Oklahoma

Syphilis prevention vs. politics

lborkowski — Mon, 28 Aug 2017 12:36:58 +0000

Syphilis prevention vs. politics

Last week’s New York Times featured a great article on a syphilis outbreak in Oklahoma. Reporter Jan Hoffman documented some of the impressive work state health investigators are doing to contain the outbreak, from using Facebook to discern likely transmission routes to showing up at the homes of people with positive test results and offering them rides to treatment centers.

CDC warned earlier this year that syphilis rates are on the rise throughout the US. Primary and secondary syphilis, the disease’s most infectious stages, rose 19% in a single year (2014-2015), and that trend appears to be continuing. The majority of these P&S cases are among men who have sex with men, but rates are also rising among women and some newborns. Pregnant women with untreated syphilis can pass the disease to their fetuses; congenital syphilis, which can cause stillbirth as well as severe illness and death in infants, has also been increasing since 2012. CDC’s map shows Oklahoma as one as several states where the syphilis rate experienced a 101-200% change from 2011 to 2015; Oregon, Idaho, Utah, North Dakota, Nebraska, Kansas, Iowa, West Virginia, and Hawaii showed changes of more than 200% over the same time period.

Source: Centers for Disease Control & Prevention, 2017: CDC Call to Action: Let’s Work Together to Stem the Tide of Rising Syphilis in the United States

A few months before that, when CDC released its STD surveillance report for 2015 (read Kim Krisberg’s report on that here), the agency’s news release sounded an alarm:

“We have reached a decisive moment for the nation,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “STD rates are rising, and many of the country’s systems for preventing STDs have eroded. We must mobilize, rebuild and expand services – or the human and economic burden will continue to grow.”

In recent years more than half of state and local STD programs have experienced budget cuts, resulting in more than 20 health department STD clinic closures in one year alone. Fewer clinics mean reduced access to STD testing and treatment for those who need these services.

Chlamydia, gonorrhea and syphilis are curable with antibiotics. Widespread access to screening and treatment would reduce their spread. Most STD cases continue to go undiagnosed and untreated, putting individuals at risk for severe and often irreversible health consequences, including infertility, chronic pain and increased risk for HIV. STDs also impose a substantial economic burden: CDC estimates STD cases cost the U.S. healthcare system nearly $16 billion each year.

In other words, we’re failing to stop the preventable spread of STDs because the people in charge of budgets are being penny wise but pound foolish. For 2017, federal STD prevention funding suffered a $5 million cut (to $152 million), and President Trump’s proposed 2018 budget slashes it by 17%. In Oklahoma, the state legislature passed a 2018 budget that cuts the state health department budget by 3%.

Years of cuts to public health budgets are problematic on their own, but now they’re coupled with increased federal hostility to the programs and providers we need in order to address STDs (and other aspects of sexual and reproductive health) effectively. It’s not new for House Republicans to try to eliminate the Title X program, which funds reproductive healthcare for millions of low-income people, or to deny reimbursement to Planned Parenthood for services it provides to Medicaid beneficiaries, but this is the first time in a while they’ve had a president who’s likely to sign off on such destructive moves. Title X clinics performed nearly six million STD tests in 2014. Planned Parenthood provides more than 4.2 million tests and treatments for STDs — and, as Texas learned recently, there’s no easy replacement for Planned Parenthood.

As US Representative Nita Lowey (D-New York) noted in an opinion piece for The Hill, “The attacks on women’s health don’t stop at our own borders.” One of President Trump’s first executive actions was a worse-than-ever version of the global gag rule, which is harming many other countries’ efforts to reduce STD transmission — and as Zika cases have demonstrated, infections acquired in other countries can end up sexually transmitted here.

In addition to testing for and treating STDs, we also need prevention efforts that help people avoid unprotected sex. The Trump administration has attacked these, too, with abrupt early termination of Teen Pregnancy Prevention programs in communities across the country. As Kim Krisberg reported recently, grantees were testing and disseminating sexual health interventions aimed at improving sexual health, including strategies to reduce STDs and sexual violence. One of the projects facing early termination, she noted, is the Seattle-King County FLASH curriculum, which is in the process of rolling out to schools across the country and “is designed to be inclusive of LGBT students and is just as relevant for young people who decide to abstain from sex as it is for those who don’t.”

