Saving the best for last

Well, the end is finally here, and who better to send us off than three former U.S. surgeons general.

At the standing-room only Annual Meeting Closing Session, public health workers poured in to hear words of wisdom from public health’s top movers and shakers: Past Surgeons General Richard Carmona, Joycelyn Elders and David Satcher. (And by the amount of camera flashes going off and rounds of enthusiastic clapping and woo-hoos, the three speakers resembled rock stars more than public health workers — of course, wouldn’t it be great if everyone viewed their local public health worker with the reverence usually reserved for the faces of MTV?)

During what was the best session that this blogger has ever attended over seven Annual Meetings, the three docs didn’t hold back — not once. When asked what their advice is for the next surgeon general, Elders said don’t let anything get in the way — always remember to have clarity of vision, be consistent in what you do, be committed and stay in control. After saying “amen” to Elders’ advice, Satcher gave some of his own: The new surgeon general must remember that she or he is part of a relay team — accept the baton and the responsibility to sustain and preserve past good works, while still reacting to new opportunities and challenges. After his “hallelujah” to Satcher’s advice, Carmona gave a bit of his own: Embrace a life-long commitment to the office.

“Once a surgeon general, always a surgeon general,” Carmona told the audience.

All three public health role models also spoke of the many obstacles they faced, and how the world of politics often tried — and was unfortunately sometimes successful — in hamstringing the sound science of public health. Satcher told of the surgeon general’s report on sexual health that the president decided not to support, Carmona told of a correctional health report that collapsed under political pressure, and Elders spoke of her STD prevention truth-telling and…well, I think we all remember what happened after that. But despite everything, the three docs persevered and continue today to rally for public health and prevention.

For this writer, Carmona seemed to put it best: “You are the surgeon general of the people of the United States,” not the surgeon general of the Republican Party or the Democratic Party, he said. The Office of the Surgeon General is often viewed as the most credible office in the federal government, Carmona said, so speak up for the science, keep the office untarnished and always represent the people.

And speaking of representing the people, we’ll end the 2008 Annual Meeting blog with some more wise words from outgoing APHA President Linda Degutis.

Voting, she said, is the “ultimate public health intervention.”

See you next year in Philadelphia for “Water and Public Health: The 21st Century Challenge.”

— K.K.

Photo by Jim Ezell/EZ Event Photography

It's how cold back east?

Take one last look Midwesterners and East Coasters before we fly home to our winter coats and wind chills. Sigh....

Another beautiful blue view from the San Diego Convention Center terrace

Nov. 4 is just the beginning

How are we going to get health reform front and center on the national agenda, no matter what happens on Nov. 4?

Appeal to people’s common sense.

“Our people’s health is an investment, not an expense,” said Larry Adelman, executive producer of the knockout documentary “Unnatural Causes: Is Inequality Making Us Sick?” He and three other health reform advocates reminded those of us gathered for Tuesday’s “Health Access and the Election: What Happened, What Didn’t, What’s Next” session that you can apply a health lens to every issue. And it’s never too late to speak out for universal coverage.

“I believe, and I think the polling evidence supports this, that most Americans want to be fair to people and that most Americans think that if you’re sick, you deserve care,” said Linda Rae Murray, APHA Executive Board member and a champion of health equity. “So the fundamentals that we’re talking about here, that health care is a basic human right, I think is something that Americans as a people accept, despite of what our government says.”

Both John McCain’s and Barack Obama’s health plans (check out the Center for Policy Analysis’ comparison of the plans) would be a drop in the bucket as far as meaningful reform, the session presenters said. Yet, the public health community needs to keep pushing for real change and find new bedfellows to make it happen.

“We have to find a way to talk about this that allows us to bring in allies on the health reform question,” Murray said. “It’s not the economy, two wars, education or health reform. Everything is health.

“I think if we back up and not worry about all the graphs and the pie charts, if we back up and just speak in plain English to people in this country, we should be able to pass — not in the first 100 days — real health reform in this country that includes single payer as the basement and builds on top of that.”

Let’s just say if Murray were running for president, she’d have my vote.

— D.C.

This smile brought to you by fluoridation

It’s a bit hard to imagine that there’s still opposition to fluoridation, but lo and behold, the Annual Meeting’s very own 2008 host city just recently declared victory for its residents’ pearly whites.

Just this past June, the San Diego City Council voted unanimously to fluoridate the city’s water supply — a victory due, in part, to the blood, sweat and tears of public health advocates, who never stopped rallying support for this proven prevention technique. In a Tuesday afternoon session on “Fluoridation in California: Is San Diego Fluoridated?” key figures responsible for San Diego’s new fluoridated future told of their journey, the obstacles they faced and the ways they overcame. And like the interwoven wires of my junior high braces, their victory relied on a large network of stakeholders and community leaders to set the fluoridation record straight.

But first, let’s take a trip back to the 1950s, when opponents argued that fluoridation was a communist conspiracy (seriously, they did). Regardless, in 1952 San Diego decided to fluoridate its water supply, but suffered a major setback in 1954 when a ballot initiative passed making fluoridating San Diego’s water illegal. Fast forward to 1995: the California governor signs legislation requiring certain water agencies to fluoridate, but only with nontaxpayer funds — and so San Diego was exempt. But in 2007, San Diego’s First 5 Commission, which promotes wellness among young children via tobacco taxes, voted to give San Diego water districts funds to fluoridate.

It’s a good thing too: San Diego Council President Scott Peter told session attendees that San Diego is the largest U.S. city that doesn’t fluoridate its water, and only 9 percent of the city’s imported water is fluoridated. Plus, studies have found that hundreds of thousands of California children suffer from tooth decay, with Hispanic children suffering at nearly twice the rate, said Eleanor Nadler, director of the San Diego Fluoridation Coalition. Finally, presenter Marjorie Stocks, of the California Dental Association Foundation, stressed the long-term coalition building and patience needed to bring fluoridation to any community.

“Fluoridation is not a sprinter’s game, it’s definitely a marathon,” she said.

So raise your glasses (of fluoridated water) to public health prevention!

— K.K.

The envelope please...

APHA rolled out the red carpet last night during its annual awards ceremony honoring some of public health's most innovative pioneers, passionately persistent advocates and creative community caretakers. Above, APHA award recipients smile for the camera. Take a bow!

Photo by Jim Ezell/EZ Event Photography

Who turned up the heat?

When you leave San Diego to head home, you may wish that your city’s weather were just as mild and sunny year-round.

But be careful what you wish for. According to presenters at Tuesday’s “Weather, Heat and Health” session, mortality increases as ambient temperatures rise above a city-specific threshold (i.e., a 100-degree day in Phoenix isn’t as damaging as a 100-degree day in Boston).

The risk not only varies between cities, but within cities, said presenter Audrey Smargiassi, whose research used satellite images to locate “hot spots” within cities. Part of the increased mortality linked to heat is tied to socioeconomic status, she said, and more research is needed to tease out the causes.

Norman King, of Montreal’s health department, said that city officials should continue the research to find better ways to protect susceptible populations in urban areas.

“It’s one thing to document the fact that people are more vulnerable to heat events in these micro-urban heat islands, but the question is what do we do about it,” he said.

King’s department distributes educational materials and uses the media to spread the word that heat waves can be deadly. He said their effects tend to be more dramatic if they come early in the warm season, before the public’s awareness is heightened.

