Closing Session: 'Social justice is the foundation of our field'

The promise of health reform is not safe — that was the message during this year's Closing Session in Denver, which opened its mountainous arms to more than 12,000 APHA Annual Meeting attendees.

Despite its potential to expand coverage to millions, its historic investment in prevention and wellness, and projections that it will save billions of dollars in the long term, the nation's landmark health reform law is vulnerable — especially in light of the recent congressional elections.

"This is a good bill, not a perfect bill," said session speaker Paul Jarris, executive director of the Association of State and Territorial Health Officials, who described the new health reform law as a substantial step forward.

Still, the fight for the law's survival isn't over, he noted. Almost half of states are suing the federal government over health reform, 40 different bills have been introduced in state legislatures to prohibit some aspect of reform and with a number of new governors poised to take office at a crucial time in reform's implementation process, problems are sure to arise. The answer? Become advocates, he said.

"Do you know this bill," Jarris asked. "Do you know how to talk about it in a way that everybody can understand?"

Maryland Secretary of Health and Mental Hygiene John Colmers, who described himself as a "passionate incrementalist," also called on session attendees to use storytelling to advocate for health reform.

Colmers cautioned that budget and deficit issues are going to drive much of the ongoing reform debate, adding that when "I think about public health (budgets), I shudder."

Unfortunately, reform supporters never convinced enough people of the notion that it's a good thing to pay into a system that will provide care for themselves and their families, said session speaker Sara Rosenbaum, chair of the Department of Health Policy at George Washington University. The great communication task before us is to bring the issue of health reform back to an everyday level — to help people grasp the enormous opportunity before us that we may be in danger of losing, she said.

"It's very clear we have work to do," said APHA Executive Director Georges Benjamin, who asked the Closing Session audience what they would do to ensure the promise of reform when they return home.

He called on them to do three things: Meet with your local elected officials and tell them what you want; when they don't vote the way you think they should, remind yourself that they work for you; and get off the bus and get into the streets. Demand health, Benjamin said, demand social justice.

Well, it's been an amazing meeting — the best that this blogger has had the privilege to attend. The energy to bring public health's unique form of social justice to communities worldwide has been palpable.

Let's bring that energy with us next year to the nation's capital for APHA's 139th Annual Meeting, which will have a theme of "Healthy Communities Promote Healthy Minds & Bodies."

"We reaffirmed that social justice is the foundation of our field," said new APHA President Linda Rae Murray at the Closing Session. "This attempt to drive our nation backward should not be a surprise. But I'm not worried. We're public health — we won't be bamboozled."

See you next year in Washington, D.C.!

— K.K.

Above, Closing Session speakers from left to right: Sara Rosenbaum, Paul Jarris, John Colmers and session moderator Joanne Silberner of National Public Radio. Photo by Kim Krisberg

Go for launch!

When Neil Armstrong took that one giant leap for mankind on the moon’s surface more than four decades ago, he probably had no idea how the space program would turn into a public health Hercules.

The NASA Applied Sciences Program links data gathered from space to projects that track malaria, forecast dust storms that can trigger asthma attacks, predict possible influenza outbreaks and more. A key focus is to monitor ways climate change is impacting health because, as NASA’s John Haynes said during a Wednesday Annual Meeting session, air quality, water and other things tracked from space “have a direct impact on public health issues across the globe.”

NASA satellites orbit the Earth and gather “slices of data” on weather patterns, vegetation density and countless other factors “much like you’re peeling an apple,” Haynes said during the session “NASA: A Unique View of the Earth for the Study of the Environment and Possible Associations with Disease Occurrence.”

The satellite data is not just for seasoned public health professionals. NASA has a student research program designed to help undergraduate, master’s level and even high school students get involved in harnessing space info for the greater health good. Students work with a NASA mentor to use data that can then be used for community-based projects like education outreach on the threats of tick-borne diseases.

Also, a pilot program in three U.S. cities is working to go further than National Weather Service heat advisories and target people at high-risk for heat-related illness and link them with services. One presenter talked of his projects aimed at giving advance notice to school nurses about dust storms and tracking pollen blooms that often set off asthma and allergy attacks.

“We’re looking at the best science,” said Stanley Morain of the University of New Mexico. “We’re really trying to get to the heart of our ability to do these things.”

Talk about a giant leap for mankind.

— D.C.

Above image courtesy NASA photo galleries

When disaster strikes

It’s been nearly seven months since one of the worst environmental disasters in U.S. history, and still the Gulf Coast oil disaster has left us in very murky waters, not to mention leaving behind a number of ongoing health challenges.

Today’s special session on "The Public Health Implications of the Gulf Oil Disaster" featured public health leaders who worked directly on the recovery and clean-up efforts in the aftermath of the explosion of a BP oil rig last spring. The first-hand accounts and pictures of the scene reminded participants of the magnitude of the disaster and why Gulf Coast residents and recovery workers are still reeling.

John Howard, director of the National Institute for Occupational Safety and Health, explained that there's not a whole lot known about the long-term health effects of crude oil. Even following the notorious Exxon Valdez oil spill in 1989, there was not much research done on the chronic health effects related to the spill. However, NIOSH is doing its part to lead efforts in ensuring worker safety and encouraging future research on this obvious knowledge gap.

Howard said a lesson learned after Sept. 11, 2001, was that there was no existing roster of workers that would allow health professionals to follow up on the possible health problems related to cleanup. So, NIOSH led efforts to develop a roster of workers responding to the recent Gulf Coast oil disaster, which includes 55,000 people. This roster is now available to researchers.

Alabama Health Officer Donald Williamson described the oil spill as “an event that had a cataclysmic economic impact on the state of Alabama and continues to have a lasting impact on the health and well-being of residents.” Research shows higher rates of reported depression and anxiety among residents, especially considering the economic impacts for fisherman and those whose livelihoods depend on tourism.

Despite seafood testing and other efforts used to determine which areas could be safely reopened to fishing, research has shown that the public is still wary about eating Gulf Coast seafood and restaurants avoid serving seafood from Gulf Coast suppliers.

Session presenters stressed that improved communication and health messaging is still needed to communicate the public health role in the Gulf Coast recovery and respond to misinformation.

— M.S.

A little birdie told me so: Tweet of the Day

On this last day of another fabulous APHA Annual Meeting, the Tweet of the Day from those of you using the hashtag #apha10 comes from — who else? — Opening Session speaker and Twitterwer CornelWest: We're in this together - cross color, cross culture, cross class. Let your light shine.

A public health program with teeth

We all know prevention, promotion and education work. But it's still incredibly reaffirming to learn about a fairly new initiative that's already making huge inroads.

That was the case today during a session on "Cavity-Free At Three: An Oral Disease Prevention Program for Infants and Toddlers in Colorado."

Begun just a couple years ago, Cavity-Free At Three educates families and health providers on good oral health and cavity prevention, pushes for the integration of oral health into well-child visits, helps children find dental homes and trains health workers in oral health risk assessments. The program puts a special emphasis on reaching pregnant women, spreading the word that mom's oral health can affect the health of her baby and that it's perfectly safe for pregnant women to seek dental care. Like the name says, the initiative's goal is for all Colorado kids to have cavity-free smiles by age 3.

