Women aren’t the only ones at risk for depression and in need of screening services when a new baby comes into their lives. Young fathers face significant mental health challenges as well, according to a new study.
Published in the May issue of Pediatrics, researchers found that fathers who live in the same households as their children experience a decrease in depressive symptoms in the period immediately before their children are born. However, depressive symptoms among young fathers, who were around 25 years old when they became fathers, increased an average of 68 percent throughout their children’s first five years of life.
The study notes that depressed fathers are more likely to experience parenting-related stress, more likely to use corporal punishment and neglect their children, and less likely to interact with their sons and daughters. As a result, their children may be at higher risk of social problems throughout life, psychiatric problems later in life, and of experiencing delays in language and reading development. According to lead author Craig Garfield, of Northwestern University Feinberg School of Medicine, the study is the first to pinpoint when young fathers face an increased risk of depression, which could help inform more precise and targeted interventions.
“It’s not just new moms who need to be screened for depression, dads are at risk, too,” Garfield said in a news release. “Parental depression has a detrimental effect on kids, especially during those first key years of parent-infant attachment. We need to do a better job of helping young dads transition through that time period.”
To conduct the study, Garfield and his colleagues examined data from more than 10,600 young men who participated in the National Longitudinal Study of Adolescent Health. The Pediatrics study found that young fathers who do not live with their children experienced high levels of depressive symptoms before their children are born, with such symptoms decreasing during the years of early fatherhood. That’s in contrast to fathers who live with their children — described as resident fathers in the study — who experience fewer symptoms before their children arrived and higher levels in the years after birth. Black and Hispanic young fathers experienced more depressive symptoms than white fathers — a finding that study authors warned may result in a “clinically significant rise” and may merit special attention.
Identifying and helping fathers struggling with depression could have a positive domino effect, improving health for the entire family, writes Garfield and co-authors Greg Duncan, Joshua Rutsohn, Thomas McDade, Emma Adam, Rebekah Levine Coley and P. Lindsay Chase-Lansdale. However, reaching such fathers and getting them into appropriate treatment is a challenge, as the study notes that men ages 18 to 44 years old are less likely than women to interact with the health care system, have a primary care doctor or have health insurance. Though, the Affordable Care Act could start improving those numbers. Plus, the study noted that fathers often accompany their children to pediatric visits, which could make such clinical settings an ideal place for reaching young fathers at risk.
“This is a wakeup call for anyone who knows a young man who has recently become a new father,” Garfield said. “Be aware of how he is doing during his transition into fatherhood. If he is feeling extreme anxiety or blues or not able to enjoy things in life as he previously did, encourage him to get help.”
To read the full study, visit Pediatrics.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
Going to a job and getting paid appropriately for your time is how it is supposed to work. Doing your job and getting gipped out of you pay is wrong and illegal. The economic consequences of wage theft for the victims and their families are profound: the threat and reality of losing utilities, food and housing. One of the single biggest risk factors for ill health is poverty. That makes wage theft a public health problem.
But catching and punishing employer-thieves is difficult. The federal and state enforcement agencies are under resourced and the laws weak. It’s also one thing to have a law on the books. It’s another to have that law enforced. A group of Houston workers fought several years for the former and succeeded last year in getting it. They took steps this week for the latter. The workers delivered their complaint to the City of Houston’s Inspector General (IG). That’s the first step to trigger a possible enforcement action under the City’s new anti-wage theft ordinance. The law took effect in January.
Thirteen workers allege that Hyland Construction, Bradley Demolition and BSP Construction hired them for jobs, which the workers completed, but the firms failed to pay them the wages owed. The workers say they are waiting for more than $200,000 in back pay.
The new ordinance provides workers with a formal process to lodge wage theft complaints and puts in place penalties for employers convicted of stealing workers’ wages. Businesses convicted of wage theft — either civilly or criminally — will be listed in a publicly accessible city database. They will also be ineligible for city contracts or subcontracts, and certain permits and licenses. That’s especially meaningful in this week’s complaint because the firms were engaged in projects contracted by the City of Houston.
One of the groups that was instrumental in getting the anti-wage theft ordinance passed was the Fe y Justicia Worker Center. Laura Boston, executive director of the worker-led organization, reported that the City’s IG, Robin Curtis, and her staff met personally with the workers to receive their complaint. “She seemed grateful,” said Boston, “and thanked the workers for coming forward.” The workers themselves, Boston added, “were proud that what they fought for [the ordinance] can work. It was not just a paper victory.”
