Janet Golden, a Rutgers University history professor, specializes in the histories of medicine, childhood and women.

By Janet Golden

Things to talk about when we talk about Newtown, mental health, and guns:

1. “The vast majority of violence in our society is not perpetuated by persons with serious mental illness.”

By Michael Yudell and Jonathan Purtle

Approximately 3.9 million babies will fondly recall 2012 as the year they were born in the United States. The year will hold a special place in their hearts for an estimated 78.5 years—the average life expectancy at birth in the U.S. Their chances of living beyond that estimate, and their quality of life as they age, will be greatly influenced by the issues that we write about on this blog—the issues which fall within the purview of public health.  Here are some of the top public health issues that we, and perhaps a cohort of 3.9 million, will think of when we reflect back on 2012. 

Fracking: While not an animal in the Chinese zodiac, 2012 was the year of the guinea pig in Pennsylvania.  As The Public’s Health’s expert panelist Bernard Goldstein described, Pennsylvania has volunteered to serve as the proverbial guinea pig of the Marcellus Shale natural gas extraction experiment.  Limited regulatory oversight, tax incentives, and an absence of research have allowed for the practice of hydraulic fracking to generate quick state revenue while its health consequences remain “inconclusive.” Like a guinea pig in a scientific experiment, however, Pennsylvania is taking on extraordinary risk for short-term gains.   Neighboring states, which are exercising more caution in their fracking decisions, are likely to benefit from the knowledge that results from Pennsylvania’s fracking experiment. 

Violence: An estimated 16,000 people died from interpersonal violence in the U.S. in 2012—most of them youth.  While coordinated efforts to prevent the community violence which plagues many U.S. cities are lacking, the tragic mass shootings in Aurora, Colorado and Newtown, Connecticut have catapulted the issue of violence to the forefront of political agenda. What real change will come from this sudden burst of attention? Time will tell.  To be sure, discussions about tradeoffs between public safety and individual liberty and the role of collective responsibility for identifying and addressing mental illness will be central to any meaningful action.

In the wake of the awful tragedy in Newtown, Conn., some pundits are already trying to peer into the mind of the killer, making misbegotten claims about the cause and nature of his violent act.

On Wednesday, it was announced that Connecticut’s chief medical examiner, H. Wayne Carver II, had asked geneticists at the University of Connecticut department of genetics to investigate whether a genetic condition might have been associated with the shooter’s behavior.

And so on Thursday, The “Booster Shots” blog at the Los Angeles Times wondered, “Will Adam Lanza’s genes help answer the incomprehensible?” The blog focused on Fragile X Syndrome, a hereditary disorder associated with mental retardation, as a possible risk factor for his behavior, as well as possible genes for depression or aggression.

Is this a reasonable line of inquiry?

Esther Chernak is a physician and director of the Center for Public Health Readiness and Communication at Drexel University School of Public Health, where she is an associate research professor.

By Esther Chernak

One of the fundamental challenges in the practice of public health – the work that keeps populations and communities healthy and safe – is balancing the rights of the individual with the rights of the public. We work hard to make sure that a person with active tuberculosis who refuses treatment has access to due process before they are deprived of their civil liberties and required to take medications and confined so they don’t infect others.

We are responsible for identifying restaurants that sell unsafe food and companies that sell unsafe medications. The public whose health we are committed to protecting expects that those businesses will be shut down until their products are no longer dangerous. 

By Michael Yudell

There is so much to say about the awful tragedy at Sandy Hook Elementary School in Newtown, Conn. on Friday.

But for now, I encourage our readers to focus on those who perished. Remember their names and learn about their lives. Have their families in your thoughts.

Charlotte Bacon                                   born 02/22/06

Daniel Barden                            09/25/05

Rachel DaVino                           07/17/83

Olivia Engel                               07/18/06

Josephine Gay                           12/11/05

Ana M. Marquez-Greene              04/04/06

Janet Golden, a Rutgers University history professor, specializes in the histories of medicine, childhood and women. Jeffrey Anderson has been researching blues lyrics relating to disease, and has written about the 1918 flu pandemic's impact on Philadelphia.

By Janet Golden and Jeffrey Anderson

Blues music, a soulful and powerful American art form, includes a number of songs about disease in history and about diseases still with us today. Here are some of our favorites.

