Category Archives: Guest blog

Guest Blog: Sepsis – A Neglected Global Killer (CUGH)

Guest Blogger: Amanda Hirsch


Sepsis can be caused by any serious infection that leads to multi-organ dysfunction. Diseases that most commonly lead to sepsis infection are pneumonia, TB, HIV/AIDS, dengue, diarrheal diseases, etc. Multi organ dysfunction can lead to death if not recognized and treated early.

Every year, approximately 30 million cases of sepsis are documented. However, it is speculated that the 30 million known cases only comprise a portion of the actual incidence of sepsis each year. Recognition and documentation of sepsis cases is lacking and the exact global burden of sepsis remains unknown.

Many deaths that occur due to sepsis are attributed to the original disease. For example, if a patient succumbs to sepsis after contracting pneumonia, their cause of death will likely be recorded as pneumonia. Secondly, late mortality from sepsis contributes to its underreporting. Many sepsis infections occur after a patient is discharged from the hospital. Yet, very few patients return to seek help for their rapidly advanced infection, resulting in a mortality due to sepsis.

The highest burden of sepsis infections occurs especially in low income countries. The lack of resilient health systems, little public education and awareness, costs of healthcare, long distances to healthcare facilities, and poor transportation all make it difficult for individuals to seek and receive care for sepsis. Also in poor countries, low immunization rates, low coverage for citizens, high levels of disease co-morbidity, unprepared or undertrained healthcare workers, a low emphasis on preventative services, few new drugs for tropical diseases circling through the market, and the export of healthcare staff make sepsis significantly more of a threat.

This underrepresentation of sepsis and lacking preparedness and recognition in the healthcare world has pushed members of organizations such as the Global Sepsis Alliance to call for help- bringing public awareness to the unacceptably high current incidence of morbidity and mortality from sepsis, asserting that something must be done.

To curb the incidence of sepsis, a multi-faceted approach is needed. This approach, according to Dr. Ron Daniels includes the following:

  • Vaccinations
  • Strict hygiene
  • Early recognition
  • Aggressive treatment
  • Rational us of antimicrobials
  • Innovations in care
  • Knowledge translation
  • Capacity building
  • Advocacy

On the topic of advocacy, Dr. Daniels spoke of turning sepsis into a political movement of sorts, putting a face and a name to the infection and what it includes. The public must be educated on the signs and symptoms, the media must spread the word, and governments must allow for more data to be collected, support more funding for sepsis research and treatment, and use their power and platform to make sepsis a priority on both the national and international political arenas.


twitter photoAmanda Hirsch is a summer Global Health intern for APHA. She is starting her final undergraduate year at the GWU Milken Institute School of Public Health. Her passion for global health began in rural Honduras, and she is particularly interested in disparities in healthcare systems that affect the Latino community. She intends to pursue an MPH degree with a dual concentration in Community-Oriented Primary Care and Global Health. You can follow her on Twitter at @amandahirsch12.

The Severity of Racial Health Inequities

Guest Blogger: Tiffany Gilliam


African American women are more likely to succumb to negative health outcomes than any other race or ethnicity. Health inequities are classified as the differences in health status between one disadvantaged population and a group of advantaged. Numerous social determinants of health are related to health inequities, such as:

  • Socioeconomic status
  • Education
  • Age
  • Sex
  • Race and ethnicity
  • Lack of access to quality healthcare

These factors also increase the risk of cardiovascular disease, high blood pressure, diabetes, strokes and healthcare inequity. Nearly 50,000 African American women die each year from cardiovascular diseases. There is a significant gap in life expectancy for African American women compared to white women.

Research has shown that larger populations, like those found in metropolises, correlate to wider gaps in life expectancy. The county of Philadelphia is one of the most racially diverse counties in the United States. That same county contains one of the most racially segregated cities in terms of access to quality healthcare and positive health outcomes. The Philadelphia population is estimated at 1,560,006 residents: 44.2 per cent of which are African American. A recent study conducted by the University of Pennsylvania examined the patient ratio to primary care physician (PCP) in low socioeconomic neighborhoods. The study revealed a PCP ratio of 3,000:1  in underserved areas of Philadelphia. Given this PCP a question is raised regarding the level of care provided to patients. The patient to primary care physician ratio is high due to several reasons such as shortage of primary care physicians, increased amount of Affordable Care Act-covered patients, and the high density of elderly and chronically ill in underserved areas.