The list of 2014 Pulitzer Prize winners announced earlier this week includes several journalists whose award-winning work addresses public health issues.
The Boston Globe Staff won the Breaking News prize for “exhaustive and empathetic coverage of the Boston Marathon bombings and the ensuing manhunt that enveloped the city, using photography and a range of digital tools to capture the full impact of the tragedy.” Among the many articles in the Globe’s extensive coverage of the April 15, 2013 attack and its aftermath are pieces on the first responders, hospital workers, and therapists who helped bombing victims – and on the drills and planning that prepared hospitals to deal with such an event.
Chris Hamby of the Center for Public Integrity won the Investigative Reporting prize for his “Breathless and Burdened” series, which “examines how doctors and lawyers, working at the behest of the coal industry, have helped defeat the benefits claims of miners sick and dying of black lung, even as disease rates are on the rise and an increasing number of miners are turning to a system that was supposed to help alleviate their suffering.” Hamby conducted a year-long investigation, reviewing thousands of pages of previously hidden legal filings and creating original databases. The Center notes on its website that the series got results:
Following the reports, Johns Hopkins suspended its black lung program, U.S. senators began crafting reform legislation, and members of Congress asked for a federal investigation. In addition, the Department of Labor announced procedural changes in the federal benefits system that deals with black lung claims, changes that could help miners navigate the complex benefits system.
Eli Saslow of the Washington Post won the Explanatory Journalism prize for “his unsettling and nuanced reporting on the prevalence of food stamps in post-recession America, forcing readers to grapple with issues of poverty and dependency.” The Washington Post summarizes and links to the stories in the series:
Saslow’s explanatory reporting on food stamps spanned six stories. The first begins with a look at Woonsocket, R.I., where one-third of the residents receive food stamps, detailing the astonishing transformation of a despairing town on the day each month when those food stamps arrive. Saslow’s subsequent stories focused on hungry senior citizens in Florida, needy children in rural Tennessee, a Florida Congressman’s push for an historic overhaul of the food stamp program, the effects of a government feeding program in Hidalgo County, TX, and finally, a 41-year-old mother of six in Washington, D.C., who has been on food stamps her entire life.
Will Hobson and Michael LaForgia of the Tampa Bay Times won the Local Reporting prize for “their relentless investigation into the squalid conditions that marked housing for the city’s substantial homeless population, leading to swift reforms.” In a Tampa Bay Times piece about the prize, Peter Jamison explains the work that went to the series and its impact:
The Times’ coverage of Hillsborough County Homeless Recovery represented a joint effort of the newspaper’s Tampa newsroom and its investigative team. Bolstered by sophisticated analysis of government records and vivid, first-hand observation, the stories led to the most significant reform of the county’s social-service programs in 20 years.
… Several ranking county employees resigned or were fired in the wake of the Times’ stories, which eventually led to the permanent dissolution of the Homeless Recovery program and the outsourcing of homeless services to local nonprofit groups.
David Philipps of The Gazette (Colorado Springs) won the National Reporting prize “for expanding the examination of how wounded combat veterans are mistreated, focusing on loss of benefits for life after discharge by the Army for minor offenses, stories augmented with digital tools and stirring congressional action.” Rich Laden writes in The Gazette about the “Other than Honorable” series:
The Gazette published “Other than Honorable” from May 19-21 in print and on gazette.com. The series used Army data to show that the number of soldiers being discharged for misconduct annually had surged to its highest level since 2009 at posts with the most combat troops.
Some of those soldiers who were discharged had come home from combat with post-traumatic stress disorder or traumatic brain injuries, then committed offenses that likely were linked to those “invisible injuries.” They then were denied benefits because their misconduct resulted in them receiving “other-than-honorable” discharges.
… The series prompted a call for action among some members of Congress. After the publication of “Other than Honorable,” Sen. Michael Bennet and Rep. Mike Coffman, both of Colorado, introduced amendments to study the surge of troops discharged from the Army for minor misconduct. However, those amendments were stripped out of the National Defense Authorization Act in December.
