Health Commissioners Blog

Another Sleazy Big Tobacco Story

During this past weekend’s Strawberry Festival in Troy there was a woman on the Adams Street Bridge collecting signatures for two petitions that seek to put two different tobacco issues on the ballot.  She was getting paid by a professional contractor to collect signatures.  The contractor in turn was being paid by the political action committees of both issues.  She didn’t care which one you signed, just so long as you signed something.   Since the woman was getting paid by the signature, hopefully passersby would sign both.

The first petition was sponsored by a group known as SmokeFreeOhio.  Their aim is to provide smoke-free environments in enclosed workspaces such as restaurants and bars.  Their proposed law would provide exemptions for private residences, certain small businesses, tobacco stores, not for profit private clubs, among others.  The SmokeFreeOhio effort is an initiative petition, which allows the voters to directly vote on this law.  They have a website, www.smokefreeohio.org.  SmokeFreeOhio is sponsored by a coalition of health groups, including the American Cancer Society and the Association of Ohio Health Commissioners.

The second petition is sponsored by a group that goes by the very misleading name of Smoke Less Ohio.  Their petition is designed to put a constitutional amendment on the ballot that would invalidate all previously passed local smoking legislation.  It would prevent local governments from passing smoke-free laws in the future, particularly in bars, restaurants and work places.  In essence, it turns the clock back to the good old days of smoke filled public spaces.  The Ohio Licensed Beverage Association and the R.J. Reynolds Tobacco Company sponsor this initiative.  They have no known website for more information.

In reality Smoke Less Ohio means More Smoke in Ohio.  This is another example of how big tobacco companies, in a desperate attempt to hold on to their market share of deadly and addictive products, use deceit to weasel their way into voters’ minds.  Voters need to be informed.

Soda Machine Vigilantes

Several consumer groups and the Center for Science in the Public Interest (CSPI) have declared war on vending machines, particularly those in schools.  There is a rise in childhood obesity. Ridding schools of sugary vending machines seems to be a logical thing to do to reduce the levels of obesity in children.  It's as if well-meaning parents want to do something, anything to combat this serious issue.  Unfortunately, what appears on the surface to be logical turns out to be misplaced energies.  The removal of soda machines in schools, or even replacing the high sugar content with juices (still high in sugar), water, or diet sodas, will not only result in failure, but will be counterproductive.

Why is this?  I've spoken to our nutritionists many times.  They assure me of one truth: weight gain is a simple matter of calories in versus calories out.  The more you eat and the less you exercise, the bigger you get.  When you reverse those you get smaller. 

Recent studies on diet soda tell us that those who drink diet soda tend to put on more weight that those people who drink regular sugared sodas.  How can this be?  Read the paragraph above and burn it into your memory, then return here.  It's the ENTIRE diet, not just sodas, that contribute to calorie intake.  And its your calorie expenditure that is the other side of the equation.  Have you ever see folks go to the fast food restaurant and order everything super sized, including the fires and then order a diet cola? 

Well-meaning parents and PTA's and school districts want to do the right thing, so they tend to pick on conveniently located external villains.   First its the soda machines.  Then its the birthday cupcakes.  They fail to look at themselves, each and every one and say to: "How did I and/or my child get this way?"  The difficult truth is that as individuals, they ate too much, or they were improperly nourished, and they exercise too little.  Usually all of the above.

Studies have also shown that the Amish consume more calories in a day than the average non-Amish.  Generally they are not obese.  Why is that?  It's because they expend more calories in a day than the rest of us.  They work hard and grow their own food corps.  Better nutrition and work habits.

No doubt about it.  America has a weight problem, and it isn't pretty or healthy.  The answer is for each of us to look at ourselves and to ask ourselves the tough questions about calorie intake and expenditure.  Be honest.  Turn of the computer and the TV, go out and make the right food choices and get some fresh air.  Be responsible for making your own right choices.

Beware of Poison Ivy Research

A few days ago, researchers at Harvard and Duke Universities released a study to the media that, after six years of study, they determined that poison ivy grows faster when under the influence of greater amounts of carbon dioxide.  The news media reports said that they spent six years on this research project.  By implication, the global warming folks are saying "see, global warming is causing poison ivy to grow bigger and meaner, and that's bad."

