Wednesday, November 4, 2015

Closing General Session: ‘Stop asking for a seat at the table…we belong at the head of the table’

In April in Baltimore, after the civil unrest that followed the death of Freddie Gray while in police custody, city Health Commissioner Leana Wen wasn’t entirely sure what the role of the health department should be in helping the city recover.

But she and her colleagues quickly realized that 13 of the city’s pharmacies had burned down, leaving some of Baltimore’s most vulnerable residents without access to life-saving medications. In response, the public health department organized to bring medicine, food and basic supplies to those in need. The agency launched a 24-hour hotline and began going door to door to offer their help. The story is emblematic of public health — we respond when people are in need. But what’s even more telling about this story is how the people on the other side of all those doors reacted, Wen said.

People automatically assumed that the offer of help was linked to a political campaign for a particular candidate or that they were being asked to fill out another survey. It was a difficult reminder that even though public health workers have the best of intentions, histories of inequity and disenfranchisement continue to frame the context in which public health is practiced. And without acknowledging those histories and allowing them to inform public health interventions, sustainable health improvements may remain out of reach.

“Sometimes the problem that we see can seem so big, it’s almost like you can’t start anywhere,” Wen said to a packed Closing General Session audience on Wednesday afternoon in Chicago, where more than 13,000 public health practitioners had attended the APHA Annual Meeting. “But each of us can play a role. …We would never wait if it was a sick patient. This is a sick system, so let’s do something today.”

Digging deep into the underlying social determinants of health was a common call to action among the session’s speakers, especially as public health moves into a post-Affordable Care Act era and can slowly, though not entirely, begin to shift its collective attention away from access to care issues. Among those underlying determinants is racism.

New APHA President Camara Jones announced at the session that she intends to take APHA and its partners on a national campaign against racism, which she defined as a systemic and institutional issue, not an individual characteristic or personal moral failing. As we move forward on this journey to achieve health equity, Jones called on the audience to keep three principles in mind: valuing all individuals and populations equally; recognizing and rectifying historical injustices; and providing resources according to need.

Public health, Jones said, is built on a commitment to achieving social justice.

“If we concentrate more attention to how racism is sapping the strength of whole societies…we will have more of us intent on dismantling the system,” Jones said.

Those social determinants of health are the new frontier of public health, said session keynote speaker Karen DeSalvo, acting assistant secretary for health at the U.S. Department of Health and Human Services. Even though the U.S. spends the most on health care, we don’t have the best health outcomes — in fact, far from it compared to the enormous amounts we’re spending. And perhaps the reason for that, DeSalvo postured, is that we’re focusing too much on genetic codes, rather than ZIP codes. Indeed, even if we get to a place of “perfect” health care for everyone, it will only improve people’s health by 15 to 20 percent, she said. But what about the other 80 percent? That’s where public health comes in.

This new frontier of health, DeSalvo said, is a place where public health practitioners don’t just run health departments; they’re the chief health strategists for entire communities.

“We want to ensure the conditions in which people can be healthy,” she told attendees.

DeSalvo talked about her hometown of New Orleans, which used to be home to some of the worst health outcomes in the world. But after the devastation of Hurricane Katrina, residents and city officials made a choice: they wouldn’t return to a place of health inequities and poor health outcomes. In her role as New Orleans health commissioner, which she stepped into in 2010, DeSalvo said it was an opportunity to build a new kind of public health — one more nimble, flexible and able to meet the community where it lived, worked and played. Fortunately, DeSalvo, her colleagues and community partners achieved great success. A recent example: In one decade, New Orleans went from one of the least healthy cities to one that chose to go smoke free.

In this new frontier of public health, DeSalvo called on session attendees to work across sectors and support a health-in-all-policies approach.

“Stop asking for a seat at the table,” she said of public health. “We need to show that we belong at the head of the table.”

Indeed, focusing on the social determinants of health gives us an opportunity to engage with other agencies that haven’t traditionally worked with public health, said Julie Morita, commissioner of the Chicago Department of Public Health, during a panel that included Wen as well as Faisal Khan, director of the St. Louis County Department of Public Health. Morita told session attendees that in developing a new health plan for Chicago, one particular social determinant rose to the top: violence.

Violence, Morita said, is an attack on the health of our community. In response, Chicago health workers are engaging in a number of activities to prevent violence, including an effort to prevent retaliatory violence. As part of that effort, health workers reach out to the families of homicide victims within 24 hours of a homicide to offer psychological first aid and other services in an attempt to break the cycle of violence.

Wen, of Baltimore, noted that public health practitioners can use social justice-informed tools to get at underlying contributors to violence. For example, she asked session attendees, what if instead of seeing someone as simply a perpetrator of violence, we saw them as a victim of trauma? To that end, Wen said Baltimore is working to become a trauma-informed city in which city workers will be trained in knowing how to identify trauma and how to respond.

However, public health must also speak up about its accomplishments, Wen noted. For example, in Baltimore, which used to have one of the worst infant mortality rates in the country, the health department convened more than 100 community partners to tackle the preventable problem. The outcome: B’More for Healthy Babies. Today, the city is celebrating the lowest infant mortality rate in its history, a 50 percent decrease in sleep-related infant deaths and an 86 percent reduction in the number of children suffering from lead poisoning.

“We have to marry our statistics with our stories,” Wen said.

In St. Louis County, the civil unrest and protests that followed the killing of Michael Brown was a symptom of already existing conditions, such as racial segregation, concentrations of generational poverty, disenfranchisement, lack of access to care, and a complete disconnect from all the resources that enable people to make healthy choices, Khan told the audience.

“Ferguson was a classic example of a community under a toxic amount of stress,” he said.

Khan said that until late 2014, his agency was your typical health department, focusing on clinical services, with no earnest focus on digging deeper into underlying social issues. However, when Khan took on the role of director about 10 months ago, his first action was changing the agency’s official name from the department of health to the department of public health. It wasn’t just semantics, he said, it was meant to send a clear signal to everyone in the community as well as staff that the agency’s mission was now fundamentally different.

If we’re going to make real change, Khan told the audience, we have get out into the community and have uncomfortable conversations about inequality and racism. He then asked the hundreds of people in the room to stand up and repeat after him.

“I am a professional public health troublemaker,” Khan boomed. “And I am proud of it!”

See everyone next year in Denver for APHA’s 144th Annual Meeting and Exposition, which will have a theme of “Building the Healthiest Nation, Ensuring the Right to Health.” And don’t forget to sign our Generation Public Health pledge and join the movement to create the healthiest nation in one generation.

— K.K.

Above from top to bottom: Closing General Session keynote speaker Karen DeSalvo; panel discussion participants, from left to right, Camara Jones, Julie Morita, Leana Wen and Faisal Khan; and immediate past APHA President Shiriki Kumanyika, left, passes the gavel to new APHA President Camara Jones. Photos by Jim Ezell, courtesy EZ Event Photography

Speak up for safe work

Protecting the health and safety of workers continues to be one of the most important functions of public health and demands support from all of us.

That was the take-home message from a Wednesday session on “Health and Safety Alliances and New Occupational Health and Safety Challenges.”