Among TPP grant programs — all of which appear to have lost funding — are three in Oklahoma. Choctaw Nation of Oklahoma is “replicating evidence-based teen pregnancy prevention programs in middle schools, high schools, and alternative schools in Choctaw, McCurtain, and Pushmataha counties, three counties in Southeast Oklahoma with some of the highest teen pregnancy rates.” Oklahoma City-County Health Department collaborates with local partners to bring elementary and middle schools evidence-based programs such as Cuidate!, Making Proud Choices, Making a Difference, Be Proud! Be Responsible!, Draw the Line/Respect the Line, and Sisters Saving Sisters. Youth Services of Tulsa, Inc. by 2020 aimed to serve 10,000 youth in middle school, high school, alternative school, juvenile detention, community-based, specialized, and clinic settings. Unless their TPP funding is restored or replaced, thousands of teens will miss out on important sexual health education as a syphilis outbreak threatens health in their state.

Evidence-based sexual health education that’s inclusive of LGBT students — or adults, for that matter — is especially important for stopping the spread of syphilis, given that the majority of cases are in gay and bisexual men and other men who have sex with men. Turning away from inclusive, evidence-based sex ed and taking an anti-LGBTQ tone, as this administration has done, risks cutting LGBTQ individuals off from information that can help them make healthy decisions when it comes to sex. “Abstinence-only sex ed and ‘no pro homo’ laws keeps kids in the dark, leaving them with bodies they don’t fully understand and experiences they have no context for,” writes BuzzFeed contributor John Paul Brammer. “I was uneducated — about gay sex, about consent — and that made me more vulnerable.”

Reading about hardworking Oklahoma public health investigators in the New York Times makes me proud of what public health can do — and fearful of how bad things will get as support for effective public health programs keeps eroding.

lborkowski Mon, 08/28/2017 - 08:36

Giant red octopuses: Suspects in unexplained drownings in Oklahoma

dr. dolittle — Thu, 19 Dec 2013 11:49:03 +0000

Giant red octopuses: Suspects in unexplained drownings in Oklahoma

Could giant freshwater octopuses really be to blame for the many unexplained drownings in Oklahoma's lakes?

dr. dolittle Thu, 12/19/2013 - 06:49

Peak Water in the American West

pgleick — Mon, 19 Aug 2013 13:50:39 +0000

Peak Water in the American West

Dropping water levels in Lake Mead, behind Hoover Dam. (Source: Peter Gleick 2013)

It is no surprise, of course, that the western United States is dry. The entire history of the West can be told (and has been, in great books like Cadillac Desert [Reisner] and Rivers of Empire [Worster] and The Great Thirst [Hundley]) in large part through the story of the hydrology of the West, the role of the federal and state governments in developing water infrastructure, the evidence of droughts and floods on the land, and the politics of water allocations and use.

But the story of water in the West is also being told, every day, in the growing crisis facing communities, watersheds, ecosystems, and economies. This isn’t a crisis of for tomorrow. It is a crisis today. What is, perhaps, a surprise, is that it has taken this long for the entire crazy quilt of western water management and use to finally unravel. But it is now unraveling.

The old adage of the blind men describing an elephant based on their experience touching different parts of it applies to western water. In the past few years, we’ve seen bits and pieces of the puzzle: a well, and then two wells, and then a town goes dry. A farmer has to shift from water-intensive crops to something else, or let land go fallow. Vast man-made reservoirs start to go dry. Groundwater levels plummet, yet the response is to try to drill new and deeper wells and pump harder, or build another dam, or move water from an ever-more-distant river basin. Competition between industry and farming increases. And politicians run back to old, tired, half-solutions rather than face up to the fact that we live in a changed and changing world.

Here are a few pieces of the puzzle that we had better start to put together into a coherent picture if we hope to change our direction.

