Wednesday, October 31, 2012

Closing session: 'Justice is never partial. Justice is always indivisible'

"It is our responsibility to inspire each other."

Those were words from this afternoon's Closing Session speaker, author and social justice activist Angela Davis, who spoke to a standing room-only crowd on "Incarceration, Justice and Health." She began her time on stage expressing her sadness for those who now face the aftermath of Superstorm Sandy. But she quickly followed it up with anger at the many who continue to dismiss human responsibility for global warming.

She brought that energizing tone to her next topic: mass incarceration. She said it's a problem that's reached crisis proportions and for which racism plays no small part. In fact, Davis said the nation's prison industrial complex feeds on, benefits from and only entrenches structural racism. She noted that while blacks represent only 13 percent of the U.S. population, they make up nearly half of the overall prison population (Latino residents and American Indians are also disproportionately represented.) Shockingly, 25 percent of the world's incarcerated population is in the United States, home to only 5 percent of the global census, she said.

"Mass incarceration is in itself a public health hazard," Davis said.

Unfortunately, she noted that there are those who contend that some people are simply more inclined to commit criminal acts than others. But they forget — or dismiss — that certain communities are "saturated" with surveillance. While other communities may have similar rates of drug use or trafficking, there simply aren't any police there to catch them, she said.

"It's such a simple explanation as to why the vast majority of people in prison...come from a few ZIP codes," she told attendees, who could be heard murmuring in agreement.

Solving the problem is complex and like the practice of public health, it means focusing on institutions, not just on individuals, she said. People are yearning for a collective vision for a better future, but instead of responding to those needs, "we incarcerate them and pretend the problem has evaporated," she said.

"Imprisonment creates the illusion that we are addressing the problem," Davis told the crowd. "When in actuality, the problem is only being reproduced."

Davis said the struggle to free our communities from oppression goes beyond our borders — "if we are examining incarceration, justice and health, we cannot limit our field of vision to our immediate communities; it is especially important to move beyond the boundaries of the nation." She noted that more than 400,000 people are held in immigration facilities every year and that private prison corporations have a direct interest in the passage of anti-immigrant legislation.

"But people who are called illegal are showing us the way to democracy," she said. "No human being is illegal."

She encouraged attendees to think of themselves as global citizens, to see their struggles as intertwined with struggles happening in all corners of the world.

"Justice is never partial," Davis said. "Justice is always indivisible. Injustice anywhere is an injustice everywhere. We need peace, equality, justice and health."

Davis continued during the Q&A with this beautiful closing quote: "When one learns how to engage in these struggles for larger sees one's light as inseparate from that process and it puts things in perspective."

Let's cap off this year's blog and Annual Meeting, which welcomed more than 12,500 attendees, with five charges from new APHA President Adewale Troutman. During his Closing Session speech, Troutman called on attendees to: bring five new APHA members to next year's Annual Meeting in Boston, where the theme will be "Think Global, Act Local: Best Practices Around the World;" stand up and take a leadership position in APHA; increase your personal knowledge of the APHA policy process; educate your local policymakers about APHA and its public health priorities; and lastly, stand for justice.

"Remember: The power of one is real," Troutman said.

See you next year in Boston for the 141st APHA Annual Meeting!

— K.K.

Above from top to bottom: Closing session speaker Angela Davis; the passing of the ceremonial gavel from immediate past APHA President Melvin Shipp (left) to new APHA President Adewale Troutman; and a pic of the Closing Session crowd. Photos courtesy Jim Ezell/EZ Event Photography

A little birdie told me so: Tweet of the day

To date, more than 8,500 tweets using the hastag #APHA12 have been posted and the hashtag trended more than once on Twitter! Thanks for helping us spread the public health word!

On this last day of the 140th APHA Annual Meeting, which also falls on the same day as a massive ticker-tape parade in celebration of World Series champions the San Francisco Giants, the tweet of the day goes out to @zoommiler, who tweeted: Thousands of screaming San Franciscans line the streets to celebrate another successful public health conference. #APHA12

Above, a bonus pic of San Francisco's beautiful views from the top of the Marriott Marquis. Thanks San Fran and Go Giants! Photo courtesy Susan Polan

Healthy fun, healthy youths

Young people will practice good health. If it’s fun, that is.

At a Wednesday morning session on "Application of Innovative Approaches to Health Communication," researchers found that dancing and speed dating were effectively used to improve nutrition and breast cancer awareness.

For example, the Best Bones Forever! initiative employed a dance video contest to address the unfortunate statistic that just 15 percent of girls ages 9-13 get the recommended amounts of calcium. Sponsored by the U.S. Department of Health and Human Services, the initiative pushed the contest out through Facebook and promoted messages about calcium and vitamin D to “get girls engaging in physical activity and strengthening their bones,” said session presenter Elizabeth Osborn, who helped develop the video.

As a result, 90 girls from 17 states participated in the contest. In a follow-up survey given to the participants:

•    93 percent reported learning about which physical activities help build strong bones and 90 percent reported learning about which foods and drinks help build strong bones;

•    97 percent agreed or strongly agreed to eat more bone-strengthening foods; and

•    100 percent agreed that they would participate in another dance contest.

Over at the BOLD Initiative, organizers used a five-day summer camp for high schoolers to improve students' science skills, increase student awareness of cancer and introduce students to careers in health. The camp used breast cancer as the baseline topic and hosted a "speed-dating" event in which students discussed with each other their interests in the health professions.

Lead researcher and session presenter Laura Liang said that students overwhelmingly agreed with the following statement: “This program provided me with insight that will help me make future college plans and/or career goals.”

— D.G.

Above, the Best Bones Forever! Let's Dance Contest video.

We're famous!

This year's APHA Annual Meeting attracted a good bit of media attention, which means word about public health's good works and research is making the rounds! Below is a brief round-up of some of the news reports that made it out from San Francisco.

My Health News Daily: "Teen Sex Rises with Smartphone Use"

Healthline: "Veterans More Likely to Access Alcohol Treatment Programs Than Non-Veterans"

UPI: "School flu shots reduce absences by half"

U.S. News & World Report: "Eating more meals linked to less student overweight"

BMJ Group Blogs: "Gabriel Scally: Obama cares, and so does public health in the USA"

• Examiner: "Teen pregnancy linked to pre-teen literacy levels"

HealthCanal: "Survey shows parents support policies limiting unhealthy food marketing to children"

Above, APHA's Dr. Benjamin gets interviewed by reporters from New Tang Dynasty, a Chinese-language TV station. Photo courtesy David Fouse

Video is up!

Full video coverage is now available from this year's Opening Session! In addition to the above video of session speaker and outgoing APHA President Melvin Shipp, APHA's YouTube channel also has coverage of speakers Reed Tuckson, Gail Sheehy, Howard Koh and Nancy Pelosi.

May the force (of the flu shot) be with you

An APHA staffer gets in the Halloween mood with a Star Wars-inspired flu message. Stop by APHA's Get Ready booth at the Public Health Expo to meet her in person or visit to find a flu shot clinic near you.

Photo by Kim Krisberg

'Policy is an instrument of power'

Without public health, you wouldn’t have clean water to brush your teeth or wash that apple. You'd be much more susceptible to eating foods contaminated with salmonella or E. coli. It'd be hard to know just how much sugar, salt and calories you're consuming without those handy nutrition labels. Imagine being on the road without seat belts, speed limits and impaired driving laws. We don't have to tell readers of this blog that life would be very, very different without effective public health policies.

