Mount Sinai Humanities And Medicine Essays On Global Warming

1. Glander M. Selected Statistics from the Pubic Elementary and Secondary Education Universe: School Year 2014–2015. U.S. Department of Education, National Center for Education Statistics; Washington, DC, USA: 2016.

2. Bush M., Ryan M., Rose S. School Calender: Length of School Year. Educational Commission of the States; Denver, CO, USA: 2011.

3. National Center for Education Statistics Elementary and Secondary Enrollment. The Condition of Education. [(accessed on 18 September 2017)];2017 Available online: https://nces.ed.gov/programs/coe/indicator_cga.asp.

4. Paulson J.A., Barnett C.L. Public health stops at the school house door. Environ. Health Perspect. 2016;124:A171–A175. doi: 10.1289/EHP530.[PMC free article][PubMed][Cross Ref]

5. Coalition for Healthier Schools Special Issues: Climate Change. Towards Healthy Schools: Reducing Risks to Children. Healthy Schools Network: Albany, KY, USA, 2016; 50–53. [(accessed on 24 September 2017)]; Available online: http://www.healthyschools.org/documents/TowardsHealthySchools-Risks.pdf.

6. Balbus J., Crimmins A., Gamble J.L., Easterling D.R., Kunkel K.E., Saha S., Sarofim M.C. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. U.S. Global Change Research Program; Washington, DC, USA: 2016. Chapter 1: Introduction: Climate Change and Human Health; pp. 25–42.

7. Zhang Y., Bi P., Hiller J.E. Climate change and disability-adjusted life years. Envriron. Health. 2007;70:32–36.[PubMed]

8. Etzel R.A., Balk S.J. Introduction. In: Etzel R.A., editor. Pediatric Environmental Health. 3rd ed. American Academy of Pediatrics; Elk Grove, IL, USA: 2011. pp. 1–5.

9. Chatham-Stephens K.M., Mann M., Schwartz A.W., Landrigan P.J. First, Do No Harm: Children’s environmental health in schools. Am. Educ. 2012;35:22–31.

10. Sheffield P.E., Landrigan P.J. Global climate change and children’s health: Threats and strategies for prevention. Environ. Health Perspect. 2011;119:291–298. doi: 10.1289/ehp.1002233.[PMC free article][PubMed][Cross Ref]

11. Landrigan P.J., Carlson J.E., Bearer C.F., Cranmer J.S., Bullard R.D., Etzel R.A., Groopman J., McLachlan J.A., Perera F.P., Reigart J.R., et al. Children’s health and the environment: A new agenda for prevention research. Environ. Health Perspect. 1998;106:787–794. doi: 10.1289/ehp.98106787.[PMC free article][PubMed][Cross Ref]

12. Environmental Protection Agency America’s Children and the Environment: Key Findings of the ACE3 Report. [(accessed on 19 September 2017)];2017 Available online: https://www.epa.gov/ace/key-findings-ace3-report.

13. World Health Organization . Don’t Pollute My Future! The Impact of the Environment on Children’s Health. World Health Organization; Geneva, Switzerland: 2017. CC BY-NC-SA 3.0 GIO.

14. Paulson J., Barnett C. Who’s in charge of children’s environmental health at school? New Solut. 2010;20:3–23. doi: 10.2190/NS.20.1.b.[PubMed][Cross Ref]

15. World Health Organization . Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. World Health Organization; Geneva, Switzerland: 2009.

16. Intergovernmental Panel on Climate Change (IPCC) Observed changes and their causes. In: Core Writing TeamPachauri R.K., Meyer L.A., editors. Climate Change 2014: Synthesis Report. IPCC; Geneva, Switzerland: 2014. pp. 39–55. Contribution of Working Groups I, II and III to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change.

