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The Racial Health Disparity in Maternal Mortality

by Anerudh Praveen
3 mins read

Maternal mortality, defined as the death of a woman during pregnancy, childbirth, or within 42 days of delivery, is a significant public health issue in the United States. Despite medical advancements, maternal mortality rates in the U.S. are among the highest in developed countries. Moreover, black and Indigenous women are disproportionately affected by this issue, and the gap between these communities and white women continues to widen.


According to the Centers for Disease Control and Prevention (CDC), black women are three to four times more likely to die from pregnancy-related complications than white women. In 2018, the maternal mortality rate for black women was 37.1 deaths per 100,000 live births, compared to 14.7 deaths per 100,000 live births for white women. The disparity is even more significant for Indigenous women. The CDC reports that Indigenous women are 2.3 times more likely to die from pregnancy-related complications than white women.


Several factors contribute to this racial health disparity. Structural racism, which includes historical and current policies that create and maintain racial inequalities, is a significant factor. For example, black women are more likely to live in impoverished communities with limited access to quality healthcare, healthy food, and safe housing. Moreover, they are more likely to experience racism and discrimination in healthcare settings, which can lead to mistrust and reluctance to seek care.


Other factors include underlying health conditions, such as hypertension, obesity, and diabetes, which increase the risk of pregnancy complications. Socioeconomic status, education, and access to healthcare also play a role.


The U.S. government has taken steps to address this issue. In 2018, Congress passed the Preventing Maternal Deaths Act, which provides funding to states to establish maternal mortality review committees. These committees investigate maternal deaths to identify gaps in care and develop strategies to prevent future deaths. Additionally, the CDC has launched the Hear Her campaign, which raises awareness about maternal mortality and encourages women to seek care when they experience warning signs.


In conclusion, the racial health disparity in maternal mortality is a complex issue that requires comprehensive solutions. Addressing structural racism and improving access to healthcare and resources can help reduce the disparity and ensure that all women have safe and healthy pregnancies and births. 





References:


Centers for Disease Control and Prevention. (2021). Pregnancy Mortality Surveillance System. https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm


National Partnership for Women & Families. (2021). Maternal Health: Women of Color. https://www.nationalpartnership.org/our-work/resources/health-care/maternal-health/women-of-color.html
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FeaturedLife

Combating Food Deserts

by Varun Sreedhara
3 mins read

A food desert is usually a low-income area in which people have little to no access to fresh, healthy food at affordable prices, and face several hardships in procuring nutritious foods such as fruits and vegetables. Not only are grocery stores harder to find in food deserts, but the fresh, nutritious products they sell are more expensive than processed foods. With processed foods often being an alternative, they can lead to an increase in health problems such as obesity, type 2 diabetes, cardiovascular disease, high blood pressure, and various types of cancer linked to obesity. The Food Desert Locator developed by the USDA’s ERS(Economic Research Service) found that about 10 percent of the approximately 65,000 census tracts in the United States as food deserts. About 13.5 million people in these census tracts have low access to a supermarket or large grocery store, with 82 percent living in urban areas. Wherever there are food deserts, they tend to affect Black and Brown communities disproportionately. According to a multi-site study done by Moreland et al in 2002, it was evident from their findings that predominantly white neighborhoods had 4-times as many supermarkets than black neighborhoods. Likewise, according to “Food Deserts: What They Are and WHAT CAUSES THEM”, “Indigenous peoples of America live farther away from grocery stores than any other demographic. 12% of American Indians and Alaska Natives live 20 miles or more from their nearest grocery store.” 