In a recent conversation with Sheila, my esthetician, she stated a previous diagnosis of ovarian cancer. The physician immediately advised a treatment of chemotherapy, without any willingness to answer questions or provide additional information.

Before that treatment occurred, however, Sheila received a second opinion from another physician, which revealed that she suffered from endometriosis, not ovarian cancer. After this conversation, numerous questions were raised.  How many other African American women were misdiagnosed and treated for illnesses they did not have? Why was it so difficult for the doctor to make an accurate diagnosis? How often are doctors encouraging participatory medicine when interacting with patients?

How can public health clinicians improve negative health outcomes amongst underserved African American women populations? It is crucial that health polices are created to enforce the overall well-being of African American women of disadvantaged populations. Health policies that promote affordable education, employment opportunities, and adequate accessible health promotion programs are needed in order to improve fair and equal treatment, along with disease prevention and detection.


 Tiffany Gilliam is a first year masters student in Public Health, with a focus in Maternal and Child Health, Social and Behavior Sciences and Health Equity.  Tiffany was elected to serve as the Secretary for La Salle University Public Health Student Organization in April of this year. She received B.S. in Health Studies from La Salle University in 2014.  Tiffany spent much of undergraduate years providing service coordination for adults with developmental disabilities and mental illness for a non-profit in home and community care organization in Philadelphia. Her academic interest includes Global Health, Reproductive and Sexual Health and Public Health Policy.  For the past three years, Tiffany has worked as a Behavioral Health Worker at Northeast Treatment Center, providing coping strategies, social skills, methods to reduce impulsive behavior at school to children with Attention Hyperactivity Deficit Disorder (ADHD), Oppositional Defiant Disorder (ODD)/Conduct Disorder and Mood Disorder.  Her experience as a Breastfeeding Counselor at North Inc. Mangers of the W.I.C program aspired Tiffany to seek graduate studies in public health.  In the near future, Tiffany hopes to become a Certified Health Education Specialist (CHES) as well as teach teens and young adult’s workshops focused on violence prevention, substance abuse and HIV/STI prevention. After completing her masters, Tiffany hopes to pursue a doctorate degree in public health.   Apart from school/work Tiffany enjoys outdoor activities, loves listening to music, traveling, most of all spending time with her three daughters Zaynah (13), Zahraa (12) and Amarachi (3) friends.

Guest Blog: Second Annual Global Social Service Workforce Alliance Symposium at the US Institute of Peace

Guest Blogger: Amanda Hirsch


The SSW symposium provided a forum for practitioners, government representatives, academics, and other experts from around the world to discuss current efforts (3) being undertaken internationally to expand the social service systems for the health and safety of children and families. The presentation was broken into three parts, each part discussing one component of the stride to strengthen the social service workforce.

  1. Planning: Dr. Jini Roby, a professor in the Department of Social Work of Brigham Young University along with Ms. Joyce Nakuta, Deputy Director of the Namibia Ministry of Gender Equality and Child Welfare spoke on the topic of planning the social service workforce. Planning the workforce, they agreed, “takes a system”- a calculated outline of each potential worker and their respective responsibility. To be most effective, social service must work on a network basis from workers on the ground (ie child health workers who raise and mentor orphaned children) to policy makers that have the capacity to encourage funding of child health worker training programs- all positions are necessary for the job to effectively get done.
  2. Robin Sakina Mama, Dean of Monmouth University School of Social Work and Ms. Zenuella Sagantha Thumbadoo, Deputy Director of National Association of Child Care Workers, South Africa discussed developing the social work force. This component of the process deals with educating and training social service workers. Dr. Robin Sakina Mamma spoke about the issue of certification and degrees. Today, many countries in need of social service work are left at a disadvantage because they lack existing institutions that provide proper degrees for social work or do not yet have a place in  the workforce for professional social workers. With that, many do not receive enough of an education in social work to be effective and many do not have a chance to practice and/or use their degrees in their home countries of need.
  3. Natia Partskhaladze of UNICEF and the Georgian Association of Social Works discussed the issue of supporting the workforce. Dr Partskhaladze spoke about worrisome recruitment and retention rates that are particularly high in developing countries, such as her home country of Georgia. The social work profession was non-existent in Georgia as of fifteen years ago. After establishing a study program and professional network for social work in the year 2000, an organization of social workers has since been formed. Centered on retention and development, the organization strives to keep social workers in the workforce while encouraging Georgians to get involved in the field of social work through the development of academic and professional programs and support groups. This organization of social workers now boasts 600 members, making Georgia an example of what committed recruitment and retention efforts can do to create or revive a supply of social workers within a country in need.