Session presenter Karen Savoie, who directs education for the oral health initiative, noted that dental caries is the most common chronic childhood disease — five times more common than asthma. Eighty percent of the disease is in 20 percent of the population and like many diseases, dental caries is often a disease of poverty. In Colorado, about 8 percent of kids have experienced some tooth decay by age 1, with that number going up to 70 percent by age 4, Savoie said. To reach as many children as possible, the initiative works hard to bring workers across various health disciplines together in the name of prevention.

"We will all gain strength by sharing the responsibility of early childhood caries," Savoie said.

So far, more than 600 workers in Colorado have received training via Cavity-Free At Three, with 24 sessions taking place in 2010, thousands of fluoride varnish and oral health kits have been distributed, and more than 10,000 Colorado infants and families are estimated to have received services through the program, according to presenter Jack Westfall, a family doctor involved in the effort.

"Primary care providers are uniquely positioned to help," Westfall said.

On the public health side, three Colorado counties have integrated the oral health program into their work with the help of technical grants from Cavity-Free At Three, said session president Melissa Broudy, who worked with Jefferson County Public Health on the effort. And the results have been impressive: Colorado's Eagle County served 253 children in 2008 (accounting for 15 percent of all kids younger than 5 in that county); Grand County served 256 children over a two-year period (or 33 percent of all kids younger than 5); and Jefferson County did more than 1,500 screenings, with an additional 500 screenings in collaboration with Head Start.

That makes me smile.

— K.K.

Above illustration courtesy iStockphoto

Honor society

Let's hear it for this year's APHA award winners! For more on APHA's many awards, which range from honoring those who excel in advocacy to recognizing outstanding public health students, click here.

Above, recipients of APHA's annual awards smile for the camera during Tuesday night's Public Health Awards Reception and Ceremony in the Colorado Convention Center. Photo by Kenneth Bordelon

Keep it simple

The H1N1 flu outbreak keeps bringing us public health lessons, especially when it comes to the best ways to get important information to the people who need it most.

Folks with the Centers for Disease Control and Prevention’s Division of Global Migration and Quarantine are constantly working to prepare for the next emerging health threat. What came out of recent evaluations of public information efforts during the H1N1 pandemic underscored the need to keep messages simple and easy to understand, no matter what the audience.

“During this event, we were able to incorporate lessons learned as we went,” said Amanda McWhorter, a CDC health communications specialist and presenter during the Tuesday afternoon Annual Meeting session “2009 Pandemic influenza (H1N1) Communication Activities at CDC: Focusing on Specific Audiences and Settings.”

Some of those lessons learned:

— Establish partnerships and channels (think websites and e-cards, but also handouts and posters)
— Coordinate messages to ensure consistency
— Adapt quickly
— Present messages in plain language

And those lessons hold true whether the audience is international travelers, the K-12 school system, child care providers, colleges and universities, or businesses.

When needed, public health communicators can step up their game to better respond to concerns in real time, said session moderator Gabrielle Benenson, also with CDC.

“There’s sort of this 'in an emergency’ thing that happens and then a ‘day-to-day’ thing that happens,” Benenson said.

A recently produced “How to Clean and Disinfect Schools to Help Slow the Spread of Flu” handout breaks it down by defining the difference between cleaning, disinfecting and sanitizing and even listing bulleted, step-by-step instructions. That’s an example, session presenter and CDC staffer Tiffani Phelps said, of how to present easily understandable and helpful health information.

How will you know what information people need? We keep hearing it, but it never goes out of style: Build relationships and partnerships, and get out there and ask.

Check out CDC's free flu resources here.

— D.C.

Say cheese!

Don't forget to stop by the Everything APHA booth at the Public Health Expo to grab a souvenir T-shirt from this year's Annual Meeting.

Photo by Michele Late

Movie night

Public health education comes in many different shapes and sizes. Traditional forms of learning certainly serve an important role. (Lord knows you wouldn’t be here at APHA’s 138th Annual Meeting if it weren’t for the countless scientific sessions on today’s most pressing public health topics).

But multimedia use and visual media in public health practice is equally as important in reaching new audiences, and a Tuesday session of APHA's Film Festival showcased some very powerful documentaries and short videos on health topics such as the correlation between spirituality and health outcomes, the impact of the U.S. health system on the physician-patient relationship, lessons learned in hospice care, work with terminally ill patients and much, much more.

“Money-Driven Medicine” describes how modern health care is contributing to the erosion of the physician-patient relationship and is ultimately having a detrimental effect on health outcomes. The film, which incorporates a series of interviews with doctors across the country as well as leading health care experts, depicts medicine as something delivered through a production line. Similar to producing widgets, physicians are increasingly pressed to see a greater volume of patients, which leads to less time spent with each individual patient. The underlying question the filmmaker poses is: Can health care truly function as a public good or is it a business?

“Eating Alaska” was an interesting look at what happens when a vegetarian moves to Alaska and marries a commercial fisherman and deer hunter. It chronicles her search for sustainable, healthy eating and how it led her to question some of her personal preferences and food choices. The film delves into issues relating to the U.S. food system and addresses the fact that lifestyle choices and healthy eating are directly influenced by where one lives (and what we put into our mouths).

Check out these and other films previewed at the APHA Film Festival. I guarantee they’ll touch a chord.

— M.S.

Wednesday's Have You Heard

Bugged: With climate change on the move, trends in vector-borne diseases may be poised for major changes. Learn how public health workers are fighting back at session 5057, "Malaria and Vector-Borne Diseases," on Wednesday from 8:30 to 10 a.m. in room 107 of the Colorado Convention Center.

Space cadets: Go for launch! Check out session 5110, "NASA: A Unique View of the Earth for the Study of the Environment and Possible Associations with Disease Occurrence," on Wednesday from 10:30 a.m. to noon in Mineral Hall B of the Hyatt Regency. Far out.

Hook, line and sinker: Fish is often hailed as part of a nutritious diet, but are there risks? Cast your line at session 5150, "Looking for Social Justice Hooks: Subsistence Fishing and Fish Advisories," on Wednesday from 12:30 to 2 p.m. in room 109 of the convention center.

Farewell 'til next year: Cap off your 138th APHA Annual Meeting experience at the Closing Session on Wednesday from 2:30 to 4 p.m. in Four Seasons Ballroom 1 of the convention center. This year's speakers include Maryland Secretary of Health and Mental Hygiene John Colmers and APHA President Carmen Nevarez. The session is moderated by NPR's Joanne Silberner.

Get empowered all over again: Video of Jenkins, West is up!

They're here! Video of APHA's Opening Session speakers, including Drs. Bill Jenkins and Cornel West, is up!

Below, part one of Cornel West's Opening Session speech and part one of Bill Jenkins' speech. Visit APHA's YouTube channel for West's and Jenkins' entire keynote addresses and more.

Let it snow, let it snow, let it snow

This Florida girl is very unhappy with the turn in the weather. But, never fear. It's warm and cozy inside the convention center.

Above, snow hits the APHA Annual Meeting in Denver. Photo by Michele Late

Three of a kind

It’s lonely being a state surgeon general.