Among the powerful stories from the occupational health and safety field is the push for a violence-prevention standard in California. Kathy Hughes, a registered nurse and union activist working to make the standard a reality, told session attendees about a nurse who was walking between buildings at a state mental hospital and was strangled by a patient. Not long after, a nurse at a detention facility was killed when an inmate beat her to death with a lamp. The lamp was the nurse’s own because the facility’s low lighting made it impossible to see properly to dispense medication.

Hughes asked audience members to weigh in on the proposed violence prevention standard, which is now in a 45-day comment period with the Cal/OSHA Standards Board.

The work of public health-driven occupational health and safety efforts have huge payoffs. Consider a new California law that protects workers from new or previously unrecognized health hazards. That law is on the books in large part because of public health advocates, said Fran Schrieberg.

Once a new threat is identified, the law then gives the health department the right to obtain a customer list from the manufacturer and find out how much of the toxin is being imported into California as well as when and where.

“It’s a really powerful piece of legislation,” said Schreiberg, one of the “founding mothers” of the group Worksafe, which helped bring the law to light. “We think it could be translated to other communities.”

A fascinating part of the session had attendees split into roundtable groups to discuss how to translate the innovative occupational health and safety work to fit their own states and localities. Before that happened, Peter Dooley called on the audience to get active with his group, the National Council for Occupational Safety and Health, or National COSH, which has local chapters across the country and focuses on issues such as better protections for temp workers.

“We’re really kind of the umbrella group that tries to keep sustained local groups but also have local groups come together and be a national voice,” Dooley said. “In the last five years, National COSH has been outspoken on the tragedy of workplace fatalities and how many workers are exposed to dangerous hazards, dangerous chemicals, and the fact that workplace injuries and fatalities are way too many every day.”

— D.C.

Above video from a nurse safety rally earlier this year in California. Video courtesy the California Safe Care Standard

Picture perfect

Let's take a moment to savor our time at this year's APHA Annual Meeting with some more photos from the last few days in Chicago. We can say good-bye in person at the Closing General Session, which starts in less than hour in McCormick Place Convention Center.

Above from top to bottom: Two attendees get excited about next year's Annual Meeting in Denver; all smiles at the Centers for Disease Control and Prevention booth at the Public Health Expo; getting to know each other at the Community Health Workers Section Business Meeting; hashing it out at the Caucus on Public Health and the Faith Community Business Meeting; and swapping tips at APHA's Social Media Lab.

All photos by Michele Late and Natalie McGill, courtesy The Nation's Health

Raising healthy babies one neighborhood at a time

When it comes to raising healthy babies, public health workers know that prenatal care is not enough.

And in communities where infant mortality rates are high, it takes more than health care workers to turn the tide. It takes collaboration.

That’s where programs such as Best Babies Zone, which was the topic of its own Wednesday morning session, come in. Started by the University of California-Berkeley with support from the W.K. Kellogg Foundation, Best Babies Zone involves building coalitions of businesses, early childhood centers, health care and more to improve the quality of life in small geographic areas with high rates infant mortality, low birth weight newborns and preterm births.

The program kicked off in the neighborhoods of Castlemont in Oakland, California; Hollygrove in New Orleans; and Price Hill in Cincinnati, Ohio. Those same communities are marked by low economic development and poverty. In Price Hill, the child poverty rate is nearly 56 percent, said presenter James Greenberg, director of the Cincinnati Children’s Hospital’s Division of Neonatology, who works with Best Babies Zone in Price Hill.

“If we’re going to address these complex problems like infant mortality, multi-sector approaches are absolutely essential,” Greenberg said. “Not only does that mean we have to think of community, health and political factors all at once; but as health care providers we have to think about why it makes sense to provide incredibly expensive neonatal intensive care without addressing drivers.”

An example of collaboration in action was Healthy Homes Block by Block, in which women in the Price Hill neighborhood serve as block captains and go door-to-door to offer information about infant safe sleep practices, safe housing remediation and children’s books. After one year, there were 50 child safety upgrades and 780 children’s books delivered across five blocks, Greenberg said.

Out west in California, more than a third of the kids younger than 18 who live in Castlemont live below the poverty line, said Jessica Luginbuhl of the Alameda County Public Health Department, who works with the Best Babies Zone’s Castlemont program.

Realizing that economic development is integral to health, community members involved with Best Babies Zone worked with residents and local businesses to create the Castlemont Community Market. The market highlighted local shops and promoted residents who were also entrepreneurs.

Today, 450 people have attended the market since January, resulting in $3,400 going back into the local economy, she said.

“The life course undergirds the work we do,” Luginbuhl said. “The bottom line is health is greater than health care. We feel that peoples' health are products of environments they live in and the opportunities they have. Those vary by where you live.”

— N.M.

A little birdie told me so: Tweet of the day

Today's Tweet of the Day goes out to @DrBMBrawner, who gave all of us a needed boost of energy on the last day of the Annual Meeting. We miss you too!

Chicagoans can ‘PrEP’ for sex without HIV

HIV infection rates in the U.S. have declined in the last decade but not in Chicago’s South Side, which has unfortunately experienced upticks of new infections in recent years.

But a new preventive drug is poised to make an enormous difference. And APHA members are on the ground making it happen right now, in spite of the barriers.

Pre-exposure prophylaxis, or PrEP, is a preventive strategy that lowers the risk of HIV infection by up to 92 percent among people who adhere to its guidelines, according to the Centers for Disease Control and Prevention. The strategy includes regular HIV screenings, medical monitoring, sexual health consulting and daily intake of Truvada, a drug approved by the U.S. Food and Drug Administration in 2012.

The bad news is that many obstacles stand in the way of people gaining access to PrEP. The good news is that Chicago’s public health workforce is demonstrably fixing the problem, as evidenced during a Wednesday morning session on “Keeping PrEP’s Promise: A Windy City Approach to a New HIV Prevention Paradigm.”

“We’ve enrolled over 200 patients to date,” said Sybil Hosek, PhD, of the John Stroger Hospital of Cook County in Chicago, which opened a PrEP clinic in April. “Our ultimate goal is to provide PrEP to whoever needs it whenever they need it.”

It’s not possible for the hospital to do this right now for a variety of reasons, such as electronic health system shortcomings, lack of staffing, physician availability and even insufficient hours of operation (the clinic closes at 4 p.m. each day). However, Hosek told session attendees that the hospital is aggressively creating solutions, with dedicated medical staff and doctors creating time and space to treat previously unmet patient needs.

Two other challenges have emerged in the early days of PrEP treatment: access and inequity. PrEP is covered by most insurance and Medicaid programs, but “it is very confusing,” according to Jim Pickett of the AIDS Foundation of Chicago, and many early PrEP patients are insured, employed and don’t mirror the typical demographics of patients who use public safety-net hospitals.

Pickett said that awareness and education among vulnerable communities — notably, young gay black men, transgender women and black cisgender heterosexual women — may be the foremost challenge. The foundation, along with the Chicago Department of Public Health and others, recently began a five-year plan to eliminate HIV in the city.

A citywide social marketing campaign is scheduled to launch in 2016, with a focus on “making sex positive,” according to Pickett.