What causes food deserts? As wealthier people have access to privatized mobility, they are able to move out from densely populated cities, and with them went many grocery stores that were in the area– this leads to the emergence of food deserts within city centers. With lower rates of employment and higher rates of poverty, low-income areas aren’t as appealing for

grocery store owners to open up shop as they prefer more affluent areas which are more profitable. According to “Urban and rural grocery stores struggling in Illinois” by Andrew Hensel of The Center Square, “Some grocers have cited poor store performance or lack of sales as reasons for their exits.” According to Owen Walsh of the Humane League, in Chicago alone over 500,000 live in food deserts. In a recent study on areas with predominantly Black residents, the closest grocery store is twice as far as the nearest fast food restaurant. High crime rates in inner city neighborhoods has also been cited as one of the reasons for supermarket owners to avoid these areas. According to Charles D. Ellison of The Philadelphia Citizen, “Rates of food insecurity, ranging from 20 percent to over 30 percent in Philadelphia, are also most prevalent where there is rising violence.” 

There are several strategies that can be utilized for dealing with urban food deserts. These communities don’t just need another grocery store, they need a holistic approach that prioritizes residents and their health. Cities need to improve infrastructure like transportation so that residents have easier access to grocery stores. City planners could also encourage small retailers such as farmer’s markets or other small street vendors near residences. Community gardens are a great alternative since fresh, healthy produce could be grown by residents and distributed to others. This could encourage a healthy and economic lifestyle as well as a sense of community between people. People in Winchester, Illinois have also tried to combat food deserts through co-op markets, where residents open up collectively owned and operated markets. As a result, the residents become both the suppliers and customers of these businesses. Another approach is to have small grocer and corner stores stock their shelves with affordable healthy foods instead of unhealthy processed foods. Currently in New York City, there is a city-wide initiative to restock the shelves of bodegas and small stores with fresh, healthy, affordable foods. Last but not least, mobile markets are another great solution to tackle food deserts, it’s just like bringing a grocery store right to your house. Transportation is often a struggle, so having a mobile market to bring fresh produce to their doorstep instead of having to commute long distances to a grocery store is a great solution. 

References: 

Michele Ver Ploeg, David Nulph, and Ryan Williams “Mapping Food Deserts in the United States” Economic Research Service U.S. DEPARTMENT OF AGRICULTURE 16 October 2022 online. 

Nathaniel M. Mead “Urban Issues: The Sprawl of Food Deserts” Nation Institute of Health 16 October 2022 online. 

Charles D. Ellison “Violent Areas Are Hungry Areas” The Philadelphia Citizen 16 October 2022 online.

Andrew Hensel “Urban and rural grocery stores struggling in Illinois” The Center Square 16 October 2022 online. 

Owen Walsh “FOOD DESERTS: WHAT THEY ARE AND WHAT CAUSES THEM” The Humane League 16 October 2022 online.







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FeaturedLife

Food Insecurity in Early Life Causes Lifetime Challenges

by Vishal Duvvuri
3 mins read

For decades, medical researchers and physicians have recognized that food insecurity is a determinant of chronic disease morbidity and mortality, a problem exacerbated during the outbreak of COVID-19. In turn, food insecurity has caused economic and public health crises that is worsened by the invasion of Ukraine by Russian, ongoing supply chain issues across the globe, and a shortage of fertilizer to maximize agriculture across the US and beyond.

Food insecurity contributes to poor health outcomes in both the short and long-term. In the short-term, increased food insecurity, low household economic disruption and resulting stresses, and interruptions in healthcare service during periods of COVID-driven isolation contribute to acute chronic disease complications. Moreover, the impact of food security lingers, even after COVID restrictions are lifted, as the ‘new normal of healthcare systems stabilize, resulting in additional risk for chronic disease development, morbidity, and mortality among food-insecure households.

The impact of food insecurity in less developed nations, such as in Africa, where more than 50% of the population is moderately or severely food insecure, reveal the longer-term impact of food insecurity. Research undertaken in Africa during the past five years reveals that food insecurity is associated with poor mental health, as well as poor developmental and physical health outcomes, including growth stunting in children.

Moreover, leading neuroscientists’ studies indicate that a major challenge for neuroscience and public health experts is to understand the effects of food scarcity on the developing brain as it is recognized that a significant number of children and adolescents worldwide experience insecure access to food. Moreover, scientists now recognize how even a transient experience of insecure versus secure access to food during the juvenile-adolescent period can produced lasting differences in learning, decision-making in adulthood, thus resulting in a major health disparity for individuals lacking adequate food security and nutrition.