In January 2012, the Texas town of Spicewood Beach ran out of water. Then Magdalena, New Mexico ran out. More recently, Barnhart, Texas. Now Texas publishes a list of towns either out or running out of freshwater. In some parts of Texas, demands for water for fracking are now competing directly with municipal demands.
Because of a severe, multi-year drought (described as “the worst 14-year drought period in the last hundred years”) and excessive water demands, the US Bureau of Reclamation, this week, announced it will cut water released from Lake Powell on the Colorado River to the lowest level since the massive reservoir was filled in the 1960s. Water levels in Lake Mead have already dropped more than 100 feet since the current drought began in 2000, but even in an average year, there is simply more demand than supply.
Las Vegas is so desperate for new supplies they have proposed a series of massive and controversial ideas, including: a $15+ billion pipeline to tap into groundwater aquifers in other parts of the state, diverting the Missouri River to the west, and building desalination plants in Southern California or Mexico so they can take a bigger share of the Colorado.
Governor Jerry Brown is pushing a $25+ billion water tunnel project to try to improve water quality and reliability for southern California farmers and cities and improve the deteriorating ecosystems of the Sacramento-San Joaquin Delta, with no guarantees that it will do any of those things at a price users are willing and able to pay.
San Luis Reservoir in California, which serves the Silicon Valley and other urban users, has fallen to 17 percent because of severe drought, making business, communities, and water managers nervous. Other major California reservoirs are also far below average, though massive deliveries of water continue on the assumption that next year will be wet.
Praying for rain has become an official water strategy for some politicians in Texas, Georgia, Florida, Oklahoma, and elsewhere.
Another popular water strategy seems to be to sue your neighboring state. Here are some examples: Texas v. Oklahoma and Kansas v. Nebraska and Colorado, and outside of the west, Florida v. Georgia (and Alabama too).
Groundwater is disappearing in California; the Great Plains; Texas (tables in this report (pdf) show continuous and often massive declines in almost all Texas groundwater systems); and elsewhere in the West, because our laws and policies ignore the fact that surface and groundwater are connected. Contributing the problem, water managers and legislators typically put no restrictions on groundwater pumping, leading to inevitable, and inexorable, groundwater declines.
In the Lower Tule Irrigation District in California, demand for water has grown over the past two decades from 250,000 AF/year to 450,000 AF/year, much of it supplied by overpumping groundwater. In parts of the district, the average depth to groundwater in 1983 was 50 feet. In 2003, groundwater levels had declined to 75 feet. Today it is 125 feet, and some wells 300 feet deep are going dry. In April 2013, John Roeloffs, a farmer and member of the Lower Tule Irrigation District Board, noted “Some guys are drilling wells 800 feet deep.”
There is more and more and more evidence of declining snowpack in the western US as the climate warms.

These are just a few recent examples of the growing water-related dislocations in the western US. Writ large, the entire region is at risk. As long as we fail to address the real problems, real solutions will never be applied.

First, we must acknowledge that we've reached peak water in the American west. We have promised more water to users than nature provides. Until demand and supply are brought back into balance, groundwater levels will continue to drop and our rivers will continue to run dry, destroying natural ecosystems. Second, we must acknowledge that there are limits to new supply and that we must turn to the demand side of the problem. This means figuring out how to use water more efficiently and productively, and thinking about moving some water-intensive activities and products to more water-abundant regions. Maybe it is time to grow less rice, alfalfa, cotton, and pasture with flood irrigation. It is past time to retire the green lawn as an acceptable landscape option in arid climates. All toilets and washing machines should be water- and energy-efficient. Finally we have to stop assuming that the water available for future use is the same as in the past. Climate change ensures that it won’t be, but until politicians start to heed the warnings of climate scientists and the on-the-ground evidence of the current water situation, our water problems in the west, and elsewhere, will worsen.

Peter Gleick

pgleick Mon, 08/19/2013 - 09:50

Is there a simpler solution than declaring a groundwater bankruptcy, in which all water-rights holders are awarded acre-inches on the acre-foot, to be reviewed periodically to match further changes in precipitation ?

Regards,

Lewis

Interesting idea. Part of the problem is there is little groundwater management (or little consistent and effective management), so there are few places where a mechanism to impose such a solution are in place. But overall, yes, we will have to start limiting withdrawals to what is called the "safe yield" -- the amount that can be renewable pumped and permitting recharge to occur in wetter years.

Hi Peter,

Has the privatisation of the water industry contributed to the problems of water supply in the American West?

If so, are these companies still making a profit?

Thank you.

