Thursday, February 18, 2016

What Makes You Beautiful?



WomanWhat makes you beautiful? Some would say it’s the color of your hair or its texture; the color of your eyes, or the subtle hew of your complexion.  Eighty percent of women agree that every woman has something about her that is beautiful but do not see their own beauty.
Although beauty is in the eye of the beholder, society has and to continues to formulate the essence of what makes up beauty. Some of society’s ‘norms’ on beauty are dependent on one’s weight, race, and age; girls are affected more by these societal guidelines than boys.  Nine out of 10 girls want to change at least one aspect of their physical appearance; only 4% of women around the world consider themselves beautiful.

 A study evaluating self esteem and body weight in adolescent girls, showed strong associations between girls with higher BMIs and increased risk of low self-esteem.  Girls who consider themselves to be over weight have also demonstrated higher risk of depression.  

 Society’s depiction of beauty is also heavily reliant on race, e.g., light, dark, or fair complexion; ‘African’ or ‘European’ features.   It’s these critical self-evaluations that dilute the richness of ones heritage, ones ancestry and the eloquence of someone’s unique characteristics.

 The notion of a ‘youthful look’ has also made the ‘impressionable list’ of ‘accepted’ beauty.  Studies show that women over the age of 50 still feel the pressure of ‘keeping up’ with their appearance, more so than men in the same age bracket. Results from a Dove research study showed that beauty-related pressure increases, and body confidence decreases, as girls and women grow older; 72% of girls feel tremendous pressure to be beautiful.

In a world made up so many cultures, history and traditions, a melting pot per se, how can we standardize beauty and how far are we willing to go to fit its ‘suggested’ mold? We are saturated with advertisement, i.e., media, internet, billboards dictating the guideline to beauty.  Since 2012, beauty-related sales increased by 14%, $392 million on revenues from make-up alone.   Nearly half of women in the United States feel that wearing makeup makes them feel in control; 82% of women believe wearing make-up makes them feel more self-confidence, while 86% of women find that wearing makeup improves their self-image.

Luckily, we can, with guided effort and support, seek healthier, more gratifying techniques to relinquish and embrace our beauty.   Experts recommend we focus on techniques that help generate a deeper sense of self-confidence, i.e., focus on what you have NOT on what you don’t, don’t forget to smile, spend some time with yourself, eat healthy nutritious food, work out and practice ‘radical’ acceptance, just to name of a few.  Beauty is beyond the topical surface that society tends to gravitate towards, it is among many things, utter acceptance of oneself.
For more information: 


                                                                                                                       Lidyvez Mejia

                                                                                                                  Research Assistant
                                                                                              Office of Urban Health Equity, Education & Research

Thursday, February 11, 2016

Everyone's Talking About Zika

                           Every year about this time, commercials advertising getaways to Caribbean, Central and South American destinations seem particularly enticing.  But before you pack your bags, know what you might encounter besides palm trees and tropical breezes – these days, the talk is all about arboviruses.  These are viruses spread by mosquitos and ticks and can cause potentially debilitating, sometimes fatal diseases. So it’s important to take appropriate precautions (light weight long-sleeved clothing, a good mosquito repellent, and a strong dose of common sense) when you travel to endemic locales.  

For the last few weeks we’ve been inundated with reports about Zika virus, an arbovirus that may be linked to microcephaly in infants of infected pregnant women.  Though a causal relationship has not been definitively confirmed, circumstantial evidence linking a 20-fold increase in cases of microcephaly in Brazil where concomitant Zika virus transmission is ongoing is creating panic. 

Zika is not the first, nor is it likely to be the last arbovirus that has generated alarm in the Americas.  It joins West Nile virus, dengue and chikungunya, all of which spread from Africa eastward to the western hemisphere.  Because the presenting symptoms can overlap somewhat, distinguishing between these viral syndromes can be difficult.  Zika infection does not result in hemorrhagic fever or death the way dengue can.  In fact, most often it is very mild or asymptomatic.  However, it may present with an initial flu-like illness (fever, arthralgia, conjunctivitis) and rash characteristic of the other viruses.