If you want more information about weather and public health, the National Environmental Education Foundation offers free information for meteorologists to help them incorporate public health and environmental messages into their broadcasts. And here’s an additional online resource to check out: heat-waves.org, a site dedicated to analyzing climate change in urban areas.

Well, that’s it for this blogger and public health student at this year’s APHA Annual Meeting. It’s been a great time, and I’m leaving more inspired than ever to continue my education and career in public health. Thanks for reading and safe travels!

P.T.

Wednesday’s Have You Heard...

Well, aren’t you special: Students get free access to APHA’s Public Health Expo Wednesday only, 8:30 a.m. to 12:30 p.m. Visit the Exhibitor Registration counter in the convention center’s Sails Pavilion to register. Connect with hundreds of public health vendors, including schools of public health, federal and state health agencies, and nonprofit and advocacy groups. For even more info on why public health might be right for you, visit the Association of Schools of Public Health’s Pathways to Public Health.

Pac-Man does public health: Is video game technology one of public health’s many new frontiers? Find out Wednesday during session 5164.1, "Games and Simulations in Information Technology," in the Manchester Grand Hyatt Randle Ballroom E from 12:30 to 2 p.m. Speakers will touch on topics such as using video games to promote healthy living among children and how the “infection” of hundreds of online game players with a virtual disease led to the “first opportunity to examine the potential use of persistent virtual worlds in the advancement of public health.” Cool.

Doctor, Doctor, Doctor: That’s right, three of the nation’s former top docs — Surgeons General Joycelyn Elders, David Satcher and Richard Carmona — talk shop during the meeting’s Closing General Session, “Becoming the Healthiest Nation: A Dialogue with the Former U.S. Surgeons General,” from 2:30 to 4 p.m. in Room 6 C/F of the San Diego Convention Center.

No recess for nutrition

It’s hard enough to get adults to eat a healthy diet — and we’re supposed to know better. Ensuring children have access to healthy foods and encouraging them to actually eat those healthy foods is a whole other animal.

Panelists at Tuesday afternoon’s session “School Food Innovations: Making Sustainable Change” discussed the challenges and opportunities for improving our nation’s school food environment.
Despite the unfortunate (and all too common) lack of nutrition education in her school district in Charlottesville, Va., Alicia Cost raised awareness of healthy meal choices in a pilot program called C.H.O.I.C.E.S. (Creating Healthy Opportunities and Initiatives in the Cafeteria for Everyone).

Meals and side items were assigned a red, yellow or green stoplight symbol based on federal fat and saturated fat standards, and signs and posters were placed in the cafeteria to show students how to put meal components together to create a healthier meal. Although there were no observed decreases in purchases of “red” menu items at the school for fifth- and sixth-graders during the study period, students did show increased understanding of nutrition, and Cost is hopeful that with increased education and funding, a larger impact can be realized.

Another school food challenge is marketing within schools, as described by Lisa Kraypo of Samuels and Associates, a California-based public health research firm. From the obvious ads on beverage vending machines in high schools to the more subtle scholarship and fundraising programs, companies want their brand to be known from an early age. An example is a fundraising effort called McDonald’s McTeacher’s Night, where teachers work at a McDonald’s and encourage students and their families to eat dinner at the restaurant to raise money for the school.

But foods within the schools aren’t the only concern when it comes to childhood nutrition. Marnie Pureil, of the Built Environment and Health Project at Columbia University, studied the proximity of fast food restaurants and convenience stores to urban schools in New York City and found that zoning differences and other features of the built environment account for the higher prevalence of inexpensive, energy-dense food near schools serving low-income and ethnic groups at greater risk of obesity.

What do you think are the biggest challenges in improving childhood nutrition? The incessant ads for gooey candies and sugary snacks? The lack of nutrition education in schools? Or improving parents’ commitment to healthy diets for their kids (and understanding what that means)?

— P.T.

We are how we eat

How big is your food carbon footprint? Did you know red meat and dairy products are responsible for 48 percent of the greenhouse gas emissions coming from the agricultural sector? And it might be a better choice to buy tomato paste made from locally grown tomatoes than fresh tomatoes flown to your supermarket from overseas.

As public health professionals help shine a spotlight on the health effects of climate change, the food supply should be another concern, said presenters at the “Climate Change: Will There be Food?” Annual Meeting session. Rising sea levels, more frequent floods and harsher hurricanes are already impacting the U.S. agricultural system. At the same time, many traditional farming and food distribution practices are upping greenhouse gas emissions and leading to adverse effects.

What’s needed? Not only should individuals aim for a plant-based diet and overall lowered consumption (i.e., don’t drive across town to buy highly processed foods), but public health professionals should devote more research into the climate change-food supply puzzle.

“We simply don’t know enough about how to adapt our food systems in this changing world,” said Molly Anderson, a food systems consultant. “We need far more research.”

The issue is a veritable cornucopia. There’s consumption, production, equitable food distribution and the need to rethink the way food is grown, sold and used locally and globally. Creative multitasking — such as creating urban edge “AgParks” that provide land access for small farmers and parkland for fresh food, recreation and education to local communities — can lead to a better overall agricultural picture while reducing greenhouse gas emissions.

Read more about it in “Think Globally, Eat Locally: San Francisco Foodshed Assessment,” the University of California-Davis Agriculture Sustainability Institute’s Low Carbon Diet plan and “Cooking up a Storm — Food, Greenhouse Game Emissions and Our Changing Climate” from the Food Climate Research Network.

— D.C.

Centennial celebration

One hundred years old? You barely look a day over 99! Stop by the Public Health Expo and say "Happy 100th Anniversary" to members of the Health Administration and Statistics Sections, whose booths are in the Sections area of the expo.

The Statistics Section, top, hands out celebratory cupcakes, and the Health Administration Section, bottom, greets a booth visitor.

Antibiotics for dinner again?!

Tuesday morning’s session “ Industrial Agriculture: Health Threats and Solutions,” jointly organized by the Environment and Food and Nutrition Sections, brought together an impressive group of speakers who synthesized the range of concerns about industrial agriculture and human health, from antibiotic resistance to peak oil.

David Wallinga, of the Institute for Agriculture and Trade Policy, discussed the dangers of widespread antibiotic use in animals and the contamination of meat with antibiotic-resistant bacteria. Although the industry doesn’t measure its antibiotic use, researchers have estimated about 20 million to 30 million pounds of antibiotics were fed to livestock in 2001, largely for preventing disease and promoting growth.

“The obvious concern is that the use of these drugs in animals is going to undercut their effectiveness in treating human illnesses,” he said.

John Balbus, of the Environmental Defense Fund, echoed Wallinga’s concerns about antibiotic use in animals, particularly in pigs. Ninety-five percent of the antibiotics used in pigs are similar to human antibiotics, so if we were to see cross-resistance between animals and humans, pigs would be a likely place to see that, he said.

Shifting to energy, it’s no surprise that industrial agriculture uses massive amounts of fuel in pesticides, fertilizers, irrigation, transportation and packaging. Ashley Wennerstrom, a DrPH candidate at the University of Arizona, discussed the challenges ahead as fuel prices rise and supplies fall. This isn’t just an issue for economists or energy policy analysts, this is a public health policy issue as well, she said. The reactive (not-proactive) nature of the market system means we must advocate for increased investments in alternative energy and public transportation, oppose subsidies for corn grown for fuel, and provide incentives for farmers to rotate crops and use natural fertilizer to prevent soil degradation.