 

References:

Anna M Leddy, Sheri D Weiser, Kartika Palar, Hilary Seligman, A conceptual model for understanding the rapid COVID-19–related increase in food insecurity and its impact on health and healthcare, American Journal of Clinical Nutrition, V 112, Issue 5, Nov 2020, Pages 1162–1169, https://doi.org/10.1093/ajcn/nqaa226

John Paul Trudell, Maddison L. Burnet, Bianca R. Ziegler, Isaac Luginaah, The impact of food insecurity on mental health in Africa: A systematic review, Social Science & Medicine,

V 278, 2021, 113953, ISSN 0277-9536, https://doi.org/10.1016/j.socscimed.2021.113953.

(https://www.sciencedirect.com/science/article/pii/S0277953621002859)

Linda Wilbrecht Ph.D Professor of Psychology and Neuroscience, University of California, Berkeley, The Wilbrecht Lab, “Transient food insecurity during the juvenile-adolescent period affects adult weigh, cognitive flexibility, and dopamine neurobiology. Wilbrecht Lab.

https://www.eatright.org/health/wellness/your-overall-health/food-insecurity-and-health

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EducationFeatured

21st Century Engineers Vital in Solving Modern Health Disparities

by BHARATH MALIPEDDI
3 mins read

While learning how I can use my evolving computing and tech skills to help identify health disparities so that they can be addressed and in turn, improve overall public health. In the U.S. many health disparities have raised significant amounts in the past couple of years, but through my research I have learned that through the work of engineering mixed with our fundamental science can help us understand these health disparities 

 

Health disparities are challenges people face in their health care based on their, background, gender, etc. A two-part study which was conducted at grove school of engineering at the city college of New York to educate kids in health disparities and also, show them a pathway into STEM. The students were given many surveys and assignments to complete to educate them on the rising cost of US health care along with a rise in STEM majors which I found very interesting because of my background in STEM. In the second part of the project the students used health disparity data to understand which is an important skill in STEM while also educating them on health disparities. And lastly the students at the start of the course were asked “Why are true challenges in US health disparities important” 45 percent of the students responded with “I don’t know,” 33 percent responded with different types of health insurance plans, and 12 percent claimed they felt it was not important, and the remaining said that health disparities were only in diseases.  At the end of the course there was real change as 31 percent said they are important because they are caused by, or were symptoms of, inequality and unfairness in health services, health research, or health care, 28 percent they are import because they disproportionately affect my community, 29 percent said they were a great national expense and 12% said they were important because they were in need of engineering tools. 

 

Students’ understanding and grasp of these complex community-based concerns improves when engineering undergraduates are exposed to health disparities in many situations and may even help them present solutions. When people are exposed to health disparities as an engineering problem when they are younger, they will help in research of health disparities in the STEM fields, as well as the incorporation of health disparities into engineering

 

References:

 

Vazquez M. Engaging Biomedical Engineering in Health Disparities Challenges. J Community Med Health Educ. 2018;8(2):595. doi:10.4172/2161-0711.1000595

 
 
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EducationFeatured

Bullying’s Impairment on Health

by Shivangi Kumari
3 mins read

One of the biggest messages spread around almost every school is an anti-bullying campaign. A lot of students don’t pay attention to these because it seems normal to be picked on by your peers, or made fun of because of how you dress or your income status. Stopbullying.gov lists out some of the most common risk factors for kids who have been bullied, including being perceived as different from others,  and weaker or seemingly easier to prey on. The impacts of bullying are lightly addressed, but to what extent do they affect people?

