Natural Disasters

Natural disasters such as a tsunami, earthquake, hurricane or mudslide can trigger a cascade of social and health problems. Before the advancement of injury prevention, injuries were viewed as random, unavoidable accidents. Where a natural disaster is unavoidable, the injuries associated with them can be reduced through pre-event, event and post-event intervention. Injury intervention involves prevention/limitation of energy build-up, controlling circumstance of energy use to prevent release, modifying energy transfer to limit damage and improving emergency response, treatment, rehabilitative care to limit disability and promote recovery. 

Hurricane Katrina triggered a re-evaluation of the United States emergency response to natural disasters. The lives lost, homes destroyed and displacement of communities has had a huge impact on New Orleans and the surrounding area. Our nation is still responding to the aftermath of the hurricane. For instance, a deadly amoeba was found in St. Bernard that when inhaled through the nose causes a deadly meningitis. The free-living, Naegleria fowleri, amebic infection has claimed the lives of several individuals. The Lousiana Department of Health and Hospitals argue that the presence of amoeba found in chlorine treated water is a result of population decline after the hurricane. St. Bernard was a thriving 67,000 person community before the hurricane but the population has declined to almost 15,000 after Hurrican Katrina. The underuse of the public water system has allowed the chlorine to dissipate, allowing the pathogen to colonize and grow. An outbreak such as this can be hard to predict but disease and injury prevention methods that would require surveillance of the public water system may have prevented such an outbreak. 

Injury prevention in regards to a natural disaster include reduction in environmental impact, advancement in emergency response and limitation of disease occurence. Environmental protection including dams, reservoirs, wind protectors can reduce the structural damage often associated with a hurricane or tsunami. Increased adherence to emergency response pre-event can limit the number of people directly exposed to a hurricane or tsunami by evacuating the area. Pre-event emergency response also includes an evacuation plan and roads that can meet the needs of the community. Post-event emergency reponse includes better response time to emergency situations and quick transport time to a hospital. 

The recent mudslide in Washington state emphasizes the importance of occupational and environmental safety. Landslides and floods are unfortunatlely common and present a major public health concern. A total of 24 people have died from the mudslide and several are still unaccounted for. More than a square mile of a residential area along the bank of a river has been affected by the mudslide. Injury prevention would include evaluation of the soil and observation of rain levels to predict and prevent the impact of a mudslide. 

ADHD

The DSM-V defines Attention Deficit Hyperactive Disorder (ADHD) as having 5 or more of the listed symptoms including; difficulty with organization, losing or misplacing items, frequently forgetting information, distracted and failure to pay close attention to details. According to this definition myself
and the majority of the population should be diagnosed and treated for ADHD. 

It is well-known that the United States is the most medicated country in the world. Direct-to-Consumer advertising allows Big Pharma to push drugs into the marketplace. As pharmaceutical advertisements list the symptoms that this drug can treat, consumers begin to think that they have that disease and need that drug right away. No sooner than when the commericial ends, consumers are scheduling doctor appointments in hopes of a new prescription. Drugs are viewed as a quick fix and the demand continues to rise. 

I have seen ADHD medication misused and abused more than any other prescription drug. Individuals who are prescribed it will sell it to their peers during midterm and finals week. I have seen parents use it during the holiday season to cross off everything on their to-do list. Most alarmingly, I have witnessed individuals take it at parties claiming that it makes them more alert and sociable. 

In my opinion, there are two types of individuals who are diagnosed with ADHD: those who have a normal level of distraction or impulsiveness and those that have an underlying disorder. There are several conditions or disorders that can lead to symptoms that parallel ADHD symptoms including; sleep disorders, undiagnosed vision or hearing disorders, substance abuse, iron deficiency, bipolor or major depressive disorder, Obsessive Compulsive Disorder and learning disabilties such as dyslexia. 

The stimulants that are prescribed to ADHD patients are highly addictive, have negative side effects and only work short term. ADHD medication isn't a treatment option, it is a band-aid at best, simply masking the underlying effect of the disease. I cannot minimize the fact that some individuals are more distracted than others and have a hard time paying attention but in most cases there is another cause.  

Some of the side effects of stimulants include; increased anxiety, irritable, depressesion, severe weight loss due to appetite suppression and suicide. In a recent study, children treated with stimulants for ADHD experienced slower BMI growth followed by a rapid rebound that could continue to obesity. The rapid rebound occured in late adolescene after discontinuation. The study emphasized it was the stimulant that was associated with rapid rebound and not the disease as the stimulant can cause growth delays. 

Public health professionals should pay attention to the effect that stimulants can have on childhood obesity and should aim at restructuring the diagnosis and treatment of ADHD.