As of today we have three — Joseph Thompson of Arkansas, Ana Viamonte Ros of Florida and Kimberlydawn Wisdom of Michigan. They told a packed Annual Meeting session audience what it’s like blazing the trail as a state-level public health champion.

“When I was the lone surgeon general, I was kind of concerned. It’s kind of lonely to be the only one, and your conventions are small,” Wisdom joked. “I was so happy when there were others.”

Each of those three states has a different model of how the surgeon general’s position is structured, but all have been appointed by their respective governors. A University of Michigan study highlighted at the Tuesday session, "Health Reform and the Changing Role of the Public Health System: The Experience of Arkansas, Florida and Michigan," found people like the idea of a state surgeon general but that a lack of “bi-partisan buy-in” by state legislatures makes the person in the seat vulnerable to political criticism.

“And public health certainly doesn’t need any more criticism than it already deals with,” researcher Jodyn Platt said to laughter from the audience.

Having a state public health bully pulpit has led to great success. Arkansas' Thompson cited a 45 percent reduction in youth smoking rates in recent years, Wisdom talked of a wellness effort that’s being led by middle-schoolers in under-served Michigan communities and a well-supported anti-obesity agenda, and Florida's Ros blocked efforts to scale back childhood vaccinations.

Still, Wisdom was powerless to change the minds of decision-makers who did not earmark any of the state's landmark tobacco settlement funds for tobacco prevention and cessation in Michigan. And legislatures in both Florida and Michigan have sued to halt implementation of the federal health reform law.

Thompson said he doesn’t know if his input kept his state out of that fray, but he was sure to make it clear that the law’s implementation will mean $3.5 billion in yearly federal money to insure more Arkansans.

Former U.S. Surgeon General David Satcher, also an advocate of state surgeons general, said he’s “optimistic” about health reform implementation.

“We have a tremendous opportunity, I think, with health reform,” Satcher said. “The fact of the matter is, we’re serious as a nation about the prevention agenda.”

State surgeons general can move that agenda forward, Ros said, but only if politics take a back seat.

“I think we struggle in public health to define who we are,” she said. “I think it’s very important to de-politicize public health. We are non-partisan. We should be bi-partisan.”

— D.C.

Above, former U.S. Surgeon General David Satcher moderated an Annual Meeting session on health reform and public health. Photo by Jim Ezell/EZ Event Photography

A little birdie told me so: Tweet of the Day

Today's Tweet of the Day from those of you using the #apha10 hashtag comes from Twitterer ar0ugE: Did you know that 90% of Americans underestimate by about 642 calories when they eat unhealthy foods. 642!!

Eww. I will now officially stop eyeing the chocolate-covered pretzels at the convention cafe.

Justice! It's what's for dinner

I don’t know about you, but every time I walk the halls of the Colorado Convention Center, food is on my mind. Maybe it’s the hot-off-the-fryer donuts or that intoxicating smell of roasted nuts that gets me every time.

Today’s special session, "Social Justice, It’s What’s Not for Dinner: Understanding and Overcoming Food System Disparities to Promote Health," gave me more food for thought, but of the healthier variety.

Presenters discussed the adverse health impacts of the U.S. food system and the important role for the public health community in redesigning a sustainable food system that better meets the health needs of all Americans, including those who work to grow, care for and distribute our food.

Don Villarejo, founder of the California Institute for Rural Studies, spent more than 20 years looking at the incredible health inequities facing farmworkers. Out of an estimated 1.4 million U.S. crop workers, about 30 percent have family incomes below the federal poverty level. Obesity, high cholesterol, high blood pressure, dermatitis and decayed teeth are among the poor health outcomes researchers have found among young, active, male farmworkers. The worst part is that the lack of access to care results in undiagnosed and untreated health conditions, and the high prevalence of chronic diseases in farmworkers is, for the most part, preventable through public health interventions, Villarejo said.

Session presenters also touched on the impacts of the dominant food system, which is characterized by consolidation and aggregation in food processing. The structure of the U.S. food system, they said, has led to an erosion of land ownership by farmers, a loss of local control, environmental degradation and health threats caused by industrial farm pollution, and a narrowing of access to fresh, nutritious foods for many low-income communities.

So, where does public health fit in? Health practitioners are critical players in promoting infrastructure and policy changes that enhance food justice and improve people's health, presenters said. There are many drivers for a better food system, but the connection to health is a critical one and will create greater demand for a sustainable, healthier food system.

Let's eat!

— M.S.

Look Ma! We're on TV!

 

Here at APHA, we're media darlings — we like to think so, anyway.

And this year's Annual Meeting is attracting a slew of media attention covering some of latest public health data coming out of Denver. Take a gander at some of the coverage for yourself:

USA Today: Fast food survey: Nearly all are high in calories, sodium
MSNBC.com: Study finds worst fast food meals for kid
CNN's 'The Chart' Blog: Study: Girls take more chances during first sex
Associated Press/The Washington Post: Sex, drugs more common in hyper-texting teens
WebMD: Girls More Likely Than Boys to Have Unprotected First Sexual Encounter
HealthDay News: Teens Waiting Longer for Sex, But Still Taking Risks: Analysis
New York Times: Behavior: Too Much Texting Is Linked to Other Problems

Above, a clip from a local news broadcast covering new fast food marketing data presented at APHA's Annual Meeting.

Strange phenomena

This year, one of the top news stories about cancer was grim: The disease is projected to replace heart disease as the leading cause of death worldwide. But at a Monday session on "Alternative and Complementary Health Practices for Cancer and Chronic Diseases," APHA Annual Meeting-goers glimpsed a more upbeat cancer topic that gets little attention from researchers.

Doctoral candidate Kelly Turner, MSW, has been focusing her research on trying to understand why and when spontaneous remission of cancer occurs. She told session attendees that spontaneous remissions are rare events, and defined the phenomenon as the "complete or partial, temporary or permanent disappearance of a tumor, metastasis or blood cancer." But the most important part of the definition, she said, is that it happens in the absence of Western medical treatment or after Western treatment has failed to produce results. According to Turner, there are only about 20 cases of spontaneous remissions published each year in medical journals.

To study the topic, Turner traveled the globe to study unpublished cases. Interviewing healers and survivors alike, she zeroed in on the physical, emotional and spiritual commonalities that resonate through survivors' and healers' recollections of how they were able to lick cancer. For example, one woman attributed her cancer's spontaneous remission to diet. In other words, the woman simply stopped eating for two weeks, and when she did begin to eat again focused her diet mainly on vegetables — no meat, no dairy, no sugar — and juiced cabbage. Other survivors attributed their spontaneous cancer remissions to various herbs and vitamins.

One Japanese man attributed his spontaneous remission 22 years ago to surrendering to his cancer by increasing his positive emotions. Simply stated, after being sent home from a hospice with no hope, the man decided to just embrace his cancer and decided that he would "think of his cancer as his child," Turner explained. The man sent his "unconditional love to it."

Surrendering, being at peace with dying and being at peace with living, as well as deeper spirituality, also resonated throughout Turner's qualitative research.

Turner believes that such occurrences can shed light on how cancer goes away.

"It is very rare and a lot of people don't study this because it is so rare," Turner said. "But the implications of what it could mean, if we could understand what is going on, are quite huge. From a public health standpoint, it also might reveal inexpensive cancer treatments."