Smart public health folks instantly recognize two important points about this research.  First, the results were released via news release, not in a peer reviewed journal.  This is always, and you can pretty much count on the word "always" here, that something is amiss.  Publishing via the press means that you have some sort of ideological point to make, rather than something that resembles real science.  The second problem here is what every person should ask is, "well, fine, but how do all the other plants on the earth fare when subjected to greater amounts of carbon dioxide?"  The first rule of epidemiology is to compare, compare, compare.

CO2 is plant food for green plants.  It was never news that CO2 might stimulate the growth of poison ivy.  CO2 also makes corn, soybeans, trees, rain forests, food crops, etc., grow more, too.  Remember the photosynthesis cycle from junior high school?  Plants turn carbon dioxide into oxygen.  They require it.  More CO2 means longer growing seasons, more food to feed people.

I'm not here to debate global warming.  It's been warming since the last glacier, generally, with the exception of the little ice age from 1650 to about 1850.  I'm not putting a good or bad spin on it, or laying blame for it on anybody.  I'm just pointing out really dumb research when I see it.

Nightmare on Flu Street, Part 1

Today, the Feds came out with a worst case scenario for a future influenza pandemic.  The 229-page report stated that up to 40% of the work force would be immobilized either due to the flu, its complications, or family members taking time off to care for sick ones.  Ultimately, the disease could be responsible for two million deaths.

Who writes this stuff?  Did they arrive at this scenario by the BOGSAT (bunch of guys/gals sitting around at a table) method?  Or did they hire a Hollywood script writer?

The point here is that the only actual experience anybody has to about flu pandemics is the Spanish Flu of 1918-19, and three lesser episodes.  No doubt, Spanish Flu was a nasty one.  The other three resulted in higher than usual mortality rates, but nothing that created much of a disruption.  The current scenario is essentially pure fiction.  It might make for a half-way decent scary movie on TV, but it isn't based on any reliable data.  Unfortunately, this is all the Feds have to go on is a fictional scenario in order to make some plans.  All of us in the public health arena are constantly reminded to hurry up and plan for the big one.  Since no one really knows what it looks like, we spend a lot of time running around in circles.

While we are out planning for the totally unknown, ponder this:  while no one in the U.S. dies of bird flu, 700,000 folks die of heart disease.  And 65,000 die from the old fashioned influenza a pneumonia.  Other than flu shots, not nearly as many resources are going in to combat the known causes of disease, which just about everything from smoking to being hit by a meteorite comes before bird flu.

What scares you the most, preparing for fictional scenarios or ignoring the current state of disease?

Sewage in Ohio; Whats stopping you from doing the right thing?

Public health in Ohio is currently in a real tizzy of proposed new rules concerning household sewage treatment systems.  In Ohio, we have had a simple set of rules that a good many departments paid absolutely no attention to.  One far the more egregious things that many locals did wrong was to discharge partially treated sewage effluent into road ditches, common tiles, ditches or just onto their neighbor's property.  All of it perfectly illegal.  But probably the biggest error of all was that most local health districts do not take household sewage disposal all that seriously.  By that I mean that designing, approving and overseeing the installation of household sewage treatment devices is the lowest form of employment in their department.  Small local health districts are plagued by shortage of resources (this means money!) to hire and train a person or persons to bring intelligent design (ooops!) to sewage treatment.  The state health department said they could do nothing about the problem as they had no power to do so. 

Now, a new state law has been passed that sets up a framework by which the state board of health (in Ohio, the Public Health Council) can adopt new rules.  Many people from industry to Realtors and builders to local health districts worked many hours for over six months on the new rules.  At last weeks Public Health Council Hearing, it seemed as if nobody like them!  There were several folks who testified that life as we know it would cease to exist if the rules were passed; or that financial ruin would befall the entire state and its economy would collapse if they didn't allow sewage to be discharged into ditches.