“Love, lust, intimacy, pleasure — we’ll use these words because we want people to enjoy sex without fear, anxiety or shame,” Pickett said. “And … without HIV.”

To learn more about PrEP, check out this article from The Nation's Health.

— D.G.

Start spreading the news!

With so much exciting new science coming out of the 143rd APHA Annual Meeting and Exposition, it's no wonder we're making headlines. From the mental health effects of binge watching TV to food insecurity among college students, the public health research being presented in Chicago is showing up in media outlets across the country. Below is a quick, but not comprehensive, round-up of all the attention we're getting.

Modern Healthcare: Public health issues push past flu and cigarettes into socio-economic areas

CNN: Kids seeing more unhealthy snack ads, report says

Chicago Tribune: Health conference calls for access to abortion as 'human right'

New York Daily News: Binge-watching may lead to depression and other health problems

ABC Radio: Study: Letting your teen party at home could lead to addiction Many college students struggle with food insecurity

International Business Times: Why are anti-vaxxers so persuasive? Pseudoscience, misinformation and healthy behavior

Medical Daily: Lazy Boy: People who don't exercise twice as likely to develop alcohol abuse problems

Business Standard: How Ebola scare stigmatized African immigrants in U.S.

Hey ladies: How the ACA covers — and fails — women

Who’s falling into the coverage gap of the Affordable Care Act? That's the murky area where you make too much money to qualify for Medicaid, but not enough to afford the cheapest coverage through state exchanges.

The folks most at risk: Women. People of color. Lesbian, gay, bisexual and transgender folks. Southerners. People who have been incarcerated. People who are undocumented.

“The Supreme Court messed with us,” admits Cindy Pearson, executive director of the National Women’s Health Network, referring to the court’s decision to uphold the ACA but allow states to opt out of Medicaid expansion. And that was just the start of a lively late Tuesday session from the APHA Women’s Caucus, “Who Is Left out of the Affordable Care Act and How Do We Change That?”

Though millions more people now have health insurance thanks to the health reform law, even those who have it can feel overwhelmed by information, surprising fees and increasing costs. Coverage through the ACA for care such as contraceptives and abortion can be murky as well, with an insurance provider’s website saying one thing and their representatives saying another, said presenter Kathy Waligora, director of health reform initiatives at EverThrive Illinois, which was also the beneficiary of this year's APHA Help Us Help Them campaign. That’s why the Women’s Caucus session highlighted efforts that help patients understand their rights and access to care.

A highlight of the session included the outlining of “My Health, My Voice: A Woman’s Step-by-Step Guide to Using Health Insurance,” published by Raising Women’s Voices for the Health Care We Need.

Resources like “My Health, My Voice,” and organizations led by women of color are crucial in reaching the at-risk and uncovered populations who need health care reform most, said Cecilia Sáenz Becerra, field organizer for Raising Women’s Voices.

“These are really tough barriers for people to overcome,” Becerra said. “It’s important to really center…(and) facilitate relationships and increase organizational capacity.”

To learn more and pick up a copy of “My Health, My Voice,” visit the Women’s Caucus booth, #1909, in the Public Health Expo.

— L.W.

One world, one health

Showing a photo of football players in a huddle, veterinarian Cheryl Stroud described the One Health approach to human, environmental and animal health as "very much a team sport.”

“There are a lot of people walking around this meeting who’ve never heard of One Health,” said Stroud, executive director of the One Health Commission, during Tuesday's special session on "Exploring the Interface between Emerging One Health Issues and Health Policy." “It’s a way of thinking. It’s a way of being sure that everyone who needs to be at the table for all the wicked problems we’re facing” is there.

Those wicked problems include pollution in our oceans and emerging infectious diseases that spread from animals to humans, she said. Like so many Annual Meeting presenters, she said the answer lies in relationships and partnerships, and working hard to break out of silos in medicine, public health, veterinary medicine and environmental science.

“We’re trying very hard to figure out who’s doing what in One Health, so we can connect hands,” she said. “Collaborations don’t just magically happen. They start with relationships. And relationships don’t magically fall out of the sky.”

At the session, co-sponsored by APHA’s Epidemiology Section and Veterinary Public Health SPIG, Stroud told several stories about why everyone should be involved in One Health. When her son was 20 months old, for example, he developed diarrhea that persisted for six weeks. She and her husband fell ill as well. Her son’s pediatrician had no answers.

Frustrated, the then-student at the North Carolina State University College of Veterinary Medicine took one of her son’s soiled diapers to the school’s lab for analysis. The results showed he had cryptosporidiosis, a diarrheal disease caused by microscopic parasites. Stroud says the work of One Health in connecting animal, environmental and human health means these days, her son’s diagnosis would have come much more quickly.

Another example she used: hypothyroid cats, which vets in past years had never come across, but now see fairly often. And research shows the emergence of that condition among our feline friends can be linked to a chemical used to make flame-resistant fabrics and upholstery. Now research is looking into the health effects of that chemical on children.

“We need to heal the past and live the present, and indeed we need to dream the future,” she said, urging session attendees to help spread the word about One Health. “It’s really up to us.”

— D.C.

The envelope please...

At last night's annual APHA Public Health Awards Reception and Ceremony, we honored some of the great innovators in the field for their contributions and creativity. Above from top to bottom: Hortensia Amaro, dean's professor in social work and preventive medicine at the University of Southern California, received the Sedgwick Memorial Medal for Distinguished Service in Public Health, which is APHA's oldest and most prestigious award.

Rahul Gupta, state health officer and commissioner at the West Virginia Bureau for Public Health and former health officer at the Kanawha-Charleston Health Department in Charleston, West Virginia, received the Milton and Ruth Roemer Prize for Creative Local Public Health Work, which was presented by the Roemers' daughter, Beth Roemer Lewis. William DeJong, professor in the Department of Community Health Sciences at Boston University School of Public Health, received the Student Assembly Public Health Mentoring Award from APHA President Shiriki Kumanyika.

Helene Gayle, inaugural CEO of McKinsey Social Initiative and former director of the Bill and Melinda Gates Foundation's HIV/AIDS, TB and Reproductive Health Program, was honored with the APHA Presidential Citation. And APHA Executive Director Georges Benjamin presents this year's Help Us Help Them donation check to EverThrive Illinois, which works to improve the lives of women, children and families.

Visit APHA to read about all of this year's award winners. And congratulations to all!

All photos by Jim Ezell, courtesy EZ Event Photography

APHA Storify: We're on the move!

This morning's APHA Storify brings you all the movin' and shakin' from the 143rd Annual Meeting and Exposition in Chicago.

Tuesday, November 3, 2015

Wednesday’s Have You Heard

Happy anniversary Medicare!: Celebrate the 50th anniversary of Medicare at session 5032, “Medicare and Civil Rights: Celebrating and Uncovering Our History,” at 8:30 a.m. in MPCC Skyline Ballroom W375a. Learn why the enforcement of civil rights was so important to the enactment of Medicare, the role of black physicians, and the desegregation of thousands of the nation’s hospitals.

