'When the wave comes, be right there to catch it'

Public health has been on a roller coaster ride for the past few years.

The economy crashed and state and local governments trimmed their budgets, and with them, public health jobs.

Then there was health reform, and with it the Prevention and Public Health Fund, which promised a new funding stream dedicated solely to the prevention of disease.

But then the fund was cut. And health reform was threatened.

Through it all, public health has changed and adapted. And the changes continue, but public health doesn’t always respond as swiftly as it could.

That question — how to move public health forward — was the focus of Saturday's Robert Wood Johnson Foundation Summit, a gathering one speaker called the "who’s who" of public health. They gathered before the official opening of the 141st Annual Meeting and Exposition in Boston to talk about the challenges they face and the solutions they’ve found, in the hopes that they can share their success.

“This is an opportunity to figure out where the public is going and then, when the wave comes, be right there to catch it,” said APHA Executive Director Georges Benjamin.

One of the best ways to do that is to actually get out there in the community, said plenary speaker Mildred Thompson, director of the Center for Health Equity and Place at PolicyLink. She said engaging and involving communities and giving them a stake in improving their own health is what will ultimately turn the tide.

Several speakers at the session noted that public health is increasingly turning its focus on areas that might have been intimidating in the past.

“Many public health departments are… addressing issues of race and class and are work(ing) toward healing,” Thompson said.

As an example, she cited Seattle/King County, for whom she worked as a consultant in the past. When she met with health department representatives, they wanted to address issues of race and racism.

“I thought it was a good idea, but how are you going to measure improvement?” she said. "I was stunned by the bold approach they wanted to take. And then, over the  years, they were able to refine it to create this equity and social justice initiative. Create a process in which most decisions must be viewed through a health equity lens…It was a bold approach, and it took refining over the years.”

Other bold approaches that have been showing success were featured during the day’s breakout sessions. In one, representatives from San Bernardino County, Calif., talked about getting their community on board with public health.

One of the keys to that success, said Evette DeLuca, director of Reach Out, was the inclusion of five Spanish-speaking representatives, who were deployed to the majority-Hispanic side of town to make the case for the group’s health initiatives. They had been trained in and became invested in the effort and were able to make the case to their community.

Because of that effort and others, the county began making changes in the first year of the initiative. They passed an ordinance allowing residents to grow produce in their front yards, for instance.

Other breakout sessions explored financing public health efforts and work to advance health in Minnesota.

Look out for an APHA report on the summit in the next few months.

— C.T.