Alison Gustafson, a doctoral student at the University of North Carolina, has researched local food environments in North Carolina and their links to diet patterns, obesity and chronic disease.

“A big function of what we eat is what’s available in our communities,” she said.

She has found that the large number of livestock farms in North Carolina hasn’t necessarily translated to local benefits for residents, but collaborations between sectors of the food system (for example, between production and retail distribution) could help improve the situation.

Linda Shak, of the Prevention Institute, detailed her work to link health and sustainable agriculture, which includes a useful Web site that can be used by schools, communities and governments to improve access to healthy food in a sustainable way. To try out this interactive tool, visit the Prevention Institute’s Environmental Nutrition and Activity Community Tool (or ENACT) Web site.

— P.T.

Strange bedfellows…literally

“Good night, sleep tight, don’t let the bed bugs bite” is an expression many of us grew up reciting just before drifting off to sleep. Somewhere between kindergarten and fourth grade, most of us forgot about the charming childhood chant, but not Judith Saum. As the self-described “bed bug queen,” Saum grew up to become the person who literally won’t let the bed bugs bite. That’s her goal, at least.

When there’s a bed bug problem anywhere in Reno, Nev., Saum is on the case. An environmental health specialist with the Washoe County Health District Department, Saum doesn’t back down to the reddish brown, quarter-inch-long, flat-as-a-credit-card critters. In her purse, she carries a flashlight and a magnifying glass, and she means business.

At a Monday afternoon meeting session about the persistent pests, Saum told public health nurses that the bugs happily hitchhike from place to place on clothing, used furniture, shoes, backpacks, pillows and luggage, to name a few of their most popular forms of transportation.

The common bed bug, or Cimex lectularius, is no stranger to the United States and in fact was a common problem before World War II. Through the use of the insecticide DDT in the 1940s and 1950s, bed bugs were nearly eradicated, but in the 1990s they began making a comeback because of increased mobility and travel and greater resistance to insecticides. But the good news is that while 28 different pathogens have been cultured from bed bugs, no studies to date indicate that they are capable of vectoring disease.

It’s been estimated that at least 50 percent of hotels and motels in Las Vegas have bed bug problems, Saum said, and humans generally don’t feel it when this insect bites them.

“You wake up in the morning and you have welts,” says Saum, who herself has had the memorable displeasure of cohabitating in a bed infested with them. “I recall feeling a very strange sensation in the middle of the night, like a feather passing over my body.”

It seems these nasty creatures have some sort of anesthesia in their saliva, so their victims don’t feel pain at first bite. Bed bugs are active at night, Saum says, when they leave their daytime resting places deep inside cracks and crevices to seek out a bloody meal.

If you think you have a bed bug infestation, call a licensed pest control professional, Saum says. A steam cleaner is useful for killing nymphs and eggs, and clothes can be washed in hot water and dried on the hot cycle. After treatment, mattresses and box springs should be encased in a zippered cover that’s bed-bug proof.

Despite the concerns, Saum managed to put things in perspective through her parting take-home message to session participants: “Don’t lose sleep over this.”

— T.D.J.

Marketplace of ideas

Last night’s Town Hall Meeting on Health System Reform was a veritable smorgasbord of juicy quotes on our nation’s health crisis and the different ideas to finally fix it.

One of our top public health docs, Centers for Disease Control and Prevention Director Julie Gerberding, kicked off the dialogue, warning that if we don’t do something, today’s children can look forward to shorter life spans than we do — that’s a crisis, she said. Solving the problem will, of course, take time, Gerberding said, but any solution will require at least two steps: creating a social movement and enacting policy changes broad enough to reach everyone.

After all, “health doesn’t just happen in the health care delivery system,” she said. In fact, Gerberding said she hopes a framework will emerge that looks for health in all policies — maybe a health impact assessment should be conducted every time new legislation is proposed or reauthorized, she offered.

“When we invest in the public’s health, we get real results,” Gerberding told the audience.

Among the speakers sharing the panel with Gerberding was Quentin Young, national coordinator for Physicians for a National Health Program, who pushed for public health workers to back a single-payer health coverage system. The marketplace holds the solutions to some problems, but it won’t work to fix the health crisis, he said. Our country sits “wounded by the health care system,” he lamented.

“Our present health system is the opposite of solidarity,” Young said.

A quote from panelist Cheryl Matheis, an AARP rep who spoke about the group’s Divided We Fail health reform campaign, struck this blogger best: “If we don’t demand it, it will not happen.”

— K.K.

Sunrise slog

It was dark, it was chilly outside and after three days of non-stop Annual Meeting activities, I wasn’t wild about going for a run this morning. But thanks to some energetic members looking to form an APHA Physical Activity Special Primary Interest Group, I had good reason to schlep down to the Marriott hotel lobby at the crack of dawn.

About 50 of us laced up our sneakers for the hopefully first annual APHA Annual Meeting 5K fun run and walk. The route was perfect — who wouldn’t love trekking along the San Diego harbor with tall ships and funky California trees in the background? And for us East Coasters, it felt like 9:30 a.m. instead of 6:30 a.m. That’s what we told ourselves in the pre-dawn dark, anyway.

As the sun rose, the cheerful public healthers jogged along the scenic Embarcadero, and this year’s run was more like a group fitness outing than an actual race. We talked about key public health issues (maternal and child health needs, mental health care access disparities, health care reform and the impact of the upcoming presidential election, to name a few). Race co-organizer Steve Hooker set the tone for the run, saying he was aiming for a slog, also known as a slow jog.

I managed to keep up with the lead pack for about two miles but then hung back — to save energy for the rest of the day, I said to myself. It was pretty much like any other race back home, where my top goals are: don’t be last and don’t fall down. Mission accomplished.

Future Annual Meeting fitness event ideas bantered around this morning include yoga sessions and group bike rides. Special thanks to a very chipper and friendly Genevieve Dunton, also on East Coast time because she hails from Washington, D.C., who had the idea for this morning’s 5K and snapped a photo of us before we hit the trail.

— D.C.

‘Passion will win the day’

You can’t beat the Physicians for Human Rights’ pitch when trying to convince a decision-maker that the group has clout.

“We say that we are a human rights group that’s been around for 22 years, and in 1997 we were a co-recipient of the Nobel Prize,” said Jirair Ratevosian, the group’s Health Action AIDS Plan national field organizer. Having credibility is key in mounting an effective public health campaign, but if you didn’t win a Nobel Prize, other credentials will do.

Cool promotional materials also help. Before the “Mobilizing a Campaign Around a Public Health Issue” Annual Meeting session on Monday, attendee Lois Uttley ran out of hand-held fans imprinted with the Raising Women’s Voices message that women can work together to get quality, affordable health care for everyone. (She noted that they’re popular with the menopausal crowd for fighting hot flashes.) And they just have that old-timey feel of sitting in church on a hot summer Sunday, waving in agreement to the preacher’s sermon.

Another thing you need when championing a public health cause is a personal champion. In the fight to bring fluoridation to California’s water supply, APHA Oral Health Section President Howard Pollick and the California Fluoridation Task Force have C. Everett Koop, possibly the nation’s most popular and recognizable surgeon general, saying fluoridation is “the single most important commitment a community can make to the oral health of its children and to future generations.”