17. Bailey Z.D., Krieger N., Agénor M., Graves J., Linos N., Bassett M.T. Structural racism and health inequities in the USA: Evidence and interventions. Lancet. 2017;8:1453–1463. doi: 10.1016/S0140-6736(17)30569-X.[PubMed][Cross Ref]

18. Bullard R.D., Mohai P., Saha R., Wright B. Toxic Wastes and Race at Twenty, 1987–2007. United Church of Christ; New York, NY, USA: 2007.

19. Rubin L.I., Geller R.J., Nodvin J., Marcus M., Howett M., Merrick J. Break the cycle of environmental health: Disparities in vulnerable children. Rev. Environ. Health. 2011;26:135–137. doi: 10.1515/reveh.2011.019.[PubMed][Cross Ref]

20. Skiba R.J., Rausch M.K. Zero tolerance, suspension, and expulsion: Questions of equity and effectiveness. In: Evertson C.M., Weinstein C.S., editors. Handbook of Classroom Management: Research, Practice, and Contemporary Issues. Routledge; New York, NY, USA: 2006.

21. Skiba R.J. Interventions to Address Racial/Ethnic Disparities in School Discipline: Can Systems Reform Be Race-Neutral? Race and Social Problems. Springer; New York, NY, USA: 2015. pp. 107–124.

22. Kerr Z.Y., Casa D.J., Marshall S.W., Comstock R.D. Epidemiology of exceptional heat illness among U.S. high school athletes. Am. J. Prev. Med. 2013;44:8–14. doi: 10.1016/j.amepre.2012.09.058.[PubMed][Cross Ref]

23. Commonwealth of Massachusetts Department of Public Health: Bureau of Environmental Health Emergency Response/Indoor Air Quality Program: Methods for Increasing Comfort in Non-Air-Conditioned Schools. [(accessed on 28 September 2017)];2007 Available online: http://www.mass.gov/eohhs/docs/dph/environmental/iaq/comfort-non-ac-school.pdf.

24. Verner G., Schütte S., Knop J., Sankoh O., Sauerborn R. Health in climate change research from 1990 to 2014: Positive trend, but still underperforming. Glob. Health Action. 2016;9:30723. doi: 10.3402/gha.v9.30723.[PMC free article][PubMed][Cross Ref]

25. World Health Organization Climate Change and Human Health. Infographics on Health and Climate Change. [(accessed on 26 September 2017)]; Available online: http://www.who.int/globalchange/climate/infographics/en/

26. World Health Organization Climate Change and Human Health: Country Profile USA. [(accessed on 26 September 2017)]; Available online: http://apps.who.int/iris/bitstream/10665/254647/1/WHO-FWC-PHE-EPE-15.49-eng.pdf?ua=1.

27. US Environmental Protection Agency [(accessed on 26 September 2017)];EPA Region 2 Climate Change Adaptation and Implementation Plan. 2014 May; Available online: https://www3.epa.gov/climatechange/Downloads/Region2-climate-change-adaptation-plan.pdf.

28. Rosenzweig C., Solecki W., DeGaetano A., O’Grady M., Hassol S., Grabhorn P. Responding to Climate Change in New York State: The ClimAID Integrated Assessment for Effective Climate Change Adaptation. New York State Energy Research and Development Authority; Albany, NY, USA: 2011.

29. US Environmental Potection Agency Climate Impacts in the U.S. Islands (Snapshot) [(accessed on 21 September 2017)]; Available online: https://19january2017snapshot.epa.gov/climate-impacts/climate-impacts-us-islands_.html.

30. IPCC . Working group II: Impacts, Adaptation and Vulnerability, Chapter 16. In: Core Writing TeamPachauri R.K., Meyer L.A., editors. Climate Change 2014: Synthesis Report. IPCC; Geneva, Switzerland: 2014. pp. 39–55. Contribution of Working Groups I, II and III to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change.

31. Crowell M., Coulton K., Johnson C., Westcott J., Bellomo D., Edelman S., Hirsch E. An estimate of the U.S. population living in 100-year coastal flood hazard areas. J. Coast. Res. 2010;262:201–211. doi: 10.2112/JCOASTRES-D-09-00076.1.[Cross Ref]

32. US Environmental Protection Agency Superfund: The Superfund Climate Change Adaption (Snapshot) [(accessed on 22 September 2017)]; Available online: https://www.epa.gov/superfund/superfund-climate-change-adaptation#impacts.