“Health is a right that needs to be protected and policy is an instrument of power [to protect those rights],” said Erica Di Ruggiero, associate director with the Canadian Institutes of Health Research-Institute of Population and Public Health and chair of the Canadian Public Health Association, during a Tuesday afternoon session on “Experiences & Challenges for Public Health Policy: Do We Make A Difference? The Views from WFPHA, CPHA and APHA.”

Public health associations are instrumental in illustrating why evidence-based public health policies can be so powerful in lifting the health of communities worldwide. To continue on the path toward health equity and make sure all people have access to good health opportunities as well as health care, we need to create awareness and understanding among politicians and the media, Di Ruggiero said. Don't be shy about sharing the compelling stories of public health's many successes. 

APHA Associate Executive Director Susan Polan said during the session that the biggest challenge for public health associations is “making public health a priority. (People) go through (their) days without realizing how public health impacts (their lives).”

Not surprisingly, when people are unaware of the importance of public health policies, there's less support and less government funding available for protecting “food safety, child nutrition, clean air, reproductive health, paid sick leave, and Medicaid and Medicare,” Polan said. The challenge today is to create “a common message and a language for people to understand,” she told attendees.

Director and head of the World Federation of Public Health Associations, Bettina Borisch, emphasized the importance of establishing a union of public health associations that mobilizes voices around the factors that contribute to health inequity. When big countries and smaller countries look to each other’s health care systems for lessons learned and best practices, it encourages other countries to follow suit, she said.

“It’s all about raising the bar so that everyone will have an equal opportunity,” said Di Ruggiero.

To learn more about WFPHA, click here. To find your state or regional public health association, click here.

— T.H.

Put down the salt shaker

Sometimes, a small change can make an enormous difference.

When Broome County in upstate New York reduced the sodium content in school lunches by 300 mg a day, the effort cut a ton of salt out of kids' diets in a two-year period. Yep, a ton (or 2,381 pounds of salt, presenter Yvonne Johnston of New York's Binghamton University said during yesterday’s “Sodium in School Meals and the Local Food Environment” session).

Grant money and California’s year-round availability of fresh produce helped lead the sodium-reduction effort at the Los Angeles Unified School District, which serves more than 650,000 meals a day at more than 800 sites. And 80 percent of students qualify for free or reduced-price lunch, said Patricia Cummings of the Los Angeles County Department of Public Health's Division of Chronic Disease and Injury Prevention.

That school district has traditionally been on the forefront of healthy changes and has been working to adopt the Institute of Medicine’s recommendations on school meals. A preliminary evaluation of the sodium reduction piece found levels dropped in half for school breakfasts, from a whopping 1,064 mg in middle and high schools to 502 mg.

What helped? The school district’s food service team and board of education championed the policy and menu change, Cummings said. They also benefited from national momentum, including Centers for Disease Control and Prevention funding (such as a Community Transformation Grant) and Michelle Obama’s Let’s Move! campaign. Something she strongly recommended for others undertaking sodium reduction: taste testing for parents and kids. The school district served more than 30,000 meals as part of its taste testing, which was “really informative in finding out what the students liked and what they didn’t like.”

That’s not to say such change was or will be easy, both Cummings and Johnston said. For one, cost is a problem. Broome County found the popular grilled cheese and tomato soup offering was 53 percent more expensive in its reduced-sodium version.

“We have this challenge of looking at all the nutrients and micro-nutrients essential to health and putting it on a plate with little cents signs and figuring out the cost,” Johnston said. But connecting local growers with schools to improve the supply of local fruits and vegetables is a start.

Los Angeles County, when replacing high-sodium pepperoni pizza with choices like hummus and quinoa, found some kids really miss their pizza. Both school districts are looking for the right recipe for a lower-sodium pizza with whole grain crust. One idea: add garbanzo bean flour to the crust for a fiber and protein boost.

Like many public health movements, though, the effort to improve nutrition in school meals is one that demands all our support.

“This work at the local level is actually starting to create a demand (for lower-sodium foods)," Cummings said. “I think it’s this whole momentum nationwide and at the local level that’s really going to make a difference in lowering sodium.”

— D.C.

And the winner is...

APHA honored pubic health's movers and shakers during last night's Public Health Awards Reception and Ceremony. To read more about APHA annual awards, click here.

Above from top to bottom, Beth Roemer (left) presents the Milton and Ruth Roemer Prize for Creative Public Health Work to Gretchen Sampson; APHA Awards Committee Chair Satya Verma (left) presents APHA's Award of Excellence to Jonathan Fielding, who accepted on behalf of Antronette Yancey; and Mariana Clair Arcaya speaks after accepting the Jay S. Drotman Memorial Award. Photos courtesy Jim Ezell/EZ Event Photography


The public health implications of hydraulic fracturing, or fracking, to harness natural gas are still not well understood, as research into the practice “is in its infancy,” said Roxanna Witter of the Colorado School of Public Health.

“This is really a very, very, very new literature,” Witter said yesterday during a session on “Fracking — Public Health Implications of Shale Gas Development.” “This is good for the time limitations of (this) presentation, but not for anything we’re attempting to do in scientific knowledge.”

Presenter Dallas Burtraw, a researcher with Resources for the Future, talked about acknowledging how the use of natural gas can be a good thing, especially considering that a gas-fired power plant would have much lower emissions than a coal-fired plant. But he also acknowledged a lack of any studies examining the long-term health effects of fracking.

He cited many possible benefits of fracking, such as cheaper electricity, cheaper home and commercial heating, and the possibility of reducing oil consumption in transportation. And one of the “big issues on the table,” even in the face of health concerns, is the economic revitalization of some areas, he said.

However, even the U.S. Environmental Protection Agency is noting possible water contamination at fracking sites, such as in Pavillion, Wyo. In fact, the literature review Witter conducted found evidence of water and air contamination linked to fracking.

The National Resources Defense Council is so opposed to fracking, the organization has a “Don’t Get Fracked” page dedicated to helping people learn about the health dangers of fracking and how to stay informed. They put it this way: “Although drilling can create jobs and income, many fear the effects of drilling on their health, land and quality of life. Current laws need to be changed to catch up with the drilling explosion.”

Click here to read more about the public health effects of fracking in The Nation’s Health.

— D.C.

Tuesday's storyboard

Happy Halloween public healthers! Here's your round-up from yesterday's Annual Meeting events brought you by APHA's Storify.

Tuesday, October 30, 2012

Wednesday's Have You Heard

One life (span) to live: Stick with this year's Annual Meeting theme and check out Wednesday session 5036, "Healthy People 2020 Across the Life Span," which starts at 8:30 a.m. in Marriott Marquis Yerba Buena Ballroom Salon 2.

Bridging the gap: It's a topic that often comes up in this new era of health reform: better integrating public health and health care. Explore the topic with your fellow public healthers on Wednesday at 10:30 a.m. at session 5128, "Public Health and Hospitals: More Than Ever Needed and Under Attack," in Moscone Convention Center South Room 228.

Finding the less fortunate: Join APHA's Caucus on Homelessness for a walking tour of San Francisco homeless service providers from 11 a.m. to 12:45 p.m. Meet at the Moscone Convention Center South main entrance.

Still a global epidemic: The world of HIV prevention will descend on Moscone Convention Center Esplanade Ballroom 300 on Wednesday for session 5187, "International Issues in HIV Prevention," starting at 12:30 p.m. Hear presentations on HIV prevention and treatment efforts in China, Russia and Central Asia.

