Psychology of Becoming a Parent

Growing from a couple to a family is a significant change. For one, it’s a lot more stressful. But what about the other changes soon-to-be-parents aren’t aware of? OCH Psychologist, Dr. Annie Beatty expands upon a few elements that will come to surface in your new life as you make the transition to parenthood & offers tips to make sure you maintain a sane brain throughout it all.

Parenting is rewarding and challenging, not just with the daily responsibilities involved, but also the impact it has on your relationship with your spouse. When a child is welcomed into a family, the focus shifts from your partner to the newest member.  Although this is a natural process, it potentially could leave one or both partners feeling abandoned, neglected and stressed.  Research has shown stress changes a person physiologically and emotionally; it can also impair communication patterns and interfere with intimacy.  It is important to prepare for these changes and consider the necessary adjustments in all aspects of your relationship.  A few key points to consider and prepare for include:

• Change in  daily routine (less alone time, less sleep, less time to engage in couple-related activities, less freedom to be spontaneous)
• Potential impact on one or both careers (mothers  may feel the need to stall their careers while fathers may feel  pressure to work harder to support the bigger family)
• Financial considerations (daycare, medical insurance, etc.)
• Shift from being independent to focusing on family;  shift of now being responsible for someone other than yourself
• Less privacy
• More time and focus will likely be spent on your child than your spouse

The key to making this transition smooth is to prepare your relationship for the addition of children before it happens. As always, communication is the key to keeping your relationship healthy.

Annie Beatty, PsyD works at Ozarks Community Hospital in Springfield and spends time at OCH Christian County Clinic in Nixa. She received her education from the Forest Institute of Professional Psychology and completed her residency at Burrell Behavioral Health. To contact Dr. Beatty, call (417) 875-4682 – Specialty Office, or (417) 725-8250 -  Nixa Clinic.

 

10 Things You Didn’t Know About Nuclear Medicine

In honor of National Nuclear Medicine Week (October 2-8), we’ve put together a list of facts you may not know about the study of Nuclear Medicine. But before we begin, here’s a little refresher about the topic: nuclear medicine is a branch of medicine that uses radioactive substances to image your body. In other words, it provides doctors another way to look inside your body in a non-invasive manner to search for tumors, aneurysms, inadequate blood flow, blood cell disorders, and more. Here are a few additional interesting points you may not know about nuclear medicine.

1. An estimated 16 million nuclear medicine imaging and therapeutic procedures are performed each year in the United States. Of these, 40 – 50% are cardiac exams and 35 – 40% are cancer related.
2. Nuclear medicine has been around for at least 58 years.
3. There are nearly 100 different nuclear medicine imaging procedures available today.
4. Unlike other tests, procedures, etc., nuclear medicine provides information about the function of virtually every major organ system within the body.
5. Nuclear medicine procedures are among the safest diagnostic imaging tests available.
6. The amount of radiation in a nuclear medicine procedure is comparable to that received during diagnostic x-ray.
7. Children commonly undergo nuclear medicine procedures to evaluate bone pain, injuries, or kidney and bladder function.
8. Nuclear medicine procedures are painless and do not require anesthesia.
9. Common nuclear medicine applications include diagnosis and treatment of hyperthyroidism (Graves’ disease), cardiac stress tests to analyze heart function, bone scans for orthopedic injuries, lung scans for blood clots, and liver and gallbladder procedures to diagnose abnormal function or blockages.
10. There are approximately 4,000 board certified nuclear medicine physicians and 15,700 certified nuclear medicine technologists worldwide.

Ozarks Community Hospital has an extensive list of Radiology and Nuclear Medicine services available in Springfield, Mo. For more information about the tests and services offered, visit http://ochonline.com/patients-and-visitors/services/diagnostic-imaging-services/ or call (417) 837-4000.

Top 10 Childhood Rashes – Part 2

In Part Two of the childhood rashes blog post series OCH pediatric nurse practitioner, Sandy Hinds shares the second set of common rashes among children. See below for a quick guide to identifying each of them and learn the causes, symptoms, and treatment options available.

ECZEMA  (ATOPIC DERMATITIS)

Eczema is characterized by a red, extremely itchy rash. It often starts on the cheeks at 2-6 months of age, and is most common on the creases of elbows, wrists, and knees or occasionally the neck, ankles and feet.