33. Cutter S.L., Boruff S.L., Shirley W.L. Social vulnerability to environmental hazards. Soc. Sci. Q. 2003;84:242–261. doi: 10.1111/1540-6237.8402002.[Cross Ref]

34. National Center for Educational Statistics . Digest of Education Statistics: Elementary and Secondary Education. U.S. Department of Education, National Center for Educational Statistics; Washington DC, USA: 2015.

35. National Center for Educational Statistics State Education Data Profiles. [(accessed on 21 September 2017)]; Available online: https://nces.ed.gov/programs/stateprofiles/

36. Young N., Diakova S., Earley E., Carnagey J., Krome A., Root C. School Food Purchase Study-III: Alaska, Hawaii and Puerto Rico. Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis; Alexandria, VA, USA: 2012.

37. National Center for Educational Statistics Digest of Education Statistics, Table 204.40: Number and Percentage of Public School Students Eligible for Free or reduced-price lunch, by State: Selected Years: 2000–2001 through 2012-13. [(accessed on 27 September 2017)]; Available online: https://nces.ed.gov/programs/digest/d14/tables/dt14_204.10.asp.

38. US Virgin Islands Department of Education: Office of Planning, Research and Evaluation Public Schools Enrollment by Grade, 2015–2016. [(accessed on 18 September 2017)];2015 Available online: http://www.vide.vi/documents/pre/ public-school-enrollment/854-2015-2016-enrollment-by-grade-1/file.html.

39. Centers for Disease Control and Prevention Asthma: 2013 Child Asthma Data: Prevalence Tables. [(accessed on 21 September 2017)];2015 Available online: https://www.cdc.gov/asthma/brfss/2013/child/tableL3.htm#modalIdString_CDCTable_0.

40. United States Census Bureau Small Area Health Insurance Estimates: Table Uninsured, under 19 Years, All Races, both Sexes, All Incomes. [(accessed on 22 September 2017)]; Available online: https://www.census.gov/did/www/sahie/data/interactive/sahie.html?s_appName=sahie&menu=grid_proxy&s_measures=ui_snc&s_agecat=4&s_statefips=34,36.

41. Centers for Disease Control and Prevention Attention-Deficit/Hyperactivity Disorder (ADHD): State-Based Prevalence Data of Parent Reported ADHD Diagnosis by a Health Care Provider. Table: Currently Diagnosed. [(accessed on 22 September 2017)]; Available online: https://www.cdc.gov/ncbddd/adhd/prevalence.html.

42. Bauermeister J.J., Shrout P.E., Ramírez R., Bravo M., Alegria M., Martinez-Taboas A., Chavez L., Rubio-Stipec M., Garcia P., Ribera J., et al. ADHD Correlates, Comorbidity, and Impairment in Community and Treated Samples of Children and Adolescents. J. Abnorm. Child Psychol. 2007;35:883–898. doi: 10.1007/s10802-007-9141-4.[PMC free article][PubMed][Cross Ref]

43. State Health Access Data Assistance Center Uninsurance Rates for Puerto Rico in 2013 and 2014. [(accessed on 22 September 2017)]; Available online: http://www.shadac.org/sites/default/files/Old_files/shadac/publications/VI2009FactSheet.pdf.

44. State Health Access Data Assistance Center . Results from the 2009 Virgin Islands Health Insurance Survey. SHADAC; University of Minnesota, MN, USA: 2009. [(accessed on 22 September 2017)]. p. 7. Ph 612.624.4802. Available online: http://www.shadac.org/sites/default/files/Old_files/shadac/publications/VI2009FactSheet.pdf.

45. National Vital Statistics Report . CDC; 2017. [(accessed on 22 September 2017)]. Births: Final Data for 2015; p. 66. Available online: https://www.cdc.gov/nchs/pressroom/sosmap/preterm_births/preterm.htm.

