Health Risks and Impacts

#AntimicrobialResistance (AMR) threatens to send the world back into the era before antibiotics and other antimicrobials, when a routine infection could be deadly.     Already, an estimated 5 million people die every year from infections associated with AMR.    Over the next decade, AMR could reduce global life expectancy by 1.8 years and cost the global economy more than $800 billion annually, due to additional health costs and lost productivity.     It’s fueled by many factors:  1. Poorly functioning health systems 2. Weak regulation 3. Sub-standard practices in industrial farming and agriculture 4. Poor management of waste and wastewater      AMR disproportionately affects people in low and middle-income countries, and is closely linked to poverty and a lack of access to adequate water, sanitation and hygiene.     Later this month, the World Health Assembly will consider how to accelerate action in the human health sector, as part of a multi-sectoral #OneHealth approach.     The World Health Organization has outlined six recommendations for consideration: 1. Leadership and governance, based on effective and well-resourced coordination that includes all relevant stakeholders, and high-level oversight.   2. Allocation of domestic and international funding for accelerated national, regional and global action.   3. Evidence for action through strengthening AMR and antimicrobial use surveillance, strengthening bacteriology laboratory systems, research and sharing and use of data.    4. Accelerated implementation of a people-centred public health approach to address AMR, with a core package of interventions at all levels of health systems.    5. Scaling up learning, experience sharing and technical support for countries;    6. Promotion of science, research, and innovation, targeted to public health needs and to ensuring equitable access.   From communities to health workers. From youth organizations to parliamentarians.     From the private sector to people directly affected by drug-resistant infections and their consequences.    By working together, we can chart a clear path towards a safer world for all. 

Terrible bicondylar tibial plateau fracture with joint comminution. These are bad injuries, with risk of compartment syndrome, wound complications, infection, and post traumatic arthritis. Studies show about 30% risk of complications. This patient had a fasciotomy and external fixation placed. Then definitive surgery 2 days later. Fracture was fixed and wounds were closed. You can see the joint was pretty smashed. It was fixed as best as possible, but it’s hard to make these perfect when there’s so much joint comminution. The lateral meniscus was torn which was fixed as well. And dual plate fixation for medial and lateral sides. ❗️The goal of surgery is to achieve a stable straight knee, and avoid complications (wound healing and infection). While many develope radiographic arthritis, most don’t need a knee replacement. ❗️Studies show the risk of total knee arthroplasty at 10 years post injury is about 7% (5 times higher than a matched cohort). So not as high as some people think, but not insignificant. This one has some radiographic evidence of post traumatic arthritis, which is expected given the initial injury. But one year later patient has minimal symptoms and great range of motion. Used with patient permission #orthotrauma #orthopaedics #orthopedics #ortho #fracture #bone #tibialplateau #knee #tibia

We need to talk about Black women’s healthcare. May is Women’s Health Month, and I thought it pertinent to specifically highlight some current statistics of Black women’s health in the United States—and the racism in our healthcare system that is contributing to these statistics. 🔹 Black women are more likely than other racial or ethnic groups to die of cardiovascular disease, hypertension, stroke, lupus, and several cancers. 🔹 Black women are 2x more likely than White women to have high blood pressure or develop diabetes over age 55. 🔹 Black women are significantly less likely to be able to obtain health insurance, face higher medical debt, and have longer travel times and distances to clinics and hospitals. 🔹 Although Black women are slightly less likely than White women to develop breast cancer, they are 40% more likely to die if they do develop it. 🔹 Black women reach menopause an average of 8.5 months earlier than White women and have worse symptoms. 🔹 Black women are 2-3x more likely than White women to develop uterine fibroids. 🔹 Of the states that have imposed strict abortion restrictions since the fall of Roe v. Wade, 22 of them are home to 45% of the Black women under the age of 55. 🔹 Black women have been 3x more likely to die from Covid than White men. These are just the beginning of some of the startling statistics to have come out of recent studies. And when I say “recent,” I mean that Black women weren’t even included in most medical studies until around 30 years ago, when Congress passed the NIH Revitalization Act establishing guidelines for the inclusion of women and underrepresented racial and ethnic minority populations in clinical research. Then, in 1995, Boston University started the largest and longest-running study focusing exclusively on Black women’s health. Importantly, one of the key determinations the researchers in the BU study have come to is that racism and other stressors specific to many Black women’s experiences may have much stronger implications on their health than their individual choices or genetic differences. This includes the psychological trauma of persistent racial discrimination, historically racist government policies, and disinvestment in Black communities and neighborhoods. In fact, the research finds that zip code alone is a strong predictor of health (and poor health) among Black women. Their findings are not inconsequential. Our health is inextricably linked to our environment, financial stability, education, interpersonal interactions, and so many other factors that don’t fall into the category of “healthcare.” When racism affects all of these factors, you better believe it affects health too. For Black women, it’s a matter of life and death—and too often, a shorter life than a longer one. Read some of the research here (& in the comments): https://hubs.la/Q02yb9l90 #WomensHealth #Healthcare #BlackLivesMatter