In her opening remarks Deputy of the Child Protection Section of UNICEF, Dr. Karin Heissler, noted that social work uses data and lessons learned in order to make decisions about the social service workforce and influence policy- a concept that is very familiar in public health.

Public health is entirely driven by data and “lessons learned”- both are at the base of nearly all interventions and both are necessary when public health professionals must have a voice at the community or policy levels.

The process of “planning the workforce” described is similar to the process of planning an intervention in public health. Both require assessing an issue; anticipating the immediate, medium, and long-term needs to be addressed; and creating a system with which to achieve a goal at all anticipated levels.


twitter photoAmanda Hirsch is a summer Global Health intern for APHA. She is starting her final undergraduate year at the GWU Milken Institute School of Public Health. Her passion for global health began in rural Honduras, and she is particularly interested in disparities in healthcare systems that affect the Latino community. She intends to pursue an MPH degree with a dual concentration in Community-Oriented Primary Care and Global Health. You can follow her on Twitter at @amandahirsch12.

Disney, measles, and parents’ choice not to vaccinate: Who’s to blame?

Guest bloggers: Brittany Seymour and Rebekah Getman

The recent challenges surrounding childhood vaccinations in the United States have received notable attention in both popular and scientific press, illustrating a spectrum of parental concerns and resultant attitudes ranging from vaccine hesitancy to outright refusal. The current measles outbreak traced to Disneyland has contributed to the highest number of US measles cases in fifteen years and resulted in the Centers for Disease Control and Prevention’s release of an official CDC Health Advisory in January this year. Over half of the individuals who have come down with the illness are unvaccinated; of those, more than 80% are old enough to receive the MMR vaccine but have not, leading many states to reevaluate their personal belief exemption policies. Unsurprisingly, this now multi-state outbreak has reignited the emotional debate over vaccine safety, efficacy, and policy in mainstream and social media. While vaccinations are likely one of the most prominent health debates in the United States right now, health officials are increasingly battling unfounded controversy regarding several of public health’s greatest achievements.  The field that is tasked with controlling global disease epidemics is now up against what have been dubbed “digital pandemics:” the far-reaching, rapid spread of unrestricted, scientifically inaccurate health information across the Internet through social networks.

Researchers at Harvard University recently studied this phenomenon over another common public health intervention: community water fluoridation. A lobby to end fluoridation pushes on in communities across America, despite more than 3,000 studies confirming its safety and benefits. The researchers’ findings indicate that, similar to the anti-vaccination community, a small but vocal and very tightly knit network is driving the anti-fluoridation lobby. A well-known social theory describes individuals in the world as connected by six degrees of separation, and Facebook’s one billion users are four degrees separated; the study found that individuals in the anti-fluoride community are separated by a mere two degrees. Often, highly connected networks develop a strict set of norms and values, and any person or information in violation of those norms, such as scientifically accurate pro-fluoride information, will be quickly rejected, making rational discourse nearly impossible. The researchers also traced online social conversations about fluoride through the network. Members of the anti-fluoride network frequently shared and cited scientific studies to back their arguments; however, in more than two-thirds of conversations, the actual study cited was buried two or three links away from the online discussion, or was not reachable at all. This is concerning because, under these circumstances, the risk of evidence becoming misrepresented or misinterpreted likely increases with each link that takes readers further away from the source.

The researchers’ findings support the theory that highly connected social networks, and not science or evidence, are driving digital pandemics of health information on openly accessible Internet sites. In the digital information age, scientific fact is only one piece of the complex health decision-making process. When capable, intelligent parents encounter the sea of voices online while researching how to make optimal decisions for their children’s health, of course they become concerned with what surfaces to the top of their Google search. The Harvard study suggests that perhaps we need to stop blaming parents for choosing not to vaccinate their children or for lobbying to end fluoridation in their communities, an approach that only alienates parents with questions and shuts down dialogue. Moreover, corrective scientific information inserted into existing social communities without respect for norms and values, even if in response to misinformation, runs the risk of insulting those not readily convinced solely by the prevailing science, an ultimately detrimental approach.  Rather, additional research is needed to discover new, social health communication strategies that are more inclusive and acknowledge social networks’ differing belief systems. Digital pandemics are a part of our current, connected reality. Rather than fight against this trend (which may prove impossible), public health communication approaches must empower and partner with parents so that the voices of expertise, evidence, and experience are the ones they trust, and share within their networks, once again.