• Cause: Eczema is an inherited type of sensitive skin.  A personal or family history of asthma or hay fever, makes it more likely that your child has eczema.  Flare ups occur when there is contact with an irritating substances. Certain foods can cause eczema to flare up including cow’s milk, eggs, peanut butter. This itchy flare up could develop 2 hours after eating. 
• Expected Course: This can be a chronic condition, and will usually not go away before adolescence. 
• Treatment: Steroid creams is the main treatment for itchy eczema. When the rash quiets down, use it at least once daily for an additional 2 weeks. 
• Bathing and Hydrating: Hydration of the skin followed by lubricating cream is the main way to prevent flare-ups.  Your child should have one bath each day for 10 minutes.  Water soaked skin is less itchy. Eczema is very sensitive to soaps.  Some lubricating creams are Keri, Lubriderm, Nivea and Nutraderm.  Avoid applying any ointments, petroleum jelly, or vegetable shortening because they can block the sweat glands, increase itching and worsen the rash (especially in warm weather).  
• Prevention: Wool fibers and clothes made of scratchy, rough materials make eczema worse.  Cotton clothes should be worn as much as possible.  Avoid triggers that cause eczema to flare up such as excessive heat, sweating, excessive cold, dry air (use a humidifier) chlorine, harsh chemicals, and saps.  Never us a bubble bath.  Keep your child off the grass. Try to avoid the foods such as cow’s milk, eggs, peanut butter, wheat, and fish during the first year of life.  

HIVES  (Urticaria)

Hives are a very itchy rash, raised pink spots with pale centers (looks like mosquito bites.) Size can rage of ½ inch to several inches across, shapes variable, and rapid repeated changes of location, size and shape. 

• Cause: Hives are usually an allergic reaction to a food, drug, viral infections, insect bit, or a host of other substances. Often, the cause is NOT found. Localized hives are usually due to skin contact with plants, pollen, food or pet saliva. Hives are NOT contagious.
• Expected Course: 10% (or more) of children get hives for 3-4 days and then it disappears. Swelling can be common around the eyes, lips, and genitals. Some may develop as big hives (called popular urticaria) at the sites of old and new bits that can last for months. 
• Treatment: Antihistamine medicine. This medicine will not cure the hives, but I will reduce their number and relieve itching.  Benadryl is one of the most commonly used drugs for hives, with the main side effect being drowsiness.  Please check the dosage according to your child’s weight. Cool baths are helpful to relive the itching.  Avoid triggers that might cause the hives. Call your pediatrician if your child is having trouble breathing, swallowing or acting sick. Also, if the rash does not go away after 1 week, or 24 hours of antihistamines are not effective.   

SCABIES

Scabies are little bugs (mites) that burrow under the skin and cause severe itching and little red bumps. They are so small that they can only be seen with a microscope.  Usually more than one person in a family has them. 

• Care: Creams are usually prescribed by your physician.  Pregnant women need special medicines for scabies and need to see their physician.
• Expected Course: The itching and rash may last for 2-3 weeks after successful treatment with the medication. Cool baths without the use of soap, followed by 1% hydrocortisone cream, which you can buy without a prescription.
• Contagiousness: Children can return to school after one treatment with the scabies medicine, otherwise scabies is HIGHLY contagious.  The symptoms take 30 days after exposure. Machine wash all your child’s sheets, pillowcases, underwear, pajamas, and recently worn clothing.  Blankets can be put away for 3 days.  Scabies cannot live outside the human body for more than 3 days.

IMPETIGO (Infected sores)

Impetigo, or infected sores, are sores within less than 1 inch in diameter; and begin as small red bumps that rapidly change to cloudy blisters, then pimples, and finally sores. They can be covered by soft, yellow-brown scabs that can contain pus.  Impetigo often spreads from scratching and picking at the initial sore. 

• Cause: Superficial infection of the skin, caused by Streptococcus or Staphylococcus bacteria.  It is more common in the summer when the skin is often broken by cuts, scrapes, and insect bites.  When caused by the strep infection of the nose, the impetigo usually first appears near the nose or mouth. 
• Expected Course: With proper treatment, the skin will be completely healed in 1 week.  Scars are unusual unless your child repeatedly picks her sores. 
• Treatment: After the crust has been removed, antibiotic ointment should be applied to the surface three times a day prescribed by your physician. 
• Prevention: Discourage your child from touching or picking at the sores.  Keep your child’s fingernails cut short, clean and wash their hands with one of the antibacterial soaps.
• Contagiousness: Impetigo is quite contagious.  Do not share your child’s towel or washcloth.  Keep your child out of school until she has taken oral antibiotics for 24 hours.  For mild impetigo treated with an antibiotic ointment, the child can continue to attend day care or school if the sore is covered with a Band-aid. 