1. “TB Blues / Jimmie Rogers

Jimmie Rogers knew of what he sang; he died of tuberculosis in 1933 at the age of 35. This one-time railroad worker became a southern country music star, famous for his yodeling. He wrote enduring songs that have been covered by many artists.

Matt O’Brien is an assistant professor of medicine and public health at Temple University and a founder of Puentes de Salud, a health center serving immigrant Latinos in South Philadelphia.

By Matt O'Brien

Almost six months ago, at a community meeting in South Philadelphia, I heard the following story, one that tragically illustrates a powerful connection between education and health:

A 17-year-old girl, born in Mexico and brought to Philadelphia as a young child, took her life — in large part because she saw no opportunity to pursue a college education after graduating from South Philadelphia High School, a milestone that she would have reached this coming June.

JoAnne Fischer is executive director, and Bette Begleiter deputy executive director, of the Maternity Care Coalition, a Philadelphia nonprofit that works to improve maternal and child health and wellbeing through the collaborative efforts of individuals, families, providers and communities.

By JoAnne Fischer and Bette Begleiter

Each year, Americans spend an average of more than $7,500 per person on healthcare and over $10,000 per birth. This is more than in any other country in the world. Does this expense lead to improved health outcomes? In terms of maternal mortality it is totally counterintuitive. The United States has some of the best economic development, nutrition, technology, and medical institutions in the world. We’d expect that mothers would no longer die in childbirth. We have made steady improvements over the past 80 years. Nonetheless, we are losing ground. And if we don’t make important changes in our health and our health-care system, the trajectory is grim.

The U.S. ranks a dismal 50^th in maternal mortality – dead last in the developed world and behind numerous other countries, from Turkey and Saudi Arabia. About 1,000 women across the country die each year from pregnancy-related complications, a rate of 14.5 deaths per 100,000 live births in 2007, the most recent data available from the Centers for Disease Control and Prevention. Another 34,000 women experience “near misses” that often result in chronic illness such as diabetes and hypertension. And the trend in recent decades often has been toward more deaths, not fewer. In Pennsylvania, for example, the maternal mortality rate rose from 9.7 per 100,000 live births in 2005 to 14.5 in 2010. These women do not have to die. Many of the complications are preventable with better access not only to prenatal care but to healthcare in general for women of child bearing age.

The harsh fact is that young women today are arriving to pregnancy in poorer health than their mothers. The obesity epidemic has impacted teens and young women, with over 50 percent of women giving birth in Philadelphia overweight or obese according to the Philadelphia Department of Public Health. Obese women are 50 percent more likely to have a surgical (Cesarean) birth and to experience more complications such as preeclampsia (1.5-3 times the risk) and gestational hypertension (2-3 times the risk). These complications dramatically increase their chance of dying.

By Michael Yudell

Sometimes I wonder if a subset of Republicans in this country completely misunderstood the classic and creepy 1990s TV show The X-Files. You know, the one where a sinister shadow government works in cahoots with space aliens to facilitate the colonization of planet earth. That series made constant references to a government out of control, seeking to diminish our rights and sacrifice our nation’s sovereignty in preparation for the alien landing. Sound familiar? Save for the alien landing part (for now, at least), that rhetoric sounds an awful lot like the hogwash offered up by many on the far right and, sadly, by those who on Tuesday led the Republican effort in the Senate to vote down the United Nations Convention on the Rights of Persons With Disabilities.

All but eight Senate Republicans voted to defeat a treaty inspired by and modeled on the Americans with Disabilities Act (ADA), the landmark disabilities rights law passed in 1990. With cries of the treaty’s threat to American sovereignty, I’m curious whether these same Senators and other treaty opponents thought The X-Files was a documentary film rather than a dramatic exploration of our fear of the irrational and unfamiliar.

The U.N.’s Convention on the Rights of Persons With Disabilities was first signed by former President George W. Bush (the ADA was signed by his father), and later by President Obama. Its biggest booster – former senator and Republican presidential nominee Bob Dole, now a frail 89 who was recently released from Walter Reed – was wheeled onto the floor of the Senate by his wife, Elizabeth, in a show of support just before voting began.