Getman HeadshotRebekah Getman is the Senior Program Manager for Education at the Harvard Global Health Institute, tasked with creating and implementing multi-disciplinary curriculum for students that supplements their in-classroom learning. These curricula combine global health knowledge with other disciplines to provide students with a broad lens through which to study and assess global health interventions.

SeymourHeadshotBrittany Seymour is an Assistant Professor of Oral Health Policy and Epidemiology at the Harvard School of Dental Medicine’s Department of Oral Health Policy and Epidemiology and the Inaugural Harvard Global Health Institute Fellow. Her research includes interdisciplinary global health curriculum development and pedagogy, capacity strengthening for oral health delivery systems in resource-challenged regions, and digital information transfer and impacts on health.

World Mental Health Day Forum by the Global Mental Health Advocacy Working Group: A Review

photo (2)Guest blogger: Socorro Lopez

Mental illness has proven to be one of society’s greatest invisible burdens, accounting for 4 of the 10 leading causes of disability worldwide. The Global Mental Health Advocacy Working Group recently honored World Mental Health Day by hosting a forum to discuss mental health needs amongst people in humanitarian crises, an extremely vulnerable group in terms of developing and dealing with mental illness.

The event’s panelists included Kelly Clements, the U.S. Department of State’s Deputy Assistant Secretary of the Bureau of Population, Refugees and Migration, Dr. Inka Weissbecker, the Global Mental Health Psychosocial Advisor for the International Medical Corp (IMC), and Dr. James Griffith, the Chairman in the Department of Psychiatry and Behavioral Sciences at the George Washington University School of Medicine and Health Sciences.

The discussion touched on three important themes in relation to mental health in emergency settings: the vulnerability of people suffering from mental illness, the critical gap in mental health services, and the detrimental social isolation that the mentally ill are frequently subjected to.

While approximately 10% of a population is traditionally at risk of developing a mental disorder under normal circumstances, this rate has the potential to double during a humanitarian crisis, meaning more people must deal with these disabilities in highly unstable environments. Furthermore, mentally ill individuals are more susceptible to stigma, discrimination, violence, abuse, and human rights violations in these circumstances.
Although there is a vast need for mental health services in emergency settings, there is a significant lack of access to quality care. The number of health professionals who can implement psychosocial interventions that effectively address mental illness is minimal during crises.

“There is a treatment gap between the people who need care and those who receive it,” said Dr. Weissbecker, who has monitored IMC’s mental health and psychosocial programs in countries such as South Sudan, Ethiopia, Sierra Leone, Syria, and Afghanistan.

A lack of healthcare professionals and mental health services often means that the burden of care for a mentally ill individual is placed on their families. Unfortunately, mental disorders are still fundamentally misunderstood around the world, causing many communities to be ill equipped to properly care for a portion of their citizens. In the absence of related health services, families resort to harmful traditional health practices that stem from local beliefs. These practices regularly call for extreme measures, such as chaining the mentally ill to trees or institutionalizing them in inept facilities, to isolate people dealing with mental disorders from the rest of the community.

By acting as natural buffers to instability and prejudice, Dr. James Griffith discussed the vital role that local caregivers, families and communities can play in treating mental illness. In accordance with this line of thought, IMC programs have integrated community involvement into their programs by hosting educational seminars that utilize local volunteers to raise awareness and social consideration for mental illness.

The panelists also addressed how this knowledge could be applied to two topics that have been making recent headlines: Ebola and the Islamic State in Iraq and Syria (ISIS). In terms of treating mental illness within extremist groups such as ISIS, the panelists were quick to correct the misconception that violence can commonly be associated with mental illness, a stereotype creating stigma and driving discrimination. According to the American Psychiatric Association, “the vast majority of people who are violent do not suffer from mental illness.”

In relation to Ebola, preventing and treating mental illness proved to be more applicable. In order to diminish emotional and psychological trauma, Weissbecker discussed the need to provide more education to people who contract the disease and their families, in order to decrease debilitating fear and prevent transmission. Reintegration services should also be offered to survivors who may be treated differently once they return to their communities. Finally, it is important to find ways to safely bury the dead, while ensuring that burials are still culturally significant.

Addressing mental health in emergencies is undoubtedly a multifaceted and complicated health challenge. Nevertheless, increased rates of mental disorders and the potential social ramifications of having such illnesses illustrate that mental illness in humanitarian crises is an urgent issue for global health. Reducing the current treatment gap and increasing communities’ understanding of mental disorders are two of the most promising tactics to improve the health status of the mentally ill in these situations. In doing so, devastating disability and demoralizing hardship can be prevented in populations that have already experienced immeasurable adversity in their lives.