Uttley’s group has health reform champions in thousands of women who’ve faced challenges because of insurance coverage problems. In working for reauthorization of PEPFAR, or the President’s Emergency Plan for AIDS Relief, Ratevosian said personal messages from U.S. physicians and medical students as well as online postcards from those in Uganda and Kenya brought the needed zing to the issue. The law was reauthorized in August and included some language identical to Physicians for Human Rights fact sheets used in lobbying efforts.

For those of you who couldn’t make it to the session but have an important cause to champion, the eight key steps in advocacy are: 1) define the problem; 2) set campaign goals and objections; 3) get the facts; 4) choose targets; 5) understand the policy and decision-making process; 6) build alliances and coalitions; 7) choose actions and tactics; and 8) renew, review and re-energize.

I’ve never seen a more dedicated group of people than public health professionals, and that dedication will work in your favor when pressing for change, said Pollick, a California dental professor who had a toothbrush sticking out of his breast pocket during the presentation. Use your enthusiasm for change to get it done.

“Time and time again, passion will win the day,” he said.

— D.C.

Where's Waldo?

Hey, I think I see my booth! Don't forget to stop by the Public Health Expo for free goodies galore!

Photo by Jim Ezell/EZ Event Photography

Healthy People needs you!

Have an opinion on how healthy Americans should be? Now is your time to speak up and have your say. The federal government is calling on public health workers to step up to the plate and play a role in the development of the next edition of Healthy People, the landmark document that sets goals and objectives for the health of the nation.

Developed with input from a broad range of public and private stakeholders, Healthy People is used by states, communities, federal agencies and others to improve the health of Americans. The most recent edition of Healthy People, released in 2010, contains 467 objectives on a range of public health issues, such as vision, mental health, immunization and tobacco use.

Work is now well under way on Healthy People 2020, the much-anticipated new edition, with a framework for the plan expected to be released this December or January, according to Penelope Slade Royall, director of the U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion, who addressed APHA Annual Meeting attendees yesterday.

“I think that Healthy People is one of the best things that is coordinated by the federal government,” said Royall, who is also U.S. deputy assistant secretary for health. “Healthy People is a widely trusted, tested commodity. It has evolved as the nation’s health priorities have evolved.”

Healthy People leaders plan to spend the next year gathering input and feedback from a wide range of stakeholders, with the complete set of 2020 goals and objectives to be released in January 2010.

In the meantime, Royall called on public health workers to become involved in the Healthy People 2020 process, encouraging people to provide comments online, attend Healthy People Advisory Committee meetings (the next one will be held online Dec. 17) or join the Healthy People Consortium, a group of agencies and organizations that work to support Healthy People.

“We need opinion and input from many people,” Royall said. “You are important to us. Healthy People needs you.”

— M.L.

Tuesday’s Have You Heard...

Ready, set, go: Join physical activity advocates working to form a new APHA Physical Activity Special Primary Interest Group for their first annual 5K Fun Run and Walk on Tuesday morning at 6:30 a.m. Meet up in the lobby of the San Diego Marriott Hotel and Marina near the concierge desk.

It’s (not) a small world after all: Moderated by outgoing APHA President Linda Degutis, a special session on Globalization and Public Health, session 4079, will explore poverty, looming public health threats and environmental public health in an increasingly interconnected world. Check it out from 10:30 a.m. to noon in Meeting Room 6 C/F of the San Diego Convention Center.

Shhhhhhhhhhhh: Public health’s own little Sundance continues its successful run this year in San Diego, so join fellow movie-goers at APHA’s annual Film Festival offerings. Session 4157 features U.S.-made public health-focused films and takes place Tuesday from 12:30 to 2 p.m. in Meeting Room 11B of the convention center. (And search the Annual Meeting online program for 2008’s other Film Festival sessions.)

Rolling out the welcome mat: Meet staff of APHA’s membership and component affairs departments during an Open House event at the APHA Membership Booth in the Everything APHA exhibit area of the Public Health Expo from 12:30 to 3:30 p.m. Become a new APHA member or learn how to take better advantage of all the membership benefits APHA has to offer.

Green is the new black: Not ones to miss an opportunity to make the world a healthier place, the public health and health care fields are making their own waves within the green movement, making sure the mantra of “first, do no harm” extends beyond the delivery of care. Learn more about this growing trend Tuesday from 2:30 to 4 p.m. in session 4244.1, the Greening of Health Care, in Meeting Room 11A of the convention center.

Public health and one big border

At a meeting themed “Public Health Without Borders,” we need to look no further than a few miles south of the San Diego Convention Center to find a geographical border that illustrates a public health and human rights crisis.

At Monday afternoon’s session “Dying to Work: The Risks from Injury and Death on the Migrant’s Journey to Work in the United States,” Amy Liebman, of the Migrant Clinicians Network, said that despite a nearly ninefold increase in funding for the U.S. Customs and Border Patrol since 1993, the agency’s strategy of preventing illegal immigration through deterrence has failed.

This shift in the border patrol’s strategy in 1993 helped create an even more vulnerable population of immigrants coming to the United States by making it more treacherous to cross the border, but at the same time, not decreasing the prevalence of illegal immigration. The end effect was more migrants diverted into harsh, rugged areas such as the southern Arizona desert and an increase in the number of deaths and injuries.

Once migrants enter the United States and begin working, often in the construction, agriculture and meatpacking industries, their lives don’t get any easier. Liebman called them a “hyper-exploited” work force, vulnerable to safety violations in the workplace and at heightened risk of injury and mortality.

Liebman said we should immediately enforce workplace safety and minimum wage standards, create legal pathways for undocumented workers to stay, and create incentives for immigrants to return to their homelands.

Selena Ortiz and Christina Trimmer, of the University of Arizona’s Mel and Enid Zuckerman College of Public Health, stressed the need to frame immigration as a public health concern driven by economic, political and social factors. Policies addressing migrants from a public health and human rights perspective would be a departure from current immigration policy, but it’s a controversial issue that neither presidential candidate has touched, Ortiz noted.

Ortiz and Trimmer are very aware of the resistance, even among the public health community, to tackle this issue. In fact, they said faculty at their institution rejected their proposed position statement identifying migration as a preventable public health concern.

Such highly politicized debates are nothing new in public health, right? So what do you think?

— P.T.

Nurses vs. Katrina

If living in a hurricane-prone area has taught public health anything since the walloping of Hurricane Katrina in 2005, it’s that emergency preparedness really works, especially if you put a public health nurse in charge.

“We’ve learned a lot, we’ve drilled a lot and we’ve put some best practices in place,” said Doris Brown, executive director of the Louisiana Department of Health and Hospitals’ Office of Public Health. Among her many hats, she heads emergency preparedness efforts and said Hurricanes Katrina and Rita offered invaluable lessons, which she shared during an Annual Meeting session on “Disaster Nursing: Public Health Nurses Meet Katrina.”

Nurses on the ground after Katrina and Rita deserve all of our thanks. They stitched up patients by flashlight, turned hospital parking garages into makeshift MASH units and held the hands of the terminally ill during their last hours. As the flood waters rose outside one hospital, nurses carried the bedridden down as many as 12 flights of stairs, loaded them onto small powerboats, ferried them across to a parking garage and then carried them to the roof so a helicopter could evacuate those critically ill patients to safety. Talk about doing the best you can in the worst of circumstances.