We often teach health disparities by leading with statistics. 📈 Higher mortality. Lower life expectancy. Worse outcomes. But when we stop there, without explaining how and why these disparities exist, we risk doing more harm. Without context, data can reinforce deficit-based thinking, quietly placing blame on patients and communities rather than on the policies, practices, and systems that shape access, exposure, and opportunity. We see this when disparities are attributed to “nonadherence” without examining structural barriers, when race is treated as risk instead of naming that racism leads to unequal care, or when outcomes are discussed without acknowledging housing, environmental exposure, insurance design, or historical disinvestment. For our health professional trainees, 'just naming the stats' approach flattens complexity. For clinicians, it can normalize our own biases. For public health, it weakens our ability to design interventions that actually work for the communities that need them most. If we are going to teach, present, and publish health disparity data, we owe it to our learners, patients, and communities to also name the systems that produced it. Accuracy requires context. And context creates accountability. #publichealth #healthequity #healthcareeducation

New Paper: “A Crowdsourced Topic Map and Future Research Agenda for Women’s Health” in the International Journal of Women's Health. 👉 Women’s health remains systematically underfunded, under-researched, and too often narrowly defined around reproductive health alone. Among the reasons for these persistent gaps is that the questions raised by women, caregivers, and women’s health experts are too rarely collectively formulated, systematically prioritized, or institutionally taken seriously — a clear example of “question inequity.” To help address this gap, we applied the GovLab’s 100 Questions Initiative methodology to develop: ✅ A comprehensive topic map of women’s health ✅ A crowdsourced global research agenda ✅ A prioritized set of top questions for future investment, innovation, and policy action. Working with 70+ global experts across more than 30 countries, we mapped women’s health across four interconnected dimensions: 🔹 Key health domains 🔹 Determinants and barriers 🔹 Technology and innovation 🔹 Research and evidence gaps. The resulting agenda highlights critical challenges including: ➡️ Persistent gender bias in biomedical research ➡️ Underrepresentation of women in clinical trials ➡️ Lack of sex-disaggregated data ➡️ Gaps in AI systems trained on male-centric health datasets ➡️ Underinvestment in emerging areas such as menopause, maternal mental health, aging, and FemTech. 💻 Read full paper: https://lnkd.in/ebWkcijP ✍️ Co-authors: Roshni Singh, Marta Dell’Aquila, Leonie Kunze, and Cosima Lenz, + the many experts and contributors who helped shape this agenda. 🙏 #WomensHealth #HealthInnovation #DataGovernance #AI #FemTech #Research #PublicHealth #GenderEquity #QuestionScience #DataForGood