PITIRYASIS ALBA

Pityriasis alba is characterized by multiple oval, scaly, flat hypo-pigmented patches on the face, extensor surface of arms, and upper trunk.  Multiple patches may be seen. Pityriasis alba occurs predominantly between the ages of 3-16 years, and up to 40% of all children may be affected.  The lesions do not itch, and medical help is sought because of the child’s appearance.  It can be distressing in dark-skinned children.

• Expected Course: It is a chronic dermatitis and may be recurrent over several years.  It can be diagnosed as atopic dermatitis. 
• Cause: The cause of the hypo-pigmentation is not known, but is likely related to inflammatory mediators that inhibit melanocyte function.
• Treatment:  There is no satisfactory treatment for pityriasis alba.  Bland lubricants and topical gluco-corticorsteroids have some influence on the disorder.

All pictures courtesy of Instructions for Pediatric Patients, second edition, W.B. Saunders Company, 1999

Sandra Hinds, CPNP-PC works at the OCH Christian County Clinic located in Nixa, Mo. She received her education from the University Missouri-Columbia, the University of Missouri-Kansas City School of Nursing and the Vickie Millazzo Institute. Sandra is currently a member of the following professional organizations: National Association of Pediatric Nurse Associates and Practitioners, American Academy of Nurse Practitioners, Kansas City Nurse Practitioner Networking Association. To contact Sandra, call OCH Christian County Clinic at (417) 725-8250.

Top 10 Childhood Rashes – Part 1

Not all childhood rashes are created equal. Some are more contagious, others are life threatening. And, (of course) all are unpleasant! OCH pediatric nurse practitioner, Sandy Hinds shares the top 10 common rashes among children and offers a quick guide to identifying each of them. Learn the causes, symptoms, and treatment options available (Part 1). Take note, moms and family members, and stay tuned for the second set of common rashes to be posted next week. 

HAND, FOOT & MOUTH DISEASE

Hand-foot-and-mouth disease is always caused by a Coxsackie A-16 virus. It has no relationship to hoof and mouth disease of cattle. Symptoms include the following: small ulcers in the mouth and a mildly painful mouth, small water blisters or red spots located on the palms and soles and on the webs between the fingers and toes, five or fewer blister per limb and sometimes on the buttocks. Low-grade fever between 100 and 102. It mainly occurs in children 6 months to 4 years of age.

Image of Hand, Foot & Mouth

• Expected Course: Fever and discomfort are usually gone by 3-4 days. Mouth ulcers resolve in 7 days, with the rash lasting 7-10 days. Only complication is dehydration from refusing fluids.
• Home Care: Antacid solution: use for pain relief. Children under 4 yo. ½ tsp. antacid solution in the front of their mouth 4 times a day after meals. Children over 4 yo. 1 tsp. antacid solution after meals.
• Diet: Soft diet for a few days and encourage plenty of liquids. Cold drinks, popsicles, sherbert. Avoid citrus, salty or spicy foods or ones that need much chewing.
• Fever: monitor fever and administer fever reducer as needed.
• Contagiousness: Quite contagious and usually some of your kids playmates will develop it at the same time. Incubation period is 3-6 days. Because the condition is harmless, these children do not need to be isolated. They can return to daycare when the fever is normal. Most children are contagious 2 days before to 2 days after the rash, but avoidance of other children is unnecessary.

POISON IVY

Poison Ivy causes redness and blisters, eruption on exposed body surfaces. It is shaped like streaks or patches, very itchy, onset 1-2 days from being in a forest or field.

 

Image of poison Ivy

 

• Cause: poison, ivy, sumac can cause the same type of rash. More than 50% of people are sensitive to the oil of these plants. The course usually lasts 2 weeks. Treatment reduces the symptoms, but doesn’t cure the disease. Prevention is the best approach.
• Prevention: Learn to recognize these plants. Avoid all plants with three large shiny, green leaves. If exposed wash clothing and areas of skin with soap for 5 minutes, because after 1 hour it is of little value in preventing absorption of the oil.
• Contagiousness: The fluid from the sores is not contagious, however, anything that has poison ivy oil or sap on it is contagious for about 1 week. This includes the shoes, or clothing worn as well as any pets that may have it in their fur. The rash begins 1-2 days after exposure.
• Home Treatment: Cool soaks, Benadryl (weight appropriate dosage).