Brown and co-presenter Dian Traisci-Marandola, also a public health nurse and director of national programs for the Children’s Health Fund, have seen first-hand what happens when people with health and access issues are hit with a disaster.

“Needs that are not met prior to a disaster are only going to be worse after a disaster occurs,” said Traisci-Marandola, who recently met two new mothers with 2-week-old infants at a Houston shelter last month. Refugees from Hurricane Gustav in August, they had been homeless before the storm and gave birth at the shelter.

All those in emergency preparedness, we salute you. To learn more about what Brown and her colleagues have learned, check out recommendations, treatment guidelines and other documents online.

— D.C.

Cool genes. Where’d you get ‘em?

Genomics. The word itself invokes a bit of confusion (even in this seasoned public health writer). It has an aura of complexity and intricacy that often relegates it to the pages of scientific journals and university laboratories. But public health, as it has done throughout its history, is beginning to use the language of community outreach and health promotion to bring the field of genetic research to the masses.

In its very first Annual Meeting session, “Education, Environment and Genes: Genomics in Health Promotion and Disease Prevention,” APHA’s new Genomics Forum welcomed a variety of presenters working on the forefront of the intersections between genetic research and public health. The overarching questions seemed to be: How can genetic research and knowledge be used to beef up public health prevention techniques, and how do public health educators bring the power of genetic knowledge to the communities they serve? Not easy tasks, but thankfully the roads toward such beneficial intersections are being carefully paved.

Presenter Lei-Shih Chen discussed collaborations between genetic counselors and public health educators, referring to a call from the Centers for Disease Control and Prevention that such public health workers begin to integrate genomics into their work. Chen also mentioned the many similarities between public health educators and genetic counselors, stressing the need for better cooperation between the two professions. In fact, some schools have already taken this step into the DNA dimension: Sarah Lawrence College in Bronxville, N.Y., now offers a Public Health Genetics/Genomics Certificate Program.

Hailing from Sarah Lawrence College, session presenter Linwood Lewis took us to the storytelling side of genetic history — how our family stories and histories influence our perceptions of inheritability. Linwood noted that while genetic counseling has typically been available to the more privileged, its accessibility is broadening. Still, more than 90 percent of genetic counselors are white women, which can complicate issues tied to trust and cultural competency. How to begin overcoming such barriers? Make sure the patient’s voice isn’t lost in the narrative moment, Linwood said, and work to ensure the conversation is a mutual one. It’s not a case study, he urged, it’s a case story.

For more on the new Genomics Forum and their activities in the coming days, visit their Web site.

P.S. Genomics (jə-nō'mĭks) noun: The study of genes and their function

— K.K.

Banishing the burden

Reducing the burden of disease globally and in the United States will require a shift from spending vast amounts treating preventable diseases to actually preventing those diseases in the first place, according to Monday morning’s special session “Reducing the Global Burden of Disease,” where the U.S. surgeon general and health minister of Taiwan discussed the challenges and opportunities in embarking on such an endeavor.

Panelist Chris Murray, professor of global health at the University of Washington, noted that large increases in global health funding is now leading to slow progress in achieving health priorities, which vary greatly among developed versus developing nations. Still, around the world the proportion of noncommunicable disease is growing.

“This epidemiological transition is much further along than even some in global health realize,” Murray said.

Acting U.S. Surgeon General Rear Admiral Steven Galson outlined his education and health promotion priorities for reducing underage drinking, eliminating health disparities, and preventing and reducing childhood obesity. Galson called on his fellow public health workers to improve the environments that contribute to obesity, saying that one way we can do so is via “nontraditional public health practitioners” who work on agriculture and transportation policies.

“We really need to change the way we think about public health…chronic disease prevention should be our number-one priority in the United States,” Galson said.

Improving our health care system to make it value-driven and accountable is also an important goal. Americans have more information about the cars they purchase than about their health care plans, Galson said.

Ching Chuan Yeh, minister of health in Taiwan, spoke about the successes of Taiwan’s national health insurance program, which was implemented in 1995. Offering subsidies to lower-income residents is a significant feature of the program, which stresses equity and accessibility. Yeh noted that despite far less spending and resources than the United States, life expectancies and infant mortality rates are comparable to those in America.

Clearly, there is still much to be done worldwide to improve the health status of populations with diverse risk factors. Luckily, Murray outlined four approaches to reduce the global burden of disease: (1) develop new diagnostics, vaccines, drugs and procedures; (2) increase investments in public health and medicine, and increase health system efficiency; (3) improve ways to measure progress; and (4) expand interventions to treat and prevent infectious diseases such as HIV, TB and malaria.

— P.T.

Wandering eyes

So many questions come to mind: Did they miss the parking lot? What kind of gas mileage does that get? How'd they get it in the building? Can you imagine trying to parallel park?

Talk a walk through the Vision & Eye Health Work Group's mobile vision van at the Public Health Expo.

Posters galore

As usual, the poster sessions located in the back of the Public Health Expo offer an impressive variety of research. Aisle after aisle of presenters explained their work to interested onlookers Sunday afternoon after the Opening General Session officially got the Annual Meeting under way.

With universal health care on everyone’s minds this election cycle, an assessment of pilot programs will be important to finding areas with room for improvement. One poster, titled “Improving Access to Health Care for all Vermonters: Assessing Knowledge about Catamount Health,” did just that. Researchers found that despite press coverage about Catamount Health, a plan implemented in October 2007 to cover uninsured Vermonters, community-based organizations and health care providers generally had a poor understanding of the program.

Changing gears completely, researchers from the University of Pennsylvania and the Philadelphia Department of Public Health explored rates of prenatal HIV testing for foreign-born and undocumented women in Philadelphia. They found that contrary to their original hypothesis, undocumented immigrants had similar rates of being offered and accepting prenatal HIV testing compared to other pregnant women. However, foreign-born, Medicaid-eligible immigrants had the lowest acceptance rate, perhaps due to factors such as cultural and language barriers, perceived lack of risk of contracting HIV or previous testing via the immigration process.

Walk a few more aisles over and you’ll find posters with a completely different flavor…literally. Jayagopal Parla and Gurucharan Khalsa explored the psychosomatic effect of tastes in weight loss and health promotion. They concluded that utilization and appropriate balance of six tastes — sweet, sour, salty, pungent, bitter and astringent — have a significant function in understanding and preventing eating disorders and diseases. Preference for sweet and salty tastes in particular is a strong contributing factor to obesity, and choice of foods is influenced by a wide spectrum of economic, social and behavioral factors as well as psychological responses to stressors, researchers said.

Stop by the poster sessions whenever you get a free moment — you’re bound to find something to (pardon the pun) whet your appetite.

— P.T.

One woman, many faces

A Hispanic Iraq war veteran, a Dominican university student, an Asian pharmacist in Chicago and a black barber working in Los Angeles were just a few of the personas that Tony Award-winning performer Sarah Jones, above, channeled during last night's performance of "A Right to Care," which illustrated the many faces of racial and ethnic health disparities.

Photo by Jim Ezell/EZ Event Photography

Don’t worry, you’ll make your way

As a public health student, it’s gratifying to be pursuing a career in a field that excites me and impresses me every day. But there are so many interesting aspects of the field and so many paths to a successful career that it can be a bit overwhelming (but in a good way, of course).

