Sunday's Have You Heard

And justice for all: Don't miss this year's Opening Session, from noon to 2 p.m. in the Colorado Convention Center's Wells Fargo Theater, with social justice speakers Dr. Cornel West, American philosopher and civil rights activist, and Dr. Bill Jenkins, who helped end the infamous Tuskegee experiment. Plus, hear welcoming remarks from APHA's own Dr. Georges Benjamin as well as from local public health folks. Not in Denver with us? Visit APHA's YouTube channel later for highlights from the 2010 Opening Session.

Expo!: The grand opening of this year's Public Health Exposition takes place right after the Opening Session at 2 p.m. in the convention center's Exhibit Halls A/B. Hundreds of public health booths will be rolling out the welcome mat for you, including the Everything APHA booth, which will be located in the center of the Expo and is the go-to place for...well, everything APHA. The aptly named booth is also the perfect place to pick up a souvenir from this year's meeting.

Dazed and confused?: Don't worry, we know how you feel. There's so much going on at APHA's Annual Meetings, it's hard to know where to begin. But we're here to help. Check out "Orientation to the APHA Annual Meeting and Membership" on Sunday from 3:30 to 5 p.m. in room 605 of the Colorado Convention Center. The session was created for first-time meeting attendees and members, but all are welcome.

Book 'em: Like to read? So do we. Stop by the APHA PubMart booth, #1348, for the newest public health titles as well as updated editions of public health standards. And get info on opportunities to meet public health authors and get your book signed during this year's Annual Meeting. Book signings kick off with Vincent DeMarco and Michael Pertschuk, authors of "The DeMarco Factor: Transforming Public Will Into Political Power." The signing takes place Sunday from 3:30 to 4:30 p.m. at the PubMart booth.

Better days ahead

It's not a comparison I expected to hear at today's APHA Summit on Health Reform, but I think it's my favorite (and a nice way to round out our summit coverage). When talking about the work to improve quality in care, APHA member Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said a colleague once compared the efforts to 6-year-olds playing soccer: No one's really sure what's going on and they're kinda confused about where the goal is. The best thing about 6-year-olds playing soccer? "They all get better," Clancy said.

Here's to hoping things get better.

— K.K.

Above, from left to right, summit closing session speakers Ileana Arias, principal deputy director of the Centers for Disease Control and Prevention, Carolyn Clancy, AHRQ director, and Mary Wakefield, administrator of the Health Resources and Services Administration. Photo by Kim Krisberg

The fresh faces of public health

How do today’s public health students become tomorrow’s public health leaders?

“It’s not as simple as just taking the reins from our predecessors,” University of Colorado MPH student L. Kendall Krause, MD, told the 200 students gathered for today’s National Student Meeting, which is organized by APHA's Student Assembly. “Continually, gaps exist between what is and what could be. I challenge you all to step away from the status quo and be innovative and take risks. You must actively seek out opportunities for progress.”

And don’t forget to keep your eyes and ears open.

“As you go throughout your day, you’ve got to be learning,” said keynote speaker Lon Kieffer, a motivational speaker and health professional. “You cannot be so in love with your own opinion that you fail to take things in.”

A panel offering guidance on how to run a successful public health campaign touched not only on practical steps (research on your target audience beforehand, and reach out to celebrities, community groups and other partners) but also encouraged students to keep the fire alive.

“I was infected early with the social justice disease,” joked Amy Hagopian, PhD, of the University of Washington School of Public Health and a long-time public health advocate.

To be effective, whether advocating against war or cigarette marketing or for better health care or access to produce, “pick some issues that really are important to you and resonate with you and follow those across your career,” Hagopian said.

Cute kids don’t hurt either, said T. Bella Dinh-Zarr, PhD, MPH, of the Make Roads Safe Campaign for Global Road Safety. Posters of Vietnamese schoolchildren wearing helmets helped encourage actress Michelle Yeoh of "Crouching Tiger, Hidden Dragon" fame get active in the safe roads campaign. And the helmet safety project resulted in an incredible increase — from 3 percent to 90 percent — in helmet use in the Vietnam capital.

And in the face of ever-shrinking budgets and sometimes seemingly insurmountable public health problems, “keep showing up,” said Heather Kennedy, MPH, who helped a group of Colorado seventh-graders successfully advocate for a city ordinance requiring stores to stop putting tobacco products on countertops near candy and other kid-enticing products.

“Be persistent," she said. "People will know who you are.”

— D.C.

Above, It’s fun to be a public health advocate! From left, panelist T. Bella Dinh-Zarr, of Make Roads Safe, APHA Student Assembly Action Committee Co-Chair Kristi Stone-Garza, and panelist Sharon Rudy, director of the Public Health Institute’s Global Health Fellows Program. Photo by Donya Currie

The Massachusetts experiment

Yes, we can do it. That was John Auerbach's message during today's Summit on Health Reform. Commissioner of Public Health for Massachusetts, Auerbach detailed the challenges and successes involved in his state's health reform experience, which began four years ago.

After three years of implementing the reform measures, Massachusetts' uninsured rate is now less than 3 percent — which means the state is nearing its goal of near-universal coverage, Auerbach said. But beyond having access to insurance, how did the state's reform efforts help improve people's health?

In the first year of reform, there was a 7 percent increase in residents receiving flu shots (many of which happened in a doctor's office), colonoscopy rates went up 8 percent, and smoking rates declined sharply, with more than 10 percent of adults enrolled in Medicaid taking advantage of nicotine replacement therapy, Auerbach said.