As the United Nations convenes its consultation on pandemic preparedness next week, #Ebola is already putting those discussions to the test. On 16 May, World Health Organization (WHO) declared the Bundibugyo Ebola outbreak in the Democratic Republic of the Congo and Uganda a Public Health Emergency of International Concern. More than 100 lives lost. No approved vaccines or therapies. And a rapidly evolving crisis. But this is more than an outbreak. It is a real-time stress test of the global health system. 👉 Can we detect faster? 👉 Can we finance earlier? 👉 Can we deliver equitably—everywhere? These are exactly the questions Member States will debate at the upcoming #PPPR multi-stakeholder hearing on 9 June—shaping the Political Declaration for September’s UN High-Level Meeting at #UNGA And one message is already clear: The gap is no longer in commitments. It is in delivery. In this blog, I outline five priorities to close that gap: • Stronger routine immunisation systems as the first line of defence • Real equity in access to vaccines, diagnostics and treatments • Faster, more predictable financing for emergencies • Expanded regional manufacturing capacity • A more cohesive global health architecture that can act as one This is not theoretical. It is about whether the system works now—for communities facing Ebola today.

New report highlights need for sustained investment in #infection #prevention and #control programmes: Nearly 5 years since #COVID19 was 1st reported, a new global report on infection prevention and control (IPC) by the World Health Organization (WHO) shows there has been slow progress in addressing critical gaps to prevent #healthcare associated infections (HAIs) A large proportion of HAIs can be prevented with improved IPC practices and basic #water, #sanitation and #hygiene #WASH services, which are also a highly cost-effective "best buy" to reduce #antimicrobial resistance #AMR in health care settings. This report provides a baseline assessment for #policymakers, IPC #professionals, #health care workers and stakeholders to guide action The report finds that though 71% of countries now have an active IPC programme, just 6% met all of the WHO IPC minimum requirements in 2023-2024. This is well behind the target of more than 90% by 2030 set in the WHO Global action plan and monitoring framework on IPC. The report also highlights that patients in low- and middle-income countries (LMICs) have up to 20 times higher risk of acquiring infections during health care delivery than in high-income countries (HICs) “The COVID-19 #pandemic, along with #outbreaks of #Ebola, #Marburg and #mpox are the most dramatic demonstrations of how #pathogens can spread rapidly and be amplified in health care settings. These healthcare associated infections are a daily threat in every hospital and clinic, not only during #epidemics and pandemics,” said WHO DG, Tedros Adhanom Ghebreyesus. “Every country can and must do more to prevent infections in health facilities and control them when they strike.” HAIs prolong #hospital stays and result in complications such as #sepsis and in some cases #disability or #death. Addressing HAIs through improved IPC is also critical to reduce the risk of AMR, as recent estimates indicate that 136 million antibiotic resistant HAIs occur each year The report found that health care facilities face significant financial and resource challenges, including a lack of IPC professionals and budgets, especially in LMICs. Nearly a quarter of countries reported shortages in their supply of personal protective equipment in 2023   New #data from WHO and the Organisation for Economic Co-operation and Development estimates that up to 3.5 million patients could die each year from HAIs without urgent action. Improving IPC measures at every level will help to reduce the number of deaths. The modelling estimated that IPC interventions at the point of care in health facilities, coordinated by Ministries of Health or established networks, could avert up to 821 000 deaths/yr by 2050. Such an intervention would also yield annual savings in health care expenditure as high as US$ 112 billion  https://lnkd.in/ebijddfx