Reading, writing and babies?: Does reading ability predict teen pregnancy risk? Find out at Wednesday session 5194, "Teen Pregnancy: Fostering Health and Prevention," at 12:30 p.m. in Moscone Convention Center South Room 200.

Call to justice: Cap off your 140th APHA Annual Meeting experience with Wednesday's "Closing General Session: Incarceration, Justice and Health," featuring keynote speaker Angela Davis, author, lecturer, researcher and social justice activist. Also, meet APHA's incoming president, Adewale Troutman. Congrats Dr. Troutman! The closing session starts at 2:30 p.m. in Moscone Convention Center West Room 2001/2003/2005.

Taking on tobacco

Earlier today, Stanton Glantz and Sharon Eubanks signed copies of their book, "Bad Acts: The Racketeering Case Against the Tobacco Industry," at Everything APHA at the Public Health Expo. Stop by the Expo tomorrow before it closes at 12:30 p.m. to pick up your copy! And click here to read a Q&A with Eubanks from APHA's Public Health Newswire.

Photo courtesy Jim Ezell/EZ Event Photography

Will there be a doctor in the house?

Public health advocates rightfully cheered the passage of health reform in the form of the Affordable Care Act in 2010. Expanded insurance options and greater eligibility for Medicaid mean that more people will have the safety net of coverage.

But 30 million to 40 million more insured people also means more people making appointments at the doctors' offices, and, at a time when the primary care workforce is already stretched, how will we accommodate all of these new people? And as the U.S. grows more diverse, how will we find culturally and linguistically competent providers?

We'll need to be innovative, said presenters at a Tuesday session on "Who Will Serve Them? Health Workforce Shortages Under Expanded Coverage."

The current system creates too many barriers for those who wish to be health care providers, particularly if those people are licensed in their home countries, said Jose Ramon Fernandez-Pena, founder of the Welcome Back Initiative. The program, which seeks to build a bridge between internationally trained health workers living in the U.S. and the need for a culturally competent workforce, operates centers in California, Massachusetts, Rhode Island, Maryland, Texas, New York and Colorado.

"The lack of minority health professionals compounds the nation's persistent racial and ethnic health disparities," he said during his presentation.

"The Welcome Back Initiative asks 'Who were you, who are you and who do you want to be?' and we try to start rescuing pieces of their professional persona," Fernandez-Pena said.

One of the main problems faced by health professionals seeking to work in the U.S. is a lack of command of English, a problem the initiative addresses with an intensive English-as-a-second-language program aimed at medical professionals.

So far, the initiative has assisted 110 physicians to enter residency training, helped more than 3,400 validate their credentials, 1,900 pass licensing exams and 1,100 obtain licenses in their original professions, he said.

Another avenue for expanding the workforce is expanded use of nurse practitioners and physician assistants, said Catherine Dower, of the University of California–San Francisco's Center for the Health Professions.

In this area, state legislators can be important drivers of change. Studies of the variations among the jobs that nurse practitioners can do in each state showed that no two states are the same. In some, nurse practitioners have full prescribing power, while others require that they work in poorly defined "collaboration" with physicians.

This leads to a lack of clarity about who can do what as well as a lack of communication.

"People don't talk to each other when they don't know what each other can do," she said. "They're not working together in the patients' best interest."

Solutions include expanding the legal scope of practice for nurse practitioners and physician assistants, tapping into underused pools of providers, including military veterans who might have medical field experience, and expanding loan repayment programs, she said.

— C.T.

Transforming the nation one community at a time

Arriving at Huston-Tilloston University to talk to faculty and staff about implementing a tobacco-free policy, Phillip Huang was met by a security guard smoking a cigarette.

Just a few months later, that same guard had quit smoking and was one of the most outspoken supporters of the campus-wide tobacco ban.

The Austin, Texas, school’s comprehensive tobacco-free policy was just one of many heartening success stories shared during today’s session on “Early Lessons Learned from Community Transformation Grants Communities.” APHA is one of three national organizations working to support projects funded by the Centers for Disease Control and Prevention grants, which are aimed at preventing chronic disease by reducing tobacco use, improving healthy eating and physical activity, and widening access to preventive services such as cancer screenings. The grants where created via the Patient Protection and Affordable Care Act.

Huang, medical director of Austin/Travis County Health & Human Services' Disease Prevention and Health Promotion Division, shared the road to putting tobacco-free campus policies in place at two other Austin area schools. The process at the University of Texas, for example, started with a student resolution that asked the school administration to enforce a tobacco-free campus within seven years. 

Then, the Cancer Prevention Research Institute of Texas adopted a policy that anyone receiving their grant funding (including the University of Texas) had to have a tobacco-free policy. Effective April 9, the campus became mostly tobacco-free. Designated smoking areas will be eliminated at the end of February 2013.

“You have to treat these campaigns almost like a political campaign and be ready to be nimble and respond to whatever is happening,” Huang said.

Other examples of the transformation grants in action: In Bernalillo County, N.M., a new database of existing policies on topics like tobacco-free spaces and built environments that supports active living has been set up to help identify where gaps exist. And in Maryland, work already has resulted in tobacco-free policies in apartment buildings, among other successes.

Learn more about what’s working well and the pitfalls to avoid during a Community Transformation Grant networking session today from 6:30–7:30 p.m. in the Mix and Mingle Lounge in Moscone Convention Center South.

There won't be any food at tonight's session, but there will be “a lot of really great conversation because we’re all doing really great work,” said Shawn McIntosh, APHA’s project coordinator for the Community Transformation Grants. “One of the best things we can do is talk to each other about all the wonderful things we are doing so we can learn from each other.”

— D.C.

A little birdie told me so: Tweet of the day

Tuesday's Tweet of the Day goes to tweeter @GabrielScally, who wrote: "If it wasn't controversial it wouldn't be important!" Best activist quote at By Alexandra Desautels of Alameda Co, CA 

Now I'm dying to know what Alexandra presented about! If you were there, let us know in the comments!

'The spirit of America'

In California's Central Valley, new farmers markets are increasing access to healthy foods. In Santa Ana, dozens of community members regularly get involved in civic opportunities to improve neighborhood conditions. And in California's Arvin-Lamont region, 300 residents pushed for the closure of a hazardous, polluting recycling plant.

What do they all have in common? They're all examples of Latino communities banding together to improve and create opportunities for better health, according to research presented during a Tuesday session on "Latino-Effective Policies: When Will We Be Included?"

"We still have a big fight, it's not a clear path," said presenter George Flores, program manager at the California Endowment, home to the Health Happens Here campaign and its Latino-focused sister campaign, La Salud Empieza Aqui. "But we each have a role."

Flores noted that Latino children often grow up facing "tremendous adversity," which then puts them at risk for facing "tremendous health adversity too." In a scan across Latino communities to explore what works and what doesn't, researchers found that when it comes to health, a person's physical location and the social factors that shape that environment really do matter.

"Social and place and environmental inequities lead to health inequities," he said.

Luckily, smart policy can shape these factors to favor better health, Flores said, and that's exactly what's happening in many Latino communities across the nation. Some examples: healthier food menus in mercados (markets), healthier food choices in bodegas (corner stores), and the creation of local produce markets and urban gardens.

"A community initiative can really make these kinds of changes," said Flores, who added that when policymakers say prevention doesn't work, the answer needs to be: "BALONEY!" It does work!"