Author Dan Fagin won the General Nonfiction prize for his book Toms River: A Story of Science and Salvation, which “deftly combines investigative reporting and historical research to probe a New Jersey seashore town’s cluster of childhood cancers linked to water and air pollution.” Longreads has posted an excerpt of the book, and Elizabeth Grossman wrote about it for us last year.
Journalists, news organizations, and book authors and publishers play an essential role in advancing public health. They expose public-health problems while connecting readers with the people who face them, whichoften strengthens the push for change. They can also highlight the important work of the first responders, hospital workers, volunteers, and others who save lives when disasters strike. At a time when many news organizations are shrinking their reporting staffs, it’s wonderful to see so many examples of top-notch work on issues that matter for public health.
Congratulations to all of the Pulitzer Prize winners and finalists, and to their colleagues and organizations. You can view them all here.
Second in a series of blog posts from the Russian Arctic polar bears, wolves, reindeer, wolverines, walruses, Asia’s only population of snow geese, and 417 plant species. Joel Berger, a field biologist with the Wildlife Conservation Society and the University of Montana, spent several weeks on Wrangel Island this spring. In the second of three blog posts for e360, he describes the arduous conditions under which Russian and U.S. scientists collect data on the island’s odd assortment of creatures.
I often find myself trying to reconcile a company’s description of its safety program with what I hear from workers. One worker I met summed it up this way:
“Yeah, we have safety talks, but a talk is where it ends. It’s all talk, not real action on safety problems.”
Two recent incidents brought his remark back to life for me. It started with a recent news release from OSHA. The agency announced a proposed penalty of $50,600 to Grede Wisconsin Subsidiaries LLC at the firm’s Browntown, Wisconsin iron foundry. Funny thing is, the firm was touting its safety record last month at OSHA’s public hearing on its proposed silica regulation.
In its comments to the agency, Grede said
“safety is the top priority, with environmental, health and industry-leading safety policies and safety metrics that are best in class.”
Yet with “safety as a top priority” they didn’t offer a single provision of OSHA’s proposed regulation that they would support. And their OSHA inspection history also tells a different story. In just the two last years, the firm has received citations for five repeat and 31 serious violations at its foundries in Biscoe, NC; Berlin, WI; Browntown, WI; Columbiana, Alabama; Kingsford, MI; Omaha, Nebraska; and Radford, Virginia. One inspection at the Browntown foundry resulted in citations for 17 serious and three repeat violations. OSHA proposed a penalty of $274,500 which was settled by the company for $133,000. Just a few weeks ago, came the citations for one repeat and two serious violations, and the proposed penalty of $50,600. Their “safety is a top priority” talk sounds to me like it’s just talk.
The second incident comes courtesy of the American Meat Institute. It’s the trade association for U.S. packers and processors of meat and poultry industry. AMI announced this week the recipients of its awards for “high levels of worker safety performance.” AMI chairman and president and CEO of American Foods Group, Greg Benedict, said:
“Worker safety progress is one of our industry’s greatest success stories. During the last 19 years, injury/illness rates in the US meat industry have improved by nearly 80 percent. The rate of injury and illness in the meat and poultry industry continues to fall — and this is no accident.”
Let’s have a reality check. Both the meat and poultry industry are listed by the Bureau of Labor Statistics as those with the highest reported rates of injuries that require a worker to be on restricted duty or transferred from their regular work tasks. Out of 1,066 six-digit NAICS industry codes, both meat and poultry are on that illustrious list of just 17 industries. At one poultry plant which was recently evaluated by NIOSH, the researchers reported alarming results: forty-two percent of the workers (n=318) had physiological evidence of carpal tunnel syndrome. 42 percent! That’s no success story.
It’s true in foundries, in meat packing, poultry processing and every other industry. Firms will tout their safety records, but when a light is shown on them, we see a different story. It is, as the worker said, just safety talk.
The Washington Post’s After the Wars series offers an in-depth look at the challenges facing veterans returning from Iraq and Afghanistan. This past week, it’s featured Rajiv Chandrasekaran’s “The Other Wounds,” about veterans’ injuries and illnesses that aren’t the direct results of enemy attacks, and Stephanie McCrummen’s “The Choice,” about one of the difficult decisions facing survivors of military sexual assault.