46. March of Dimes Premature Birth Report Card Puerto Rico. [(accessed on 26 September 2017)]; Available online: http://www.marchofdimes.org/materials/premature-birth-report-card-puerto-rico.pdf.

47. Health Resources and Services Administration Maternal and Child Health: National Outcome Measures Virgin Islands. NOM 5.1: Preterm Birth. [(accessed on 26 September 2017)]; Available online: https://mchb.tvisdata.hrsa.gov/PrioritiesAndMeasures/NationalOutcomeMeasures.

48. United States General Accounting Office . Condition of America’s Schools. United States General Accounting Office; Washington, DC, USA: 1995. [(accessed on 22 September 2017)]. Available online: http://www.gao.gov/assets/230/220864.pdf.

49. U.S. Department of Education, Office of Planning, Evaluation and Policy Development, Performance Information Management Service . Washington, DC, USA: 2012. [(accessed on 25 September 2017)]. Free and Reduced-Price Lunch Eligibility Data in EDFacts: A White Paper on Current Status and Potential Changes. Available online: https://www2.ed.gov/about/inits/ed/edfacts/index.html.

50. Virgin Islands Demographic Profile; University of the Virgin Islands: St. Croix (US Virgin Islands), 2010; Income in 2009, Families. [(accessed on 28 September 2017)]; Available online: http://www.uvi.edu/files/documents/Research_and_Public_Service/ECC/SRI/2010%20USVI%20Census%20Dempgraphic%20Prof%20Printable.pdf.

51. Alexander D., Lewis L. Condition of America’s Public School Facilities: 2012–2013. US Department of Education; Washington, DC, USA: 2014.

52. Filardo M., Jeffery M.V. State of Our Schools: America’s K-12 Facilities. The Center for Green Schools; Washington, DC, USA: 2016.

53.

Dr. David Muller, dean of medical education at Mount Sinai, believes that including in each medical school class some students who have a strong background in the humanities makes traditional science students better doctors, too. Cindy Carpien for NPR hide caption

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Cindy Carpien for NPR

Dr. David Muller, dean of medical education at Mount Sinai, believes that including in each medical school class some students who have a strong background in the humanities makes traditional science students better doctors, too.

Cindy Carpien for NPR

You can't tell by looking which students at Mount Sinai's school of medicine in New York City were traditional pre-meds as undergraduates and which weren't. And that's exactly the point.

Most of the class majored in biology or chemistry, crammed for the medical college admission test and got flawless grades and scores.

But a growing percentage came through a humanities-oriented program at Mount Sinai known as HuMed. As undergraduates, they majored in things like English or history or medieval studies. And though they got good grades, too, they didn't take the MCAT, because Mount Sinai guaranteed them admission after their sophomore year of college.

Adding students who are steeped in more than just science to the medical school mix is a serious strategy at Mount Sinai.

Dr. David Muller is Mount Sinai's dean for medical education. One wall of his cluttered office is a massive whiteboard covered with to-do tasks and memorable quotations. One quote reads: "Science is the foundation of an excellent medical education, but a well-rounded humanist is best suited to make the most of that education."

People who look at the same problems through different lenses will make us better in the long run.

Dr. David Muller, Dean for Medical Education, Mount Sinai

The HuMed program dates back to 1987, when Dr. Nathan Kase, who was dean of medical education at the time, wanted to do something about what had become known as pre-med syndrome. Schools across the country were worried that the striving for a straight-A report card and high test scores was actually producing sub-par doctors. Applicants — and, consequently, medical students — were too single-minded.

Kase, according to Muller, "really had a firm belief that you couldn't be a good doctor and a well-rounded doctor — relate to patients and communicate with them — unless you really had a good grounding in the liberal arts."

So Mount Sinai began accepting humanities majors from a handful of top-flight liberal arts schools after their second year of college. These students are expected to continue to follow their nonscientific interests for the remainder of their college careers.