Across the country in Massachusetts, Ester Shapiro, a professor of psychology at the University of Massachusetts-Boston, said that as the nation waits for real immigration reform, she and her colleagues are looking for ways to act locally, noting that the "violence of deportation has increased under the Obama administration."

"What can all of us do to protect the health of people living in the shadows of our communities," she asked attendees.

She said that immigration raids in New Bedford, Mass., were a big moment for "all of us" to start thinking about points of contact for policy change, especially policies that prevent the separation of family members. Shapiro told attendees that about half of Latinos say someone in their families or social networks are afraid of being deported. The experience means many Latino families live in constant fear, and Latino children and teens often have to take on unique burdens to care for their families.

To reach such Latino families with critical support services, you have to go to where they feel safe, Shapiro said.

"Everyone has to have a hand in policy change," she said.

During the Q&A discussion at the end of the session, Flores noted that the Latino experience "really is the spirit of America."

"We're the embodiment of that spirit," he said. "Our right to achieve is real and our drive to achieve is real."

To see more La Salud Empieza Aqui videos like the one above, click here.

— K.K.

Policy makes it possible

Are any of you old enough to remember the cigarette ads that had doctors and dentists endorsing certain brands? How about riding in the back of your parents’ car not only without a child safety seat, but even without a seatbelt?

Public health victories such as clean indoor air, motorcycle helmet and child safety seat laws have been possible because the public health community cares, especially about prevention. That was the message at today’s session on “Promoting Health Equity Through the National Prevention Strategy: Implications for Social Work.”

Social workers have been instrumental in affecting change and are critical to ensuring an increased emphasis on prevention, said Larry Cohen, founder and executive director of the Prevention Institute.

“We’ve got a lot more work to do, but we’re building a movement and we’re building it together,” he said, remembering being told it was “impossible” to make progress on tobacco control.

“It’s always impossible, and then we get it done,” he told session attendees.

Marice Ashe of ChangeLab Solutions showed a few slides that illustrated health inequities: too many liquor stores and fast food restaurants and far too few accessible sidewalks and parks in lower-income neighborhoods. How can public health workers improve community opportunities to help drive down health disparities? By helping advocate for policy change, she said.

That’s how affordable housing gets built in underserved neighborhoods. That’s how access to fresh, healthy foods improves. Policy makes it possible for roadways to be built with safe crosswalks, navigable sidewalks, and proximity to open spaces giving kids and adults places to exercise and play.

“You are not alone in this,” Ashe said of public health workers interested in advocating for policies that aim to reduce health disparities. “You’ve got backup and support.”

Check out the ChangeLab Solutions site for tools to help you advocate for meaningful policy change. Learn more about the National Prevention Strategy at And to learn more about the above Prevention Institute video on ways food companies are targeting kids with unhealthy foods, click here.

— D.C.

The climate for change

Earlier today, Annual Meeting attendees joined a Union of Concerned Scientists rally to demand federal action on climate change to protect people's health. Click here to join fellow health professionals in calling on policymakers to support the U.S. Environmental Protection Agency's authority to regulate the emissions that cause climate change.

Photo by Kim Krisberg

Casualties of war

If you doubt Gen. Sherman was right when he said “war is hell,” consider the research presented at today’s “Veterans Health Care and Health Risks” session.

Miranda Worthen of San Jose State University talked of two studies that found anger is a common problem for veterans and severely limits their ability to return to a normal life after combat. Howard Waitzken, a University of New Mexico professor and practicing doctor, gave a chilling account of what happens to some enlisted soldiers who come back home from Iraq or Afghanistan with severe mental and physical problems.

Once such soldier who reached out to the Civilian Medical Resources Network had recently returned from a tour of duty in Iraq, where he witnessed the death of several close friends as well as Iraqi children. One of his assignments while deployed involved removing blood and body parts from a military vehicle. The man went AWOL after being told he would soon be redeployed to Afghanistan. He sought help from the network for mental health problems that included suicidal thoughts and a desire to kill.

Another soldier had suffered two fractured vertebrae in Iraq, resulting in numbness in his legs and other health problems. He was scheduled to be redeployed to Iraq in two weeks when he sought help from the network, which provides free or reduce-priced mental health and medical care for the military.

“The unmet needs of active-duty GIs deserve more concerted attention by the medical profession and by our society’s leaders, as do more successful strategies for peace,” Waitzken said.

Worthen’s research that found service members and veterans suffer a high burden of anger points to a need for more research and outreach, she said.

“We can envision interventions at every layer,” she said. “The first would be to end war and war-time traumas.” Also, medications could help manage anger, as could community-based programs to support families.

Worthen said her research has found even small gestures can help combat veterans.

“As a non-military connected person doing this research, one of the things that really struck me is that veterans really did experience a lot of trouble returning to civilian life,” she said. “Just saying 'thank you' to somebody in a uniform or to have a show of support with a yellow ribbon actually really did make a difference. I encourage all of us to think about that.”

For more on veteran health from the APHA Annual Meeting, click here.

— D.C.

Nature's medicine

“I feel we all pretty much agree that nature is good for your health. The question is: How do we hook up with it?”

University of California-San Francisco's Daphne Miller wondered these words aloud in a Tuesday session on “Wellness Through Nature: Connection Across the Life Span.” And while presenters shared their findings on the environment and why merely being outside promotes better health, they each concluded that the case for it is best grounded in common sense, not published research.

Howard Frumkin of the University of Washington School of Public Health and former director of CDC's National Center for Environmental Health gave a “tapas” of evidence for nature’s positive effect on health. For example, he noted that inner-city students in Indianapolis achieved better grades in school when surrounded by green environments. And interestingly, prisoners with visible trees outside cell windows report better health than prisoners without them.

“We know enough to act,” Frumkin said. “Available evidence is compelling but far from complete.”

National initiatives are ongoing to include nature in our everyday lives, according to presenter Leyla McCurdy of the National Environmental Education Foundation. The foundation addresses two important issues: preventing health conditions such as obesity and diabetes as well as connecting children to nature.

Miller noted that the science she presented is easy for anyone to relate to — it's “for people curling up in their pajamas,” she said.

Unused green space exists throughout the nation, including in areas where major health disparities exist, and are untapped natural resources for better health, Miller said.

“Nature is our natural health care system,” she said.

— D.G.

We do too!

No jacket required

Looking for the perfect souvenir from this year's public health gathering? Stop by the Everything APHA booth at the Public Health Expo and try on a 140th APHA Annual Meeting T-shirt! Makes the perfect stocking stuffer :)

Photo courtesy Michele Late/The Nation's Health

Public health goes to the movies

“Going to my daughter’s graduation.”

“Playing with my dogs.”

“Spending a lot more time with my grandkids.”

Those were some of the words of heart attack and stroke survivors who shared their personal stories in “Faces of a Million Hearts,” a short film aimed at encouraging people to reduce their health risk.

Featured as part of the annual APHA Film Festival, that short by the Million Hearts campaign was one of many examples of the power of video to spread key public health messages. From improving exercise among Native Hawaiians to highlighting good oral health habits, the films illustrate how prevention, awareness and advocacy can translate well on the screen.

In one film, deaf breast cancer survivors described via sign language how they found hope in meeting others like them. In another, dancers in wheelchairs are part of a unique modern dance company.

This marks the ninth year of the festival, which started with a handful of public health films and has grown to span several days and spotlight both U.S. and international public health messages. Film festival co-founder Gary Black warned the audience that Monday’s domestic film session would be “rough and bumpy like a cable car ride” with many stops and starts. Yet attendees said they enjoyed the format that had screenings of public service announcements as short as 45 seconds and 3-minute excerpts of longer films.