What’s on the menu?: What kinds of labeling work to influence healthy eating behaviors? Learn what’s effective at session 5101, “Use of Food and Menu Labeling to Influence Dietary Behavior,” at 10:30 a.m. in MPCC W184bc. Hear about research on how food labeling impacts men vs. women, how to best present information on added sugars and much more. Yum!

Working on wellness: Workplace wellness programs are all the rage nowadays, but are they the best way to promote better health and habits? Hash it out at session 5170, “Workplace Wellness Programs: The Right or the Wrong Track?” at 12:30 p.m. in MPCC W176b. Presentations will focus on the National Institute for Occupational Safety and Health’s Total Worker Health Agenda, implementing workplace wellness activities in retail settings, occupational exposures that contribute to chronic illness and more.

Staying tough against tobacco: Public health has made enormous strides in reducing the U.S. smoking rate, but we’re not done yet. At session 5137, “Continuing to Clear the Air: Smoke-Free Trends,” which convenes at 12:30 p.m. in Hyatt Regency Ballroom C, attendees will take a look back at 20 years of tobacco control, hear about the ongoing smoke-free housing movement, and learn how things are going following the implementation of New Orleans’ smoke-free workplace law, which went into effect earlier this year.

Don’t go yet!: There’s no better way to cap off your Annual Meeting experience than by attending this year’s Closing General Session at 2:30 p.m. in MPCC Skyline Ballroom W375a. With a theme of “Building Health and Just Communities,” the session will feature a keynote presentation from Karen DeSalvo, acting assistant secretary for health at the U.S. Department of Health and Human Services, as well as a panel discussion with Julie Morita, Chicago health commissioner; Leana Wen, commissioner of health in Baltimore; and Faisal Khan, public health director in St. Louis County. You’ll also hear from incoming APHA President Camara Jones.

Walking the walk

Almost 8 million steps! Or to be completely accurate — since we are at a public health meeting — 7,903,702 steps! That's the collective steps of the 268 people who participated in APHA's 2015 Walking Challenge, which began on Sunday and ended today with the announcement of our winners.

Congratulations to first place winner Parth Patel from Morgantown, West Virginia, who took 104,084 steps; second place winner Paige Piontkowsky from Claremont, California, who clocked 101,126 steps; and third place winner Alison Arberg from Richmond, Virginia, who took 83,435 steps.

Above, video of all the walkers at the APHA Annual Meeting in Chicago.

Plan4Health: 'We all have a common goal of increasing well-being'

When it comes to bridging the gap between planning and health, it’s all about relationships.

That was the message from local project managers who spoke at a Tuesday Annual Meeting session titled “Plan4Health: Linking Public Health and Planning to Build Improvement in Health.”

“One-on-one, personal building relationships, makes all the difference,” said Alex Smith, who manages the Active Transportation Program for the city of Columbus, Ohio.

He’s one of the people participating in APHA’s new and very cool Plan4Health partnership with the American Planning Association. The program, which brings together APHA state and local Affiliates with American Planning Association state chapters, launched in March and has this vision: full integration of planning and public health where people live, work and play.

Current local Plan4Health projects focus on nutrition and physical activity, and a new round of projects is set to start in January. One of the projects highlighted at today’s session, the Trenton Healthy Communities Initiative, leverages a health-in-all-policies approach as “a timely strategy for addressing the web of social determinants that impact health and equity,” said presenter Tito Gezmu of the New Jersey Public Health Association.

As Anna Ricklin of the American Planning Association told session audience members, health in all planning policies is the goal. Ideally, planning should become a public health intervention, said Ricklin, who praised APHA’s involvement in the groundbreaking project.

“We couldn’t do this without APHA members,” she said.

A great example of how the local projects are using planning to improve health: pop-up traffic calming demonstrations. In St. Louis, 27 percent of residents take part in no leisure-time physical activity, said presenter Grace Kyung, a bicycle and pedestrian planner at TrailNet. Yet 80 percent of them live within a half-mile of a park. One problem? Unsafe streets hinder access to parks.

The traffic calming demonstrations took the shape of colorfully painted giant tires, plants, and other elements placed at dangerous intersections throughout the city. As project planners tracked speed and stop sign compliance at the sites, they also had a chance to survey local residents and get input on safer community design.

Overall, Plan4Health zeroes in on improving nutrition and physical activity while also promoting health equity. It makes sense that public health and planning should work together, Ricklin said.

“We all have a common goal of increasing well-being.”

— D.C.

APHA members approve 18 new policy statements

APHA's Governing Council has officially adopted 18 new policy statements at its business meeting in Chicago during the 143rd Annual Meeting and Exposition. The policy statements, which will help guide APHA's work and advocacy activities, address a diverse range of topics, from collecting data on worker fatalities to ensuring universal access to contraception to protecting communities against tick-borne disease. Go here to read brief summaries all of the newly adopted APHA policy statements.

The tipping point: On our way to reducing gun violence

Public health advocates can agree that shootings are a huge health issue for the more than 33,000 victims of gun violence in 2014 alone. But gun violence also indicates that the shooter has a health problem, according to gun violence researchers.

In front of a packed Annual Meeting crowd, advocates from the Brady Center and its Campaign to Prevent Gun Violence as well as public health advocates gathered to discuss “The Tipping Point: Activating a Public Health Movement to Address Gun Violence.” The tools to prevent gun violence are already in place, but much work still needs to be done, as 11 children are killed with a gun every day in the U.S., said presenter David Hemenway, professor of health policy and director of the Harvard Injury Control Research Center.

At the end of the day, violence begets violence, noted epidemiologist Gary Slutkin, founder and executive director of Cure Violence, but communities can do their parts to mitigate that violence. However, it’ll mean looking at gun violence in new ways — as a public health issue, rather than a criminal justice issue, he said.

“Criminal justice reform won’t be enough,” Slutkin said. “(We need to) go harder at prevention, harder at understanding, harder at care.”

The session touched on many points that the Brady Campaign has been touting for years, including at its recent National Summit with APHA in Washington, D.C. Dan Gross, Brady’s president, led the charge on Brady’s three key points: finish the job of expanding “lifesaving Brady background checks” to all gun sales in the country; stop bad apple gun dealers; and ASK (Asking Saves Kids, which promotes the simple idea of asking about unlocked guns in the home of a child’s friend).

Those small steps, Gross noted, will make a big impact on reducing gun violence.

Attitudes influenced by the gun lobby are another obstacle to gun violence prevention. In 2004, 42 percent of Americans believed a gun made a home safer. By 2014, that number jumped to 63 percent, despite clear evidence to the contrary.

But the tide is turning, Gross suggested. In pop culture and media, there is more pressure to protect American lives from gun violence. Even Kim Kardashian has gotten in on the action. These are signs to be hopeful about, Gross said.

“It’s all manifesting itself in real progress and real change,” he added, “but there’s still a lot of work to do.”

Visit APHA and the Brady Campaign to learn more about gun violence prevention.

— L.W.

Above, APHA Executive Director Georges Benjamin, left, and Dan Gross, president of the Brady Campaign and Center to Prevent Gun Violence, at last week's Brady & APHA National Summit in Washington, D.C. Photo courtesy APHA Flickr

A little birdie told me so: Tweet of the day

Today's Tweet of the Day goes out to @liveablefuture, who has officially invented a new word. Let's help it go viral!