RINGWORM

Ringworm is a ring-shaped pink patch, scaly, raised border, increases in size, clearing of center, mildly itchy. It is caused by a fungus infection of the skin, often transferred from puppies or kittens who have it.

Image of ringworm.

• Contagiousness: it is mildly contagious. It requires direct skin-to-skin contact. It is only transmitted animal to human, not human to human. After 48 hours of treatment it is not contagious at all. Animals must be treated by their veterinarian.
• Home Care: antifungal cream, Tinactin, Lotrimin cream applied twice daily to the rash.

FIFTH DISEASE (ERYTHEMA INFECTIOSUM) 

This rash is characterized by bright red or rosy rash on both cheeks for 1-3 days ( slapped cheek appearance) , followed by a pink “ lacelike” or “netlike” rash on extremities. Lacy rash mainly on thighs and upper arms, comes and goes several times over 1-3 weeks. No fever or low grade fever – less than 101F ( 38.4). Fifth disease was so named because it was the fifth pink-red infectious rash to be described by physicians. The other four are: 1. Scarlet fever 2. Measles 3. Rubella 4. Roseola. Fifth disease is caused by the human parvovirus B19.

Image of fifth disease.

• Expected Course: The lacelike rash may come and go for 5 weeks, esp. after warm baths, exercise, and sun exposure. No treatment is necessary. The rash is harmless and causes no symptoms that need treatment.
• Contagiousness: Over 50% of exposed children will come down with the rash in 10-14 days. The disease is mainly contagious during the week before the rash begins. Therefore, exposed children should try to avoid pregnant women, but that can be difficult. Once the child has ‘slapped cheeks’ or the lacy rash, he is no longer considered contagious and does not need to stay home from school. If a pregnant woman is exposed to a child with fifth disease, she should see her obstetrician. The doctor will obtain and antibody test to see if the mother already had the disease and is therefore protected.

ROSEOLA

Children ages 6 months to 3 years, presence of a fine pink rash, mainly on the trunk. High fever during the preceding 2-4 days that cleared within 24 hours before the rash appeared. Child only mildly ill during the time with fever, child acting fine now. Roseola is caused by the human herpesvirus-6. The rash lasts 1-2 days followed by complete recovery. Some children have 3 days of fever without a rash. No particular treatment in necessary. Roseola is contagious until the rash is gone. Other children of this age who have been with your child may come down with roseola in about 12 days. Call if the rash last more than 3 days, fever longer than 4 days or the spots become purple or blood-colored.

Image of roseola. All pictures courtesy of Instructions for Pediatric Patients, second edition, W.B. Saunders Company, 1999

Sandra Hinds, CPNP-PC works at the OCH Christian County Clinic located in Nixa, Mo. She received her education from the University Missouri-Columbia, the University of Missouri-Kansas City School of Nursing and the Vickie Millazzo Institute. Sandra is currently a member of the following professional organizations: National Association of Pediatric Nurse Associates and Practitioners, American Academy of Nurse Practitioners, Kansas City Nurse Practitioner Networking Association. To contact Sandra, call OCH Christian County Clinic at (417) 725-8250.

Coping with Fall Allergies

Just when your nose finally adjusted to the sights and smells of summer, fall allergy season hits full force. Sure, the crisp autumn evenings offer a welcome relief from the summer heat; but for those suffering from allergies, fall is one of the worst times to be outside. Ozarks Community Hospital of Gravette nurse practitioner Anita Marie Kane shares a few tips on how to keep the sniffles, itching and irritation at bay.

Sneezing, itchy eyes, runny nose, throat drainage…yes it is that time of year again! We are blessed to live in a region with beautiful foliage and dramatic seasonal changes. However, one of the drawbacks to this seasonal beauty is an abundance of budding, blooming, seeding, and blowing allergens.

The CDC reports over 17.6 million people were diagnosed with “hay fever” in the last year. According to Dr. Moses of Family Practice Notebook, hay fever affects 35 million people yearly, with 3 million missed work days.