Well, I have some sobering news for all of you.  The old laws, the ones that are currently on the books, do not prohibit you from doing the right thing.  Local health districts can adopt more stringent rules that the state's.  The new law in HB 231 permits the same.  Locals can ban off lot discharges of partially treated sewage.  Even if they permit their installation, they can stop themselves from emptying discharges into anything but perennial streams.   There is nothing I know of that can stop a local from hiring competent soils evaluators so that treatment systems can last the lifetime of the house without polluting of malfunctioning.  Where will the resources come from?  Simple.  Charge fees.  its always a value service when things work as they should.  No one should have to have a lousy treatment system just because its cheap.  Still need more money to run a good program due to economies of scale?  There isn't anything in Ohio law that is stopping you from collaborating with neighboring health districts in order to make the numbers work.  The only thing stopping you is the lack of will.

Its high time that locals stop trying to preserve the ways of the past simply because they don't wish to change.  You can do the right thing with your local program. 

Global Warming? Nothing New!

There are a lot of folks out there who believe that global warming is some new phenomenon and that due to mankind's burning of fossil fuels, the world will heat up and make life here very uncomfortable.  They also believe that there is something (costly I might add) that we as humans can do to slow it, stop it, and/or reverse it. 

Consider this:  The fact that the earth has been warming for quite some time now is nothing new.  About 15,000 years ago, if you were sitting in West Central Ohio, the ice above you would be between one-half and one mile high.  We've been warming ever since.  At that time, the world was about 30% covered in ice.  It is down to 10% now. 

For most of the 6 billion year history of the earth, it was mostly a very hot place.  It ranged from a very inhospitable place to a not-so-bad climate.  We are now living in one of the few spells of the latter.  In the last 2.5 million years (that's only four one hundredths of one percent) there have been no fewer than seventeen severe glacial episodes.  We can expect several more.  At several times during earth's history, the entire planet was nearly entirely covered with ice, and was nothing if not one big ice ball.  This is according to Bill Bryson, author of A Short History of Nearly Everything.

None of the aforementioned episodes had anything to do with mankind's interference.

So, weather happens.   There isn't anything we can do to stop it.

Liability and Septic Systems

Many Health Districts in Ohio require some sort of third party involvement in their design and approval process for household sewage treatment devices.  I've asked several of my colleagues why they do this.  Their reply is always the same: to limit their liability.  If something goes wrong, they can always point the finger at someone else and say it was someone else's fault.

I've never been able to figure this kind of logic.  I'm guessing this attitude was developed over several decades of having to suffer though numerous failed septic systems.

I think that this kind of thinking, blaming others for your own shortcomings, is not the right thing to do.  I think that we must remember that first of all we are in the prevention business and the best way to prevent anybody from suing you, or worse yet, collecting damages from you, is to provide the customer with a product that performs as it was intended to perform.  That is to say, a local health department should be able to ensure that the household sewage treatment system that goes in the ground is the best product that it can be.  Let me be more specific.  The HSTS should, at a very minimum, 1.) not discharge anything off the lot; 2) last the lifetime of the house without malfunction; and 3) require only a minimum of maintenance (one diversion device and/or one pump).  As a homeowner, I should expect nothing less. And it should be guaranteed.

Impossible?  Not so.  It is very possible to design, drawn specs for and oversee the installation of such systems.  Greene County has been doing it since 1973.  No design related failures since.  Miami County has been doing it since 1999.  No design failures since.

But lets get back to the liability issue.  I'm not a lawyer (thank goodness), so anything I say here you might wish to check with your legal counsel.  Ask you legal counsel this:  If we approve a HSTS that was designed by a third party PE and it fails within some short period of time, can people sue us and collect, or are we somehow protected from liability?  The fact is that you are just another potential pot of money.  Plaintiffs usually sue everybody that's touched the thing, jsut to see what will stick.

But even this misses the point.  In my years of public health service I've found that the best way to avoid lawsuits and judgments is to do the right thing in the first place.  If the public places its trust in you to do the right thing, then you should be ensuring that your product is the best that it can be, which means that it should perform as mentioned above.  A product that works and doesn't fail is unlikely to attract lawsuits.  And a lawsuit that isn't filed costs you nothing.

So don't try to shift your responsibility to others.  Instead, take your own responsibility seriously and give people a product that works.  No failures, no lawsuits.