Public Health On Call

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 Leetsa Wiliams, 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

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.

Treatment for substance use disorders during pregnancy is effective, and recommended by experts in many cases. But outdated, and often misinformed, policies have led to babies being taken by child welfare agencies because their parents was on anti-addiction medication. Two Johns Hopkins experts in opioid policy, Sachini Bandara and Alex McCourt, talk with Lindsay Smith Rogers about these laws impacting pregnant people and their families, the role of child removal in the opioid epidemic, and what needs to be done to bring a public health lens to the issue. Check out our previous episode on treating substance use disorders during pregnancy here.

When patients don't feel heard by their doctors, there's an erosion of trust that can lead to serious health consequences—even if clinicians have their patients' best interests in mind. Dr. Mary Catherine Beach, who studies patient-provider communications, talks with Stephanie Desmon about what can happen when patients don't feel heard, interventions to teach providers better listening skills, and how bias comes into play.

How we talk about disability frames the way we view the importance of access. The Accessible Stall podcast co-hosts Emily Ladau and Kyle Kachadurian talk about disability a lot in episodes covering everything from pre-peeled fruit and lingerie to health care and ableism. Today, they join the podcast to talk with Lindsay Smith Rogers about why authentic representation of disability is so critical to designing policies and spaces that serve everyone. To explore the resources recommended in this episode, visit the links below: Demystifying Disability: What to Know, What to Say, and How to be an Ally by Emily Ladau Disability Visibility: First-Person Stories from the Twenty-First Century by Alice Wong Being Heumann: An Unrepentant Memoir of a Disability Rights Activist by Judith Heumann, with Kristen Joiner Loud Hands: Autistic People, Speaking by Julia Bascom Squirmy and Grubs (YouTube channel)

An estimated 97,000 Black women and girls have gone missing or been murdered in the US in the last year—which represents about 40% of all missing persons. These women and girls are often viewed as criminals or runaways and not victims or survivors, which can hamstring efforts to find and support them. Dr. Tiara Willie, gender-based violence researcher, and Dr. Kamila Alexander, a nurse and trauma researcher, talk with Dr. Josh Sharfstein about the first organized effort to focus long overdue attention on this problem, which was recently launched in Minnesota, and its implications for the nation.

Starting in January, 2024, every family with a new baby in Flint, Michigan will be eligible to receive cash payments for the first year of life. Dr. Mona Hanna-Attisha, the pediatrician who exposed the Flint water crisis in 2014, and Luke Shaefer, Michigan public policy professor, talk with Dr. Josh Sharfstein about how this effort came together and what it hopes to accomplish. Professor Schaefer's new book is The Injustice of Place. Learn more at flintrxkids.com

The Johns Hopkins Bloomberg School of Public Health's Institute for Global Tobacco Control was founded in 1998, and since then it has become a global leader in the efforts to end the tobacco epidemic. To highlight the Institute's 25th anniversary, Joanna Cohen, director of IGTC, and founding director Jonathan Samet talk to Stephanie Desmon about the past, present, and future fight against tobacco. Check out the video version of the podcast here.

A major bankruptcy case of Purdue Pharma—the makers of Oxycontin—now sits with the Supreme Court. How did it get there, and what's at stake? Andy Dietderich, an expert in bankruptcy law and co-head of finance and restructuring at New York law firm Sullivan and Cromwell, talks with Dr. Josh Sharfstein about the case, the Sackler family's involvement, and what a SCOTUS decision could mean for future settlements.

Extreme heat, wildfires, hurricanes, and more are driving huge changes for emergency managers like Chas Eby, the deputy executive director of the Maryland Department of Emergency Management. Eby talks with Stephanie Desmon about an “all-hazards” approach for emergency management agencies, and their work to be better problem solvers when it comes to what climate change is expected to bring in the future. They also discuss how to increase the capabilities of communities to make them more resilient.

Daily health care operations in the US account for 8.5% of all greenhouse gas emissions. Shanda Demorest is a cardiac nurse and Associate Director of Climate Engagement and Education at Health Care Without Harm. She takes Dr. Josh Sharfstein on a virtual tour of a hypothetical hospital, pointing out opportunities for sustainability. They discuss how, despite a lack of regulation, health care systems are making pledges to reduce emissions—and how individual clinicians and patients can help the cause.

There's a bit of detective work that has to go into investigating outbreaks of foodborne illnesses, and your local health department plays a key role. Cari Sledzik, an epidemiologist in the Office of Acute Communicable Diseases at the Baltimore City Health Department, talks with Dr. Josh Sharfstein about what goes into piecing together a potential outbreak and what happens once the source is found. To round out this Food Safety Education Month episode, she also shares some tips for how people can avoid foodborne illnesses. Learn more about how to lower your chances of getting sick with the FDA's Food Safety Education Month resources.

Methadone is a gold star treatment for opioid use disorder but it's heavily regulated at the federal level, making it hard for patients to get and even harder for doctors to prescribe. Dr. Brian Hurley, president of the American Society of Addiction Medicine, talks with Lindsay Smith Rogers about the process of getting methadone, how its regulatory roots in legislation from the 1970s contribute to its stigma, and what's being done and what more could be done to streamline prescribing so that the patients who need the life-saving medication can actually get it.