The faces of #APHA15

We keep clicking away here at the APHA 143rd Annual Meeting and Exposition! From top to bottom: Attendees smile for the camera at the McCormick Place Convention Center; APHA's Lesbian, Gay, Bisexual and Transgender Caucus of Public Health Professionals welcomes a visitor to their Public Health Expo booth; two public health practitioners take a break in the Mix and Mingle Lounge; big hugs at the Population, Reproductive and Sexual Health Section Awards Ceremony; and new friends at the Applied Public Health Statistics Section Social Meeting.

Photos by Natalie McGill and Michele Late, courtesy The Nation's Health

Climate change and health: 'No environmental justice without social justice'

Later this month in Paris, nearly 200 countries will convene for the 21st Conference of the Parties of the United Nations Framework Convention on Climate Change. It’s being billed as one of the most important climate change meetings ever. However — if all goes as planned — it could also end up being an enormous leap for public health too.

At a Tuesday morning Annual Meeting session on “Connecting Climate Change and Health Policies: Prioritizing Necessary Actions to Protect Public Health,” presenter Jonathan Patz, director of the Global Health Institute at the University of Wisconsin-Madison, told attendees that the goal of the Paris conference is to establish binding agreements to limit global warming to 2 degrees centigrade above pre-industrial levels. In fact, in the run-up to the Paris gathering, every country has been asked to provide their intended contributions to the reduction of greenhouse gas emissions. For instance, the U.S. intention is to reduce such emissions 32 percent below 2005 levels by 2030. However, Ethiopia’s commitment is really setting the bar high — that country intends to reduce its emissions by 64 percent by 2030, Patz said.

The whole endeavor is a bit daunting, Patz admitted, and the real question is “how are we going to get there?” But Patz thinks there’s a “secret” to this puzzle and that secret is public health. In other words, if policymakers better understood the enormous health and economic co-benefits of combating climate change — such as preventing pollution-related mortality, illness, medical care and absenteeism — then deciding to reduce greenhouse gas emissions in earnest could transform from the daunting choice to the easy choice.

And there’s no shortage of health statistics to make Patz’s case. For instance, he reminded session attendees that 8 million people die prematurely every year due to air pollution and more than 3 million die from sedentary lifestyles. On the flip side, he cited research that found if Canada could achieve the same biking and walking rates as the Netherlands — which would also reduce vehicle emissions that contribute to climate change — the country would avoid 175,000 disability-adjusted life years, which measures the number of years lost to illness, disability and early death.

“This is the time — right now — that we can really change society and make some major benefits,” Patz said.

In the U.S., the Centers for Disease Control and Prevention is leading public health efforts to prepare for and adapt to the health effects of climate change. Session presenter George Luber, who leads CDC’s climate and health activities, noted that the health impacts of climate change — such as heat illness and food- and water-borne illness — will have a disproportionate impact on already vulnerable populations. He also noted that the cumulative impact of climate change will be substantial as well — he described it as “morbidity and mortality by a thousand cuts.”

Luber also noted that the threats climate change pose to human health aren’t necessarily new and novel. But what will be new and novel is where the threats occur and how intense and frequent they’ll be.

Right now, Luber reminded the audience, the CDC Climate and Health Program is the only federal investment in climate change preparedness in the public health sector. The agency is helping states and cities prepare for future health challenges, use climate science and modeling, develop decision-making and support tools, and much more. In particular, CDC has the developed the BRACE framework to assist public health agencies in developing effective preparedness strategies.

So, what does integrating climate and health policy look like at the community level? Kimberly Wasserman, organizing and strategy director at the Little Village Environmental Justice Organization, told attendees of the group’s many victories that blend health and environmental justice. Little Village is a Chicago neighborhood of about 95,000 people within a five-mile radius — Wasserman said it’s often referred to as the Mexican capital of the Midwest. Among their biggest accomplishments was the closure of two of the nation’s oldest and dirtiest coal-fired power plants — one of the plants had been situated just a few hundred feet from Little Village, where residents suffer high rates of asthma and bronchitis. The organization, along with the Chicago Clean Power Coalition, pushed a local clean power ordinance and eventually, faced with pricey upgrades to its pollution controls, the power plants closed.

Other accomplishments Wasserman reported on included a new bus line where a three-mile gap in public transit had previously been, a quarter-acre community garden and an urban agriculture program. Little Village Environmental Justice Organization is in the middle of a new fight too: Unilever, the company that makes Hellmann’s mayonnaise, wants to expand its factory in Little Village, which means a huge jump in truck traffic and vehicle pollution right near a school. Wasserman and her colleagues are now working to ensure that children’s health doesn’t get left behind in the rush for new economic development.

“We never end this vicious cycle of environmental injustice in our community,” she said.

Wasserman told attendees that “as a community, our local economy is our strength.” As such, if the residents of Little Village aren’t intimately involved in local development decisions, “we’re going to be displaced and gentrified as a community,” she said.

“There can be no environmental justice without social justice,” Wasserman said.

Visit APHA for more resources on climate change and health, including our report, “Adaptation in Action: Grantee Success Stories from CDC’s Climate and Health Program." And watch an APHA TV interview with Patz on our YouTube channel.

— K.K.

Fitness apps: A fad or an agent for behavior change?

Whether worn on a wrist or downloaded to a smartphone, mobile fitness apps are becoming a more popular way to track physical activity.

“For the last 12 years, I’ve seen people in their search for fitness and many people do not ever find it," said Lynn Herrmann, an assistant professor at Northern Illinois University’s College of Health and Human Sciences, during a Tuesday morning Annual Meeting session on “Increasing Physical Activity: There's an App for That!” “Technology is giving us some hope that people will get there.”

But while there are benefits to mobile fitness apps, such as being free, low-cost and easily accessible, Herrmann and other presenters agreed that owning a fitness app doesn’t automatically lead to behavior change.

For example, Ralph Turner, associate director of research at HealthCore, led a FitBit tracker study of over 940 Anthem Inc. insurance employees after the company’s leadership voiced concerns about workers’ sedentary lifestyles. Participants were split into people who used the FitBit to track physical activity and those who used the FitBit in conjunction with a fitness coach.

Overall, he found a high rate of people who stopped using the tracker: 46 percent  stopped use after three months, 61 percent after six months and 79 percent after one year. People who already exercised stopped using the electronic trackers too, though at a slower rate than those who didn't exercise, he said.

Additional interventions that go hand in hand with fitness tracker use should be based in psychology, Turner noted.

“These devices are extremely popular,” Turner said. “But they’re not going to get you up off your butt and get you walking. But there’s room for growth. There’s promise and perhaps over the next decade, we’ll see movement in this area.”

For five months, Herrmann’s study tracked three apps used by 47 people whose average age was about 44 and who exercised at least four times per week.

Across all three apps, users reported liking the workout variety and number of activities. However, use dropped significantly, with participants citing difficulty in use and difficulty in navigating across all three apps.

Herrmann said in an ideal world, research on how people actually use mobile fitness apps would inform the development of new apps, and such development would be rooted in evidence-based health behavior research.