The advice from the mentors who took part in an APHA Student Assembly speed mentoring session on Sunday left me with this advice: Focus in on what you love, make a list of life and career goals…and take a deep breath, it will all work out.

The main topic of the mentoring session was securing funding — a hot topic for doctoral students. While applying for grants can be a frustrating process, mentor Linda Olson-Keller said that concise writing is essential to a favorable outcome. Read it out loud and have others read it before submitting. And if you don’t get funding, take time to explore how to improve the grant and the presentation of your goals. Also, ask the reviewers for feedback to improve your chances the next time around.

“If you can’t write it down clearly, it definitely lowers your credibility,” Olson-Keller said.

In order to finally get that degree and put those initials behind your name, you don’t have to save the world yet. You have to leave something to do during your career, right?

“The best dissertation is a deposited dissertation,” said mentor Lyndon Haviland. In looking for jobs, emphasize your strengths and apply for what you’re qualified for. It’s okay if you don’t have a lot of experience yet.

Also, no career is forever, they stressed. Even jobs within the same organization often transition into completely new positions. You don’t have to be a “doer” or a “thinker” — as Haviland pointed out, you can be both! Make your own path and don’t restrict yourself based on others’ limited ideas of what you can and cannot do with your degree, said mentor Brenda Liz Henry. Being open to relocation often helps as well, but now may be a good time to break out that list of life and career goals and balance your priorities.

Talk about food for thought…more like an all-you-can-eat buffet of possibilities. I know I’ll be thinking about that old question: “What do you want to be when you grow up?” for the rest of the day and the meeting. Ya know, I thought once you picked a profession, this was supposed to get easier…

— P.T.

Monday’s Have You Heard...

The other election: Stop by a “Meet the Candidates” forum sponsored by APHA’s Committee on Affiliates and Intersectional Council and get to know the candidates running for the association’s Executive Board as well as for APHA president. The first-ever jointly sponsored event runs from 7 to 9:10 a.m. in the Marriott Manchester I.

Give a little, get a cookie: The San Diego Blood Bank is holding a blood drive in front of the San Diego Convention Center’s Hall C from 9 a.m. to 3 p.m. The blood drive will continue on Tuesday, also from 9 a.m. to 3 p.m.

Where’s Willard Scott when you need him: Wish APHA’s Health Administration and Statistics Sections a Happy 100th Anniversary at their celebration booths at the Public Health Expo!

Our town: In just a little more than a week, it’ll be time to go to the polls. And so what better time to discuss the future of health care and public health’s role in bringing health care to all than right now. Stop by a Town Hall Meeting on Health System Reform today from 4:30 to 6 p.m. in Meeting Room 6 D/E of the convention center and have your voice heard. Moderated by health reporter Susan Brink from the Los Angeles Times, the panel will also feature CDC Director Julie Gerberding, Quentin Young of Physicians for a National Health Care Program, and a representative from Barack Obama’s presidential campaign, among others. (Full disclosure: A representative from John McCain’s campaign was invited as well.)

What do body piercers, alligators and chocolate have in common?

It’s hard to know where to begin when talking about the Public Health Expo, where exhibitors are handing out everything from free pens to chocolate to first aid kits. You can win free T-shirts and pins after taking the Susan G. Komen booth’s wheel of fortune for a spin (and answering a breast health question), pick up a yellow LIVESTRONG wristband from the Lance Armstrong Foundation, play with plastic fruits and vegetables at the Coordinated Approach to Child Health display and satisfy your sweet tooth at any number of booths offering baskets of candy. Thank you to the University of California/Berkeley’s Center for Weight and Health for the packet of delicious California raisins.

I doubt there will ever be a lull at booth # 1140, where members of the National Certification Board for Therapeutic Massage & Bodywork are offering free, five-minute massages. Hello, stress relief.

It’s the eighth Annual Meeting for the Association of Professional Piercers, whose members carry a strong health and safety message for the increasingly popular art of body piercing. Vice President Didier Suarez has huge chunks of fossilized walrus bone in his earlobes, a round black stone in his lower lip and an important message about infection control and safety standards. He’d be happy to talk to you about that.

One of my favorite sections: schools of public health along aisle 200. You’ll find some of the most enthusiastic public health students and faculty in the country offering information on degree programs and outreach efforts. I picked up a squeezable little alligator from a couple of students with the University of Florida College of Health Professions (go Gators!). And you won’t find a more enthusiastic bunch of future public health professionals than with the Consortium of African American Public Health Programs. Five historically black colleges and universities have joined to provide leadership in eliminating health disparities and promoting social justice.

“It’s about empowerment,” said Corliss Allen, an MPH student at Florida A&M University (go Rattlers!) and president of the school’s Future Public Health Professionals. “It’s about giving our communities the skills they need to take control of their lives and take control of their health.”

Hear, hear, Corliss.

I was a little disappointed that the gigantic mobile vision clinic isn’t offering free vision exams, but in its non-expo life, the 40-foot RV sponsored by the National Association of Chronic Disease Directors’ Vision and Eye Health Work Group and its partners brings comprehensive vision services to disaster victims, the homeless and under-served communities. Check out the interior, which features state-of-the art exam equipment and nicer cabinets and countertops than my home kitchen.

— D.C.

‘Well-behaved advocates rarely make history’

“I would like for you to dream with me, to dream of a world where social justice is taken seriously.”

— Michael Marmot, chair, World Health Organization’s Commission on Social Determinants of Health

The heart and soul of public health was on display today during the Annual Meeting’s opening session, as speakers called on their colleagues to stand up, speak out and fight back.

Of course, standing up, speaking out and fighting back isn’t without its risks and slight embarrassments. Just a few advocacy hazards, according to opening session speaker and outgoing APHA President Linda Degutis: you might get labeled the “safety nerd,” your kids could starting wearing helmets to bed, you may get skipped over for promotion or tenure, and there never seems to be enough room on your car for all those bumper stickers. But then again, “well-behaved advocates rarely make history,” Degutis proclaimed.

“There’s strength in numbers and we have those numbers,” said Degutis before a crowd of 6,000, noting that her fellow public health workers are often “too modest and too quiet.”

One public health worker who certainly doesn’t hold his tongue is Sir Michael Marmot, the opening session’s keynote speaker and a globally known expert in health inequities. A leader in the worldwide movement to close the health disparity gap, Marmot didn’t hide his frustration, lamenting that while the world has the knowledge to close the health inequity gap within a generation, it probably won’t. But Marmot didn’t veil his hope either, reminding audience members that “there is a tide running in our favor at the moment.”

While Marmot called for health reform in the United States, he was also quick to remind us that health inequities will not disappear with universal coverage. In Glasgow, Scotland, where everyone has access to care, he reported that the life expectancy gap between men in different regions still ranges from age 54 to 82. Within our own nation, life expectancy for men in Washington, D.C., averages about 63, while for men just a few miles away in Montgomery County, Md., the life expectancy average is 82. How do we account for such pronounced differences: the social determinants of health.

In his work with WHO’s Commission on Social Determinants of Health, Marmot — like Degutis noted before him — has faced his share of criticism and push back. People say that by trying to close the health inequity gap, advocates would be taking away a person’s individual responsibility to maintain their health. Not so, Marmot argued. In our work, we’ll be creating the social conditions that indeed make it possible for a person to take responsibility for her or his health, he said. And when faced with suggestions that he argue why closing the gap is good for the economy (or he was warned: no government will take the commission’s recommendations seriously), Marmot fought back again. Improving health is a matter of social justice, he said, it’s the right thing to do.