Producers of some of the films were on hand to share lessons learned in making effective public health films. One such lesson: It doesn't always take a big budget. Those with smaller budgets can shoot the videos using an inexpensive flipcam, which runs about $150. Also consider collaborating with local community colleges or television stations for help, they said. One key to success is to involve your target audience both in putting the film together and distributing its message.

Joshua Romero of the University of California San Diego Antiviral Research Center said an existing community advisory board helped with the messaging behind “Would you or wouldn’t you?” That film introduces a community-based HIV testing campaign.

“A lot of the people we serve are very anxious and willing to give us their feedback," Romero said.

Other film producers said focus groups can help ensure the video resonates best with the target audience, whether that be inactive adults, new mothers or teens at risk for engaging in unsafe sex practices.

How do you reach your audience with the video message? Use websites and YouTube, producers said during yesterday's session.

“I’m sure all of us have posted some of these to our Facebook pages,” said Black, who helped produce the “Wonderful Thing About Breastfeeding” film for the Mecklenburg County Health Department in Charlotte, N.C. “Use every available channel and ask your audience, ‘where do you get your information?’”

Black said he’s amazed and heartened by how the annual film festival has grown.

“One of my goals when I started doing this was to let other folks know you don’t need a million-dollar film studio to help you in your work,” Black said. “That’s my bias: to have a grassroots effort of people using these digital tools and using the art of storytelling to achieve social justice, to eliminate health disparities and to achieve a healthier nation.”

Three more sessions of the film festival are scheduled for today: session 4110.2 from 10:30 a.m.–noon, session 4215 from 12:30-2 p.m. and session 4307 from 2:30-4 p.m.; and session 5178 on Wednesday runs from 12:30 to 2 p.m. All the film festival sessions take place in Moscone Convention Center West Room 2014.

— D.C.

Public health works

Is there a better place to learn about public health career opportunities than at an APHA Annual Meeting? See for yourself — stop by APHA's CareerMart booth at the Everything APHA section of the Public Health Expo.

Above, meeting attendees participate in job coaching sessions at CareerMart at the Public Health Expo. Photos courtesy Jim Ezell/EZ Event Photography

Monday's storyboard

For your viewing pleasure, below are highlights from yesterday's Annual Meeting events via APHA's Storify. And as many attendees tweeted, our thoughts and best wishes are with those in the wake and path of superstorm Sandy.

Monday, October 29, 2012

Tuesday's Have You Heard

Public health toolbox: APHA's Center for Public Health Policy hopes you'll stop by Tuesday session 4007, "The Nuts and Bolts of Health in All Policies," at 8:30 a.m. in Marriott Marquis Pacific C. The session will help bring into sharper focus this emerging — exciting — approach to improving the nation's health.

Give a little: The Vinyl Institute will be holding a Red Cross blood drive at their booth, #1702, in the Public Health Expo on Tuesday. Stop by and give a pint.

Behind the banner: Want to learn more about the California Endowment, the sponsor behind those cool banners around the convention center featuring the relationship between a child's ZIP code and their life expectancy? Then check out Tuesday's special session 4095, "Health Happens Here: Building Community Power and Systems Change for Social and Health Equity in California: A New Public Health Practice for the 21st Century," which starts at 10:30 a.m. in Moscone Convention Center South Esplanade Ballroom 305.

Go tell it on the mountain
: It's a growing problem across the country and one that public health certainly has a role in curbing: Prescription drug abuse and related unintentional poisonings (check out this recent article from APHA's Public Health Newswire on the issue). Learn more about the problem as well as other unintentional injury topics at 12:30 p.m. on Tuesday at session 4187, "Climbing the Mountain to a Safe Future: Public Health's Journey to an Injury and Violence-Free World," in Marriott Marquis Sierra A.

¡A Su Salud!: Listen to experts in the field of Hispanic health at Tuesday session 3434.1, "Health Equity for Latinos: Are We Making Progress?," at 4:30 p.m. in Moscone Convention Center South Room 220. Topics include chronic disease, border health and improving Hispanic health in an era of health reform.

Honor society: Come celebrate the achievements and dedication of this year's APHA award winners at Tuesday's Public Health Awards Reception & Ceremony, which starts at 6 p.m. in Moscone Convention Center West Room 2001/2003/2005. Among this year's distinguished winners are Richard Jackson, author of "Designing Healthy Communities"; past APHA President Deborah Klein Walker; and U.S. Rep. Rosa DeLauro. (And click here for a Public Health Newswire Q&A with Steven Whitman, winner of this year's Helen Rodriguez-Trias Social Justice Award.)

Above, a Public Health Expo attendee smiles after giving blood at the Vinyl Institute booth on Monday. Photo courtesy Michele Late/The Nation's Health

Booths, browsing and books

APHA Annual Meeting attendees enjoyed perusing the hundreds of booths at the Public Health Expo today, taking advantage of a little down time in the Mix and Mingle Lounge in the south lobby of Moscone Convention Center South, and flipping through APHA books and publications at the Expo's Everything APHA booth.

Photos courtesy Jim Ezell/EZ Event Photography

For the dogs

When Jacqueline Epping first told her colleagues she was interested in using dog walking to promote health, they weren’t always on board.

“The first reaction that I would get from people a lot of times was, ‘are you kidding?’” Epping, of the Centers for Disease Control and Prevention’s Physical Activity and Health Branch, told an overflow crowd at Monday's “Benefits of the Human-Animal Interaction” session.

But in the past decade, a growing body of literature shows a strong relationship between dog walking and health.

“Dogs can and do increase physical activity, and we even see some secondary health benefits,” Epping said.

The body of knowledge around dog walking is “relatively young,” she said, but there is a “robust body of evidence” as to the health benefits of pets, including lower cholesterol and blood pressure, reduced stress, improved mental health, speedier recovery, increased longevity after a heart attack and improved quality of life among older adults, just to name a few.

Ann Toohey, a PhD student at the University of Calgary, talked of a study she participated in that found frequent dog walkers were more than 10 times more likely to meet the recommended guideline of 150 minutes of weekly physical activity and twice as likely to report feeling a sense of community.

Rebecca Johnson, a University of Missouri professor and co-author of such books as “Walk a Hound, Lose a Pound” and “The Health Benefits of Dog Walking for Pets & People,” said her research has found dog walking led to increased walking speed for older adults.

How do dogs help their owners stay active?

“A dog sitting at the front door with a lead in its mouth can create expectations, as well as being a walking buddy, if you will, a companion,” Epping said.

Dog walking can also be a catalyst for environmental and policy changes to improve the walkability of our communities. Sounds like a win-win. 

Epping coordinates the International Dog Walking and Activity Group and invites fellow public healthers to join the informal group that shares research findings and funding opportunities by e-mailing her at Johnson would love to see some of you at the International Association of Human-Animal Interaction Organizations meeting this July in Chicago.

— D.C.

Illustration courtesy iStockphoto

Healthy borders

The many challenges facing communities living on the U.S.-Mexico border were explored during a Monday session on "Border Health–PAHO." That's the Pan American Health Organization for those new to the world of global health.

Four presenters highlighted unique public health topics that exist on both sides of the border, such as immunizations, violence and injury prevention, mental health and communicable diseases.