Minimizing the risk of neurological deficits in spinal deformity surgery is a top priority for every spine surgeon in the operating room. But despite the advancements in technology and intraoperative neuromonitoring, we are still seeing a prevalence of intraoperative neurological events as high as 23%. There is a plethora of studies in the literature that discuss a variety of different risk factors to try an anticipate these problems and potentially adjust the surgical plan accordingly, such as the Cobb measurements, deformity angular ratio (DAR), 3DCT DAR, and the spinal cord shape classification system (SCSCS) among others. However, no preoperative risk stratification tool of IONM loss exists to help delineate important preoperative factors that should be considered in the decision making process prior to deformity correction. In our newly published study in The Journal of Bone and Joint Surgery, Inc., we leveraged a machine learning approach to develop the first preoperative prediction tool for spinal cord-level IONM data loss during adult and pediatric spinal deformity surgery. From a total of 1,106 patients, we were able to delineate 8 critical non-modifiable preoperative factors with the following scores: conus level below L2 (2 points), type 3 spinal cord (2 points), cervical UIV (2 points), preop thoracic cobb angle ≥75 degrees (2 points), sagittal-DAR ≥15 (2 points), preop lower extremity deficit (2 points), preop TK ≥ 80 degrees (1 point), and the total-DAR (1 point). Scores between 0 and 2, 3 and 6, and 7 and 12 resulted in low, moderate, and high risk of cord-level IONM data loss, respectively. The performance of our model had an AUC of 0.921 and 0.898 on our training and testing sets with over 90% accuracy! By employing predictive modeling for proper risk stratification, clinicians can engage in more informed discussions with patients and potentially adjust operative plans to optimize neurologic safety, particularly those with elevated risk factors for cord-level IONM data loss and resultant neurologic deficit. Link to the full study: https://lnkd.in/g3vz2_U3 Nathan J. Lee, MD Varun Arvind Ted Shi Alexandra Dionne Chidebelum Nnake Anastasia Ferraro Matthew Cooney Erik Lewerenz Justin L. Reyes Steven Roth Justin K. Scheer Tom Zervos Earl Thuet, CNIM Joseph Lombardi Zeeshan Sardar Ron Lehman, MD Benjamin Roye MD-MPH Michael Vitale Fthi M. Hassan, MPH

Dealing with deformities poses significant challenges. While the easy solution is often T10-Pelvis, dedicating more time to preoperative evaluation and questioning conventional approaches while addressing deformity principles can lead to exceptional outcomes with less extensive surgical procedures in specific cases. In a highlighted case, a patient presented with persistent back pain, notable coronal and moderate sagittal balance issues, and a "dynamic" deformity that displayed a significant difference between supine and upright imaging during preoperative assessment. I opted for stand-alone MIS lateral L2-5 and L5/S1 ALIF. A two-year follow-up revealed outstanding imaging and clinical results. Barrow Neurological Institute AANS/CNS Section on Disorders of the Spine and Peripheral Nerves Winward Choy Alphatec Spine Scoliosis Research Society Society for Minimally Invasive Spine Surgery (SMISS)

A petition📖for reparations for American Descendants of Slavery (ADOS) is justified by historical evidence of policies that have critically harmed the black community. Exhibit B: Healthcare Policies The lack of adequate investment in healthcare infrastructure within (ADOS) communities has played a significant role in exacerbating disparities. Healthcare policies have had detrimental effects on ADOS individuals, leading to elevated rates of chronic illnesses and limited availability of high-quality healthcare services. The Flexner Report of 1910 directly addressed race within healthcare, highlighting disparities in access to and quality of healthcare services based on race. It revealed that African Americans were often segregated and restricted to receiving care in facilities designated for "colored" or "negro" individuals, which were typically underfunded and lacked necessary resources compared to those serving the white population. Also, the report criticized medical schools that discriminated against minorities in admissions policies, limiting opportunities for aspiring minority physicians to receive proper medical education and training. This perpetuated a cycle of healthcare inequality, as minority communities struggled to access competent and culturally sensitive healthcare providers. Numerous instances have demonstrated how flawed healthcare policies have worsened disparities within communities over time: 1. Limited access to affordable health insurance may hinder individuals from receiving vital medical treatment, leading to increased disparities in health outcomes. 2. Inadequate funding for community health centers may prevent individuals in underserved areas from receiving necessary primary care services, resulting in disparities in preventive care and chronic illness management. 3. Failure to address social determinants of health, such as poverty, education, and housing, through healthcare policies can perpetuate inequalities within communities by inadequately addressing the root causes of health disparities. 4. The lack of culturally sensitive care in healthcare policies can subject individuals from marginalized communities to discrimination and bias in healthcare settings, contributing to disparities in health outcomes and access to care. 5. Disregarding systemic racism in healthcare policies can compound disparities for communities of color, leading to unequal access to quality care and inferior health outcomes. #policychange