Connect with us

Tech

Envisioning better health outcomes for all

Published

on

Envisioning better health outcomes for all


The current covid-19 pandemic has shined the spotlight on longstanding health inequities for people of color. According to the Centers for Disease Control and Prevention, compared to the general United States population, African Americans are 1.4 times more likely to contract the coronavirus, and 2.8 times more likely to die from covid-19. Similarly, Native Americans and Hispanics/Latinos are nearly twice as likely to be infected by coronavirus, and 2.5 to 2.8 times more likely to die from it.

Underlying these statistics are significant structural, social, and spatial issues. But why is this? And how do we begin to quantify and address the nested problems of public health inequality?

Understanding the geography of health inequity

One tool that can help us understand the higher coronavirus infection and death rate among people of color is mapping produced by a geographic information system (GIS). GIS correlates geography to key issues by layering relevant, sometimes seemingly disparate data to achieve clarity on complex situations.

For instance, one of the first things GIS users and epidemiologists mapped in the pandemic was the locations of vulnerable populations. Each layer of data took into account various contributing factors to such vulnerability. These include potential exposure through essential jobs; disease susceptibility for seniors and people with certain health conditions; the risk of transmission for public transit commuters and those in group living situations; and socioeconomic disadvantages through poverty, inadequate education, and lack of health insurance. The dynamic analyses that GIS enabled immediately guided actions by first responders and gave epidemiologists an evidenced-based way to assess vulnerability against hospital accessibility and capacity.

As awareness of the disproportionate number of deaths in communities of color grew, the same tool was applied to understand the causes behind this inequity, which, in turn, can aid in defining and developing potential solutions.

Mapping covid-19 cases across Europe

It’s been long understood that people living in inner cities face conditions that have clear correlations to overall health. These include income and education disparity, a low percentage of home ownership, increased exposure to neighborhood pollution, and reduced access to wellness care and reasonably priced fresh food. Another important dataset relevant to the covid crisis is the disproportionate percentage of people of color in service jobs that put them into daily close contact with the virus.

“GIS can help identify where outcome disparities exist, perform analysis to understand root causes, and focus mitigation efforts on places where systemic racism concentrates causal factors,” says Este Geraghty, chief medical officer and health solutions director at GIS vendor Esri. By analyzing all relevant data on a GIS-based smart map, Geraghty says leaders are poised to uncover localized insights that drive potential solutions. This means, “we can provide stopgaps until we have fully equitable systems, ensuring that one day everyone will have the same opportunity to reach their full health potential.”

Geraghty adds, “If you can’t understand all of the contributing factors in context, you might not anticipate potential problems or solutions.”

GIS for effective covid-19 vaccine distribution

Another pandemic-related problem tied closely to geography is how to get covid vaccines to the public in an equitable, safe, and effective manner. GIS provides the tools to analyze prioritized needs, plan distribution networks, guide deliveries, see the real-time status of inoculation missions, and monitor overall progress.

Geraghty developed a covid vaccine distribution approach using GIS. She explains that the first step is to map those facilities currently suitable for distributing the vaccine to the public. Since some vaccines need ultra-cold storage, facilities will have to be differentiated according to that and other storage capabilities. As part of the facility dataset, Geraghty says, GIS can also be used to calculate how many vaccines each facility’s staff can potentially administer in a day. In addition to hospitals, other facility types will need to be considered based on their ability to deliver the vaccine to underserved and remote populations. Facilities might include university health clinics, independent and retail pharmacies, and potentially even work sites willing and able to inoculate employees, among others.

The next step involves mapping the population—not only their locations and numbers, but also according to the categories recommended by the CDC guidance and state-based plans for the phased rollout of the vaccine.

By correlating these two layers of data on the map (facilities and population), it becomes clear which communities aren’t within a reasonable travel time to a vaccination location, based on multiple modes of travel (for example, driving, walking, public transit).

Geraghty explains, “That geographic perspective will help find any gaps. Who is left out? Where are the populations that aren’t within the range of identified facilities?” This is where GIS can improve decision-making by finding options to fill gaps and make sure that everyone has access to the vaccine.

In areas where GIS analysis identifies “gaps” on the map, such as communities or rural areas that aren’t being reached, Geraghty envisions pop-up clinics in places like school gyms, or drive-throughs in large parking lots, or, in some circumstances, personal outreach. For example, Geraghty explains, “People experiencing homelessness may be less likely to show up at a clinic to get a vaccine, so you may have to reach out to them.”

Public communication about vaccination progress offers another opportunity for mapping and spatial thinking. For example, an updated map could give a clear picture of how many people have been vaccinated in different parts of a state or county. The same map could help people figure out when it’s their turn to be vaccinated and where they can go to receive their vaccine. Maps could even help community residents compare wait times among different facilities to guide their choices and offer the best possible experiences.