Socorro Lopez is an undergraduate at the George Washington University, majoring in environmental studies and minoring in public health and geographic information systems. Her interests include environmental, reproductive, and global health. Prior to working at the American Public Health Association (APHA) as a Global Health Intern, she was part of the Collegiate Leaders in Environmental Health (CLEH) program at the Centers for Disease Control and Prevention (CDC). Socorro is originally from Roatan, Honduras and recently returned from Tanzania, where she was studying coastal ecology and doing research on water quality.

Contagions, content, and confusion in the digital age of health information

SeymourHeadshotGuest blogger: Brittany Seymour, DDS, MPH

Sixteen years ago, a study alleged an association between the MMR vaccine and autism. The authors disclosed in their publication that they could not claim a causal link, and the paper was eventually found to be faulty and was retracted. Nonetheless, flaws and all, the information was made visible and still today, anti-vaccine sentiments continue to rekindle the paper’s alarming claims, plus additional concerns. Anxious parents persistently echo one another’s worries through blogs, video-sharing websites, and other social media platforms, which too often contradict scientific consensus and current knowledge. A small but mighty group of doubting individuals are dismantling decades of life-saving research and successful health policy.

Disturbingly, content errors and false information tend to linger, even following subsequent correction. Particularly in the face of highly charged and emotional topics, individuals can become even more unwilling to revise their beliefs. When virtually anyone anywhere can publish anything online, people have little difficulty finding support to back any belief, creating a digital “corrupted information environment” one blog, share, and tweet at a time. We are entering an age of digital pandemics: rapid spread of misguided and incomplete online health information that has resulted in unsubstantiated confusion around some of public health’s greatest achievements, such as vaccines, contraception, and fluoridated drinking water.

We are witnessing an accentuated Kruger and Dunning effect, namely that unskilled people are also unaware that they are unskilled. Individuals are crafting convincing and persuasive arguments riddled with empirical citations and links to scientific studies. However, they ultimately lack the sophisticated skillset required for deeper interpretation of their own sources within the context of the larger issue. Without formal expertise, they are unable to move from the basic stages of knowledge, comprehension, and even application to advanced strategies for accurate analysis, synthesis and evaluation of the subtle yet significant complexities embedded in the scientific method. Put simply, a clever compilation from Google does not qualify one as a health expert any more than possession of a fine camera makes one a photographer.

These shortcomings go unnoticed while their confidence motivates readers to action. Ultimately, they are unable to recognize the larger harm their social media “publications” are causing in the absence of information porters such as the peer-review process or expert consensus. Now that over half of adults turn to the internet for health information, including using social networking sites, the hosts of these digital pandemics are becoming easily accessible and their content is proving contagious. Conversely, the most competent experts often underestimate their own competence, the “burden of expertise;” in part because scientific competence requires open acknowledgment of limitations in order to discover accurate truths. But on a public forum, citing any limitation, even as a requisite for the scientific process, attracts the naysayers who predictably share it across the web without context, and thus without accurate meaning. When searching #fluoride on Twitter for example, we discover, at surface level, an evenly matched digital Clash of the Titans: the proficient yet restrained domain expert versus the unskilled but vociferous lay person touting content that is masquerading as science but is actually nothing more than shallow advocacy. It’s no wonder the public has become confused and distrustful.

Clearly, social media is an expanding worldwide phenomenon. Yet, little is known about the precise mechanisms at play at the interface of social media and high-level global health strategies. Why does some content “go viral” when others don’t? Key findings include factors like an innate desire to share, emotion, storytelling, and public access- aspects that are perfectly ripe for success across social media. Yet, these aspects are also in direct conflict with the gold standard for acquiring, conveying, and applying scientific knowledge: objectivity, avoidance of conclusions based on anecdotal accounts, and publication in private peer-reviewed journals.

Despite its shortcomings, social media can provide public health experts with answers that once were private yet now are public: individuals, along with sharing misinformation, are also sharing their most intimate sentiments about that information.  In the past, interviews and conversations would have been necessary to uncover the numerous and highly nuanced reasons why individuals oppose particular public health interventions. Today, on the very websites publishing information that infuriate the experts also exist literally thousands of personal concerns made public for all to see, and minus researcher bias. The public nature of social media is perhaps our utmost barrier to information accuracy and yet a tremendous untapped resource for public health research, innovation, and intervention.

