Analyze

WHAT (& WHAT FOR): Lead is a metal often found in pipes, and in old paint (before it was banned in paint in the late 1970s). Before 1996, lead also found in vehicle fuel resulting in  soil contamination in many communities from both paint dust and vehicle pollution. 

HEALTH IMPACT: Lead is a neurotoxin and is known to have no safe blood lead level in children. 

Has been linked to:

1. Brain swelling, anemia, seizures, renal failure, reduced IQ, and ADHD

2. Damages brain development in children

3. Connected to behavioral problems like aggression and bullying, and internalizing problems such as depression and anxiety 

LOCAL IMPACT: Recent research in Santa Ana has shown that there is a disproportionately impact of solid lead contamination crisis on lower income, people of color communities. 

POSSIBLE RESPONSES: There are many ways to respond to lead contamination:

1. Providing special health care for children with high blood lead levels, and investigating possible sources of lead exposure in homes, daycares and school, playground, etc.

2. Implement strict housing policies where landlord and city housing officials are required to have lead inspections of homes for lead paint hazards (especially in low income, people of color communities)

3. Requiring a minimum reduction standard for lead paint in older homes 

4. Requiring blood lead level test as part of the routine check up for children (extremely important for children in low-income housing)

WHAT (& WHAT FOR): PFOAS are a group of large manufactured chemicals that are widely used in various everyday items. Often used in waterproof items and nonstick pans among other products.  They are used in a number of industrial processes. Improper disposal of the chemicals from industrial manufacturing has resulted in PFAS seeping down into the ground and into the water supply.  These chemicals are known to be forever chemicals that  do not degrade in the environment. 

HEALTH IMPACT: PFAS are known to be forever chemicals that cause weakened immune systems, increased cholesterol level, increased risk of testicular and kidney cancers, and decreased vaccine response in children. EPA has concluded that exposure to PFOA and PFOS over certain levels may result in developmental effects to fetuses during pregnancy (low birth weight) or breastfed infants (accelerated puberty, skeletal variations). 

LOCAL IMPACT: Both the State Water Board and the Santa Ana Water Board have initiated investigations. The PFAS investigation done by State of California Regional Water Quality Control Board reveals results that show PFAS concentrations above the current Notification Levels for drinking water. Santa Ana Water Board staff is currently working to identify potential sources of the contamination in the groundwater. 

POSSIBLE RESPONSES: 

1. Conduct wellhead treatment to treat PFAS impacted drinking water to levels below state-established PFOA/PFOS notification levels.

2.  Obtain a more comprehensive monitoring information on potential sources of PFAS

3. Set Effluent guidelines, develop analytical methods and issue water quality criteria for PFAS

WHAT (& WHAT FOR): Lead is a metal often found in pipes, and in old paint (before it was banned in paint in the late 1970s). Before 1996, lead also found in vehicle fuel resulting in  soil contamination in many communities from both paint dust and vehicle pollution. 

HEALTH IMPACT: Lead is a neurotoxin and is known to have no safe blood lead level in children. 

Has been linked to:

1. Brain swelling, anemia, seizures, renal failure, reduced IQ, and ADHD

2. Damages brain development in children

3. Connected to behavioral problems like aggression and bullying, and internalizing problems such as depression and anxiety 

LOCAL IMPACT: Recent research in Santa Ana has shown that there is a disproportionately impact of solid lead contamination crisis on lower income, people of color communities. 

POSSIBLE RESPONSES: There are many ways to respond to lead contamination:

1. Providing special health care for children with high blood lead levels, and investigating possible sources of lead exposure in homes, daycares and school, playground, etc.

2. Implement strict housing policies where landlord and city housing officials are required to have lead inspections of homes for lead paint hazards (especially in low income, people of color communities)

3. Requiring a minimum reduction standard for lead paint in older homes 

4. Requiring blood lead level test as part of the routine check up for children (extremely important for children in low-income housing)

The purpose of this program is to help instill into nurses, doctors, social workers and more with the ability to mix their clinical practice with the ability to interpret, recognize and be moved by stories of illness according to their mission statement. This program is for those that want to improve the effectiveness of their care by increasing their familiarity with the skill of narrative medicine. 

There is a separate section of the study that cites where the funding for the study came from. The study was supported by Grants-in -aid for the Cancer Control Policy from the Ministry of Health, labour and Welfare, Japan. The study also notes that the funder didn't play a role in the conduct of the study .

I further researched narrative medicine and  to see how widely it is applied to medical fields today. I also researched the areas in the Middle East that were discussed int eh chapter and read about their customs and traditions to further my understanding of how it may influence their actions medically. I also read other parts of the book in order to gain more information on the topic in general. 

The American Red Cross has been on the forefront of research and testing, especially when it comes to blood. It was one of the first organizations to implement the testing of infectious diseases and is a single major contributor to clinical trials to improve blood safety according to their site. They were also among the first to develop testing for not only infectious disease, but HIV, Hepatitis B and C, West Nile, and Chagas disease. Currently they are actually working on a study in which they are investigating the blood supply for a tick-borne parasite in donated blood. They often work with the CDC and are always innovating ways to monitor donor blood by way of antibody recognition as well as disease detection and transmission. 

This policy was received in good light by the public for the most part. Patients were only to benefit from this, especially those who lacked insurance. Even those with insurance didn't have to waste time proving it any longer, they were treated and stabilized and insurance issues and payment were brought up later. Any ethically sound doctors, such as the ones working in hospitals that were already implementing the actions set forth by EMTALA (before it was law) had no issues with EMTALA. No doctor should have any issues with it due to their duty to act as well as ethical and moral standards they should be holding themselves up to, written in their oath they took to become doctor. The only people that would stand to receive this act negatively would be the doctors who were actively turning away patients in need, who are clearly morally compromised. Yet, media, patients, a majority of doctors and staff found and received this act positively or with little reservation.

There are two authors Andrew Lakoff and Stephen Collier. Andrew Lakoff works at USC and has roughly 40 publications. He is a professor of anthropology, sociology and communication at USC and has written many works with Stephen Collier. Collier has about 36 publications, and is a professor of international affairs at The New School. They are not directly involved in emergency response research but they do a lot of international studies related to medicine and disaster.

Through the use of surveying, this study identified that there are in fact inequalities in people's understanding of proper responses to pandemic influenza outbreaks. This study helped identify these vulnerable groups, and that social media and forms of mass media are the main ways to reach these groups. To address this vulnerable population, the public needs an increased accessibility to information, overall increasing the public's level of knowledge about the pandemic.