"We have to show how (reform is) having a short-term impact in terms of improving people's health," he said. "Public health people are good at that."

He also shared his three big lessons from the Massachusetts experience: Public health can help health reform succeed, health reform is not a substitute for public health, and public health must adapt to health reform.

1. Public health can help health reform succeed: Behind the scenes of implementation, public health input was crucial, Auerbach said. When stakeholders gathered to design the new insurance packages, public health folks were they only ones who brought up prevention, tobacco cessation, counseling newly diagnosed patients about chronic disease management, the importance of community health workers, substance abuse and mental health treatment. Public health workers were also the strongest advocates for making sure co-pays and deductibles didn't obstruct residents' access to care. Plus, public health workers are critical in reaching residents who may fall through the cracks.

2. Health reform is not a substitute for public health: Fixing the broken health care system is an expensive endeavor, so policy-makers are always looking for ways to save money — sometimes deciding to cut into public health services. For example, Auerbach said, Massachusetts legislators decided to cut funding for public health family planning services, as they thought the new reform measures would fill in the gap. But public health had the data showing that, among other concerns, many teens didn't want to talk to their parents about their sexual health needs — they wanted to access such services on their own. The data was compelling and the funding was eventually restored.

3. Public health must adapt to health reform: Public health should be at the discussion table and must be able to demonstrate that prevention works to save money. A lot of decisions will be made based on us being able to show cost savings, Auerbach said, and not over a lifetime, but in the short-term.

At the end of the day, Auerbach said, health reform is neither nirvana nor hell (he really did say that). To this blogger, it seemed the lesson was that reform is a give-and-take — almost a trial of errors — but that it is imperative to tackle if we're to keep moving forward.

— K.K.

Above, Massachusetts Commissioner of Public Health John Auerbach speaks to attendees at APHA's Summit on Health Reform. Photo courtesy Jim Ezell/EZ Event Photography

A little birdie told me so: Tweet of the Day

As a blog, we have to show our solidarity with our social media brothers and sisters. So, every day we'll be posting a tweet of the day from all you Twitterers using the hashtag #apha2010.

Today's shout-out goes to Twitter user chiphughes, who tweeted: Off to #APHA2010 in Denver for a social justice renewal of hope w good friends and colleagues! Keep hope alive!

APHA Summit: Public health key to health reform's success

The one thing I didn't expect when I attended APHA's Summit on Health Reform today was to get emotional. Policy and practice, yes. Feeling tears well up behind my eyes, no. But that's what happened when summit speaker Howard Koh, assistant secretary for health at the U.S. Department of Health and Human Services, presented a short video of Gail O'Brien, an uninsured cancer patient from New Hampshire.

Before the enactment of national health reform, Gail, who was diagnosed with non-Hodgkin's lymphoma, couldn't get insurance. With her pre-existing condition, she was denied coverage. Thankfully, health reform changed everything. After the March signing of the groundbreaking health law, people with pre-existing health conditions finally had insurance options — including Gail. In the video, Gail receives a phone call from President Barack Obama, telling him "if wasn't for you, I probably wouldn't be here right now."

It's an emotional moment: To see how policy transforms people's lives...how policy changes can help save people's lives. It was a motivating way to help kick off APHA's Summit on Health Reform, where more than 400 people gathered to learn more about the public health and prevention provisions of the health reform law and discuss ways to ensure that public health remains central to reform's implementation.

After welcoming remarks, HHS' Koh broke down the complicated health reform law, discussing implementation dates and explaining key provisions, including the law's public health aspects and how they can transform the nation's current health system. In fact, he said federal health officials will soon be releasing a new report outlining priority areas for improving quality in public health. (The report is now available).

"I know that health is a gift and the only way to protect that gift is through the power of public health," Koh said.

U.S. Surgeon General Regina Benjamin took to the stage next, hailing the heath reform law for requiring the coverage of proven and effective preventive services, such as mammograms and prostate screenings. Benjamin told attendees that as chair of the new National Prevention, Health Promotion and Public Health Council, she and colleagues will be working hard to develop the first-ever National Prevention Strategy — working to "move from a system of sick care to a system of wellness and prevention." Our goal, she said, should be making the United States No. 1 in life expectancy.

Well, the task ahead seems daunting, especially in light of the recent gains among health reform's opponents. Luckily, it isn't like public health to back down.

"It won't be enough to study health reform, we're going to have to be activists," said APHA President Carmen Nevarez during the summit's opening. "Vote public health."

— K.K.

Above, from left to right, APHA Summit on Health Reform speakers: Massachusetts Health Commissioner John Auerbach, APHA Executive Director Georges Benjamin, U.S. Surgeon General Regina Benjamin, APHA President Carmen Nevarez, HHS Assistant Secretary for Health Howard Koh and summit moderator Anthony Iton. Photo by Kim Krisberg

Fall back (asleep)

Ahhhh, an extra hour to catch up on some sleep. That's right, it's time to set the clocks back an hour: Daylight saving time officially starts tonight, well tomorrow, at 2 a.m.

A change in the clocks also means it's time to check your stocks. Visit APHA's Set Your Clocks, Check Your Stocks emergency preparedness campaign for all you need to know on creating and maintaining your emergency stockpile.

Welcome to Denver!

Man, that guy really wants to get into the 138th APHA Annual Meeting. Can you blame him, though? (I bet he's a member of the Veterinary Public Health SPIG.)

Above, the 40-foot high big blue bear sculpture outside the Colorado Convention Center.