Heather

Heather, not particularly. There has been very little privatization -- just a few small municipalities. The biggest challenges for water in the West related to uncontrolled or managed groundwater extraction, large-scale inefficient agricultural water use, and long-term drought and shortage.

thorium reactors could cheaply desalinate seawater. if you place them underwater they would be immune to overheating and tsunamis

Except for the "cheaply" part. And the immune to disaster part.

Wouldn't reversing desertification help?
http://www.ted.com/talks/allan_savory_how_to_green_the_world_s_deserts_…

Just a brief note; maybe I'll have a thought later about this notion of "peak" water.

I saw no mention in this piece of water shortage or trouble in my home state of Arizona.

But how can that be? Arizona is in drought, and has been for a while. It's reeeely hot here. So why no water problems?

Planning, grasshopper. Planning and preparation. We had some very smart folks who saw what our needs might be and planned for them.

I don't think you can really say that Arizona has avoided water problems -- I may not have included any examples, but still....
Your general point, however, is certainly right: planning, planning, planning, and preparation!

Jack, tell us about the Rim aquifers that Flagstaff is pumping so dry that towns like Camp Verde are seeing their springs running dry. And last I heard, CAP or no the water table in central Arizona is still dropping.

A minor correction: Magdalena's water problem is due in large part to a broken well, not to a drop in water level per se (there's still a problem there, but it's not the one that's causing the town to import water from Socorro.) Actually, Magdalena is in relatively good shape since their aquafier is not shared with cities (Magdalena is small and if anything shrinking) or irrigated agriculture.

Georgia is trying to move the state line so as to access the Tennessee River near Chattanooga.

http://www.timesfreepress.com/news/2013/mar/25/georgia-senate-passes-re…

Why not just charge more for water? Then people will take the hint and conserve.

For those who aren't familiar with the Lower Colorado: USBR isn't reducing water deliveries in 2014, just moving less water between Powell and Mead because Powell is lower than Mead as a percent of storage after 2 dry years in a row. Note that Powell is still higher than in 2005. As of last week storage equaled 50%, or about 4 times the annual release planned for Powell, and under the most probable inflow scenarios (which assume below average inflow) even 2015 will still see normal water deliveries.

From the USBR press release linked above: "however, Lake Mead will operate under normal conditions in calendar year 2014, with water users in the Lower Colorado River Basin and Mexico receiving their full water orders in accordance with the 2007 Interim Guidelines and the 1944 Treaty with Mexico."

Arizona is certainly not perfect on water policy, but I've read the state water plans for both Texas and Arizona, and there's no question whose plan is closer to realistically sustainable. Phoenix is in better shape for water than any other major metro area in the Southwest. Most folks don't realize that Phoenix sits on a major river and has roughly 1maf a year of gravity flow surface water from SRP, before even talking about CAP water. The majority of water used in AZ is still for AG, it's not Vegas.

Also here in Texas, the Lower Colorado River Authority is saying the series of man-made lakes west of Austin will likely hit a new record low, below that of Texas' drought of the 1950s, by the end of this year.

As the former head of the Las Vegas Valley Water District (left in 1989) I gave a report that predicted severe water problems somewhere around 2010 - even with some conservation initiatives - and was essentially forced out largely due to that. Sadly you don't have to be a 'rocket scientist' to figure out the problem and its magnitude. But looking at our political landscape today I am not optimistic about nearterm solutions - betting that severe economic dislocation and pressure will force huge societal changes.

It seems like poetic justice. Texas, which has long assumed a much greater role for itself in the national conversation than is otherwise justified, simply by virtue of its energy industry is now about to become a beggar because of the same policies that mistakenly caused swagger. Hard to swagger when you're down on your hands and knees begging for help you wouldn't give anyone else. It reminds me of an old saying, "Tough titty said the kitty when the milk ran dry!"

Peter begs a question when he avers " it is time to grow less rice, alfalfa, cotton, and pasture with flood irrigation. It is past time to retire the green lawn as an acceptable landscape option in arid climates. All toilets and washing machines should be water- and energy-efficient."

His imperatves address only human demand as though nature did not take away water as well-- every man , woman and child on Earth is losing a tonne of stored fresh water a day to solar evaporation.