Brittany Seymour is an Instructor on Global Health at the Harvard School of Dental Medicine’s Department of Oral Health Policy and Epidemiology and the Inaugural Harvard Global Health Institute Fellow. Her research includes interdisciplinary global health curriculum development and pedagogy, capacity strengthening for oral health delivery systems in resource-challenged regions, and digital information transfer and impacts on health.

An emerging threat of “digital pandemics”- lessons learned from the anti-vaccine movement

SeymourHeadshotGuest blogger: Brittany Seymour, DDS, MPH

During the 20th century alone, the world experienced a larger gain in life expectancy than in all the previously accumulated history of humankind. This triumph has been dubbed one of the greatest achievements in global health and is largely attributed to the 20th century success of vaccines. However, a digital assault (one that began with autism but has ballooned to numerous other concerns) regarding the safety and importance of vaccines has permeated the Internet. Anti-vaccine sentiments, derived from this study – now retracted – perpetuated by celebrities such as Jenny McCarthy and Kristin Cavallari, and other concerned citizens, have gone viral. A “digital pandemic” is underway, and like a game of telephone, the truth has morphed, facts were lost in translation, and the story of vaccines today boggles the mind. Public acceptance and trust in their safety and utility has waned. Regions of the world, including the United States, are experiencing their worst disease outbreaks in nearly two generations (IOW since the invention of the associated vaccines), and many of these are attributed to exemptions from the recommended vaccine schedule. As rotavirus vaccine inventor (and recipient of death threats due to his pro-vaccine work) Paul Offit describes it, every story has a hero, victim, and villain; in this story gone viral, Jenny McCarthy is the hero, the children the victims, which leaves one role for public health experts: the villain.

More recently, is public health at the forefront of yet another digital assault, susceptible once again to the label of villain? Last month, a study with known limitations was released naming fluoride as one of six newly identified developmental toxins in children. Ironically, this followed the American Dental Association’s announcement only two weeks prior that it has changed its longstanding guidelines for the use of fluoride in young children, recommending an increase in fluoride exposure before the age of two years old, as compared to the former recommendations. Yet, within a matter of hours from the release of the study, the story of fluoride as a new threat to normal child development created a flood of posts on Twitter (just search #fluoride) and was covered in popular media news stories for CNN,USA Today, Forbes, and Time. These news sources alone generated over 54,000 views and shares over social media by the end of the weekend. Does fluoride share the same vulnerabilities as vaccines?

To many public health experts, these stories trigger bewildering thoughts. How is it possible that such misguided health information can spread so far so fast, painting public health experts as villains? Is there a way we can reverse our role in this story and emerge the heroes? Lessons learned from the vaccine story provide insights into an emerging threat of digital pandemics and the power of social media as the medium. Public health is encountering an unfamiliar menace, a rising global pandemic of rapid and unrestricted information transfer.

In today’s global society undergoing tremendous technological advances, new and emerging media modalities are greatly affecting health by influencing policy decisions, direction of philanthropic aid, and individual health behaviors. No doubt, due to the power of handheld technology and online social networking,social media and “citizen journalist”have played a role in propagating potential detriment to what is revered as one of public health’s greatest triumphs (vaccines). Thomas Patterson explains that information accuracy is becoming obscured, “The internet is at once a gold mine of solid content and a hellhole of misinformation.” As Nicco Mele illustrates, the internet makes David the new Goliath, where citizens are capitalizing on the power of social media’s velocity and reach, disarming the traditional gatekeepers of information quality.

Even when presented with corrective information, it’s no wonder the public continues to be confused, and concerned, about potential dangers of our intentional public health interventions. But what triggers a digital pandemic, and where is the threshold between an outbreak of bad health information versus a true online pandemic wrought with content persuasion? In a world of expanding voices sharing health information online through social media, how can we ensure that the cream still rises to the top and the public is making health decisions based on the most accurate information possible?These are the big “opportunity” questions we as public health experts need to be addressing under our responsibility to keep today’s citizens, their children, and our societies healthy.

Brittany Seymour is an Instructor on Global Health at the Harvard School of Dental Medicine’s Department of Oral Health Policy and Epidemiology and the Inaugural Harvard Global Health Institute Fellow. Her research includes interdisciplinary global health curriculum development and pedagogy, capacity strengthening for oral health delivery systems in resource-challenged regions, and digital information transfer and impacts on health.