Stopbullying.gov states that children who experienced bullying have “Decreased academic achievement—GPA and standardized test scores—and school participation. They are more likely to miss, skip, or drop out of school.” The CDC elaborates how about 160,000 high schoolers missed school because of bullying or violence at school. In 2019, about 20% of high schoolers reported having experienced bullying, 16% of which was online. Not to mention how “Overall, individuals with less education are more likely to experience a number of health risks, such as obesity, substance abuse, and intentional and unintentional injury, compared with individuals with more education.4 Higher levels of education are associated with a longer life and an increased likelihood of obtaining or understanding basic health information and services needed to make appropriate health decisions.”

In the end, bullying obviously has no good results, and a mere constant of insults can greatly impact many people for the rest of their lives. A youth disparity index by the CDC confirms, “These trends are consistent with previous studies that show LGBTQ students are at a disproportionately higher risk for negative health outcomes related to sexual behaviors, experiences of violence, substance use, and mental health, including suicide, and poor academic performance”. Being targeted at school can affect a student’s mental and physical health, along with stunting their academic growth.


Works cited: 

Assistant Secretary for Public Affairs (ASPA). “Effects of Bullying.” StopBullying.gov, 21 May 2021, https://www.stopbullying.gov/bullying/effects.

“Health Disparities.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 24 Nov. 2020, https://www.cdc.gov/healthyyouth/disparities/index.htm#:~:text=Health%20disparities%20are%20preventable%20differences,experienced%20by%20socially%20disadvantaged%20populations.

“YRBSS Data & Documentation.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 May 2022, https://www.cdc.gov/healthyyouth/data/yrbs/data.htm.

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FeaturedHealth

How the Recent Monkeypox Outbreak has Shaken up the LGBTQ Community

by Angeline Dangca
3 mins read

With the recent national concerns with monkeypox, worries about who, when, and how you can contract it have surged. Recent cases have shown the majority of the cases to be in men who have had sexual contact with other men. However, as health experts have highlighted, anyone can contract monkeypox. A recent report of 11,000 cases drove officials to report this as a public health emergency. FDA Commissioner Robert M. Califf stated in a recent interview that, “in recent weeks the monkeypox virus has continued to spread at a rate that has made it clear our current vaccine supply will not meet the current demand.” 


So posing the question, what exactly is monkeypox? Monkeypox is a viral disease that is caused by the monkeypox virus. It originated from Africa but has only recently posed a national concern among humans. According to the CDC, some symptoms include a rash present on or near the genital or anal area as well as on other areas like the hands, feet, chest, face, or mouth. There has been a vaccine made, but the supply is very limited. Because of this and the distress, the situation is causing, some people have found a need for a scapegoat which ultimately gives rise to the stigmatization of the gay community. 


In an interview by the Washington Post, Aaron Backman, a member of the LGBTQ community with monkeypox, claimed he had received information from his doctor’s office and local health officials about whether he would qualify for treatment, which he, in the end, he never received. He stated that “I feel like public health doesn’t care if gay men die or not.” The fear others have is that this shortened, but the sexually targeted message can lead to discrimination among a community who has already struggled to progress with the rights they have now not only economically or socially, but in healthcare as well. Ella Washington, a professor at Georgetown University, emphasizes the fact that the information shared with others highly depends on how much people limit generalization which can greatly raise the potential for awareness rather than stigma. With all of the uncertainties surrounding the disease, defining and singling out a group based on the majority will fuel the start again of inequity among these communities. As stated by many health as well as LGBTQ advocates, the best thing for everyone is to be aware rather than selective so that a proper understanding of the situation is addressed.


References

Centers for Disease Control and Prevention. (2022, July 22). About Monkeypox. Centers for Disease Control and Prevention. Retrieved August 17, 2022, from https://www.cdc.gov/poxvirus/monkeypox/about.html

Gonzales, M. (2022, August 11). Monkeypox and LGBTQ workers: How to avoid stigmatizing gay and bisexual employees. SHRM. Retrieved August 17, 2022, from https://www.shrm.org/resourcesandtools/hr-topics/behavioral-competencies/global-and-cultural-effectiveness/pages/monkeypox-and-lgbtq-workers-how-to-avoid-stigmatizing-gay-and-bisexual-employees.aspxz

