Students advocate for 2024 focus on drink marketing, opioid crisis response, expanded voter registration and enhancing maternal care access.
We asked our public health communications fellows what topics they would like legislators to make a priority in 2024.
Amma Agyemang-Duah
Master of Public Health second-year student in Maternal, Child and Family Health
In the fall of 2023, a family sued the dining chain Panera because their daughter died from cardiac arrest in the restaurant after consuming their “Charged Lemonade.” The drink contains 390 mg of caffeine and is also included in their “Unlimited Sip Club.” Despite the drink’s name, consumers don’t necessarily realize it contains more caffeine than most energy drinks, such as Monster and Bang. That is not the image associated with Panera.
In the spring of 2024, a TikTok influencer described a drink purchased at a gas station that is for consumers ages 21 and up but is not alcohol or marijuana. The drink contained kratom, an herbal substance with “opioid-like” effects. The video cautions others to carefully read the ingredients in items they are consuming. The company that produces the drink posted a video attempting to discredit the claims that the drink is harmful by focusing on the natural ingredients used in the drink; the video has since been deleted. Currently, kratom is not controlled under the Controlled Substances Act, but the Drug Enforcement Administration has listed kratom as a drug and chemical of concern.
Intentionally misleading and manipulative marketing can lead vulnerable audiences into making uninformed purchases and make these potentially dangerous drinks appear more benign than they are. Stronger regulations regarding drink marketing should be in place, especially considering that target audiences for these drinks are typically adolescents and young adults. Even drinks that are marketed for consumers over age 21 can create underage drinking risks, such as Sunny D Vodka Seltzer, which leverages the brand name of a popular children’s drink.
With more stringent marketing regulations, consumers are better equipped to make informed decisions. Many preventable deaths and accidents can be avoided with these regulations in place.
Ethan Chupp
Master of Public Health first-year student in Applied Epidemiology
The opioid crisis has devastated the United States over the past 25 years. Hundreds of thousands of Americans have died since the epidemic began, first from prescription opioids, then from heroin, and most recently from fentanyl and other synthetic substances. But a new wave of the crisis threatens to make things even worse.
Xylazine, a synthetic veterinary tranquilizer, has emerged in the drug supply — first in Puerto Rico, then in Philadelphia and other northeastern cities. Xylazine has since been spreading across the U.S. The estimated number of deaths in the U.S. involving xylazine grew more than 12 times between 2018 and 2021. But the true scale of the crisis is not known. Xylazine is not a controlled substance, and many toxicology labs do not test for it.
Xylazine presents severe health risks. Its misuse can lead to slowed breathing, drops in blood pressure and death. Xylazine also causes skin ulcers when injected, which can lead to abscesses, cellulitis and infection. Xylazine is not an opioid, but it is almost always mixed with opioids, intensifying the risk of overdose.
Beyond that, our best tools for saving lives do not work for xylazine overdoses. Naloxone, or Narcan, is a medicine that reverses the effects of opioids and restores breathing during an overdose. First responders and federal agencies recognize its life-saving capacity. However, because xylazine is not an opioid, naloxone cannot reverse an overdose. Worse yet, xylazine use disorder could be harder to treat than opioids, as the medications methadone and buprenorphine may be ineffective. Furthermore, xylazine withdrawal may be more severe than from opioids, making quitting extremely difficult.
The time is now. As the substance use crisis continues to evolve, we need new tools to protect the health of the public. Action on xylazine now could save countless lives.
Rachel Morrow
Master of Public Health second-year student in Maternal, Child and Family Health
There are many ways to improve individual health, from nutrition to exercise to vaccination to cancer screenings. However, one way that many people don’t think about supporting their individual health is through voting. Voting gives citizens a voice in policies that will affect their health and the health of those around them. Research shows that our communities are healthier when more voters can participate in the democratic process.
I recently learned about the organization Vot-ER, which develops nonpartisan civic engagement tools and programs for every corner of the health care system. They supply health care providers with tools, such as voter registration lanyards and conversation starters, which allows them to serve as a resource for anyone looking to get engaged with the democratic process and encourages patients to advocate for their health.
Health care settings are great places where people are already thinking about the importance of health and health policy and therefore can serve as a convenient place to encourage people to register to vote. In practice, using Vot-ER as a resource might look like providers at UNC Hospital wearing an additional lanyard with a QR code for patients to scan to register to vote or providers asking a patient if they are registered to vote as they ask about other behaviors, such as smoking.
Health care providers in hospitals, outpatient clinics and local health departments should consider using Vot-ER tools to add another angle to best support their patients and communities.
However, while Vot-ER is doing essential work, we don’t necessarily need a non-profit to provide this service alone. I urge policymakers to create more accessible voting registration to work alongside other voting advocacy organizations to make voting more accessible. The time is now!
Shriti Pant
Master of Public Health first-year student in Maternal, Child and Family Health
Access to maternal health care is crucial for promoting the health and well-being of children and birthing individuals across the U.S. As indicated by a 2022 report from March of Dimes, 36% of counties in the country are categorized as maternity care deserts. This surge in maternity care deserts has resulted in a decline in available obstetric services in these areas, exposing approximately 6.9 million women of childbearing age to higher risks of mortality and morbidity before, during and after pregnancy.
Maternity care deserts are areas without birthing centers, obstetricians or hospitals that are equipped to provide essential support throughout the pregnancy journey. Residents of these care deserts also face limited or non-existent access to midwifery care, doula services, lactation consultants and family care providers. Such deserts are particularly prevalent in geographically isolated and rural communities, where obstacles such as transportation limitations, communication challenges with health care providers, and insufficient community education on maternal and child health delay or impede access to care.
The U.S. has the highest maternal mortality rate among developed countries globally. With the rise of maternity care deserts, it has become crucial for policymakers to prioritize maternal health care in 2024. This need for care disproportionately impacts rural communities and individuals of color. Previous studies have revealed that one in four Native American babies and one in six Black babies are born in maternity care deserts nationwide, highlighting the systemic disparities in maternal health care that contribute to the alarming maternal mortality rates. Addressing this public health crisis is essential for advancing the health of birthing people across the nation and decreasing maternal and child mortality caused by maternity care deserts.
There is a nationwide need to improve access to quality health care and education to ensure the well-being of all birthing individuals and the growth and development of all children. By prioritizing increasing access to maternal care services in rural communities, policymakers can take the necessary steps toward deconstructing systemic inequities and fostering healthier outcomes for families.