Immunization is one of the most cost-effective public health strategies and the most socially accepted; yet, it's a preventive tactic that the border region still struggles to employ. Those who migrate to the U.S. are often missing vaccinations, resulting in gaps in immunization coverage. In addition, immunization requirements vary by region, so those who migrate to the U.S. from Mexico with little or no health records may not receive any vaccines or get duplicate doses.

To address the issue, presenter Gustavo Iturralde, a health promotion officer with PAHO, told attendees that “institutions on both sides of the border have strengthened in order to increase immunization coverage and decrease inequities.” This includes increasing communication between the two nations and between health care agencies to prevent the overuse of these valuable and limited resources.

High rates of communicable diseases, such as TB, syphilis and HIV/AIDS, are also plaguing communities surrounding the U.S.-Mexico border.

“These obstacles arise due to legal issues, continuity of care (due to deportation) and complexities of reporting and case management," said presenter and PAHO officer Enrique Perez-Flores, who highlighted the need to "strengthen binational information systems and surveillance.”

Violence in media coverage and its effects on viewers were explored at the global health session as well. Lorely Ambriz, also with PAHO, provided an in-depth analysis of a three-week study conducted in the Mexican city of Juarez on violence in the media (television, images and newspaper headlines) and its effects on mothers and young girls. Ambriz revealed that “on average, more than 50 percent of [media content] focused on the topic of violence.” Study participants felt conflicted and “stressed whether they [should] watch or read the media,” while young girls perceived their community in a negative light.

To address the media-violence issue, Maria Teresa Cerqueira, also with PAHO, discussed the objectives and community impact of the Violence and Injury Prevention Initiative in Juarez. The initiative focuses on strengthening mental health in primary care and promoting cultural changes.

“The initiative has trained approximately 400 community health workers in 31 social health facilities to identify and refer individuals in need and at risk for mental illness and psychological problems," Cerqueira said. "Over 3,200 people have been referred.”

Children are also involved in the initiative’s services, as they are encouraged to engage in silly putty, photography and silkscreen workshops to cultivate their young minds.

— T.H.

A little birdie told me so: Tweet of the day

Today's #APHA12 Tweet of the Day shout-out goes to @donlaz4u, who tweeted: Just met the president-elect of American Public Health Association. I'm so excited.

The APHA Annual Meeting: Where public health leaders are as famous as pop stars.

Protecting our pearly whites

One dad in Jennnifer Messenger Heilbronner's study was adamant. His kids don't drink soda. It's bad for them.

But during his interview — part of a study on how to improve oral health among low-income kids — researchers noticed that the man's baby was sitting on the floor, drinking something bright purple from a bottle.

What's that? researchers wanted to know.

"Kool-Aid," the father said. "The baby loves it, and it comes in a convenient packaging that's just the right size to make a bottle."

He was astonished when the researchers told him there was just as much sugar in one of those packets as in soda.

Lack of knowledge about what was bad for their kids' teeth was one of the key barriers to low-income parents taking good care of their children's teeth, said Heilbronner, who presented the findings during a Monday session on "Communicating with the Public to Improve Oral Health."

Studies have found that 20 percent of the population has 80 percent of dental caries, Heilbronner said. Her company, the social change communication firm Metropolitan Group, worked with Delta Dental of Colorado Foundation to figure out how to better change attitudes and teach parents how best to care for the teeth of children ages 0-3.

"This is really about getting inside the lifestyle and the mindset of the people we're trying to reach and the communities we're trying to engage," she told session attendees.

Researchers conducted in-clinic and at-home interviews with low-income families and found that a number of factors combine to lead to poor oral care. Kids sometimes have inconsistent care — parents who care for their teeth, but grandparents or babysitters who do not. Plus, junk food has great appeal and dental care can be expensive.

Heilbronner said the good news is that parents recognize the value of good oral health and are willing to make changes.

"There's a common agreement that healthy teeth play a role in parents' dreams for their children," she said. "They would say, 'You don't ever see a doctor or a successful person who doesn't have teeth.'"

That desire for their children's success and education later in life could prove a key motivator for parents to encourage good oral health, Heilbronner said.

Finally, she said, public health folks know that disease often penetrates through generations. And it's true, she said, that parents who model poor health tend to have less healthy children. Luckily, prevention is also passed down through the family.

"This really has to be something that we're building over generations," she said. "We have to find and seize that pivotal moment when a parent decides that just because their parent didn't teach them healthy habits, they will teach those habits to their own children."

— C.T.

Low wages, high anxiety at work: Which communities suffer?

The demographics were varied, but working conditions are similarly brutal in under-represented communities across the United States.

The question is: How to fix this problem?

Presenters at a session on “Low-Wage Workers: Occupational Health Hazards” detailed their research on Monday and suggested solutions in the communities they studied.

For example, home health care aides in Massachusetts face challenges including verbal abuse, back injuries and exposure to infectious disease, while often receiving below minimum wage salaries, according to presenters. Focus group participants were largely female immigrants.

“It’s not uncommon that it’s lower than minimum wage — and you ask, ‘How can that be?’” said Pia Markkanen, a research professor at the University of Massachusetts Lowell. “Home care workers suffer from an exemption called the Companionship Clause in the Fair Labor Standards Act. If you provide comprehensive services, you are exempt from minimum wage and overtime pay in many states.”

Despite the challenges, aides were found to enjoy their profession because of “appreciation from clients and client family members,” Markkanen said. The study suggested that occupational safety and health standards can be improved through basic public policy interventions, including the U.S. Department of Labor’s minimum wage and overtime protection rule.

In Georgia as well as Baltimore, Md., Hispanic residents are at higher risk of experiencing job instability, dangerous working conditions, high injury rates and high stress rates, researchers found.

A sample of 100 migrant farmers — 87 percent male and 93 percent from Mexico — found a high correlation between farming work hazards and depression, researchers from Georgia Southern University said. Another study indicated that high temporary work rates among Hispanics living in Baltimore led to high anxiety rates and threats of physical, economic and sexual abuse.

"We need to include safety training into occupational and professional licensing programs for intermediaries and ensure Spanish-language materials reflect an elementary level of Spanish,” said Airin Martinez from the Johns Hopkins Bloomberg School of Public Health.

— D.G.

Food fight

Given a choice between a bag of potato chips and an apple, which snack would most kids buy?

More and more research is supporting the move to not only improve school lunches but also those “competitive foods” sold on school grounds, such as vending machine snacks and beverages. Presenters during today’s session on “Regulating Competitive Foods in Schools: From Assessment to Policy” encouraged the public health community to help make the case for why such efforts are needed.

“Changes are being made to school lunches,” said Maureen Spill of the Kids’ Safe & Healthful Foods Project. “These need to be supported by changes to the snack food environment.”

A study to be released by the project later this week — Hurricane Sandy permitting — found states are varying widely in the types of snacks they offer to students. None of them are doing a great job, Spill said, with the majority of students living in states where less-healthy snack foods, such as chips, sweetened baked goods and candy, are available.

Yet a health impact assessment that measured how snack food regulations would affect health as well as a school’s financial bottom line found the rules didn’t hurt revenue and improved kids’ health. That assessment also found vulnerable populations  — such as low-income and minority students — benefited the most from stronger school-based nutrition standards.

The U.S. Department of Agriculture is set to release nutritional guidelines on competitive foods sold in schools sometime in the coming year. As public health advocates comment on those guidelines and raise support through advocacy, they should bear in mind five key messages, said Matt Kagan, who conducted research for the Robert Wood Johnson Foundation and California Endowment:

•    Healthier foods mean healthier kids. “This is our best argument” for national regulations on foods sold at school, Kagan said.