  So why all of the concern?  Two reasons:  an observed increase in cases of Guillain-Barre syndrome (a paralyzing neurologic syndrome) and fetal microcephaly (small brain size) in areas where Zika infection has become established.   In fact, if a causal relationship is proven, Zika would be the first flavivirus to have teratogenic effects.
There have also been recent reports of sexually transmitted Zika virus infection.  It is not yet clear how effectively it might be spread through blood and other body fluids, but the CDC and WHO have issued multiple advisories urging precaution and use of barrier protection (condoms) when engaging in sexual intercourse.

Given the potential for congenital Zika virus infection, pregnant women are strongly urged to avoid travel to endemic areas.  In addition, if a pregnant woman’s male partner has recently traveled to these areas, condoms should consistently be used during sexual intercourse.  There are no commercially available tests at this time, but if Zika infection is suspected, testing of serum samples (RT-PCR and serologies) can be performed at the CDC.  If positive, fetuses should be monitored for the development of microcephaly or brain calcification via serial ultrasound.  No vaccines or specific antiviral treatment are currently available. 

For more information, visit

                                                                                                                                        Judith Wolf, MD
                                                                                                                              Associate Director, WHEP




Thursday, February 4, 2016

Who is the "gardener" in Medicine (and why does it matter)?

If you attended last Thursday’s WHEP seminar on Unconscious Bias in Medicine, you engaged in thought-provoking interactive discussions about these two TED talks and their relationship to clinical medicine:

Here are some of the highlights of the discussions that took place: 

What creates unconscious bias?

Unconscious bias is reinforced systemically through society and is culturally rooted. Segregated communities create different economic landscapes, which influence jobs, experiences, and what people in privileged communities (those with a Eurocentric history) view as “normal”.  The media rarely portrays communities of color in a positive light, thus generating fear of violence in underprivileged areas. In short, people of color have a limited voice.   

Dr. Horner's talk illustrated how unconscious bias is neurologically rooted in fear - specifically, linking safety to bias.  This starts with parental influence in early childhood and complicates our ability to recognize unconscious bias.  

In the Gardener’s Tale, Dr. Jones described the concept of institutional bias or racism in our society as differential access to goods, services and opportunities by race, codified in our institutions of custom, practice and law.   It is the gardener who has control over resources with the power to decide and act.  According to the students, potential gardeners within the field of medical practice included medical schools/admissions, government (local / state / federal), physicians, hospitals systems and insurance companies.

What is the relationship between bias/racism and health outcomes?

The discussion here centered on access to healthcare (location, lack of insurance), differences in disease presentation, inherent bias in presentation history, communication barriers, health literacy, food insecurity, and acceptance of the status quo.                                                      

How can one become aware of unconscious bias?
Noting that it is very difficult for individuals to become aware of their own unconscious bias, there were a number of suggestions for improving awareness and reducing bias:
  • try to distinguish between quick judgments based on “experience” vs. those made because of unconscious bias.  Students stressed the importance of differentiating between a diagnosis based on race/color/gender vs. individual predisposition to certain conditions.  They felt that physicians should be more attentive to patients who are different from them, try to better relate to them, be aware of favoritism and common assumptions, and spend appropriate/equal time with every patient
  • read articles on the subject – become knowledgeable
  • “test” yourself to assess your unconscious bias – for example, reflect on uncomfortable situations and ask yourself “Why do I feel this way?”
  • understand your community and its diversity instead of categorizing people strictly based on race / color 
  • recognize how language barriers can lead to assumptions on the part of providers and result in missed information
Attendees also came up with a series of questions to pose to and discuss with a select panel of practicing physicians on Tuesday, February 9 during the second part of this important, provocative seminar.  It should be a very interesting evening.  Join us!!

                                                                                                                                  Judith Wolf, MD
                                                                                                                          Associate Director, WHEP