Nirappil, F. (2022, August 4). Struggle to protect gay, bisexual men from Monkeypox exposes inequities. The Washington Post. Retrieved August 17, 2022, from https://www.washingtonpost.com/health/2022/07/27/monkeypox-gay-men-vaccine-treatment/

Spencekimball. (2022, July 28). WHO recommends gay and bisexual men limit sexual partners to reduce the spread of Monkeypox. CNBC. Retrieved August 17, 2022, from https://www.cnbc.com/2022/07/27/monkeypox-who-recommends-gay-bisexual-men-limit-sexual-partners-to-reduce-spread.html

Stack, L. (2022, July 28). ‘it’s scary’: Gay Men Confront a health crisis with echoes of the past. The New York Times. Retrieved August 17, 2022, from https://www.nytimes.com/2022/07/28/nyregion/gay-men-monkeypox-health-crisis.html

Treisman, R. (2022, July 26). As monkeypox spreads, know the difference between warning and stigmatizing people. NPR. Retrieved August 17, 2022, from https://www.npr.org/2022/07/26/1113713684/monkeypox-stigma-gay-community

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FeaturedHealth

Inequalities in Access to Healthy Foods

by Madhuhaas Gottimukkala
3 mins read

According to the United States Department of Agriculture, neighborhoods with higher levels of poverty, a greater number of fast food restaurants, little to no access to healthy foods, and with grocery stores more than 1 mile away qualify as food deserts. In these areas, it is more common to find fast food restaurants and small, local stores instead of grocery stores. People in a neighborhood most likely consume food based on the choices available in their neighborhood. Other factors such as income and access to transportation to grocery stores also play a role in food consumed. Access to nutritious food becomes a major problem in low-income neighborhoods and food deserts where there are more fast-food restaurants compared to higher income neighborhoods. People are left with no choice but to eat what they have access to. While many argue that obesity is a result of poor choices made by an individual, there are factors that may be out of an individual’s control such as access to food, income, and location that influence the food choices. Low-income communities tend to lack supermarkets and do not provide adequate safety for exercise, causing residents to live unhealthy lifestyles that put them at greater risk for obesity.

In the article “Fast Food: Oppression through Poor Nutrition,” Freeman discusses the growth of fast food in urban neighborhoods and the relocation of supermarkets. He notes that “This migration, combined with the lack of transportation to the suburbs and the higher prices charged by local convenience stores, has made fast food the dominant food source in many low-income, urban communities.” This leads to negative impacts on one’s diet and health. Eating too much fast food is linked with numerous health issues, such as obesity, diabetes, and heart disease. Freeman claims, “There are higher rates of diabetes, heart disease, strokes, and cancer in poor neighborhoods than any other area.” (Freeman page 2228). The lack of options caused by food deserts in low-income neighborhoods are producing unequal and unfair side effects in these communities. “Neighborhood Disparities in Access to Healthy Foods and Their Effects on Environmental Justice” by Angela Hilmers also describes the dense caloric intake of these foods. She states, “In general, fast-food outlets and convenience stores offer high-calorie foods, leading to higher total caloric intakes for their customers.” (Hilmers, 2012). The disproportionate access to unhealthy foods in low-income communities is linked to adverse side effects such as high obesity rates.

References

Dutko, Paula, et al. “Characteristics and Influential Factors of Food Deserts.” USDA ERS, U.S. Department of Agriculture, 31 Aug. 2012, https://www.ers.usda.gov/publications/pub-details/?pubid=45017. 

Freeman, Andrea. “Fast Food: Oppression through Poor Nutrition.” California Law Review, vol. 95, no. 6, 2007, pp. 2221–2259. JSTOR, www.jstor.org/stable/20439143. Accessed 16 Mar. 2021.

