IMPACT

Beauty’s Not-So-Pretty Side

Historical and present-day racism continue to shape the use of potentially harmful skin and hair products.

A new study from Columbia Mailman School and the nonprofit WE ACT for Environmental Justice reveals that women and femme-identifying people continue to use chemical hair straighteners and skin lighteners linked to poor health outcomes, likely due to beauty norms rooted in racism.

Studies have tied hair relaxer use with earlier age of first menstrual period and increased risk of uterine fibroids, uterine cancer, and breast cancer. Skin lighteners can contain corticosteroids, linked to metabolic problems, and mercury, which is tied to nervous system damage. While evidence suggests chemical straightener use has declined among Black women, who are the primary users of these products, skin lightener use by Asian women remains steady. (About 1 in 5 non-Hispanic Black women currently use straightening products, the study found.)

When respondents were asked whether they thought others believe that straight hair or light skin make women look more beautiful or professional, about half agreed. Although fewer than half said that they personally felt that way, those who did were most likely to use the products. “Beauty norms shaped by historical and present-day racism and sexism continue to determine the use of these products,” says study first author Lariah Edwards, PhD, associate research scientist in Environmental Health Sciences. Adds co-senior author Ami Zota, ScD, associate professor of Environmental Health Sciences, “Programs and policies are needed to counteract natural hair discrimination and colorism. Educating consumers could motivate them to advocate for the Safer Beauty Bill Package, which ensures safer products for all.”

Concerns around beauty aren’t limited to adults. Other re-searchers in Environmental Health Sciences have found that 79 percent of parents say their children 12 or younger use makeup and body products marketed to children. These products often contain lead, asbestos, and phthalates. Latino children were especially likely to use the products. “Children’s small size and developing tissues make them susceptible to toxins,” says study senior author Julie Herbstman, PhD, professor of Environmental Health Sciences and director of the Columbia Center for Children’s Environmental Health.

Safety Surprise 

Installing new doors and windows and cleaning up trash and weeds at abandoned houses in Philadelphia led to a substantial drop in nearby gun violence, according to a new study by researchers at Columbia Mailman School and the University of Pennsylvania. For this study, 258 abandoned houses across Philadelphia were put into one of three groups. The first received new windows and doors, trash cleanup, and weeding; the second received trash cleanup and weeding only; the third received no interventions. When compared to areas around homes that received no intervention, blocks around homes that received the full intervention showed a 13.12 percent reduction in gun assaults and a 6.96 percent reduction in shootings. (Trash cleanup and weeding alone showed no change in gun violence.) “This is powerful scientific evidence showing that place-based interventions can improve health and safety, even for some of our most challenging crises like gun violence,” says Charles Branas, PhD, Gelman Professor and chair of Epidemiology.

A Health Horror Story in CAR 

Researchers at Columbia Mailman School, in partnership with a global team of other experts, are sounding the alarm about the health and humanitarian emergency in the Central African Republic (CAR). Their findings, from a nationwide mortality survey of almost 700 households conducted in 2022, suggest that CAR has the world’s highest nationwide mortality rate, a rate that is four times what the United Nations estimated in 2010. The researchers estimate that 5.6 percent of the population is dying each year. (The U.S., in contrast, has a death rate of 1 percent per year.)

This crisis is likely due not only to COVID-19 but also to human rights abuses by Russian paramilitary organization the Wagner Group, which has been fighting rebel groups in the country. In addition to a high death rate, with malaria and diarrhea rampant, 82.3 percent of households reported eating less than one meal per day, and the country has relatively few children under age 3, a warning sign possibly linked with malnutrition and high risk of pregnancy loss. “The crisis level mortality rate suggests that the needs in CAR are being largely unmet,” note the authors, a group that includes Les Roberts, PhD, professor emeritus of Population and Family Health.

COVID-19’s Continued Challenges

ICAP at Columbia University has released new results from its SILVER Study revealing that older New Yorkers living at home have encountered a range of issues in the wake of the pandemic. “The pandemic exacerbated social, economic, and structural inequities that have resulted in notable negative consequences,” says Abigail Greenleaf, MPH ’12, PhD, who leads the SILVER research team.

Phone surveys of New Yorkers aged 70 years or older living at home reveal that depression and anxiety remain higher than pre-pandemic levels. Older New Yorkers with limited mobility and/or who did not often leave their homes were particularly vulnerable. Technology was a pain point, with fewer women than men having access to technology and confidence in their tech skills. This could enhance isolation and make access to health services challenging. Racial disparities also emerged: The study found that while 70 percent of white elders used video for telehealth conferences, others mainly used phone calls. A substantial proportion of older New Yorkers had also struggled to discern the accuracy of available health information.

The researchers recommend prioritizing the health—and particularly the mental health—needs of older adults, especially those with limited mobility. “The SILVER survey provides insights into how we can better meet the needs of different sectors of our society, so that, when the next health emergency strikes, they will have the support they require to stay healthy,” says Wafaa El-Sadr, MD, MPH ’91, MPA, ICAP’s director and co-lead of the New York City Pandemic Response Institute.