Geraghty says that organizing covid vaccine distribution in this way can represent hope for people. “If we take this logical and strategic perspective, we can be more efficient in vaccine delivery and enjoy our normal activities much sooner.”

Vulnerable populations, geographic insights

Long before the world was forced to struggle with covid, the connection between geography and solving public health and social issues was very clear. Using GIS to address homelessness is one example.

In Los Angeles County, GIS has been used to map the homeless population by location, and also document and analyze the risk factors that create homelessness in each community. GIS analysis revealed that a predominant risk factor for homelessness in the northern, and especially northwestern part of the county, was veterans with post-traumatic stress disorder (PTSD). Conversely, in the northeast area, the predominant risk factor creating new homelessness was women and children escaping domestic violence.

In Snohomish County, Washington, health-care workers hit the streets to gather the data needed to facilitate such risk-factor mapping. They used GIS to perform the biannual survey and census of homeless people, gathering details on the conditions and needs of 400 people in short order. They collected standard information like the age of people in camps and whether any were veterans and reported whether they saw needles used for drugs.

Once location-specific differences like these are identified, appropriate resources can be deployed on a community-by-community basis, such as targeted social and health services to help specifically with domestic violence, PTSD, addiction, joblessness, or other identified root causes. “Using a geographic perspective, you can allocate resources, which are always limited, in ways that do the most good,” Geraghty says.

Lessons from the pandemic

Addressing disparities related to living conditions, locations, and genetics has always been a factor of disease spread and mortality, but it has never been tracked, measured, and analyzed on such a scale. However, confronting the covid crisis has been an ongoing case of catch-up, trying to find and correlate critical data to save lives, and Geraghty doesn’t want to see that level of frenetic activity repeated.

“Building strong public health preparedness systems means having foundational data ready,” she explains. “For instance, where, relative to the population, are the hospitals, the shelters, blood banks, and key infrastructure? Who are the community players and partners, and what services can they provide, and where?” In March, at the start of the pandemic, there was no comprehensive map of how many beds each hospital had, what percentage were intensive care beds, the number of ventilators available, and how much personal protection equipment was easily obtainable, and from where. “For anything that is health-related infrastructure,” explains Geraghty, “you should have a baseline map and data that you keep updated, as well as population demographic data.”

The crisis has also brought to light other issues; for example, better and more data sharing is needed, as well as clearer governance for which data are acceptable to share, so nothing will delay essential communications among institutions in the next crisis. And improved system interoperability ensuring key systems can work together to keep data fresh and reaction times quick should be a priority. The covid-19 pandemic has been a tragedy in terms of the human toll. But if we can learn from it, perhaps we can make corrections so that all communities and future generations can look forward to better, longer, and healthier lives.

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff.

Tech

Your microbiome ages as you do—and that’s a problem

Published

on

Your microbiome ages as you do—and that’s a problem


These ecosystems appear to change as we age—and these changes can potentially put us at increased risk of age-related diseases. So how can we best look after them as we get old? And could an A-grade ecosystem help fend off diseases and help us lead longer, healthier lives?

It’s a question I’ve been pondering this week, partly because I know a few people who have been put on antibiotics for winter infections. These drugs—lifesaving though they can be—can cause mass destruction of gut microbes, wiping out the good along with the bad. How might people who take them best restore a healthy ecosystem afterwards?

I also came across a recent study in which scientists looked at thousands of samples of people’s gut microbe populations to see how they change with age. The standard approach to working out what microbes are living in a person’s gut is to look at feces. The idea is that when we have a bowel movement, we shed plenty of gut bacteria. Scientists can find out which species and strains of bacteria are present to get an estimate of what’s in your intestines.

In this study, a team based at University College Cork in Ireland analyzed data that had already been collected from 21,000 samples of human feces. These had come from people all over the world, including Europe, North and South America, Asia, and Africa. Nineteen nationalities were represented. The samples were all from adults between 18 and 100. 

The authors of this study wanted to get a better handle on what makes for a “good” microbiome, especially as we get older. It has been difficult for microbiologists to work this out. We do know that some bacteria can produce compounds that are good for our guts. Some seem to aid digestion, for example, while others lower inflammation.
 
But when it comes to the ecosystem as a whole, things get more complicated. At the moment, the accepted wisdom is that variety seems to be a good thing—the more microbial diversity, the better. Some scientists believe that unique microbiomes also have benefits, and that a collection of microbes that differs from the norm can keep you healthy.
 
The team looked at how the microbiomes of younger people compared with those of older people, and how they appeared to change with age. The scientists also looked at how the microbial ecosystems varied with signs of unhealthy aging, such as cognitive decline, frailty, and inflammation.
 