Hilmers, Angela et al. “Neighborhood disparities in access to healthy foods and their effects on environmental justice.” American journal of public health vol. 102,9 (2012): 1644-54. doi:10.2105/AJPH.2012.300865 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783380/


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EducationFeatured

Combat Disparities Through Improved AI Tools

by Sathvik Charugundla
3 mins read

By researching health disparities, I am learning that there are disparities in access to health insurance and healthcare, quality of care received based on geographic regions, and real biological differences. For example, University of Michigan Medicine researchers have been studying racial disparities in the healthcare system to gain a better understanding of how complex factors create differing health outcomes for Black and white Americans. With this research I am learning how the use of artificial intelligence (AI ) in healthcare helps combat some of these disparities.

 

Researchers note that Black patients tend to report suffering more intense pain than white patients but are less likely to undergo knee replacement surgery. Interestingly, U-Michigan researchers are training a new algorithm to read knee X-rays for patients with arthritis found that their AI program performed more efficiently in diagnosing Black patients’ reported pain than human radiologists. 

 

Yet, my research revealed that some AI tools have increased disparities rather than combating them. For example, an algorithm previously used by a health insurance company to predict future healthcare costs and recommend patients for care actually reduced care provided for Black patients from 50% to 20%. As AI and ML algorithms scale, they take more repetitive tasks, so inequities included in these algorithms can increase as well. As these algorithms used cost as an endpoint, the algorithm was faulty, even though it was intended to be theoretically race-blind.  In contrast, the algorithm researchers trained on knee X-rays was “trained on patient reports of pain” so as Black patients reported higher levels of pain with clinically equivalent images, AI-assisted Xray readings were improved and resulted in more accurate diagnosis of disease patterns and in turn, led to better care for Black patients.

 

 

References:

Adnan Asar “AI Could Reduce Racial Disparities In Healthcare” Forbes Technology Council 1 Oct 2021 online.


Jordyn Imhoff “Health Inequality Actually Is a “Black and White Issue” University of Michigan Health 3 June 2020 online.

Wired “New Algorithms Could Reduce Racial Disparities in Health Care: Machine learning programs trained with patients’ own reports find problems that doctors miss—especially in Black people” 25 Jan 2021 online.

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Featured

Is Gaming Causing Health Disparities in Youth?

by Akshay Varma Alluri
3 mins read

In research disparities resulting from gaming activities by levels of internet use and gender, I discovered a study conducted published on the CDC, whereby researchers investigated differences by sex in association between video gaming or other nonacademic computer use and resulting depressive symptoms, suicidal behavior, and being bullied among adolescents in the US. To conduct the study, researchers used data from a 2015 study of 15,624 students where students were asked whether, during the past 12 months, they had felt sad, been bullied, or exhibited suicidal behavior. They also asked how many hours on average they spent playing games or doing non academic work. The study’s data was also adjusted to minimize nonresponse and other biases.


Researchers found about 1 in 5 adolescents spent more than 5 hours a day doing non-academic computer use per day on average. Another interesting statistic was females had a higher percentage of people who spent either 0 hours or more than 5 hours on nonacademic use. The results also showed that depressive symptoms, bullying, and suicidal behavior were more prevalent in females than males. About ⅓ of all adolescents in the study had depressive symptoms, ⅕ had considered suicide, and ¼ had been bullied at school with females nearly twice as likely to have these symptoms than males. When graphing the relationship between hours used and percentage of symptoms, the graph appears to be a U or J-shaped curve where the percentages are roughly the same between 0-4 hours, but spike up for all 3 symptoms, at more than 5 hours as shown in the graph noted above. 


These results are not new as previous Korean and Swiss studies of adolescents, both determined that more than 2 hours of high internet usage is unhealthy for adolescents and found similar results when comparing respective hours and symptom percentages. When assessing the wide-scale use of the study, it is essential to note this study cannot be used to determine any cause-effect relationship due to data used. Another important note is video games and nonacademic use was compiled as one variable between genders, an issue because a significantly higher percentage of males than females spent more time playing video games while females spent more time on social media. Although these issues have arisen, the data still gives some evidence that more than 5 hours causes a significant increase in depressive symptoms, suicidal behavior, and being bullied with a higher likelihood of females experiencing these problems than males. 