— K.K.

National Public Health Week 2009: ‘Building a Foundation for a Healthy America’

It’s almost here. After months and months and months of commercials, pitches, debates and 24-hour punditry, the presidential election is just around the corner. And no matter who wins, the pressing issues will remain: the nation’s growing health care access crisis, the 45 million Americans who live, work, play and care for their families without any health coverage, and a nationwide health status that continues its perilous trend southward.

And so the advent of a new presidential administration and new Congress provides another critical opportunity for public health to make its voice known — to tell our policy-makers at every level of government that fixing our health care system must be a priority. To tell them that without a serious commitment to improving and strengthening the very foundations of our health — otherwise known as public health — that any health reform won’t live up to its full potential.

That’s why APHA has chosen “Building a Foundation for a Healthy America” as the theme for 2009’s National Public Health Week. The annual public health observance will focus on garnering our collective voice and strength as the protectors of our community’s health to advocate for public health’s vital role in improving our nation’s health. It seems more important than ever to not only build on public health’s past achievements, but to protect those achievements from slowly unraveling.

So start planning now for your 2009 National Public Health Week celebration. Visit the official National Public Health Week Web site and blog for more information on the 2009 theme as well as info on how to become a partner or sponsor, or walk down to the Public Health Expo to visit the National Public Health Week booth. And visit the site in coming months for more details, event ideas and ways to advocate for public health in your community.

Q&A with labor activist Garrett Brown: ‘I have never seen a place as bad’

“We have an opportunity to make small but meaningful contributions to change that will make a big difference in other people’s lives.”

— Garrett Brown, coordinator, Maquiladora Health & Safety Support Network

The brainchild of APHA Occupational Health and Safety Section members, Brown’s network was founded at the 1993 APHA Annual Meeting in San Francisco and is still paving the way for better working conditions in foreign-owned factories along the U.S./Mexico border. In addition to shining a spotlight on health and safety atrocities in those maquiladoras (or foreign-owned factories), the network also has branched out to Asia and Central America. All of the network’s 400-plus members have full-time jobs, but volunteer their advocacy time.

“Those of us who live in the developed world have some moral obligation to assist workers who are producing the products we consume,” Brown said about those factories churning out televisions, toys, shoes and electronics, sometimes at high costs to its poorly paid workers. “I find it very inspiring to work with workers in the developing world who brave just incredible odds to protect health and others’ rights, and exercise those rights.”

The network’s most recent project sent an eight-member team (a physician, industrial hygienist, pulmonary technician and nurse among them) to Cananea just across the Arizona/Mexico border to assess the health of miners at the city’s large, open copper mine.

“I have never seen a place as bad,” Brown said about the mine’s processing plant, where the ventilation system was dismantled by owners retaliating against worker demands for better maintenance and clean-up of the site. He said piles of rock dust the size of snow drifts posed a major health hazard to workers because of exposure to silica. He expects “a wave of lung cancers” in the area within 10 years.

The “little network,” as Brown called it yesterday during our talk on the steps of a classroom at San Diego City College, where APHA Annual Meeting attendees gathered to learn more about border health and safety issues, struggles for funding and visibility like many grassroots advocacy groups. Learn more, volunteer or donate to the cause here.

— D.C.

Students in Action!

The overarching message from the Student Assembly meeting: Students have the power to change the world! When it comes to advocating for health policies, students are uniquely positioned to affect change because they are (in no particular order) 1) energetic and motivated 2) have time 3) can vote 4) are viewed as unbiased 5) have the latest research knowledge and 6) are media darlings.

Panelists Breanna Lathrop and Chris Griggs are deeply involved in the success of HealthSTAT (Health Students Taking Action Together) in Georgia, a statewide nonprofit organization started in 2002 by a small group of medical students concerned about uninsured Americans. Now it is represented by more than 250 health professions students at Georgia universities and is funded primarily through grants from state and national organizations. Breanna and Chris helped lead a successful campaign called “Grady is Vital” to fund an Atlanta hospital set to close due to budget concerns.

“We need to sustain this enthusiasm, regardless of outcome of the presidential election,” said Lissa Knudsen, co-chair of the Student Assembly’s Action Committee. “We need to capitalize on what we’ve started to do. We need to get organized and come together. This is an opportunity for our generation to resist the idea that we are disengaged and apathetic — and this particular niche of students in public health is a powerful group.”

Students who want to get involved with the APHA Student Assembly can e-mail studentmeeting@aphastudents.org or visit the Student Assembly booth at the Public Health Expo.

— P.T.

Public health party people

APHA's Committee on Affiliates honored some of the best and brightest from the nation's 53 state and regional public health associations last night during the CoA's annual reception.

Photos by Jim Ezell/EZ Event Photography

Sunday’s Have You Heard...

Welcome back!: Kick off your APHA Annual Meeting experience by attending the Opening General Session from noon to 2 p.m. in the San Diego Convention Center’s Exhibit Hall D. Hear from APHA Executive Director Georges Benjamin as well as keynote speaker Michael Marmot, chair of the World Health Organization’s Commission on Social Determinants of Health. And if you seriously high-tail it to the PubMart exhibit at the Public Health Expo after the opening session you can catch a book signing with Marmot from 2:30 to 3 p.m.

Believe us, we know how you’re feeling: Overwhelmed as you flip through the hundreds of pages of the Annual Meeting program? Don’t fret, just stop by the APHA Member Orientation to the Annual Meeting, session 259, from 3:30–5 p.m. in Meeting Room 10 of the San Diego Convention Center and get all the basics you need for a fulfilling — and fun — meeting.

Hallelujah!: Like George Michael once sang: You’ve got to have faith. So take a bit of a break from your business meetings and note-taking to stop by the 10-year anniversary celebration of APHA’s Caucus on Public Health and the Faith Community today from 4 to 6 p.m. in Meeting Room 1B of the convention center.

I see public health workers: Visit the vision screening van, provided by the Vision & Eye Health Work Group, at the Public Health Expo, booth 2243, today through Wednesday.

Border justice

“Tijuana’s coming here since we can’t go to Tijuana,” said Maquiladora Health and Safety Support Network Coordinator Garrett Brown, as a gaggle of APHA Annual Meeting attendees gathered at San Diego City College this afternoon for a presentation on labor and environmental conditions in the foreign-owned factories along the U.S./Mexico border.

About 55 of us had expected to board buses at noon and head across the border on the eve of our “Public Health Without Borders” meeting, but recent drug-related violence had the San Diego Maquiladora Solidarity Network cancel the tour for the first time. The group organizes regular tours to bring light to the often intolerable conditions in the foreign-owned factories in Tijuana known as “maquiladoras.”

“It’s not because Tijuana is any more violent than say Chicago or Los Angeles,” Brown said. “It’s that the violence has become more rampant and generalized.”

Antonia Arias, a Mexico native who has worked in several different Tijuana factories, spoke at the presentation about the conditions in far too many work environments, where workers handle toxic, carcinogenic chemicals without protective equipment and are exposed to sexual harassment, unsafe working conditions and low wages. Antonia said that after seven years of handling acetone at a factory producing glass lenses, she cannot be near the chemical without her throat and mouth burning. Other commonly used chemicals have been linked to lung disease in long-time workers.