— T.D.J.

Question of the Day: Still got hope?

If you were lucky enough to get a one-on-one meeting with the President of the United States, what advice would you offer for improving the nation's health? Let us know your thoughts in the comments section below.

The few, the proud

Where were you at the crack of dawn? A small but chipper gaggle of public healthers braved the early-morning chill for the Physical Activity Special Primary Interest Group’s third annual 5K Fun Run/Walk, and we were wondering what happened to the rest of you.

The lovely trek down Cherry Creek Trail behind the Colorado Convention Center gave some of us a chance to get a little exercise and fresh air before today’s marathon of scientific sessions. Studies show regular physical activity improves mental alertness, so squeeze a walk in today if you can.

I think it’s true that Denver’s high altitude makes running a little more challenging. During the run I felt like I was really haulin’ the mail, but my time was a couple of minutes slower than the 5Ks I run back home in Virginia. Any of you finding it challenging to work out here in Colorado?

For the record, I came in fourth behind two locals (they’re used to the thin air) and a woman from California who’s training for a 50-mile ultra marathon. One great thing about the 5K, though, was that it was “low-key” and non-competitive, with walkers welcome. Participants were awarded Physical Activity SPIG hats, and I’ll be wearing mine with pride.

And while the SPIG does a great job promoting physical activity, this year’s turnout of about 20 people was the smallest yet, despite Mother Nature’s mercy in giving us pretty much perfect running weather. Any ideas on how the SPIG can promote the run so more of the 12,000 or so people gathered for the Annual Meeting take part?

— D.C.

Above, Annual Meeting attendees do the right thing (and make the rest of us look bad) by joining the annual crack-of-dawn fun run and walk. Photo by Jim Ezell/EZ Event Photography

The old college try

Sure, college is place to grow, a place to experiment and try new things. It's also a place where many young people might try their first cigarette. So, why make that unhealthy temptation any easier to fall prey to?

That was the message during yesterday evening's session "SFU: Smoke-Free Universities," where public health students and teachers shared their experiences campaigning for smoke-free policies on campus.

At California State University-Northridge, Kathleen Young, who's with the university's Department of Health Sciences, helped create COUGH (Campuses Organized and Unified for Good Health) in 2008. The neat acronym wasn't the group's original name — the switch came because members wanted the message to be about good health and not convey an adversarial tone toward smokers, Young told session attendees.

Young said there's five phases to such an effort: assessment and investigation, strategizing and planning, recruiting, campaigning and implementation. The California campus currently bans smoking within 20 feet of entrances (though, it's not always followed), and COUGH is hoping to convince university decision-makers to create designated smoking areas and eventually go smoke-free in 2013, Young said.

Already, more than 200 colleges and universities nationwide have tobacco-free campus policies, and the American College Health Association recommends campuses adopt 100 percent indoor and outdoor tobacco-free policies. Tavis Glassman, an assistant professor at Ohio's University of Toledo, has been working for more than two years to help his campus go tobacco-free.

Some lessons he's learned along the way? It's important to persuade a committee or coalition to endorse the initiative — "you don't want to be the only person taking heat on this issue," he told session attendees. Also, educate the campus on the need for such policies and conduct surveys before taking a vote on smoke-free sentiment.

The survey lesson came after a 2009 student vote on the issue, in which only 58 percent voted for more restrictive tobacco policies, with students, faculty and staff voting almost identically. Also, women tended to support the effort at a higher rate than men. Needless to say, it wasn't the voting result he had hoped for, Glassman said.

Other lessons Glassman shared: Always be ready to advocate, don't get intimidated by your opponents, and try to tie your tobacco-free initiative to the university's mission. Be tough, he said, and persevere.

— K.K.

A job well done

Don't forget to check out APHA's CareerMart booth at the Public Health Expo or visit CareerMart online.

Above, Annual Meeting attendees take part in CareerMart coaching at the Public Health Expo on Monday. Photos by Jim Ezell/EZ Event Photography

Moments from the hot tub

I started my job at APHA less than two weeks ago. At the time, I knew the APHA Annual Meeting would be a quick education on all manner of public health issues. But I had no idea how much I'd learn just sitting in my hotel's hot tub.

It was 7:30 Sunday morning. Hardly a time when most of us are thinking about work.

Five ladies, public health workers from around the country most of whom had never met before, sat in the hot tub for a little relaxation and what turned into an impassioned discussion about smoking cessation, of all things.

Of course it did.

Because if I've learned anything in my few days at APHA, it's that the people in this field are passionate about their work. They can toss out statistics on teen smoking and the effectiveness of e-cigarettes in cessation efforts without notes or preparation. They trade stories of smoke-free campuses and the days when surgeons would smoke at the nurses' station.

That's the beauty of the Annual Meeting, I'm learning. It brings together people who would never have the opportunity to meet each other, and it gets them talking, trading ideas and working together.

There are 12,000 meeting attendees in Denver this week. Who will you wind up talking to?

— C.T. (Whose full name you'll soon be seeing the pages of The Nation's Health)

Tuesday's Have You Heard

Work it out: Join APHA's Physical Activity Special Primary Interest Group for their 3rd Annual 5K Fun Run and Walk. Meet Tuesday morning at 6:15 a.m. in the outdoor plaza of the Colorado Convention Center.

Get tested: Heard about the new Certified in Public Health exam, but not quite sure what it's all about? Check out session 4004, "Everything You Ever Wanted to Know About Being Certified in Public Health, But Didn't Know Who to Ask," on Tuesday from 8:30 to 10 a.m. in room 702 of the convention center. Visit the National Board of Public Health Examiners for more.

Health reform needs you!: Join moderator and former U.S. Surgeon General David Satcher for session 4171, "Health Reform and the Changing Role of the Public Health System: The Experience of Arkansas, Florida and Michigan," on Tuesday from 12:30 to 2 p.m. in room 113 of the convention center.

The medium is the message: How do you wade through the ever-changing world of media to reach your communities with critical public health info? Take in some tips at session 4277,"How to Use Media and Social Networking Effectively in Public Health Settings," on Tuesday from 2:30 to 4 p.m. in room 501 of the convention center.

Best and brightest: APHA's Annual Public Health Award Reception and Ceremony will honor the best and brightest in the public health field on Tuesday night from 6 to 8 p.m. in the Four Seasons Ballroom of the convention center. Honorees range from pioneers in the fields of research and advocacy to national legislators who've worked to support public health. Come on out and give your colleagues a round of applause!

Holding a town hall without any walls

If you invite them, will they tweet? That was the question the Centers for Disease Control and Prevention faced when it held its first-ever Twitter town hall in support of HIV/AIDS testing in June.

Timed to tie in with National HIV/AIDS Testing Day, the 90-minute town hall invited people across the Twittersphere to weigh in on the topic of testing by using a special hashtag. The event was promoted in advance online and through partners.

CDC officials and leaders on HIV/AIDS led the conversation during the town hall, which resulted in more than 1,000 tweets from 145 users, as reported during a social media session at APHA’s Annual Meeting on Monday, "The Role of Social Media in Public Health."