As long as we allow reservoirs to remain as dark and heat absorbing as asphalt- -water ordinarily absorbs 93% of the solar energy it intercepts, evaporation will take away more water than we can hope to conserve.

nice article

The time to have acted is long past, the actions that could have saved us are still ignored. Combustion as a source of power is no longer practical, unlimited population expansion (consumption) is no longer practical. The Sept. 11 atrocity was our wake up call, we should have jumped up to poured our trillions into alternative energy development to wean ourselves off of our combustion addiction and its dealers, we should have turned our propaganda machine over to promoting thrift and family planning, instead we poured trillions into starting paranoid wars and developing fracking methods to expand our addiction still further, and we turned our propaganda machine over to the cause of promoting unlimited consumption and suppressing family planing. Way to go Americans, the biggest "classic fail" in all of history! Arrogance is the only enemy capable of defeating the United States, its an enemy we have no defense against and it seems to be winning.

Along with those water-intensive ag crops, we should also be looking at water intensive human uses such as golf courses and swimming pools in people's backyards.

"limits to new supply"

"turn to the demand side"

Without reasonable pricing of water both of these are hopelessly out of step with economics. High water prices will incent new supply, whether the malthusians like it or not. Same for the opposite side of the coin

High prices lead to efficient consumption. If we're pretending we don't have to deal with prices, it means, in my opinion, that we dont really have a problem.

The problem is exacerbated by bad policies and practice.
Ernst & Young has recently released a report, offering a critical analysis and an actionable agenda.

Among the issues the report discussed are:
- Inefficient usage as aquifer/well levels run low
- Mispricing
- Unsustainable financing, especially given rising debt/deficits on local, state and national levels, inflation risk, and over reliance of low interest rates+dividend distribution
- Bad bond rating practices
- Huge increase in CAPEX needs coming up and climate change only adding to it
- Decaying third-world type infrastructure - water main breaks everywhere
- Lack of private sector involvement as compared to other countries
- Lack of national strategy/coherent policies
- Limited enforcement
- Almost no supply side efficiency measures
- Extreme conservatism/anti-innovation
- Lacking and inconsistent data with limited quantitative management
- High industry fragmentation, and much more if one was to dig deeper....

You can find the report here: http://www.ey.com/Publication/vwLUAssets/Cleantech_Water_Whitepaper/$FI…

Not a word about population control.
Does it not occur to anyone that a dry semi-desert land just cannot support an endless population? If so you'd never know it.
I looked in vain for any hint that anyone here thought we'd gone WAY beyond a reasonable population for the areas mentioned.
NOT A WORD.

Thanks. You might take a look at my earlier post on the population issue. http://scienceblogs.com/significantfigures/index.php/2013/06/06/the-mos….

In the 12th century AD, during the so-called "Medieval warming period", the paleo evidence shows that the western half of the U.S. was a sand dune desert. The Colorado River ran very low for decades at a time. If this drying was a local extreme, caused by complex interactions among ocean currents and air masses from climate change, we may now be entering a repeat of the same performance.

The climate denialists always include a bit of bad economics at the end of their speeches and writings, and insist that climate mitigation will destroy the economy. (This is notable, for example, in the public statements of MIT scientist Richard Lindzen, as well as in the vast outpourings of gibberish from the propagandist front groups such as the Heartland Institute. It appears to be the same uninformed and baseless anti-big-gov't fear that animates the fiscal "austerians" in the current economic crisis.) They insist that carbon mitigation will wring an economic disaster, but clearly they haven't costed-in many things, including the price tag on rehydrating the western half of the United States.
http://www.youtube.com/watch?v=SIvcQTXdjTg&feature=c4-overview-vl&list=…

Dont Believe in God? Join the club.

sa smith — Sat, 04 Sep 2010 12:43:49 +0000

Dont Believe in God? Join the club.

Well, I think its pretty obvious to ERV readers that I had nothing to do with this :P

OKC Coaltion of Reason

Leave your bets in the comments for if/how long it takes for the billboard to be vandalized. REMEMBER: Abbie wants to vandalize this board hardcore to get rid of that archaic fleck of spit between the 'n' and 't' in 'dont'.

sa smith Sat, 09/04/2010 - 08:43