“It’s not being done,” Herrmann said. “This is a direction we need to head.”

— N.M.

Monday General Session: 'Health is a river that runs through everything'

“These days we call ourselves the department of opportunity because housing is one of the tools that can spark great things in people’s lives,” U.S. Housing Secretary Julian Castro told U.S. Surgeon General Vivek Murthy during yesterday's Monday General Session on the National Prevention Council.

The council, or a “crown jewel of the Affordable Care Act,” as APHA Executive Director Georges Benjamin described it, is helping the country more fully embrace a health-in-all-policies approach. Indeed, the fact that the housing secretary was sharing the stage with our surgeon general perfectly illustrated how the council is bringing different agencies together to work toward a healthier nation.

In the housing arena, health-based efforts include those that reduce children’s exposure to lead-based paint, eliminate mold from housing units and encourage more housing communities to go smoke-free. Castro spoke excitedly about a pilot project he hopes gets funded in the near future that would give seniors in subsidized housing easier access to care.

Murthy first sat down with Castro for a friendly chat about the ways the U.S. Department of Housing and Urban Development is helping put the National Prevention Strategy into action. Created by the National Prevention Council in 2011, The strategy aims to increase the number of Americans who are healthy at every stage of life.

Making health happen in areas like housing and transportation — sectors that haven’t traditionally considered their impacts on health — depends on good leadership, Castro said. The former San Antonio mayor urged the Annual Meeting audience to be the squeaky wheel that advocates for important change.

“It makes a difference to have loud, effective advocates,” Castro said. “But you can’t just be loud. You also have to be effective and smart.” When the audience and Murthy laughed, he quickly added, “which all of you are.”

After Castro left the stage, but not before sharing a few more laughs and mutual compliments with Murthy, the nation’s top doc welcomed two more key public health figures who are working to make progress in prevention.

Jonathan Woodson, assistant secretary for health affairs at the Department of Defense, reminded the audience to keep working together.

“It is about strong partners, both within government and out of government, that will win the day,” he said.

Partnerships are what help the DOD make progress with its Healthy Base Initiative. Part of Operation Live Well, the project works to promote active living, healthy eating habits and overall well-being among the military and their families.

When asked about her prevention perspective, APHA President Shiriki Kumanyika described herself a public health stakeholder, speaking from her role with Healthy People 2020 (she was the vice chair of the advisory committee that crafted that national vision for a healthier nation).

During her Healthy People 2020 work, she said she and other committee members talked a lot about aligning sectors that often have conflicting goals, such the agriculture and nutrition field. She agreed with Woodson's thoughts on partnerships, saying cooperation between the federal government, private sector and public health sector could help maximize the work of the National Prevention Council.

“I think we in the public health field have to act as ambassadors,” she said. That means conducting health impact assessments, providing technical assistance to those who want to work in the health sphere, and helping map where health is being impacted. We must remind the for-profit sector of their stake in addressing the social determinants of health, Shiriki said.

“An educated population, and a population with a humane living wage, has got to be good for everybody’s business,” Kumanyika said to a big nod from Murthy.

Murthy summed up the work of the National Prevention Council — as well as all those gathering in Chicago for the APHA Annual Meeting — when he mentioned a quote he uses often.

“Health is a river that runs through everything,” Murthy said just before escorting Kumanyika and Woodson off the stage. “The question is whether we choose to recognize it or not.”

— D.C.

Above from top to bottom: Surgeon General Vivek Murthy, left, and U.S. Housing Secretary Julian Castro; Jonathan Woodson, assistant secretary for health affairs at the Department of Defense; and APHA President Shiriki Kumanyika. Photos by Jim Ezell, courtesy EZ Event Photography

APHA Storify: Expo-nentially awesome

Today's APHA Storify comes to you from the hundreds of booths at the Public Health Expo.

Monday, November 2, 2015

Tuesday’s Have You Heard

Documenting disparities: This year marks the 30th anniversary of the Heckler Report, a landmark report from the U.S. Department of Health and Human Services that led to the creation of the U.S. Office of Minority Health. The milestone report, which documented the existence of racial and ethnic health disparities, is the topic of discussion at session 4107, “The Heckler Report as a Catalyst for Action: Historical and Current Activities to Support the Promotion of Health Equity Through Select State and Federal Programs," at 10:30 a.m. in MPCC W175c.

Environmental health in tribal lands: Learn about environmental health challenges facing tribal communities during session 4106, “Empowered to Take Action: Environmental Health in Indian Country,” at 10:30 a.m. in MPCC W175b. Presentation topics include the impacts of industrial sand mining, the effects of Superfund sites in tribal communities, and bridging environmental and health data.

Animal house: The philosophy of “one health,” which recognizes the connections between human, environmental and animal health, is the focus of session 4258, “One World, One Medicine, One Health,” at 12:30 p.m. in Hyatt Regency McCormick Place CC24C. The session will feature discussions on rabies control, E. coli at a suburban day care and petting farm, and the Army Veterinarian Service.

Putting the 'pop' in public health: From malaria to tobacco, session 4447, “Mass Media and Pop Culture in Health Communication,” at 4:30 p.m. in MPCC W193b will explore innovative health communication campaigns, such as a stroke literacy intervention using hip-hop music and efforts in the Nigerian film industry to develop scripts based on behavior change methodology.

Public health heroes: Stop by APHA’s annual Public Health Awards Ceremony and Reception in MPCC S100a between 6 and 8:30 p.m. to congratulate the winners. Among this year’s award winners are Helene Gayle, CEO of McKinsey Social Initiative and former CEO at CARE, who is the recipient of the APHA Presidential Citation; U.S. Sen. Edward Markey, D-Mass., recipient of the APHA Distinguished Public Health Legislator of the Year Award; and Willie James Parker, an ardent reproductive health and abortion access advocate, who will receive the Helen Rodriguez-Trias Social Justice Award.

Above, check out a video about the National Tribal Environmental Think Tank and then attend session 4106 on environmental health in Indian country.

Public health in pictures

The APHA 143rd Annual Meeting and Exposition is in full swing! From top to bottom: Attendees give a smile for Generation Public Health; another bright smile at the APHA photo booth inside McCormick Place Convention Center; a Public Health Expo visitor gets her caricature drawn; and public health folks take a break and a stretch at the APHA Wellness Center. All photos by Michele Late, courtesy The Nation's Health

Hold the mushrooms please

“A Moldy Planet: Fungal Infections Are Everywhere,” a Monday morning Annual Meeting session, sounded a bit like the title of an old-school pulp comic. In fact, it made me want to frantically wash my hands. But when I left the session, I felt infinitely better. Public health was on the job.

The session offered some interesting insights into fungal diseases, which we don’t hear about that often. I mean, fungi are so cute and adorable. How dangerous could they be, right? Well, it turns out the image in my head of a red-capped mushroom with white polka dots isn’t as innocent as it appears.

“Fungal diseases don’t get a lot of love,” said session presenter Greg Greene, an epidemiologist at the Centers for Disease Control and Prevention.