What can you do to avoid those missed days? Talk to your provider about your options. Generally, try to avoid allergens you react to, use an air purifier in the home if indicated, avoid tobacco smoke, and use a mask if needed when mowing or working in dust-filled areas. Medications may offer some relief also. These include antihistamines (such as Allegra, Benadryl, Claritin and Zyrtec), intranasal corticosteroids (such as Flonase and Nasonex) and saline nasal spray. Other options in severe cases may include systemic steroids or even allergy testing with hyposensitization.

Just remember, the season will change (and there will be new allergens!). Stay healthy, drink plenty of water, exercise regularly and get adequate rest, a healthy you is your best defense.

Anita Marie Kane, APN is a long time resident of Gravette, AR, who started out as a nurse’s aide at the Gravette hospital shortly after moving to town. She obtained her MSN as a Family Nurse Practitioner from Pittsburg State University in Kansas. Kane specializes in Family Practice and Urgent Care.

Tummy Time and Your Baby’s Development

Tummy time plays a large role in your baby’s overall health and development. But when should you start? And how long should your baby spend on his or her belly each day? Ozarks Community Hospital/Advantage Therapy physical therapist Jennifer Witt shares specifics below and offers tips to help make tummy time more enjoyable for baby and mom.

“Tummy time.” If you are the parent of an infant, you probably hear this phrase all the time and you probably have questions. Why? When do you start? How long? What if they cry/get mad? These are questions I deal with frequently and here are some of the answers I give parents.

Why Practice Tummy Time

There are too many babies that sit in car seats, cribs, and lay on their backs for too many hours of the day. Needless to say, there are numerous reasons to implement tummy time into your infant’s daily routine!

• It helps babies achieve developmental milestones (i.e., holding head up, rolling, sitting).
• It strengthens muscles of the neck and back when infants have to hold their heads up against gravity.
• It prevents flat spots on the head and allows for proper head shape development.
• It allows infants to explore their environment from a different perspective.

When You Should Start

Tummy time should be started as soon as possible; even as soon as you get home from the hospital. The earlier you implement it into their daily routine, the less likely they will be to fight against it.  Place your infant on their tummy for short periods of time initially, gradually building up the amount of time they are spending in that position.

Need for Tummy Time Increases with Age

Tummy time should be a daily activity for infants. Again, this routine should be started as soon as you bring your baby home from the hospital. Here is a guide for how long babies should be spending time on their tummies.

• First couple of weeks: 5 minutes per day
• 1 month old: 20 minutes per day
• 2 months old: 30 minutes per day
• 3 months old: 60 minutes per day
• 4 months old: 81 minutes per day

Sometimes babies cry during tummy time. Usually, I tell parents not to pick the infants up, unless there is some harm to the little one. I recommend setting a timer for 5 minutes and then the baby can be picked up when the timer goes off.

Making Tummy Time Fun

Nothing makes my little ones cry more than placing them on their bellies! Some babies do great, others, not so much. Again, tummy time should be started as early as possible to get them used to being on their bellies. Here are some ideas for keeping it fun.

• Get down on the floor with them! It encourages engagement and bonding between the two of you.
• Place fun toys around them so that they have fun stuff to look at and eventually play with!
• Use mirrors (baby-proof, of course)! Every baby knows they’re super cute, so they really enjoy looking at themselves in the mirror.
• If your infant has reflux, try propping them up on a pillow or boppy to take pressure off their tummies.
• Place the baby on your chest while you’re lying down. This way, they can “talk to you” and still get tummy time.

Jennifer works at OCH/Advantage Therapy in Springfield, Missouri and at OCH Christian County Clinic in Nixa. She received both her Bachelor of Science in Psychology and Doctorate in Physical Therapy from Missouri State University. She has experience in inpatient, outpatient, home health and pediatric  settings. Her primary interest in physical therapy is pediatrics, specifically the 0-3 age group covering a variety of diagnoses. To contact Jennifer, call OCH/Advantage Therapy at (417) 777-4749. For more information about OCH/Advantage Therapy visit www.advantagetherapyonline.com. 

Is your health predetermined by your wealth?

Just how big of a role do money, race and opportunity play in our everyday health? More than you think. Read below for a post adapted from the four-hour PBS documentary series Unnatural Causes: Is Inequality Making Us Sick?

