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Tuesday, 12 July 2011

Superbugs, drinking and driving

Many physicians start their morning by doing rounds in a hospital to see to the health of their patients.  I start mine by scanning headlines for emerging public health issues.

This morning's newspaper had two stories that reminded me of why public health will never be short of work.  I at least theorize that I spend equal amounts of time addressing three main issues. 
  • First is that germs evolve very quickly,
  • Secondly is that as humans we have two unique characterisistics -
    • we apply intelligence to manipulate our environment and develop new technologies, and
    • we have the capacity to make choices, and often enough those choices are not the healthiest of choices. 
The stories were about a new form of superbug - a gonnorhea (sexually transmitted illness) that is resistant to 'all' current antibiotics.   A topic for a future blog, but superbugs are partly due to the desire of bacteria to survive, hence mutate when threatened by something that might kill them.  The overuse and abuse of antibiotics contributes to the rapidity of development of antibiotic resistence.  

The second story was about British Columbia's aggressive approach to reducing deaths and injuries due to mixing alcohol and driving.   Motorized vehicles are the product of human technology.  Using alcohol is a potentially unhealthy choice.  Mixing the two we all know is a deadly combination.  BC has taken a very hard stance with signficant penalities above .05% blood alcohol levels in addition to the Canadian criminal code penalities above .08%.  It seems the changes are resulting in protecting the public's health and will continue, despite the desperate cries of the hospitality industry that have noted reductions in alcohol sales and overall sales in restaurants and bars.  

We know that sometimes the benefits achieved by public health interventions exceed that which was predicted because of other effects.  Targetted programs to reduce drinking and driving - perhaps reduced drinking, perhaps reductions in obesity from reduced driving.

Conversely there are examples where the intended impact of a public health intervention was less than and occassional worse overall than prior to the intervention.   Evaluating programming when impacting the populations health is critical.

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