Greene focuses on Cryptococcus diseases, opportunistic infections that kill half a million people every year in sub-Saharan Africa. The fungus is found in soil just about everywhere in the world — all of us have probably been exposed, Greene said — but our immune systems are strong enough to protect us. But for those with compromised immune systems, Cryptococcus can get in the bloodstream, spread to the spinal column and brain and lead to meningitis. Fortunately, there’s an easy, cheap and commercially available test for the infection, and early detection significantly improves long-term survival. But patients have to be treated promptly and have to adhere to antifungal treatment — “there lies the challenge to this intervention,” Greene told session attendees.

To confront that challenge, public health workers are working to implement three main strategies: provider-initiated screening, automatic testing in a laboratory for those at high risk, and point-of-care screening followed by the immediate initiation of treatment. Today, 19 countries have adopted screening interventions for Cryptococcus. For example, Greene said, Rwanda adopted a strategy of provider-initiated screening in 2014 and today, providers and laboratory technicians throughout the country have been trained in the screening strategy. In South Africa, automatic lab testing has resulted in more than 55,000 samples screened and a growth in testing capacity from two labs in one province to 10 labs in four provinces. And in Lesotho, point-of-care screening has been conducted by layworkers since 2014.

But there is a key to such success, Greene said: “Government has to be behind this.”

In Washington state, public health workers take a one-health approach to coccidioidomycosis, also known as valley fever. People contract valley fever by breathing in microscopic fungal spores, although most people won’t get sick from it. Some people who do get sick will need anti-fungal medication. Session presenter Ron Wohrle, a public health veterinarian at the Washington State Department of Health, said the first endemically reported cases of valley fever in Washington state occurred in 2010-2011; fast forward to 2014, and 21 cases were reported, of which three were locally acquired. Though Wohrle said officials believe infections are under-reported.

To get a better handle on the fungal infection, Wohrle and his public health colleagues launched some surveillance efforts, taking and testing targeted soil samples from suspected exposure sites. To date, nearly 200 samples have been collected from 11 sites in two counties, with 13 samples testing positive. In terms of the one-health approach, Wohrle said he’s also working with 14 veterinarian hospitals to collect canine serum samples — so far, about 260 samples have been tested, with 2.7 percent testing positive for coccidioidomycosis. In the future, Wohrle said he and his colleagues hope to develop habitat suitability models that could help predict where valley fever risks are likely to be high.

But like lots of health threats, fungal infections are becoming resistant to medications as well, said session presenter Angela Cleveland of the Mycotic Diseases Branch at CDC. Cleveland reported that candidemia, a bloodstream infection caused by the yeast candida, is the most common fungal infection and one that’s associated with high rates of morbidity and mortality. In fact, candidemia is now the top cause of bloodstream infections in health care settings, Cleveland told session attendees.

Cleveland said CDC is particularly concerned that some strains of candida are becoming resistant to first-line and second-line antifungal treatments. And because there’s no mandatory reporting on candidemia, the true burden is unknown. However, in 2008, CDC began a surveillance effort in Maryland, Georgia, Tennessee and Oregon. Overall, it seems like resistance trends are on an upward climb, though resistance appeared to concentrate in certain hospitals.

The lesson? There’s no F-U-N in fungal diseases.

— K.K.

For your viewing pleasure

As you're strolling through the convention center or lying down for a quick bite of entertainment before bedtime, you may have noticed a new channel on the screen — APHA TV.  This is the second year APHA is partnering with WebsEdge to broadcast daily APHA TV episodes and original interviews direct from the 143rd Annual Meeting and Exposition in Chicago.

Below, for your viewing pleasure, are a few of this year's broadcasts. From top to bottom: An interview with Jonathan Patz, director of the University of Wisconsin-Madison Global Health Institute, on climate change; an interview with U.S. Surgeon General Vivek Murthy on his call to action on walking; and an interview with APHA President-elect Camara Jones on tackling health disparities. (And a bonus video from APHA's YouTube channel of Freeman Hrabowski's keynote speech at Sunday's Opening General Session.) Visit APHA for more APHA TV.

A little birdie told me so: Tweet of the day

Today's tweet of the day goes out to @befulina, who joined a jam-packed morning session on racism and public health. If you missed out on the session — or just couldn't find an empty patch of carpet — check out APHA's webinar series on the "Impact of Racism on the Health and Well-Being of the Nation."

The kids are (or will be) all right

In a year when Chicago police have pulled more guns off the street than in New York and Los Angeles combined, gun violence — particularly involving youth — has been at the forefront of the minds of educators, law enforcement officers and advocates.

There are myriad aspects to the issues of youth violence: Brain development (which continues into the mid-20s), hormonal shifts and mood swings, plus exposure to violence and trauma can all put young people at risk, Harold Spivak, deputy director and chief of staff at the National Institute of Justice, told meeting attendees. In fact, children who had experienced abuse had little to no activity in their temporal lobe — the part of the brain that controls listening, memory and emotion. Violence is literally injuring children’s brains.

So at Monday’s session on the topic, “Health in Criminal and Juvenile Justice Policy,” advocates looked at how public health might approach this public safety problem. Theron Pride, chief of staff at the U.S. Department of Justice’s Office of Justice Programs, called on public health to help protect children and prevent them from turning to violence.

“If you like to fix things, if you really like to solve problems, this is one that could really use solving,” Pride said. “We know enough. Youth violence is preventable. I believe one day we will have a cure for cancer. But we have a cure for violence now. Kids killing kids is not inevitable.”

The goal, in addition to prevention, is also to make sure that kids who do turn to violence are set back on the right path. The juvenile justice system plays a role in that, and advocates hope to move from a punitive system to one that addresses the root causes of violence, said Robert Listenbee, administrator at the DOJ’s Office of Juvenile Justice and Delinquency Prevention. The goal is to have fewer punishment-based interactions with high-risk kids, Listenbee said.

“We need to tailor our responses to heal that which has been harmed,” he said.

To learn more about youth violence prevention, visit

— L.W.

Climate changes health

Earlier today at the Public Health Expo, George Luber, right, author of "Global Climate Change and Human Health: From Science to Practice," met with Annual Meeting attendees and signed copies of his book. Luber serves as chief of the Climate and Health Program at the National Center for Environmental Health at the Centers for Disease Control and Prevention. Visit APHA for more resources on climate change and health.

Photo by Kim Krisberg

Tickets please!

A man sits in a wheelchair and explains how he lost two feet to diabetes-related complications, but that he’s relieved he is no longer in excruciating pain.

A health educator’s eyes well with tears as she talks about the ways she’s seen high school students improve their health thanks to a public health program that has them cooking meals together and exercising daily.

A former computer programmer shows off the fresh greens in his garden and smiles, saying his life is so much better now that his job involves tilling the soil.

The films of the Global Public Health Film Festival are powerful examples of how public health changes lives. At this morning’s session on chronic disease prevention and management, highlights included a California-based community wellness program, diabetes prevention outreach among indigenous residents of New Zealand and how parents in one Virginia county mobilized to help more kids bike or walk to school.

Whether clips of longer, feature-length films, public service announcements or telenovellas, the films hit home with anyone who cares about public health. Filmmakers often are available at the end of each session to answer audience questions and discuss how they came up with the concept of their films.