Ultimately, the HIV/AIDS testing town hall reached more than 243,000 Twitter users, CDC officials estimated. Which means that if you do it right, heck yes, they’ll tweet.

Healthy People 2020: Just what we’ve been waiting for

APHA Annual Meeting-goers got an inside look at the soon-to-be-released Healthy People 2020 today, and boy-oh-boy was it cool.

With more than 580 health objectives and 42 topic areas (including new ones like LGBT health, genomics and preparedness), we’re predicting this will be the hot new resource for public heath workers when it launches Dec. 2.

Instead of the old dead-tree format of the resource (which frankly, weighed more than a phone book), Healthy People 2020 will exist online in electronic form — meaning that updates can be made as needs arise. And it will take into account new population categories, such as people in prison and veterans. All in all, it’s just what many folks in public health have been waiting for.

“Healthy People is well on its way,” said Penelope Slade-Sawyer, deputy assistant secretary for health, disease prevention and health promotion at the U.S. Department of Health and Human Services. “I’m excited about it. I hope you are excited about it.”

Yep, Penelope, we sure are.

— M.L.

Amen to good health

Breaking the cycle of health disparities starts at the local level, especially when it comes to rural health issues. Today’s session on "Partnering with Rural Black Churches to Promote Men's Cardiovascular Health" served as an important case study in community-based participatory research. It also showcased a particularly interesting pilot study that helps inform health interventions directed at typically hard-to-reach communities.

“Are We Our Brother’s Keeper?” is an innovative study and intervention program aimed at improving the health of black men living in Orange County, N.C. There's a significant need to reach this community on the topic of cardiovascular disease, especially as black men have a higher heart disease- and stroke-related mortality rate than other populations.

The study, a collaborative effort lead by Eugenia Eng, a program investigator with the University of North Carolina–Chapel Hill’s Center for Health Promotion and Disease Prevention, developed an intervention program that lay health advisors can use to confront disease disparity. The program created training tools to help lay health advisors engage black church members in discussions around health promotion and men’s health issues.

The study found that cultural tools, scripture as well as training grounded in religious context is critical in facilitating health education targeting the rural black men who are particularly vulnerable to cardiovascular disease.

What are some other key findings, you ask? Training that uses visual aids and creating a forum for black men to discuss health issues with one another is key to improving peer support and breaking the silence.

Health topics are deeply personal and because many communities lack a formal structure for health education and information, outreach efforts tied to community-based organizations and religious institutions can be an important partner-in-crime when fighting health disparities.

Learn more about the study here.

— M.S.

Recipes for prevention

Sure, the childhood obesity facts are grim: About 17 percent of U.S. children and adolescents are obese, and the rate has tripled in the past 10 years.

But once again, some public health heroes are showing us how to tackle that problem. A Monday Annual Meeting session, "Institute of Medicine Obesity Prevention Tools for Policy-Makers and Researchers," highlighted two recent reports that can serve as guidebooks for the public health community: "Local Government Action to Prevent Childhood Obesity" and "Bridging The Evidence Gap In Obesity Prevention: A Framework to Inform Decision Making."

APHA Executive Board member Adewale Troutman reminded the audience at the packed session to take on obesity as well as other pressing public health needs using a health equity lens. He shared success stories from Louisville, Ky., that have brought fresh produce to convenience stores in the city’s poorest neighborhoods and given children a voice in shaping health policy.

He encouraged improved coordination among agencies and organizations whose activities address determinants of health in areas such as education, housing and planning.

“That’s obvious, but we don’t do enough of it,” Troutman said.

The local government report, which already has been used to garner grant money in communities — including Troutman’s Louisville district — lays out specific action steps such as attracting supermarkets and grocery stores to under-served neighborhoods to build “food oases” as opposed to food deserts.

And once again, session presenters stressed the need to reach out to some non-traditional partners. Consider Dallas, said Eduardo Sanchez, where the Dallas Regional Chamber, made up of a number of Fortune 500 companies, has said educating young people is a priority, that disparities and determinants of health drive inequities in graduation rates, and that childhood obesity is a factor in need of serious attention.

“At the local level, there is the opportunity, I believe, to have those conversations, and in some communities more than others,” Sanchez said. “What works in Louisville may not be what works in Dallas or what works in Brooklyn, but those of you who are in those communities understand the culture.”

Take a cue from the reports, he said, which have science-based strategies that work.

“You don’t have to go inventing things," he said. "You can follow a recipe.”

— D.C.

A little birdie told me so: Tweet of the Day

Today's Tweet of the Day among all you social media gurus using the #apha10 hashtag comes from Twitterer danipoppins: Not that I would expect anything less - but love that there are breastfeeding lounges at the conference.

Right on, mamma!

A blog way from home

Take a break in the Mix and Mingle Lounge in the lower level of the Colorado Convention Center and swing by APHA's Social Media Desk while you're there.

Above, APHA Annual Meeting attendees take a break in the Mix and Mingle Lounge, top, and APHA staffers smile from the Association's Social Media Desk, bottom. Photos by Kim Krisberg

Motivational posters

If you haven’t found the time to make your way to a poster session, run, don’t walk (OK, walk, but quickly) to the back of the Public Health Expo and check out some of today’s most interesting research.

At the Monday afternoon session, topics ran the gamut from intimate partner violence to diabetes self-management to environmental health disparities to elder abuse. It’s fascinating to see snapshots of the studies that have been conducted across the United States as well as across the globe.

Looking at injury prevention through the eyes of teen parents, a study led by Paula Yuma in Austin, Texas, found that, surprisingly, most of the young mothers had a regular pediatrician and health coverage for their children, but they were also often getting erroneous safety messages from their own parents.

“We definitely need to expand our interventions and somehow interact with the teenagers’ parents,” said Yuma, a member of APHA’s Injury Control and Emergency Health Services Section.

Maybe it has no place in a blog, but a Centers for Disease Control and Prevention poster highlighted the fact that 70 percent of U.S. adults do not regularly access the Internet. Yes, 70 percent. That means a lot of nifty new online outreach tools aren’t getting out there at all.

“From a public health and program planning perspective, do we need to start thinking about people who aren’t online? That’s the question,” said lead researcher James Weaver.

Poster presenter Kimberley Bullard interviewed women at an abortion clinic in New York and found “serious access barriers” still exist. Those can be money, laws limiting the time frame of abortions and lack of reproductive health education.

“A lot of women just didn’t know they were pregnant for a long time,” Bullard said.

The poster sessions run until 5:30 p.m. today, from 12:30 p.m. to 5:30 p.m. Tuesday and 8:30 a.m. to 9:30 a.m. Wednesday morning.

— D.C.

Above, APHA poster sessions and their presenters in the Public Health Expo. Photos by Michele Late and Donya Currie

A welcoming climate

The good news: Environmental justice is getting more attention these days among a range of federal health agencies. The bad news: Research demonstrates that adverse health impacts from climate change, exposures to toxic agents and occupational injuries all have disproportionate impacts on vulnerable populations and marginalized communities and, unfortunately, there’s no easy fix.