•    Schools can do it. Despite budget cuts, many school districts already have implemented healthy changes in the cafeteria. “These are standards that can reasonably be met,” he said about recommended rules on snack foods and beverages. "We’re not asking them to do the impossible.”

•    Academic success. Studies have linked good nutrition to school performance.

•    Choices/flexibility. Even with proposed national rules, schools have the flexibility to apply those rules in ways that makes sense for individual communities.

•    Childhood obesity. Many are concerned with the fact that one in three schoolchildren is overweight or obese, and nutrition standards are a strong tool in reversing that trend.

Kagan also said we in public health should work to bring students’ voices to the forefront. A recent survey of California schoolchildren found they liked the new lunches that met updated nutrition standards and would support snack food guidelines aimed at improving healthy food and beverage choices on school grounds.

“They do not want to go backwards, and that’s the message all of us need to get out there,” he said.

— D.C.

Above graphic courtesy Kids’ Safe & Healthful Foods Project

Not just for girls

The HPV vaccine, that is. Unfortunately, that seems to be part of the reason why men aren't availing themselves of the prevention tactic — they think the vaccine is just for girls, according to presenters at today's session on "Male Sexual Health: HPV Vaccines for Boys."

Session speaker Ellen Daley, an associate professor in community and family health at the University of South Florida, said HPV, a sexually transmitted disease that can infect both sexes, has become viewed as a female-only issue. And even though an HPV vaccine for males is now available, the lag time between approval for females in 2006 and vaccine approval for males in 2009 means we are "way behind the curve" in trying to ensure immunization messaging reaches both sexes, Daley said.

"We're concerned that men don't think HPV concerns them when in fact we know it's an enormous concern," she said.

In four studies conducted by University of South Florida researchers, they found that oftentimes the HPV vaccine was "nowhere on men's radar," said session speaker Eric Buhi, director of the university's Collaborative for Research Understanding Sexual Health. In fact, among college-age males and men who have sex with men, only 5 percent and 12 percent, respectively, said they had intentions of getting immunized.

The studies found that the most common barriers to vaccination were cost and concerns about vaccine side effects, Buhi said. Among college-age males, one-fifth believed they weren't at risk for HPV; among men who have sex with men, 31 percent said they weren't willing to pay for the vaccine and 63 percent were concerned about side effects; and among minority male respondents, barriers cited were side effects, belief they weren't at risk for HPV, fear of vaccines as well as the time they'd have to take off from school or work to get immunized.

"Health messages should really target HPV infection and prevention in men," Buhi said.

Speaker Cheryl Vamos, associate director of the university's Center for Transdisciplinary Research in Women's Health, noted that the vast majority of psychosocial research related to the HPV vaccine has been conducted among females. However, the more information that men receive on the vaccine and its benefits, the more likely they are to critically assess whether it's an appropriate intervention for them.

In 2012, officials began recommending routine HPV vaccination for boys ages 11 to 12 as well as 22- to 26-year-old men who have sex with men. According to the Centers for Disease Control and Prevention, about 20 million U.S. residents currently have genital HPV.

— K.K.

Missed yesterday's Opening Session?

No problem — we've got ya covered. Now up on APHA's YouTube channel, and posted below for your viewing pleasure, are excerpts from Opening Session speakers Reed Tuckson and Nancy Pelosi. And keep checking back here for more videos to come. Enjoy!

Puffs and pounds

In this morning’s “Fact or Fiction: Connections Between Tobacco Use and Weight” session, researchers stressed why public health must not only help people quit smoking but also give advice on healthy eating and exercise.

Obese smokers, for example, have lower quit rates and gain more weight when they do break the smoking habit. Adolescent girls, in particular those with body image issues, might start smoking to try to lose or control their weight. And, not surprisingly, a study in Hungary that surveyed youth ages 11–19 found parents who smoked and believed smoking helped them avoid weight gain were more likely to have kids who also smoked.

“As you’re well aware, we’re in the midst of an obesity epidemic, which has now gone global,” said researcher Terry Bush, of Alere Wellbeing, the service providers of state smoking quitlines.

Her study found many obese smokers are trying to quit and lose weight at the same time, putting themselves at risk for failure by taking on too much of a lifestyle change at once. Her study, like many others, found a lot of people use smoking to alleviate stress.

Yet the study found obese smokers would “really welcome” counseling on how to quit smoking and how to eat healthfully. She and her fellow researchers noted a low level of nutritional awareness among obese smokers who called quitlines.

“Many people were astounded they were so heavy because they said they only eat one meal a day and it was at night,” Bush said.

Francis Annor, of the Georgia Department of Health, talked about a study looking at the risk of obesity over the long term among obese smokers who quit. He said the public health community must emphasize that smoking cessation should also address concerns about weight gain.

In Annor’s study, obesity rates were higher among former smokers than current smokers or those who never lit up in the first place. That points to a common sense public health message, he said.

“It is always a good idea to never start smoking.”

— D.C.

APHA officially launches Flu Near You!

About 300 people attended last night's Flu Near You event at the historic Castro Theatre, where APHA, HealthMap and Skoll Global Threats Fund officially launched the Flu Near You tool and mobile app. Flu Near You, which just wrapped up its pilot year, depends on your input and participation to create a dynamic flu tracking system that can help health officials better respond to flu trends. To date, more than 124,000 reports have come into Flu Near You since the 2011 flu season.

At last night's event, attendees caught a free screening of the movie "Contagion" and heard from a panel of preparedness and public health experts.

Above from top to bottom, the Castro Threatre advertises the Flu Near You event; the event's preparedness panel; and a snapshot of the Flu Near You mobile app. Photos courtesy Michelle Holshue

Public Health is ROI: Save Lives, Save Money

It's never too early to start planning for April's National Public Health Week celebration, so let's get started.

Announced by APHA's Dr. Georges Benjamin during yesterday's Opening Session, the 2013 National Public Health Week theme is "Public Health is ROI: Save Lives, Save Money." And there's no better time to celebrate and raise awareness about the importance of investing in a strong public health system than in these times of uncertain funding and declining resources. As the National Public Health Week 2013 brochure states, we are all examples of the public health return on investment.

Consider this persuasive statistic: Investing just $10 per person each year in proven, community-based public health efforts could save the country more than $16 billion within five years! Talk about a serious return on investment.

So, visit the official National Public Health Week website to learn more, download the brochure and sign up for email updates. Or stop by the National Public Health Week booth, #2332, at the Public Health Expo. It's time to shout from the rooftops that we support public health!

Sunday's storyboard

Below, APHA's Storify has all the juicy highlights from the first official day of the APHA 140th Annual Meeting.

Sunday, October 28, 2012

Monday's Have You Heard

Keeping up with Koh: U.S. Assistant Secretary for Health Howard Koh will speak at two scientific sessions on Monday. The first is an APHA Special Session, session 3013, titled "Health Equity: Are We Making Progress?" During the session, Koh will talk about the role of the U.S. Department of Health and Human Services in closing the inequity gap. Session 3013 starts tomorrow at 8:30 a.m. in Moscone Convention Center South Esplanade Ballroom 303. Later on Monday, Koh will moderate session 3215, "Advances in Public Health Quality Education and Measurement," which begins at 12:30 p.m. in Marriott Marquis Yerba Buena Ballroom Salon 4.