 

References:

CDC, “Differences by Sex in Association in Association of Mental Health With Video Gaming or Other Nonacademic Computer Use Among US Adolescents” by Hogan H. Lee, Jung Hye Sung, Ji-Young Lee, and Jae Eun Lee.

Lee HH, Sung JH, Lee J, Lee JE. Differences by Sex in Association of Mental Health With Video Gaming or Other Nonacademic Computer Use Among US Adolescents. Prev Chronic Dis 2017; 14:170151. DOI: http://dx.doi.org/10.5888/pcd14.170151.

Youth Risk Behavior Survey. Figure. Prevalence of depressive symptoms, suicidal behavior, and being bullied in relation to time spent on video gaming or other nonacademic computer use among male and female adolescents, 2015. 


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Featured

Water Quality Impacts Health Disparities: Is your Water Sufficiently Fluoridated?

by Pranav Golla
3 mins read

Until recently, my view of clean water was a given. Water is from a clean source, properly treated, tested, and then sent through pipes to us. Turns out, it’s not that simple. Most people in America rely on public water systems regulated by the EPA, however research demonstrates that EPA regulations are always followed, so many public water systems are exposed to contaminants. After coming across Columbia University’s Drinking Dashboard tracking tool noting contaminant concentration estimates in community water systems across the US, I was energized to learn more about the ‘health’ of our water. 

 

In reviewing water sources, not only did I learn that not all water across our state is fluoridated, but also, water fluoridation levels recommended by the CDC and numerous public health and medical organizations, including the American Medical Association, American Dental Association, American Academy of Pediatric Dentistry, and World Health Organization are not followed. Water fluoridation is the process of adjusting naturally occurring fluoride levels to prevent tooth decay and unfortunately, only 70% of the US population lives in communities served by fluoridated water. The task of setting water quality standards at a national level is allocated to the EPA (they regulate 90% of water purchased in the US and 10% comes from private wells). Some states may have additional quality standards that need to be met in their state. My research reveals that with the California Assembly Bill 733 (1995), water systems with 10,000 or more service connections in California must fluoridate their water supply, but only when funding becomes available.


According to Calwater, fluoride levels in the water they serve can range from 0.1 mg/l to 1.0 mg/L based on location and time of year. This is because they purchase water from MWD and mix it with local sources for most customers. This changes the composition of Fluoride in every customer’s water which can lead to health disparities depending on the area you live in. Fluoride is a neurotoxin and can be harmful if taken in high doses. It can also lead to tooth discoloration and bone problems if people are exposed to it too much. Certain types of toothpaste contain fluoride and calling the poison control center is recommended if more than a pea sized amount is swallowed. On the other hand, many recent studies have shown that insufficient fluoride levels can increase the number of cavities. Communities that had more than 1.0mg/l of fluoride in their water had less cavities than people who had less fluoride in their water. The studies conclude that the optimal fluoride level to prevent tooth decay is 0/7mg/. These are just some of the side effects of taking too little or too much fluoride and shows why maintaining its level in water systems is important. EPA regulations call for a maximum of 4.0 mg/l of fluoride which is over 5 times the amount that is generally recommended and safe for drinking, 0.7mg/l.


Although health risks to communities, as a whole, are apparent and inadequate fluoride can lead to health disparities, only fluoridating when federal funding will eventually reduce community public health standards. If we do not urge politicians to bring change in these policies, we could continue to be risking our health through a universal right, clean water. 


 


References:

Alameda County Water District, Water Quality Report.

Annie Nigra, “Assessing Quality to Eliminate Environmental Injustice and Health Disparities” 26 July 2021 available at https://datascience.columbia.edu/news/2021/…

California Assembly Bill 733 (1995),

City of San Francisco Public Utilities Commission and Santa Clara Valley Water District Water Quality Report.
Columbia University Drinking Dashboard is available at //msph.shinyapps.io/drinking-water-dashboard/.

https://www.calwater.com/waterquality/fluoride/

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