They found that the microbiome does seem to change with age, and that, on the whole, the ecosystems in our guts do tend to become more unique—it looks as though we lose aspects of a general “core” microbiome and stray toward a more individual one.
 
But this isn’t necessarily a good thing. In fact, this uniqueness seems to be linked to unhealthy aging and the development of those age-related symptoms listed above, which we’d all rather stave off for as long as possible. And measuring diversity alone doesn’t tell us much about whether the bugs in our guts are helpful or not in this regard.
 
The findings back up what these researchers and others have seen before, challenging the notion that uniqueness is a good thing. Another team has come up with a good analogy, which is known as the Anna Karenina principle of the microbiome: “All happy microbiomes look alike; each unhappy microbiome is unhappy in its own way.”
 
Of course, the big question is: What can we do to maintain a happy microbiome? And will it actually help us stave off age-related diseases?
 
There’s plenty of evidence to suggest that, on the whole, a diet with plenty of fruit, vegetables, and fiber is good for the gut. A couple of years ago, researchers found that after 12 months on a Mediterranean diet—one rich in olive oil, nuts, legumes, and fish, as well as fruit and veg—older people saw changes in their microbiomes that might benefit their health. These changes have been linked to a lowered risk of developing frailty and cognitive decline.
 
But at the individual level, we can’t really be sure of the impact that changes to our diets will have. Probiotics are a good example; you can chug down millions of microbes, but that doesn’t mean that they’ll survive the journey to your gut. Even if they do get there, we don’t know if they’ll be able to form niches in the existing ecosystem, or if they might cause some kind of unwelcome disruption. Some microbial ecosystems might respond really well to fermented foods like sauerkraut and kimchi, while others might not.
 
I personally love kimchi and sauerkraut. If they do turn out to support my microbiome in a way that protects me against age-related diseases, then that’s just the icing on the less-microbiome-friendly cake.

To read more, check out these stories from the Tech Review archive:
 
At-home microbiome tests can tell you which bugs are in your poo, but not much more than that, as Emily Mullin found.
 
Industrial-scale fermentation is one of the technologies transforming the way we produce and prepare our food, according to these experts.
 
Can restricting your calorie intake help you live longer? It seems to work for monkeys, as Katherine Bourzac wrote in 2009. 
 
Adam Piore bravely tried caloric restriction himself to find out if it might help people, too. Teaser: even if you live longer on the diet, you will be miserable doing so. 

From around the web:

Would you pay $15,000 to save your cat’s life? More people are turning to expensive surgery to extend the lives of their pets. (The Atlantic)
 
The World Health Organization will now start using the term “mpox” in place of “monkeypox,” which will be phased out over the next year. (WHO)
 
After three years in prison, He Jiankui—the scientist behind the infamous “CRISPR babies”—is attempting a comeback. (STAT)
 
Tech that allows scientists to listen in on the natural world is revealing some truly amazing discoveries. Who knew that Amazonian sea turtles make more than 200 distinct sounds? And that they start making sounds before they even hatch? (The Guardian)
 
These recordings provide plenty of inspiration for musicians. Whale song is particularly popular. (The New Yorker)
 
Scientists are using tiny worms to diagnose pancreatic cancer. The test, launched in Japan, could be available in the US next year. (Reuters)

Continue Reading

Tech

The Download: circumventing China’s firewall, and using AI to invent new drugs

Published

on

The Download: circumventing China’s firewall, and using AI to invent new drugs


As protests against rigid covid control measures in China engulfed social media in the past week, one Twitter account has emerged as the central source of information: @李老师不是你老师 (“Teacher Li Is Not Your Teacher”). 

People everywhere in China have sent protest footage and real-time updates to the account through private messages, and it has posted them, with the sender’s identity hidden, on their behalf.

The man behind the account, Li, is a Chinese painter based in Italy, who requested to be identified only by his last name in light of the security risks. He’s been tirelessly posting footage around the clock to help people within China get information, and also to inform the wider world.

The work has been taking its toll—he’s received death threats, and police have visited his family back in China. But it also comes with a sense of liberation, Li told Zeyi Yang, our China reporter. Read the full story.

Biotech labs are using AI inspired by DALL-E to invent new drugs

The news: Text-to-image AI models like OpenAI’s DALL-E 2—programs trained to generate pictures of almost anything you ask for—have sent ripples through the creative industries. Now, two biotech labs are using this type of generative AI, known as a diffusion model, to conjure up designs for new types of protein never seen in nature.

Why it matters: Proteins are the fundamental building blocks of living systems. These protein generators can be directed to produce designs for proteins with specific properties, such as shape or size or function. In effect, this makes it possible to come up with new proteins to do particular jobs on demand. Researchers hope that this will eventually lead to the development of new and more effective drugs. Read the full story.