Book 'em: Stop by the Everything APHA section at the Public Health Expo for two book signings on Monday. Eliot Sorel, author of "21st Century Global Mental Health," will be on hand from 10 to 11 a.m., and this year's Sedgwick Memorial Medal winner Richard Jackson, author of "Designing Healthy Communities," will be signing books from noon to 1 p.m.

Media madness: Wondering how to get your public health efforts into local media? Stop by Monday session 3113, "Media Advocacy: Breaking Through the Crowded News Cycle," organized by APHA's Communications Department and featuring first-hand tips from health reporters. The session starts at 10:30 a.m. in Marriott Marquis Golden Gate C2. 

Well, well, well: Learn more about APHA's new online community forum for Association members, The Well, at the Everything APHA section at the Public Health Expo. The Well offers a variety of ways to engage, share and collaborate with fellow APHA members on today's pressing public health topics. Use your member username and password to log into for more.

Stopping the violence: Learn about the latest public health efforts to prevent and understand violence at Monday session 3309, "CDC and CeaseFire Present: Using Public Health Models to Prevent Youth Violence," which starts at 2:30 p.m. in Marriott Marquis Nob Hill D. Learn more about the innovative CeaseFire model over at

A bicycle built for public health

Annual Meeting attendees get ready to participate in the Environment Section's Healthy Built Environment Bicycle Tour earlier today.

Photo courtesy Michele Late/The Nation's Health

Something for everyone

Want a T-shirt that says “Kiss Me, I’m Vaccinated” or a camouflage lanyard to hold your Annual Meeting ID tag? How about hand sanitizer, a football- or elephant-shaped stress ball or a lifetime supply of ballpoint pens? The Public Health Expo has all that and more.

Walden University’s eye-catching display will even go on to feed the hungry. The canned foods shaped into a car (the wheels are made of bags of black beans) by a group of architects, engineers and others called Canstruction will be donated to the San Francisco Food Bank after the meeting. Why? “Because Walden is about positive social change,” said Dennis Shephard, who works in the school’s marketing department.

APHA’s Get Ready booth has flashlights — something our East Coast friends and family could probably use considering the weather — plus hand sanitizer, forehead thermometers and more, including this year’s Cat Preparedness Calendar. Halloween candy abounds, but we’re grateful to the raimi+associates/Nelson Nygaard booth for offering clementines as well as our friends at the Association of State and Territorial Health Officials, who for the fourth year in a row are giving out apples because “it’s a health conference, and we’re a health organization,” said Lucy Fehrenbach, who was staffing the booth.

The APHA Sections are on hand with great information and some fun trinkets, such as the orange, foot-shaped pen courtesy of the Podiatric Health Section. The American College of Nurse-Midwives has “Listen to Women” buttons and clocks to promote their awareness campaign.

Have you noticed the amazing “Your ZIP code shouldn’t predict how long you’ll live” banners? The California Endowment’s booth highlights that message and also features an interactive video game in which the player tosses unhealthy choices, such as cigarettes and a handgun, into a trashcan and healthier choices, such as fresh produce, into a shopping bag. The game is part of a permanent exhibit at the California Museum in Sacramento and encourages schoolchildren to learn about healthy lifestyles. And it’s really fun.

The “Kiss Me” T-shirts, as well as those emblazoned with “Shots! Shots! Shots!” and “We’re pushing the needle,” are at the HealthMap booth. Plus, it has fascinating information on its programs to help people find flu immunizations and track disease outbreaks.

Really, there is far too much public health swag to describe here, so head down to the Public Health Expo in Moscone Convention Center South. It’s open 9:30-5:30 Monday and Tuesday and 8:30-12:30 on Wednesday. Also, feast your eyes on summaries from some of today’s hottest public health research featured at the back of the Expo during daily poster sessions. Check the program for times and topics.

— D.C.

Above, the cat preparedness calendar from APHA's Get Ready booth and the canned food car at the Walden University booth. Photos by Donya Currie

Harnessing hope

Gail Sheehy probably had a hand cramp after signing so many copies of her book “Passages in Caregiving” for Annual Meeting attendees. Her messages of hope for those caring for elderly, chronically ill family members resonate with so many.

“Those who suffer so much are caregivers, and I think she’s identified that and experienced it and is what I’d consider an expert in the field,” said Sara Johnson, who bought a book for herself and another for a friend who is a caregiver.

“I didn’t even want to read the book, honestly,” said Pamela Luna, of Riverside, whose mother has stage-four lung cancer and father is on oxygen and suffers from chronic obstructive pulmonary disease. Yet when she checked it out at the library, she found an encouraging message. “This is really a book about hope.”

Betty Daniels bought a book for her sister, who is caregiver for her 96-year-old mother. Susan Colman purchased one for herself and one for her sister-in-law, both caregivers for her 82-year-old mother-in-law who has Alzheimer’s disease.

Scott Morrow said he was afraid he’d break down in tears when asked why he bought the book. He hopes it offers support to his stepfather, who is caring for his mother, who has dementia, as well as his developmentally disabled brother. Morrow flies monthly from California to Florida just to help for a few days.

“There’s no answer to this,” Morrow said about the stress of family caregiving. “She talked about the circle of care, and that’s what they really need.”

“How do we take care of our late-living parents and in-laws without depriving men and women in midlife?” Sheehy said as the long line formed. “There is no support for caregivers who have this job. I’m happy there’s more attention to this, but I don’t see any real movement in health care” to address the problem. “Where’s the money, and where’s the will?”

Karen Hiller’s mother suffered a fall two years ago, leading to her placement in a nursing home. The first to get her copy of the book signed, Hiller told Sheehy, “listening to you today really helped me know I’m normal.”

Check out the book and other engaging public health titles at APHA Press in the Everything APHA Booth, #1925.

— D.C.

Above, Gail Sheehy talks with meeting attendee Karen Hiller at Sunday's book signing. Photo by Donya Currie

It's a public health circus! Literally!

After today's Opening Session, surprise entertainers led Annual Meeting attendees over to the Public Health Expo in Moscone Convention Center South. Halloween's come early to APHA!

Top four photos by Jim Ezell/EZ Event Photography; last photo of an Annual Meeting attendee getting her groove on by Charlotte Tucker

Health reform history is hilarious

It might look like a comic book from the outside, but in reality, the new book authored in part by APHA's executive director is both entertainment and an important teaching tool.

"The Quest for Health Reform: A Satirical History," is a collection of editorial cartoons tracing the movement for universal national health reform.

APHA's Georges Benjamin co-authored the book with Theodore Brown, Susan Ladwig and Elyse Berkman, and all four authors were on hand today to sign copies of the book at the Public Health Expo at the Annual Meeting.

"It presents information in a way that is interesting to me," said Khalid Almutairi, an associate professor at King Saud University in Saudi Arabia.

Almutairi said he will use the book in his class to help his students understand the movement for health reform in the United States.

"The way we look at the U.S., it's like a benchmark," he said, holding his signed copy of the book. "We can benefit from the experience of the U.S., so we need to watch what (you) do. It's a great way for our students to have experience with what's going on in the West."

For Jean Demmler, chair of APHA's Mental Health Section, the book will be a prize. At a Section gathering during the Annual Meeting, she'll present it as a gift to one of the Section's 40-year members.

"I just think it's a fun way to see (health reform) from a new perspective," she said.

"The Quest for Health Reform: A Satirical History" is for sale at the APHA Press booth, #1925, in the Public Health Expo.

— C.T.

Above, book authors sign copies of "The Quest for Health Reform: A Satirical History" at the Public Health Expo. Photo by Charlotte Tucker