Chronic Fatigue Connection 

People with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have a different gut microbiome than healthy people, new research shows. ME/CFS is characterized by debilitating fatigue, cognitive dysfunction, gastrointestinal disturbances, and other symptoms. Although its cause is unknown, it often follows an infection.

Scientists at the School’s Center for Infection and Immunity analyzed fecal samples collected from a geographically diverse cohort of 106 cases and 91 healthy controls from five sites across the United States. Beneficial gut bacteria Faecalibacterium prausnitzii and Eubacterium rectale were reduced in ME/CFS participants. Loss of these important bacteria contributed to trouble synthesizing butyrate, a bacterial metabolite with anti-inflammatory properties and the main fuel for the body’s colon cells. Other types of bacteria, which are correlated with fatigue and inflammatory bowel disease, were present in greater amounts. These differences in gut microbes could serve as biomarkers to aid in diagnosis of ME/CFS, which currently relies on clinical criteria and symptoms. Understanding the connection between ME/CFS and disturbances in the gut microbiome may also lead to ways to classify the disease and develop targets for therapeutic trials.

Older Drivers: Caution Signals 

A novel and highly accurate algorithm could predict mild cognitive impairment and dementia in older drivers. Investigators from Columbia Mailman School, Columbia Engineering, and Vagelos College of Physicians and Surgeons constructed 200 variable modules using naturalistic driving data on the driver, the vehicle, and the environment captured by in-vehicle recording devices for 2,977 drivers. With artificial intelligence, they processed data measuring driving behavior, performance, and tempo-spatial pattern in exceptional detail, predicting mild cognitive impairment and dementia with 96 percent accuracy.

“About 85 percent of older adults in the United States are licensed drivers. Our study show that digital markers in routinely collected driving data can be used through machine learning techniques to predict impairment, leading to timely intervention,” says Guohua Li, MD, DrPH, professor of Epidemiology.

Out of COVID-19 Came Creativity

Traditionally, healthcare delivery organizations have been slow to generate and implement new ideas. But throughout the pandemic, they have been hotbeds of innovation, according to an article co-authored by Yuna Lee, PhD, MPH, assistant professor of Health Policy and Management, in Health Affairs. Doctors and nurses repurposed baby monitors, snorkels, and hair dryer hoods for COVID-19 care; supply chain supervisors contacted laundromats and hardware stores for personal protective equipment; environmental services managers experimented with sanitizer placement and clever signage; and public health workers turned closed Sears stores into vaccine centers.

Many innovations are now standardized: Clear surgical masks facilitate lip-reading, and families are included in virtual discussions of palliative care. Telemedicine, once on a slow track, is now widely available. Says Lee: “While COVID-19 brought much devastation, it also showed the creative potential of the industry to address serious problems. That lesson should not be lost.”

Asthma: A Cannabis Connection

Asthma has increased among teens and among children from some minority racial and ethnic groups in states that legalized cannabis for recreational use. Researchers at Columbia Mailman School and the City University of New York were the first to examine the relationship between cannabis policy changes and youth asthma. “Cannabis use is increasing among adults with children in the home, and secondhand smoke is a key risk factor for asthma among children,” notes Renee D. Goodwin, PhD, MPH ’03 adjunct associate professor of Epidemiology. Asthma is already the nation’s most common chronic condition affecting children. An earlier study by Goodwin observed cannabis use in 12 percent of parents of minor children in states with legal recreational cannabis. “Yet, no education regarding child exposure to secondhand cannabis smoke is routinely offered,” she notes.

Tainted Data About Toxins 

Researchers at the School continue to examine 1970s documents related to toxicity studies conducted for Monsanto by Industrial Bio-Test Laboratories (IBT). An examination published in the American Journal of Public Health reveals fraudulent research practices used to thwart government investigations.

“Monsanto contracted with IBT in 1969 to perform chronic toxicity studies, one of which did not turn out to be ‘as favorable as Monsanto had hoped or anticipated,’” says author David Rosner, PhD, professor of Sociomedical Sciences and co-founder of the School’s Center for the History & Ethics of Public Health.  Monsanto then arranged with IBT to repeat some of the studies for better conclusions. This is the first paper to look at the relationship between the corporate funders of research and its fraudulent practices in the 1970s.

In addition to compromised test conditions, IBT employees made up data.  “The influence of industry on laboratory practices made the corruption of science more likely,” notes Rosner. “We need to maintain vigilance over companies whose self-interest has distorted science and may continue to do so.”

Good News on Naloxone

Concerns that access to lifesaving naloxone might inadvertently increase opioid misuse and overdose remain a barrier to distribution efforts. Now, researchers who examined data on adolescent substance use from a national survey of high school students report that adopting laws that make naloxone more easily available does not seem to be associated with changes in adolescent lifetime heroin or injection drug use. In fact, naloxone access was more consistently associated with decreases rather than increases in use. The findings, which cover 2007 to 2019, are published in the International Journal of Drug Policy. “Efforts to improve naloxone access continue to be an urgent public health priority,” says senior author Silvia Martins, MD, PhD, professor of Epidemiology. “This is important for people of all ages.”