Giving proof that community-level activism can change the world, Amelia Simpson of the local Environmental Health Coalition told how, after more than 15 years, an abandoned factory site with thousands of pounds of toxic waste was cleaned up. Lead levels at the Metales y Derivados abandoned lead smelter were up to 250 times higher than acceptable federal environmental standards. But the coalition, working with a group of local activists, convinced the government to step in and oversee the clean-up.

“This is an example of how a marginalized, very low-income community can raise their voices and get justice,” Simpson said.

Vist the blog tomorrow for a one-on-one interview with Maquiladora Health and Safety Support Network Coordinator Garrett Brown.

— D.C.

Excuse me, do you know where…..

“Public Health Without Borders” is the seventh Annual Meeting for this blogger, and I have to say that San Diego is the most scenic, tranquil setting for covering public health’s pre-eminent gathering so far. Plus, it’s warm and sunny (which is probably just the Floridian in me, but I digress….)

Not only is it nice outside, it’s pretty nice inside too. To pick up your meeting tote and final program, you’ll take a walk through the convention center’s Sails Pavilion, which lives up to its marine-inspired name. Surrounded by glass and sunlight, grab a seat in the pavilion’s Mix and Mingle Lounge and take advantage of free Wi-Fi, comfy cushions and the chance to meet your fellow public health protectors from around the nation and the world. As you walk into the pavilion, on your right are a row of glass doors leading to the outdoor terrace, which is dotted with tables and chairs for your leisurely pleasure.

Also inside the Sails Pavilion is an activity posting center, where you can read up on any late-breaking activities that didn’t make it into the final program. And you’ll also find another area dotted with tables and chairs in the pavilion behind the Mix and Mingle Lounge.

If you’re looking for the Marriott Hotel and Marina (where a bunch of sessions and meetings are being held), walk out the front of the convention center and take a left — it’s just right next door. Food and eats? San Diego’s trendy Gaslamp Quarter is just a short walk away from the convention center’s front doors — walk up 5th Avenue and you’ll find yourself in the heart of this lively neighborhood.

And, it’s true, living on a restaurant-fueled diet for the next four days can put a dent in the pocketbook. But luckily, a fellow APHA blogger has scouted out a Ralph’s 24-hour grocery store less than a 10-minute walk from the convention center on G street between 1st and 2nd avenues. Muy convenient.

Where the Rubber Hits the Road: Translating Research into Practice at the Student Assembly Meeting

Attendees at today’s all-day Student Assembly meeting were treated with real-life case studies from three California practitioners, and even a plug for jobs with the state! (See the California Department of Public Health’s booth at the Public Health Expo for more information.)

Andrew McGuire, executive director of Health Care for All- California, described his group’s novel effort to gain the attention of the media and the public by staging 365 events in 365 days in 365 California cities — starting with the 365th smallest city and working their way up to a finale event that drew 4,000 people to Los Angeles’ City Hall in August 2007. Despite the governor’s two vetoes of a single-payer health plan in California, McGuire’s group raised awareness and established a network of 50,000 supporters.

“It was an audacious idea, but in the end it turned into a coalition of organizations,” he said.

In addition to expanding access to care, California’s Department of Public Health is hitting the streets to empower its citizens to be “Champions for Change” by eating healthy and exercising. Alyssa Ghirardelli, of the Network for a Healthy California program, described her efforts to motivate people to make healthy choices via media campaigns aimed at low-income mothers that stress self-efficacy, “you can do it!” techniques (Sample Slogan: My kitchen. My rules.).

California has also been ahead of the curve with other public health efforts, including smoking cessation and prevention. Colleen Stevens, with the state public health department’s Tobacco Control Media Campaign, told students that her office has been focused on changing social norms. In the past 20 years (ever since a 5 cent tax per cigarette pack was earmarked for tobacco control programs), hundreds of California cities have enacted smoking prohibitions and multiple state-wide regulations have gone into effect, including this year’s ban on smoking in a car with a child younger than 18. But it all began with educational campaigns to make people aware of the hazards of secondhand smoke.

“Everyone wants to start with the kids…but we started with adults because the only way to make lasting change with kids is to build a world where smoking is not tolerated,” Stevens said.

And California’s program is showing real results: The state has the 2nd lowest prevalence of smoking, and rates of lung cancer are declining four times as fast as the rest of the country.

– P.T.

Room with a view

I think knowing that a view like this is waiting for me outside might make it a little harder to concentrate inside. But, I'll try....

View from the San Diego Convention Center terrace

P.S. Get Personal

Upon checking in at the San Diego Convention Center, you’ll receive a handful of helpful stuff: a 136th APHA Annual Meeting tote bag, a nifty nametag and a phonebook for southern California. Oh wait....that’s not a phonebook, it’s the Annual Meeting final program!

Seriously, the phonebook comparison is a bit of an exaggeration. But just by a bit. This year’s APHA Annual Meeting spans five days, offers hundreds of scientific sessions, presents thousands of scientific papers on the latest public health research and practice, and welcomes more than 700 booths to the Public Health Expo. So, the final program is no small potato — it’s more like an all-you-can-eat buffet.

But here’s where a little public health preparedness comes in handy. If you’ve already registered for the meeting, you can go online now and access the APHA Personal Scheduler. The scheduler allows you to browse the entire program, including room numbers and locations, and prepare a personalized meeting itinerary that you can access from any computer with an Internet connection.

And you can change and update your itinerary whenever you please as well as print out a hard copy. Now, how convenient is that?

Go West!

The wind is blowing a little cooler, the trees are getting a bit barer and this blogger has already seen her first Christmas commercial. All signs point to one thing: It’s APHA Annual Meeting time!

In less than one month, sun-filled, sandy beached San Diego will welcome about 13,000 public health workers for APHA’s 136th Annual Meeting, which this year has a theme of “Public Health Without Borders.” So, pack your bags, roll up your posters, and slip a few hundred business cards into your wallet (the Annual Meeting is a social networker’s dream come true) and join the public health pilgrimage to California.

Just a few of 2008’s must-see highlights include opening session speaker Michael Marmot, chair of the World Health Organization’s Commission on Social Determinants of Health; a Wednesday afternoon closing session featuring three former U.S. surgeons general; a Monday afternoon town hall meeting on health system reform to which representatives from both presidential campaigns have been invited; and the Sunday night showing of Emmy Award-winning Sarah Jones’ “A Right to Care,” her one-woman performance piece.

And, of course, don’t forget to sign up for daily e-mails from APHA’s Annual Meeting Blog. We’ll be posting multiple times a day, covering scientific sessions, social gatherings and other blog-worthy, can’t-miss events. And this year, the blog will also feature a list of daily top picks posted every morning, bright and early.

For all the details, including this year’s online program, check out APHA’s Annual Meeting Web site.

See you in 22 days!

Meeting by the sea

Already getting ready for APHA’s 136th Annual Meeting in October in San Diego? So are we. And not only are we looking forward to some hot topics inside the convention center, we’re looking forward to the hot weather outside the convention center (and not lugging our big winter coats from room to room). We can already smell the salty breeze......

But before you pack your favorite beach towel, don’t forget to subscribe to the Annual Meeting daily blog so you can begin receiving updates via e-mail in the fall. Daily postings will begin shortly before the Annual Meeting starts and go throughout the meeting, covering scientific sessions, social events and much more.

And don’t forget your sunscreen!