It’s not all doom and gloom, though. Monday morning’s special session on "Federal Perspectives on Social Justice, Climate Change and Environmental Health" brought together leaders from a variety of national agencies to discuss what federal policy-makers are doing to address such issues and how federal agencies and national partners are working together. In the words of Linda Birnbaum, director of the National Institute of Environmental Health Sciences, we “use science to promote environmental and climate justice.”

Research shows that those who suffer most from the adverse health impacts of climate change are those least responsible for contributing to it. In fact, harmful amounts of ground-level ozone and air pollution are already having a disproportionate impact on communities of color and other disadvantaged groups.

The National Center on Minority Health and Health Disparities is making efforts to address determinants of health via studies on health outcomes among blacks and whites. The findings show that the built environment, housing, poverty and nutrition all factor into social inequities and health disparities. The biggest finding over a range of research efforts led by the center?: The smaller the income gap, the lower the level of health disparities.

Although there is no immediate or obvious policy fix, the U.S. Environmental Protection Agency is working to integrate environmental justice into its decision-making and — most importantly — into its rule making. EPA’s Office of Environmental Justice is charged with paving the way for integrating environmental justice into the regulatory process.

Isn't it nice to see issues of social justice make it all the way to the top?

Check out more on EPA's partnership for sustainable communities here.

— M.S.

The other long recovery

In the wake of such disasters as Hurricane Katrina, the earthquake that devastated Haiti and the BP oil spill earlier this year, here’s some encouraging news.

“There’s no shortage of good ideas,” architect Steven Lewis, president of the National Association of Minority Architects, said during Monday's session on "Dialogue on Haiti and the U.S. Gulf Coast: Collaborating to Protect Vulnerable Communities."

He showed slides of “soft houses” that can be built quickly and offer far superior protection than tents in a post-disaster situation. Also, there's a portable device that can sanitize drinking water in two to four hours relying only on the rays of the sun, and a single-family home can be powered by a Bloom Box using biofuel.

We’ve heard this many times, but it still holds true — what will work in Haiti and New Orleans and other devastated communities are the same things that have led to public health successes for centuries: partnerships with people who live in those communities.

For example, APHA Executive Board member Andrea Kidd-Taylor traveled to Haiti in August to help start a gardening project at an orphanage as a way to encourage locals to become more self-sufficient and self-sustaining. Tilling the soil alongside children led to conversations about health care as well as the outreach work needed to help 18-year-olds — who are too old for school but lack marketable skills — find job training. She’s also one of many trying to help as the country now struggles with a cholera outbreak.

“You still have rubble. You have trash everywhere,” said Kidd-Taylor, who hopes to go back in January with a group of Morgan State University faculty and students. “There’s just so much that needs to be done.”

And in New Orleans, hometown of Beverly Lewis, the rebuilding effort still tends to favor richer white neighborhoods over poorer black areas. As founder and head of the Deep South Center for Environmental Justice, she helps lead everything from studies that show where recovery money is being spent to training programs for volunteers.

What does she want from the public health community?

“I would like to see more responsible research done by public health researchers and schools,” she said, urging grant seekers to work closely with communities on emerging health threats. “Where I live, because there’s such a close relationship between money and the petro-chemical industry, a lot of times we don’t get the research we need.”

— D.C.

Above, a resident of New Orleans' Lower 9th Ward visits what's left of her home in October 2005 in the wake of Hurricane Katrina. Photo by Andrea Booher, courtesy the Federal Emergency Management Agency

Battle against tuberculosis long from over

The world's poorest people often bear the brunt of disease burdens and when it comes to tuberculosis, the situation is no different.

While global and U.S. health officials had hoped TB elimination efforts would wipe out the disease in our lifetime, today's projections are somewhat grim. Based on U.S. TB rates from 2000 to 2008, the disease will be eliminated by 2107, according to Randall Reves, director of TB control at the Denver Public Health Department, who presented during today's session on "Tuberculosis: The Effect of Social Justice on a Global Epidemic."

Colorado has a long history with TB. In fact, in the late 1880s, the Denver Chamber of Commerce advertised the mountainous state and its dry atmosphere as being good for one's health, Reves said. With up to a third of Colorado residents in 1900 affected with TB, treatments of the day included fresh air, bed rest, nutritious food, exercise and long stays in sanatoriums. As the decades went by, officials recognized that the disease was, indeed, a public health issue, drugs were developed and a globally recognized treatment regimen known as directly observed therapy — or DOTS — was introduced.

Still, as much as things change, they also stay the same. Just like in the late 1800s, TB in Colorado is still significantly connected to immigration, Reves said.

Kenneth Castro, director of the Division of TB Elimination at the Centers for Disease Control and Prevention, said TB is "clearly a disease of racial and ethnic minorities." The overwhelming number of TB cases in the United States are among non-whites, with foreign-born U.S. residents accounting for a majority of TB cases in 2009, Castro said. Foreign-born U.S. residents also bear a higher burden of multidrug-resistant TB than those born in the country, he noted. Globally, there were more than 9 million TB cases in 2008, with almost 2 million deaths.

"The most vulnerable carry the burden of tuberculosis," Castro said.

Eighty-five percent of TB cases occur in Asia and Africa, with 80 percent of cases in just 22 nations, said presenter Carole Mitnick, who works with the group Partners in Health. And in certain parts of the world, the lack of infrastructure means the TB burden is simply not known — "we really don't know how big the problem is," Mitnick said.

The major obstacles to TB's control? Drug shortages, regulatory hurdles, lack of financial incentives to develop new and better drugs, gaps in diagnostics, and the high price of available drugs, among other reasons. And while presenters said that major improvements are not "pie in the sky," it will take serious, committed efforts backed with much-need funds to make such improvements materialize.

"The people who suffer from TB are not those who are most often heard," said Mitnick. "I personally do see lots of cause for outrage."

For more on TB, visit the World Health Organization's TB page.

— K.K.

Question of the Day: Got justice?

How does social justice figure into your public health work? Let us know in the comments section below.

A novel approach

Turns out you can fight City Hall. Or the tobacco lobby or the gun lobby. And you can win, too.

An admiring crowd of public healthers was on hand for a Sunday afternoon signing of a book that shows exactly how to mobilize in the name of public health and social justice. “The DeMarco Factor: Transforming Public Will Into Political Power” is what the Rev. Cynthia Abrams called “a roadmap for successful community-based organizing for social justice issues.” And she ought to know. Abrams, with Faith United Against Tobacco, is featured in the book's section on how the faith community was marshaled to bring about an historic tobacco tax increase in Virginia.

“You need to buy it!” Janice Bowie, of Johns Hopkins University, shouted across the PubMart booth to someone who had eyed the book signing with uncertainty. I asked her why, and she grinned broadly and told me DeMarco has “the kind of courage that we all need to have.”

He’s also pretty charismatic, cheerfully greeting everyone who stopped by the book signing in the Public Health Expo, slapping the table and throwing his head back with laughter when a woman from California relayed a story about campaign ads gone awry.

There’s a lot of mutual admiration going on between DeMarco and the book’s author, Michael Pertschuk, too. The men met about 20 years ago when Pertschuk, former head of the Federal Trade Commission, was trying to figure out how to make progress on gun control. Pertschuk saw how DeMarco could attack deep-seated special interest groups and affect change in the name of social justice.

