massachusetts General Hospital’s Midlife Women's Health Center along with a professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School. Dr. Marcie Richardson, who was featured in last week’s episode, is an OB-GYN at Beth Israel Deaconess Medical Center and Newton-Wellesley Hospital with four decades of experience. We also hear about research done by a University of Guelph professor, Glen Pyle, that’s beginning to look at how starting hormone therapy during perimenopause may protect the heart.

As Nina Coslov reached her forties, she began questioning what her body was experiencing. Are these symptoms related to my hormones or something else? Could I be going through menopause this early? Her uneasiness led to research about the aging female body, thus learning about the late reproductive stage and perimenopause. Her newfound knowledge was a relief; she wasn’t unhappy or sick, she was just changing and it was normal. She wanted to provide other women with this reassurance, thus launching Women Living Better, an educational website on the early stages of menopause, with help from experts like Dr. Marcie Richardson and Nancy Woods.

Investigative reporter Nina Teicholz was a vegetarian for over twenty years before taking a closer look at her own diet, ultimately leading to her New York Times bestseller "The Big Fat Surprise." Teicholz's work has disrupted orthodox nutrition beliefs, challenged the dietary guidelines, and debunked the weak science around dietary fat. Nina and Emily discuss how we got red meat so wrong, along with what studies show concerning women on a low-fat diet.

Sports medicine physiatrist Dr. Amy West explains how female bodies, specifically female athlete bodies, differ from male bodies. Should you be working out on your period? What do hormones have to do with injury recovery? Do transgender athletes and those with DSD have an advantage over cisgender athletes? What is RED-S and why is it often seen amongst young female athletes? West also discusses the links between the CrossFit movement and the field of physiatry.

While all mothers are constantly working on raising the next generation, moms who end up re-entering the workforce face difficult challenges. From accepting that being a stay-at-home mom may not be your thing to being discriminated in the workplace for being a mother, your career path gets complicated if and when you decide to have children. We are joined by the creator and host of the Double Shift Podcast, Katherine Goldstein which shares stories of current mothers in the workforce, along with Kathleen McGinn of Harvard Business School, who researches how gender and class impact work, home life, and negotiations.

Endometriosis is a disorder where the endometrial tissue– tissue similar to that of the uterus lining– appears in other parts of your body, usually in the pelvic region, but could spread as high as your lungs. An estimated one in ten American women have endo, however, many women remain undiagnosed. On average, it takes a decade to finally get a diagnosis. That’s a long time to deal with chronic pain, being dismissed, and the stress of it all. There is currently no cause or cure, leaving many in the dark about what’s going on with their bodies. We talk with some of the women who have endured endometriosis along with experts Dr. Stacey Missmer, the scientific director of the Boston Center of Endometriosis, and Dr. Ken Sinervo of the Center for Endometriosis Care.

This episode is a continuation from episode 16 of our conversation with investigative reporter Gary Taubes, author of "Good Calories, Bad Calories", "Why We Get Fat", and "The Case Against Sugar." Taubes has written extensively on how dogmatic beliefs around a low-fat diet are flawed and how bad science has contributed to that. If you haven't listened to that conversation from last week, we would suggest you do that first.

Gary Taubes is an investigative science journalist who has spent the last 40 years covering controversial science. Back in 2002, his New York Times Magazine piece "What if It's All Been a Big Fat Lie?" led Taubes to gain recognition as one of the few reporters taking on the challenge of questioning the conventional dietary wisdom. The article turned into a deeper investigation of the medical science establishment, resulting in his best-selling books “Good Calories, Bad Calories” and “Why We Get Fat: And What To Do About It.” In the first episode of a two-part series, Taubes discusses how questioning “pathological science” has caused him to bump heads with the scientific community. Pathological science is a term used when scientists trick themselves into believing what the want the result of their studies to be, not what the results show.

Heart disease is the leading cause of death in men and women alike, but the symptoms, causes, and outcomes differ among the sexes. Heart disease is a catch-all for many cardiovascular conditions, so for this episode, we are focusing on small vessel disease. Women tend to get blockages in the small vessels, whereas men have plaque build-up in their large arteries. Cardiologists Dr. Janet Wei of the Barbara Streisand Women's Heart Center at the Cedars-Sinai Smidt Heart Institute and Dr. Giulia Sheftel of Newton-Wellesley Hospital discuss how these blockages happen, Yentl Syndrome, and the interplay of estrogen and heart health.

We spend a great deal of time on Empowered Health discussing how sex differences affect culture and science, but accounting for gender identity is key to an all-encompassing understanding of health issues. Author and activist Sarah McBride joins us to discuss the complexity of gender identity. McBride is a transgender advocate who works as the press secretary of the Human Rights Campaign. During her senior year at American University, known for its hyper-politicized campus in the heart of D.C., McBride made headlines when she came out as transgender while serving as study body president. Since then, she had a critical role in passing legislature banning gender identity discrimination in Delaware, was the first openly transgender person to address a major party convention, and published a book detailing her experience in the fight for transgender equality.

In Italy, pregnant women are likely to enjoy a glass of wine once a week. In Japan, sushi remains a staple for dinner even during the third trimester. In America, women are told over and over again that these items, and a laundry list of others, must be restricted during pregnancy. Economist Emily Oster breaks down the typical pregnancy recommendations with data-driven research in "Expecting Better" to provide women a better understanding of the choices they can make during pregnancy. Oster's latest book, "Cribsheet", weighs the pros and cons of sleep training, breastfeeding, and the many other decisions parents have to make during early childhood.

Nearly 12 million U.S. women and girls aged 12 to 52 are living in poverty. This 40-year age range spans the average American's menstruating years. If most of these females are struggling to afford food, how can they be expected to buy tampons? For low-income menstruators, the financial burden of menstruating makes the monthly occurrence even worse. The American College of Obstetrics estimates two-thirds of low-income women don't have enough money to buy menstrual products at least one time per year. Nadya Okamoto of PERIOD. The Menstrual Movement and Kate Sanetra-Butler of Dignity Matters, two leaders working to end period poverty, break down why it should be a right to health for every woman to have access to menstrual products. Colorado Rep. Leslie Herod fills us in what it's like to get your period in prison and the bill she sponsored to better those conditions.

In November 2018, Chinese scientist He Jiankui announced the birth of the first CRISPR babies. You may have seen CRISPR popping up in science news over the past few years, but still don't really understand what it is. This week, bioethicist Francoise Baylis breaks down what exactly this gene-editing technology could mean for humanity, from futuristic super senses to disease-resistant babies. 

Every hour an American veteran dies by suicide. Behind every one of them, a wife, girlfriend, partner and often young children are left trying to process the loss and their new future. Who cares for these survivors? How do we, as a country, honor them? Turns out until recently we weren’t. This episode will answer those questions and draw a parallel between those veterans who are traumatized by a comrade’s death abroad and the women who have a similar experience when they lose their loved ones at home.  

Pornography in the United States is a massive business; some reports estimate it brings in approximately one trillion dollars in annual revenue. In this episode, we look at the differences in how women and men consume porn, how it impacts relationships and its influence on society at large. We discuss pornography's cultural implications with Samuel Perry, professor of sociology and religious studies, Cindy Gallop, CEO of MakeLoveNotPorn, and Dr. Gail Dines, anti-porn scholar and CEO of Culture Reframed.

Author Sarah McColl discusses her memoir "Joy Enough", a tribute to her late mother. McColl joins Empowered Health for a conversation on the mother-daughter dynamic, transitioning through periods of loss, and experiencing joy during life's ups and downs.