Continue Reading

Tech

The Blue Technology Barometer 2022/23

Published

on

The Blue Technology Barometer 2022/23


Overall ranking

Pillars

Comparative

The overall rankings tab shows the performance of the examined
economies relative to each other and aggregates scores generated
across the following four pillars: ocean environment, marine activity,
technology innovation, and policy and regulation.

This pillar ranks each country according to its levels of
marine water contamination, its plastic recycling efforts, the
CO2 emissions of its marine activities (relative to the size
of its economy), and the recent change of total emissions.

This pillar ranks each country on the sustainability of its
marine activities, including shipping, fishing, and protected
areas.

This pillar ranks each country on its contribution to ocean
sustainable technology research and development, including
expenditure, patents, and startups.

This pillar ranks each country on its stance on ocean
sustainability-related policy and regulation, including
national-level policies, taxes, fees, and subsidies, and the
implementation of international marine law.

Get access to technology journalism that matters.

MIT Technology Review offers in-depth reporting on today’s most MIT
Technology Review offers in-depth reporting on today’s most
important technologies to prepare you for what’s coming next.

Subscribe
today

Back

Experts

MIT Technology Review Insights would like to thank the following
individuals for their time, perspective, and insights:

  • Valérie Amant, Director of Communications, The SeaCleaners
  • Charlotte de Fontaubert, Global Lead for the Blue Economy, World Bank Group
  • Ian Falconer, Founder, Fishy Filaments
  • Ben Fitzgerald, Managing Director, CoreMarine
  • Melissa Garvey, Global Director of Ocean Protection, The Nature Conservancy
  • Michael Hadfield, Emeritus Professor, Principal Investigator, Kewalo Marine Laboratory, University of Hawaii
    at Mānoa
  • Takeshi Kawano, Executive Director, Japan Agency for Marine-Earth Science and Technology
  • Kathryn Matthews, Chief Scientist, Oceana
  • Alex Rogers, Science Director, REV Ocean
  • Ovais Sarmad, Deputy Executive Secretary, United Nations Framework Convention on Climate Change
  • Thierry Senechal, Managing Director, Finance for Impact
  • Jyotika Virmani, Executive Director, Schmidt Ocean Institute
  • Lucy Woodall, Associate Professor of Marine Biology, University of Oxford, and Principal Scientist at Nekton
Back

About

Methodology: The Blue Technology Barometer 2022/23

Now in its second year, the Blue Technology Barometer assesses and ranks how each of the world’s largest
maritime economies promotes and develops blue (marine-centered) technologies that help reverse the impact of
climate change on ocean ecosystems, and how they leverage ocean-based resources to reduce greenhouse gases and
other effects of climate change.

To build the index, MIT Technology Review Insights compiled 20 quantitative and qualitative data indicators
for 66 countries and territories with coastlines and maritime economies. This included analysis of select
datasets and primary research interviews with global blue technology innovators, policymakers, and
international ocean sustainability organizations. Through trend analysis, research, and a consultative
peer-review process with several subject matter experts, weighting assumptions were assigned to determine the
relative importance of each indicator’s influence on a country’s blue technology leadership.

These indicators measure how each country or territory’s economic and maritime industries have affected its
marine environment and how quickly they have developed and deployed technologies that help improve ocean
health outcomes. Policy and regulatory adherence factors were considered, particularly the observance of
international treaties on fishing and marine protection laws.

The indicators are organized into four pillars, which evaluate metrics around a sustainability theme. Each
indicator is scored from 1 to 10 (10 being the best performance) and is weighted for its contribution to its
respective pillar. Each pillar is weighted to determine its importance in the overall score. As these research
efforts center on countries developing blue technology to promote ocean health, the technology pillar is
ranked highest, at 50% of the overall score.

The four pillars of the Blue Technology Barometer are:

Carbon emissions resulting from maritime activities and their relative growth. Metrics in this pillar also
assess each country’s efforts to mitigate ocean pollution and enhance ocean ecosystem health.

Efforts to promote sustainable fishing activities and increase and maintain marine protected areas.

Progress in fostering the development of sustainable ocean technologies across several relevant fields:

  • Clean innovation scores from MIT Technology Review Insights’ Green Future Index 2022.
  • A tally of maritime-relevant patents and technology startups.
  • An assessment of each economy’s use of technologies and tech-enabled processes that facilitate ocean
    sustainability.

Commitment to signing and enforcing international treaties to promote ocean sustainability and enforce
sustainable fishing.

About Us

MIT Technology Review was founded at the Massachusetts Institute of Technology in 1899. MIT Technology Review
Insights is the custom publishing division of MIT Technology Review. We conduct qualitative and quantitative
research and analysis worldwide and publish a wide variety of content, including articles, reports,
infographics, videos, and podcasts.

If you have any comments or queries, please
get in touch.

Continue Reading

Copyright © 2021 Seminole Press.