“Each time he began to beat the gun lobby, the tobacco lobby, Wal-Mart…at various points I thought, ‘I’ve got to write a book,’” said Pertschuk, author of such books as “Smoke in Their Eyes: Lessons in Movement Leadership from the Tobacco Wars.”

He said DeMarco’s personality and success rate made this, his fifth book about advocacy, “by far the most joyous.”

The head of the U.S. Occupational Safety and Health Administration and APHA member, David Michaels, stopped by the book signing to shake Pertschuk’s hand. Michaels told this blogger that he’s a long-time fan of Pertschuk for his ability to distill important public health advocacy issues into readable text.

In the face of opposition to federal health reform legislation, the book’s chapter on health care expansion in Maryland offers lessons on changing the health care landscape. It lays out advice on organizing an advocacy campaign and lessons in strategies and leadership.

DeMarco himself summed it up this way as he signed copies at the Annual Meeting: “It’s a very good read about public health advocacy.”

See for yourself at PubMart (booth # 1348 at the Public Health Expo), or buy the book online at www.aphabookstore.org.

Do you have an advocacy story to share?

— D.C.

Above, Michael Pertschuk, middle, and Vincent DeMarco, right, greet an Annual Meeting attendee during their book signing at the Public Health Expo on Sunday. Photo by Jim Ezell/EZ Event Photography

The hills are alive with music

Annual Meeting attendees let their hair down during last night's performance of Aaron Neville and his Quintet in the Colorado Convention Center.

Above, Aaron Neville, top, and the crowd goes wild, bottom. Photos by Jim Ezell/EZ Event Photography

Monday's Have You Heard

Early-bird special: Take a deeper look at issues of social justice and public health by checking out the concurrent special sessions taking place Monday, Tuesday and Wednesday. Special sessions kick off Monday, from 8:30 to 10 a.m., with "Tuberculosis: The Effect of Social Justice on a Global Epidemic," session 3011; "Dialogue on Haiti and the U.S. Gulf Coast: Collaborating to Protect Vulnerable Communities," session 3012; or "Federal Perspectives on Social Justice, Climate Change and Environmental Health," session 3013. For info on Tuesday's and Wednesday's special sessions, see Page 12 in your Annual Meeting program.

Virtual reality: Like this very blog has already said, it's a social media world. (In fact, a new social media tool was probably launched in the 10 seconds it took me to write this very sentence.) Meet your fellow social media gurus, members of APHA's Social Media Team and check out the many ways the nation's premier public health association is using social media to reach you at the APHA Social Media Desk. The desk is located in the Mix and Mingle Lounge of the Colorado Convention Center, which has free wireless access too. And the APHA Social Media Desk features a scrolling Twitter feed of tweets from the meeting. Sweet. One more thing: Check out session 3383, "The Role of Social Media in Public Health," on Monday from 4:30 to 6 p.m. in Korbel Ballroom 1C of the convention center for even more tips.

Track and field: Meet players in the growing environmental health tracking movement at session 3216, "CDC's Environmental Public Health Tracking Network: Integrating Health, Exposure and Hazard Information," on Monday from 12:30 to 2 p.m. in Mineral Hall D of the Hyatt Regency. Learn more about how APHA is contributing to the tracking effort by visiting APHA's Environmental Public Health portal and clicking on "Chemical Exposure & Prevention."

Pass the (unsalted) popcorn: Check out the kick-off session of the 7th Annual APHA Film Festival at session 3190 on Monday from 12:30 to 2 p.m. in room 207 of the convention center. For a full schedule of this year's public health film festival, click here.

Momma mia: Join the March of Dimes and APHA's Food and Nutrition and Maternal and Child Health Sections for the Agnes Higgins Award Lecture and Reception on Monday from 4:30 to 6:30 p.m. in Capitol Ballroom 4 of the Hyatt Regency. The reception will honor Dr. David Barker, a pioneer in the field of fetal health and its relationship to disease in adulthood.

Booth-a-rama

It’s tough to decide where to go first in the sprawling Public Health Expo.

There will probably be a perpetual line at Walden University’s booth, where Annual Meeting attendees can pick up a bag of freshly scooped trail mix (dried cranberries, chocolate chips, granola and sunflower seeds). The school’s booth theme is “healthy cooking for healthy living” and they’re also hosting a healthy cooking demonstration featuring a local chef whipping up turkey and buffalo meatballs tonight at 6:30 and 8:30 p.m. in room 706 of the convention center.

It’s always impressive to see how schools of public health draw people to their booths. There are squishy alligators at the University of Florida’s booth, “I am Public Health” buttons from George Washington University, lip balm from UCLA, magnetic bookmarks from Kent State and, of course, great literature on each school’s programs.

Check out the NASA Applied Science Program’s interactive globe and the posters and calendars explaining how science improves public health management. Near the back of the expo hall, a gigantic RV tricked out with an exam room shows how medical and dental services can be made mobile to reach under-served populations.

The Robert Wood Johnson Foundation booth features information on their programs addressing childhood obesity and vulnerable populations as well as the launch of their Public Health Law Network, to name just a few topics. (And you can check out the Robert Wood Johnson Foundation's blog coverage of the Annual Meeting here.) The National Family Planning and Reproductive Health Association has orange and blue candy plus handouts, including “Ten Things in Health Care Reform You Didn’t Know Were Important for Women’s Health” (one is that “gender rating” is prohibited in health insurance, meaning women can’t be charged more than men for the same coverage).

Find fortune cookies, raisins and travel tissues at the Global Health Fellows Program booth, and check out the latest and greatest in public health titles at PubMart. There’s no way to give every fantastic booth a shout out, so go see for yourself. Hours are 9:30 a.m. to 5:30 p.m. today and tomorrow, and 8:30 a.m. and 12:30 p.m. Wednesday. What’s your favorite booth?

— D.C.

Above, the APHA Get Ready Booth, top, and the Walden University booth, bottom. Photos by Michele Late and Donya Currie

NPHW 2011: Safety Is No Accident

It's never too early to get ready for National Public Health Week. Next year's weeklong public health observance, April 4–10, 2011, will focus on injury prevention with a theme of "Safety Is No Accident: Live Injury-Free." Visit the National Public Health Week website to sign up to receive updates on the annual celebration and stop by National Public Health Week booth — #1367 — at the Public Health Expo for more info.

Also, check out this year's National Public Health Week video above. You can also find the video on the National Public Health Week website or stop by the expo booth to sign up to get a free copy mailed to you.

Opening Session: Justice is what love looks like

You'll have to give me a minute — I'm still recovering.

It was just intoxicating. Addictive. The kind of empowering high that makes you feel like you can do anything. It was a public health revival and I never wanna leave the tent.

I'm talking about today's APHA's Opening Session, and if you were there, you know what I mean. With a meeting theme of "Social Justice: A Public Health Imperative," you'd expect to feel the compassion, to get worked up. But these were speeches that I'll probably never forget. Public health was on fire today.

Even APHA's own Dr. Georges Benjamin was feeling feisty. In his welcoming remarks, he called on health reform's opponents and those who want to repeal the landmark law to bring it on.

"I have a message to those who want to repeal: Be careful what you ask for," Benjamin said. "There are still 23 million people who did not get covered and we want them in...we have an idea that will lower costs and we want our public option. All I can say is open up the law, make my day."