• Health is more than health care. Doctors treat us when we’re ill, but what makes us healthy or sick in the first place? Research shows that social conditions – the jobs we do, the money we’re paid, the schools we attend, the neighborhoods we live in – are as important to our health as our genes, our behaviors and even our medical care.
• Health is tied to the distribution of resources. The single strongest predictor of our health is our position on the class pyramid. Whether measured by income, schooling, or occupation, those at the top have the most power and resources and on average live longer and healthier lives. Those at the bottom are most disempowered and get sicker and die younger. The rest of us fall somewhere in between. On average, people in the middle are almost twice as likely to die an early death compared to those at the top; those on the bottom, four times more likely. Even among people who smoke, poor smokers have a greater risk of dying than rich smokers.
• Racism imposes an added health burden. Past and present discrimination in housing, jobs and education means that today, people of color are more likely to be lower on the class ladder. But even at the same rung, African-Americans typically have worse health and die sooner than their white counterparts. In many cases, so do other populations of color. Segregation, social exclusion, encounters with prejudice, the degree of hope and optimism people have, differential access and treatment by the health care system – all of these can impact health.
• The choices we make are shaped by the choices we have. Individual behaviors – smoking, diet, drinking and exercise – matter for health. But making healthy choices ins’t just about self-discipline. Some neighborhoods have easy access to fresh, affordable produce; others have only fast food joins and liquor and convenience stores. Some have nice homes; clean parks; safe places to walk, jog, bike or play; and well-financed schools offering gym, art, music and after-school programs; and some don’t. What government and corporate practices can better ensure healthy spaces and places for everyone?
• High demand + low control = chronic stress. It’s not CEOs who are dying of heart attacks, it’s their subordinates. People at the top certainly face pressure but they are more likely to have the power and resources to manage those pressures. The lower in the pecking order we are, the greater our exposure to forces that can upset our lives – insecure and low-paying jobs, uncontrolled debt, capricious supervisors, unreliable transportation, poor childcare, no healthcare, noisy and violent living conditions – and the less access we have to the money, power, knowledge and social connections that can help us cope and gain control over those forces.

• Chronic stress can be toxic. Exposure to fear and uncertainty triggers a stress response. Our bodies go alert: the hear beats faster, blood pressure rises, glucose floods the bloodstream – all so we can hit harder or run faster until the threat passes. But when threats are constant and unrelenting our physiological systems don’t return to normal. Like gunning the engine of a car, this constant state of arousal, even if low-level, wears us down over time, increasing our risk for disease.
• Inequality – economic and political – is bad for our health. The United States has by far the most inequality in the industrialized world – and the worst health. The top 1% now owns as much wealth as the bottom 90%. Tax breaks for the rich, deregulation, the decline of unions, racism and segregation, outsourcing and globalization, and cuts in social programs destabilize communities and channel wealth and power – and health – to the few at the expense of the many. Economic inequality in the U.S. is now greater than at any time since the 1920s.
• Social policy is health policy. Average life expectancy in the U.S. improved by 30 years during the 20th century. Researchers attribute much of that increase not to drugs or medical technologies but to social changes – for example, improved wage and work standards, universal schooling, improved sanitation and housing and civil rights laws. Social measures like living wage jobs, paid sick and family leave, guaranteed vacations, universal preschool and access to college, and universal health care can further extend our lives by improving our lives. These are as much health issues as diet, smoking and exercise.
• Health inequalities are not natural. Health differences that arise from our racial and class inequities result from decisions we as a society have made – and can make differently. Other rich nations already have, in two important ways: they make sure inequality is less (e.g., Sweden’s relative child poverty rate after transfers is 4%, compared to our 22%) and they try to ensure that everyone has access to health promoting resources regardless of their personal wealth (e.g., good schools and health care are available to everyone, not just the affluent). They live healthier, longer lives than we do.
• We all pay the prices for poor health. It’s not only the poor but also the middle classes whose health is suffering. We already spend $2 trillion a year to patch up our bodies, more than twice per person than the average rich country spends, and our health care system is strained to the breaking point. Yet our live expectancy is 29th in the world, infant mortality 30th, and lost productivity due to illness costs business more than $1 trillion a year. As a society, we face a choice: invest in the conditions that can improve health today, or pay to repair the bodies tomorrow.

Information produced by California Newsreel with Vital Pictures. Presented by the National Minority Consortia. Public Engagement Campaign in Association with the Joint Center for Political and Economic Studies Health Policy Institute. (California Newsreel 2008). To learn more about the series, health equity and how you can make a difference, please visit www.unnaturalcauses.org.