Mount Sinai takes care of teaching these students the science they need, during the summers. Interestingly, it's not exactly the same courses that are studied in most pre-med programs.

First-year medical students Keith Love (left) and Jimmy Murphy both studied environmental science as undergraduates, before joining Mount Sinai's HuMed program. Cindy Carpien for NPR hide caption

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Cindy Carpien for NPR

First-year medical students Keith Love (left) and Jimmy Murphy both studied environmental science as undergraduates, before joining Mount Sinai's HuMed program.

Cindy Carpien for NPR

The usual pre-med sciences — including several semesters of chemistry, physics, and calculus — date from the early 1900s, when an educator named Abraham Flexner revolutionized medical school by turning it into a truly scientific endeavor.

But those core science courses haven't changed much since Flexner, Muller says, while science has.

"The science for 1910 is only nominally relevant today; yet that's the filter through which everyone has to come," he says.

And that filter often weeds out people who could make excellent practitioners. Too frequently, Muller says, "if you can't get an A-minus in organic chemistry, you're not going to be a doctor."

Such artificial barriers "exclude people from medical school that we desperately need," he says.

Studies have shown that the students in Mt. Sinai's Humanities in Medicine program are just as successful in medical school as the students who take more science classes in college. And they are slightly more likely to choose primary care or psychiatry as a specialty — both areas of high need.

At a recent end-of-year party thrown by the medical students for professors and administrators, even the teachers had trouble remembering who was a "HuMed" student and who wasn't.

Someone finally points out Virginia Flatow. She's a second-year student from New York. She majored in psychology at Bates College in Maine. But she was also on the debate team. That meant lots of traveling to tournaments. Flatow says she would never have been able to do that if she'd been on the classical pre-med track.

"There are very few [medical school] courses — maybe, I can think of one off the top of my head — where doing a lot of science in college helps you," Flatow says. "The rest of it is just a matter of, 'How well do you study?' "

Flatow agrees with a growing number of medical educators that organic chemistry is largely irrelevant for medical school, and that its difficulty discourages many students.

"I know so many people who took one semester of organic chemistry [and] dropped pre-med," she says. "My brother was one of them."

John Rhee, another second-year HuMed student, majored in public policy at Cornell and says he was even thinking about going into hotel management. But he decided to become a doctor after taking a summer job at a hospice.

"The experience was so deep for me," he says, "partnering with a patient through end-of-life care."

Keith Love, a first-year HuMed student from Colby College in Maine, says he originally gave himself a "zero percent chance" of going to medical school. He studied environmental science and anthropology in college, and still escapes Manhattan some early mornings to go birding. But, he says, "I thought about what I really wanted to get out of a career — and it was medicine."

These non-traditional students serve yet another role: They round out what could otherwise be a class full of science wonks.

"I think the cross-fertilization of ideas that goes on ... ultimately everyone benefits from it," says Harsh Chawla, a third-year student from Danville, Calif. He did the traditional pre-med program, majoring in biology at the University of Southern California.

The effort has worked so well, in fact, that Mount Sinai is expanding it, opening it to students in any major from any college or university. Eventually half the class will be admitted via a slightly reconfigured program, which has a new name: FlexMed.

Back in his 13th-floor office, Muller shows visitors his commanding view of the East River and East Harlem, "which is sort of the core community we serve as a medical school."

And while he describes his own pre-med training as "cookie cutter," Muller has done his own share of thinking outside the box. Among other things, he is nationally recognized for helping create the nation's largest academic home-visiting program for patients.

But what would he have pursued in college had he not headed straight to the science track?

He thinks for a moment. "Literature — English lit," he says, wistfully. "I read voraciously as a kid, and that almost came to a complete standstill in college because there was just no time to breathe."

Can pursuing different interests really make a better doctor? Of that Muller is confident.

"People who look at the same problems through different lenses will make us better in the long run," he says. "Now, can I prove that's going to be the case? No. But I'd like to believe that it is."

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