Dr. B also said opening up the law would present a good opportunity to strip away the restrictive reproductive health provisions that were unfortunately included in the bill.

A few speakers later, audience members stood up to welcome Dr. Bill Jenkins, a longtime advocate to end health disparities who was instrumental in ending the infamous Tuskegee experiment. For four decades, hundreds of black men with syphilis were followed and observed — but not treated for the disease. Local physicians were asked not to help them, they were exempted from military service to avoid treatment and denied penicillin. In Jenkins' words, the "men were followed to death."

People like to think the Tuskegee experiment can't happen again, but it can...and it's up to us to make sure that it doesn't, he said.

"If there are people in this room who are willing to put people before papers, I ask you to stand now," Jenkins implored the room. Everyone stood.

And they might as well have kept standing because a little later in came Dr. Cornel West, renowned civil rights activist and philosopher. It's cliché, but it felt like church...a church of public health. There's the brain of public health and there's the heart of public health — Dr. West spoke to the heart, calling on the audience to help the voices of the suffering to be heard and lamenting that too many of our brothers and sisters have "adjusted to injustice."

"We've seen indifference toward working people and the poor," West said. "Indifference to evil is more evil than evil itself."

West said public health workers have a "blues" mentality. Blues music forces us to confront catastrophe, but it doesn't allow catastrophe to have the last word. The blues means catastrophe and sorrow are your constant companions — but it's not about optimism or pessimism, it's about being "prisoners of hope," he said.

Justice, he said, is what love looks like.

"I am going to allow my light to shine," West shouted. "Because I am a member of the American Public Health Association!"

Man, I love public health.

Also, I can't really do justice to this year's Opening Session with words on paper (or on a screen). Check back with this blog later for details on where to find a video of today's Opening Session.

How do you feel after today's Opening Session? Let us know by leaving a comment.

— K.K.

Above, Dr. Cornel West, top, and Dr. Bill Jenkins, bottom, speak passionately to attendees at the APHA Opening Session on Sunday. Photos by Jim Ezell/EZ Event Photography

A little birdie told me so: Tweet of the Day

Today's tweet of the day from those using the hashtag #apha10 goes out to Opening Session speaker Dr. Cornel West from Twitter user LaNotoriousMLE: @CornelWest I have so much to examine. Thanks for speaking out on the importance of public discourse and public good.

Tweet of the Day bonus: Dr. Cornel West himself tweeted using the APHA hashtag. @CornelWest: Blessed and humbled...

The inside scoop

Need a Denver Broncos jersey, wild huckleberry jam, Rocky Mountain postcards or a quick bike ride?

The space just outside the Colorado Convention Center has some nice spots for sightseeing, grabbing a bite or taking a break from indoor meetings to enjoy this week’s fabulous local weather.

You might have seen the racks of red bikes that are part of the city’s B-Cycle program. For a $5 membership fee, you can ride free for 30 minutes or less or take a loaner out for two hours for a mere $6.60. There are check-in stations at the corner of the convention center at 14th and Champa and also 15th Street and Tremont. I don’t think the folks with APHA's Injury Control and Emergency Health Services Section will be happy to learn helmets aren’t included, but you can pick one up at Salvagetti Bicycle Workshop, 1.5 miles from the convention center at 1611 Platte St.

Along 16th Street, the pedestrian mall offers everything from fast food chains to gourmet candy to Denver-specific souvenirs and some amazing people-watching. Check out the Wild West of America Souvenir Market at 715 16th St. for personalized tins of sugar-free mints, rock-shaped candy and Colorado T-shirts, sweatshirts and postcards. Sportsfan at 912 16th St. has Nuggets, Broncos and Rockies gear galore, but I wonder why they have a Tennessee Vols flag in the window.

Hungry? Five local restaurants will donate 10 percent of your bill to the Colorado Public Health Association when you show your APHA badge:

1515 Restaurant – 1515 Market St.
FreshCraft – 1530 Blake St.
Boney's BBQ – 1555 Champa St., Ste C
Rack and Rye – 1320 15th St.
Gumbo's – 1530 16th St.

And if you need a breath of fresh air and maybe a little peace and quiet away from the bustle of the meeting, the 10-mile Cherry Creek Trail is just a few blocks behind the convention center off Speer Boulevard. It’ll also be the site of the Physical Activity SPIG 5k Fun Run/Walk on Tuesday morning. But at dawn today, there was no one about but some ducks, a handful of joggers and one guy on inline skates.

Got any tips for your fellow APHAers? Let us here 'em in the comments below.

Above, a view of 16th Street just a few blocks from the Colorado Convention Center and, hey, wanna take a bike ride? Photos by Donya Currie

Rocky Mountain high

This blogger is starting to have flashbacks to the 2008 APHA Annual Meeting in San Diego, where the waterfront view from the convention center was so tantalizing it was a bit hard to concentrate on everything going on inside. But, like 2008, I'll try my best to pay attention....

Above, a view of the Rocky Mountains from the Colorado Convention Center parking garage. Photo by Donya Currie

Public health students take our questions

Ask a few public health students attending APHA's Annual Meeting about the most daunting challenges facing them as they enter the field, and the answers range from figuring out how to explain what public health is to conducting research that makes a lasting difference to tackling ever-increasing rates of chronic disease.

“People don’t really seem to take public health seriously,” said Brittany Marshall, an MPH student at the University of South Florida and APHA Student Assembly Student Meeting director.

She said a key challenge is “letting people know public health is important, and letting them know why.”

Public health doctoral candidate Charles Rogers, a graduate research assistant at the Texas A&M University Center for the Study of Health Disparities, said he doesn’t want to be a researcher who simply “parachutes in” to study an issue and leaves after the data is collected.

“I really want whatever we do to make a difference,” he said. “I want to be part of that new group of people who are really about change.”

Eric Roseen is a fourth-year chiropractic student in Oregon who already tries to counsel patients on healthy lifestyle changes but wonders how to make a dent in the overwhelming tide of hypertension, diabetes, obesity and the like.

“I think chronic disease is one of the biggest killers," he said. "Probably the biggest challenge is to find something that is effective” at reducing the rates of such killers.

“I think it’s important to recognize that health doesn’t exist in a vacuum,” said MPH student Elaine Ruscetta, who’s studying at Columbia University. “When somebody’s sick, it’s not just that they don’t feel well. They can’t make money. And then if you have a population that is that way, the whole population is unable to provide for themselves.”

Not to mention the sticky wicket of health disparities that exists not only between countries, communities and racial and ethnic minorities, but also between, say, a 26-year-old University of Minnesota MPH student like Krystal Rampalli and someone her age with no education and a minimum-wage job.

Rampalli said a formidable public health challenge is convincing individuals to quit smoking, eat more produce and make other changes that will affect more than one life.

“Failing to realize that small actions contribute to larger trends — I think that’s a big challenge to public health,” she said.

— D.C.

Get this party started

APHA's state and regional public health Affiliates always throw the best parties.

Above, attendees and award winners at the annual Committee on Affiliates reception, which was held Saturday night in the Colorado Convention Center. Photo by Jim Ezell/EZ Event Photography