An unprecedented release of Medicare data has allowed for a lot of reporting on how much Medicare pays physicians; Puneet Kollipara rounds up several articles in Wonbook. Two relevant op-eds I especially like are Charles Orenstein in the Los Angeles Times explaining what the data can and can’t tell us and Catherine Rampell in the Washington Post reminding us who really pays for Medicare.
A few more recent pieces worth a look:
Evan Osnos in the New Yorker: Letter from West Virginia: Chemical Valley: The coal industry, the politicians, and the big spill
Kimberly Johnson in Aljazeera America: As coal fades in West Virginia, drugs fill void
Paul D. Thacker at Slate: How to Handle FDA Rejection: Women’s groups are calling the FDA sexist for not approving female Viagra. They are so wrong.
Ellen Goodman at Health Affairs Blog: It’s Always Too Soon Until It’s Too Late: Advanced Care Planning With Alzheimer’s
Unfortunately, it’s not too terribly surprising that diseases of the developing world don’t attract as much research attention as diseases common in wealthier countries. However, a new study not only underscores that trend, it actually found zero relationship between global disease burden and health research.
Designed to identify the reasons behind global health research disparities, the study compared the global disease burden (defined as healthy life years lost to disease or disability) of 111 diseases against relevant research articles using data from the World Health Organization and the National Library of Medicine’s biomedical journal database. From the outset, the researchers wrote that they expected to find only a weak association. But they were surprised to find no relationship at all, said lead author James Evans, director of the Knowledge Lab at the University of Chicago and an associate professor of sociology. And for randomized controlled trials and animal model studies, a higher global need was actually associated with less global research.
“We have an interest in not just thinking about global health as the ultimate outcome, but an intermediate outcome of more global health knowledge. …We need more information. We may think we know everything, but we don’t know how to treat (these diseases) in resource-poor environments,” Evans told me. “My hope is that (our findings) will fuel an already existing movement to support population health and global health initiatives.”
The study, published in the April edition of PLOS ONE, found that cancers, skin diseases and endocrine disorders, such as diabetes, are over-represented in research considering their burden; whereas, infectious parasitic disorders, respiratory infections and perinatal conditions were under-represented relative to their effect on human health. In addition to examining the relationship between burden and research, the study also considered the global market for treatment. In that case, researchers found that for every $10 billion lost to a disease or disability, the number of research articles on the disease in question rose between 3 and 5 percent.
At a local level, however, the picture is a bit different. Locally, disease burden did make a difference on research. The study found that for each 10 million disability-adjusted life years lost to a disease within a country, the number of articles published by researchers also within that country went up by nearly 74 percent. Authors Evans, Jae-Mahn Shim and John Ioannidis write that this finding “suggests that whether or not researchers and funding agencies factor global health needs into their research, the influence of local needs exerts much more influence on their work.”
So, if researchers tend to focus on diseases that they know — diseases that affect their communities — what does that mean for countries without the capacity to conduct health research? Evans and his colleagues point out that there are “striking disparities” in global health research capacity, with wealthier countries conducting the most research. Adding to the challenge is that even though some research, such as cancer research, is relevant to people in wealthy and impoverished countries, its translation into effective practice within a resource-poor environment is still missing. The study authors write:
Ultimately, this article stresses that poor populations are in double jeopardy: they experience the greatest health burdens but their diseases have been studied least and even researchers from wealthy countries often lack secure knowledge for context-relevant treatments. …A growing collection of related findings have been framed as evidence that biological factors play a role in health disparities, but they also implicate the differential relevance of health knowledge produced by biomedical research for the health of different groups. In short, the same care may not always be equal. In this way, the inequality of biomedical research that our analysis demonstrates likely understates its true inequality.
“We’ve been engaged in health extension and translation, in sending over physicians for a long time…and certainly that’s a good thing,” Evans told me. “But there’s diminishing returns to that strategy. So, I’d place my next dollar in actually helping to create and bolster a research environment in those countries.”
Of course, developing biomedical research capacity in impoverished countries is an enormous undertaking. In response, Evans said supporting a regional approach could reap some of the most effective outcomes.
“Countries that are relatively more wealthy in these regions that already have existing research infrastructures in place are where I’d place my bets, as their research would be most relevant to their neighbors,” he said. “So supporting the extension of research not just from Philadelphia, but from South Africa, from Kenya to their neighbors would provide greater returns.”
To read the full study, visit PLOS ONE.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.