Hundreds of thousands of people were exposed to dust, debris, carcinogens, and trauma at the three sites of the 9/11 terrorist attacks in the immediate aftermath and then the years following. In 2011, Congress created The World Trade Center Health Program to provide health care monitoring and treatment for certified health conditions at no cost to people directly affected. Dr. John Howard, director of the National Institute for Occupational Safety and Health at the CDC which oversees the program, talks with Dr. Josh Sharfstein about the history, the extensive list of covered conditions, and the process through which people can apply to be part of the program—even if they don't have any diagnosed medical condition at this time. Learn more here: https://www.cdc.gov/wtc/apply.html

Many of us only hear about the juvenile justice system from the news in 30-second snippets. But Sam Abed, acting director of the Department of Youth Rehabilitation Services in Washington DC, has more to say. Abed talks with Dr. Josh Sharfstein about his work with juvenile justice and what he most wants people to know about the system and the young people who come through it.

Throughout the pandemic, a few medical professionals spread false and misleading information about COVID-19 and even touted potentially harmful “treatments” to their patients. But did they face consequences? Journalist Lena Sun talks with Dr. Josh Sharfstein about her Washington Post report looking at how medical professional boards handled—or dismissed—complaints about these doctors.

Part two of this series features Dr. Daniel Grossman, an obstretrician and gynecologist, and Dr. Katrina Kimport, a sociologist in Obstetrics, Gynecology, and Reproductive Sciences at the University of California at San Francisco. They talk with Dr. Josh Sharfstein about their research documenting cases where patients were denied proper medical care because of abortion restrictions—even when the care was unrelated to a pregnancy. They discuss how being forced to deny proper medical care can cause catastrophic health problems and trauma for pregnant people and their loved ones, as well as distress for the medical professionals involved. For part one of the series, check out episode 656. Read the report here: https://www.ansirh.org/sites/default/files/2023-05/Care%20Post-Roe%20Preliminary%20Findings.pdf

In part one of a two part series, Johns Hopkins demographic researcher Suzanne Bell talks with Lindsay Smith Rogers about a new report quantifying the impacts of Texas's SB8, an extremely restrictive abortion bill that passed in 2021. They discuss how empirical evidence can help to illuminate the consequences of major legislation. Read more: https://publichealth.jhu.edu/2023/analysis-suggests-2021-texas-abortion-ban-resulted-in-nearly-9800-extra-live-births-in-state-in-year-after-law-went-into-effect

Massive deadly fires, bleached coral reefs, extreme heat, ocean temps topping 100 degrees….have we reached a tipping point in climate change? Johns Hopkins planetary scientist Dr. Ben Zaitchik returns to the podcast to talk with Stephanie Desmon about recent headline-grabbing climate events and whether or not they signal a critical threshold for the health of the planet. They discuss how we can collectively approach mitigation and planning for climate change and why it can be short-sighted to see climate change as an existential crisis for humans.

Legalizing medical cannabis may have paved the way for recreational use in many states, but what is actually known about cannabis as a medical treatment? Dr. Johannes Thrul, a Johns Hopkins substance use researcher, talks with Lindsay Smith Rogers about why there are huge gaps in research of the risks and benefits of cannabis, and how legalization might create new opportunities to finally get some answers.

Principal Matt Hornbeck of Hampstead Hill Academy, an award-winning public K-8 school in Baltimore City, returns to the podcast to talk with Dr. Josh Sharfstein about gearing up for school. They discuss how students fared academically last year—and how the school is preparing to address chronic absenteeism and mental health challenges this fall.

As life expectancy slips in the US, what can we do differently to improve overall well-being and health? For one thing: start paying for health care differently. Dr. Mai Pham, physician and president and CEO of the Institute for Exceptional Care, talks with Dr. Josh Sharfstein about a new report from the National Academy of Medicine on the opportunity of innovation in payment: What if health insurance covered social needs? What if primary care clinicians were paid for extra time to help those patients who need support the most? What if health care institutions saw their role as broadly promoting health?

Outdoor air quality is a major concern but what about the safety of the air we breathe indoors in public spaces like schools and offices? Dr. Gigi Gronvall of the Johns Hopkins Center for Health Security returns to the podcast to talk with Stephanie Desmon about the threats of poor indoor air quality including spreading infectious diseases and particulate matter, and a new framework for states to consider how to mandate clean, filtered air in public spaces to keep people safe. https://publichealth.jhu.edu/2023/regulating-indoor-air-quality

During the pandemic, it became clear that America's vast and complex food system has weak spots and needs help from farm to table to be more resilient to shocks and stressors. Elsie Moore, a Johns Hopkins PhD candidate and researcher at the Center for a Livable Future talks with Dr. Josh Sharfstein about this “resiliency concept” and how some jurisdictions are thinking through their capacity to make sure food is available during emergencies from extreme weather and global unrest. Learn more about the Center for a Livable Future's Food System Resilience Planning Guide. https://clf.jhsph.edu/about-us/news/news-2022/new-food-system-resilience-planning-guide-helps-cities-prepare-disruptions

Last summer, Lifeline transitioned away from a 10-digit national suicide prevention number to the three-digit 988 line in hopes of making it easier for people experiencing a mental health crisis to call and text. One year after its launch, guest host Dan Gorenstein of the Tradeoffs podcast talks about the crisis line's successes and where it's fallen short.

More than three years after COVID first shuttered schools, researchers are taking stock of how children are doing academically. Hopkins biostatistician Elizabeth Stuart speaks with Stephanie Desmon about their research about learning gaps and why it's so important to invest in regaining lost ground while still letting kids be kids. She also explains how this data can help inform difficult policy decisions like school closures in the event of another public health emergency.

What can we learn from depictions of pandemics in films and series like The Last of Us, I Am Legend, and Contagion? Dylan George, director of the new Center for Forecasting and Outbreak Analytics at the CDC, recently participated in a panel at Awesome Con to discuss these and other depictions of dystopian realities in media. Dr. George talks with Dr. Josh Sharfstein about what these iconic pieces got right, where they took some creative liberties, and what they reveal about gaps in our own public health systems and abilities to respond.