Some of the films use actors to dramatize or comedy on the screen, while others, like this morning’s film on how diabetes is hitting hard in a community in rural Mexico, showcase real people talking about real health issues, problems and solutions. Many remind us of this unyielding public health truth: community members are the best agents of change in their own neighborhoods.

Films cover a range of fascinating public health topics, from mental health to human trafficking to inspiring action and using effective storytelling. The film festival runs through Wednesday at 2 p.m. in McCormick Place W180 and is a great way to take a load off your tired feet and be inspired about so much of the good work being done in public health all over the world.

— D.C.

Health in all policies in Chicago: Getting kids active

Drive through some streets of Chicago during the summer and you may find a double-dutch jump rope tournament where a line of cars used to be.

That’s because since 2012, some of the city’s least busy routes transform into temporary play areas under Chicago’s Play Streets program, an example of coalition building for health presented during Monday’s session on “Chicago Community Partnerships: Local Examples of Integrating Health in All Policies.”

Play Streets began in Chicago in 2012 and has been funded over the years by the city, Blue Cross Blue Shield and Partnership for a Healthier America. Since it began, more than 65,000 participants have participated in 425 events in over 35 communities, said Melody Geraci, deputy director of Active Transportation Alliance, a Chicago-based advocacy group that helps facilitate Play Streets events. The Play Streets concept originated in New York City in the early 1900s, she said.

Organizations like Geraci’s receive a contract via the Chicago Department of Public Health to pass money to community-based groups to host a number of Play Streets events.

There are unexpected community benefits to the program too, Geraci said. While it’s great to see kids moving, the thing community members say they appreciate most is its role in preventing crime, she said.

“They’re telling us things like ‘The guys who stand on the corner, they aren’t there that day,’” Geraci said. “They decide not to stand there. They bring their kids and we see them jumping rope. There’s something about play that feels like it’s deserved.”

Out of the streets and into the schools, the Chicago Public Schools’ Office of Student Health and Wellness launched a plan to reform physical education via its “Movement Movement” strategic plan in 2012. The plan stemmed from a partnership with teachers, administrators, nonprofit groups and others to come up with physical activity guidelines for Chicago’s schools.

What came out of it were multiple physical education policies passed in 2014, such as the requirement that high school students must have a daily physical education or health course for the same amount of time as other core subjects.

Schools were also required to submit physical education action plans that meet new policies, including ones that require recess for younger students. Until policies born from Movement Movement took place, recess hadn’t been mandated in Chicago public schools in more than 30 years.

Today, new policies mandate that recess be at least 20 minutes long and cannot be withheld as punishment, among other requirements, said session presenter Abby Rose, school wellness specialist for Chicago Public Schools.

“It’s one of the times kids have to be independent where they’re learning emotional and social behaviors that we’re teaching them,” Rose said.

— N.M.

Boogie nights

The most fun I’ve had at any APHA Annual Meeting? Doing the #GimmeFive dance with hundreds of my closest public health friends.

As part of this year’s new Wellness Center activities designed to help us all have a healthy meeting, the group dance brought some fabulous energy to McCormick Place. Yes, I was nervous as the crowd of onlookers started to gather around and I realized I didn’t really know the steps that well. But thanks to a lot of enthusiasm on the part of my fellow dancers and the APHA staff leading our practice rounds, it all came together beautifully. A huge thanks to everyone cheering us on as we finished the routine.

The Annual Meeting attendee dancing next to me said she’s been doing the dance in her office as a break between long data analysis sessions. What a brilliant use of stress-relieving movement.

I’d highly suggest you check out the video and dance along. Research shows physical activity improves mood. Dance is an especially fun way to move your body while having a good time.

Even if dance isn’t your thing, check out the Wellness Center behind the Mix and Mingle Lounge in McCormick Place West Central Concourse. You can take a mini exercise break or take a moment to stretch before your next scientific session.

— D.C.

Two top photos of yesterday's #GimmeFive dance by Jim Ezell, courtesy EZ Event Photography

We are Generation Public Health

By now, you’ve likely heard about Generation Public Health, APHA’s new movement to create the healthiest nation in one generation. You’ve also likely heard all the reasons to join and sign our pledge too, such as America’s poor showing in health outcomes and life expectancy when compared to many other high-income nations. But we’d like to offer a few more reasons you might not have heard just yet.

First, social justice. There’s lots of efforts and activities going on around the country that focus on improving people’s health. But there’s no cohesive health movement that outspokenly elevates the tenets of social justice as key determinants in improving U.S. health outcomes. At APHA, we know that we can’t achieve our healthiest nation goal without speaking out on social issues such as income inequality, discrimination and human rights. When you join Generation Public Health, you’re joining a movement of people who know that good health is built on a foundation of equality.

Second, prevention. With the enactment of the Affordable Care Act, policymakers and health care systems are zeroing in on how to deliver the highest-quality care and reduce costly hospital re-admissions. This is fantastic and desperately needed. But we simply can’t improve health in the long term and in a sustainable fashion without an equal amount of attention and support for community-based prevention efforts that utilize proven public health approaches. Generation Public Health is dedicated to educating the public about the power of prevention (both health wise and economically) and rallying diverse support to make prevention a priority in our health care system.

Third, health in all policies. For all of us in public health, considering the health implications of policy decisions across sectors just makes sense. Health is everywhere and so everyone must consider health. It’s a no-brainer. But a health-in-all-policies framework is still very much an emerging trend – in other words, it’s not being used nearly as much as it should be and there’s plenty of stakeholders who have no idea that they can affect positive health change. Elevating and educating about a health-in-all-policies approach is a Generation Public Health priority and we need your help to spread the word. In fact, a health-in-all-policies approach is the perfect tool to engage nontraditional partners in our goal to create the healthiest nation in one generation.

So, have we convinced you yet? Join Generation Public Health today and sign APHA’s pledge to do your part in creating a healthier nation for all.

Our communities, our sexual health

Though it hardly seems that far in the past, the HIV/AIDS epidemic first gripped the nation more than 30 years ago. In the time since, communities have worked together to fight the diseases’ deadly impacts.

It’s that history that inspired the stories in “Our Communities Our Sexual Health: Awareness and Prevention for African Americans.” Edited by Madeline Sutton, Jo A. Valentine and William C. Jenkins, the book explores the struggles and successes in the black community, from public health workers and advocates to lay people.

It’s those many stories that make the book special, says Jenkins, who was signing copies of the book with Sutton on Sunday at the APHA Press booth in the Public Health Expo hall.

“For me, it was...a journey of reflection of some great people in public health,” he says. “I’m hoping that it will describe different journeys, different views, different experiences people might have, so they can think through their journey in public health.”

Pulling from many experts in sexual and public health, the editors found that their stories, while they came from all walks of life and health, touched on similar points.

“I went into it with a very open view of what people might say, and I was pleased with this sense that there were connections in the journeys,” Jenkins adds.

It was clear that the editors themselves had made connections as well. During their book signing, many people approached both Sutton and Jenkins to thank them for their work on the book, their mentorship and their friendship over the years. Many worked in sexual health, as advocates for black health or both, but some were laypeople. That’s just the mix the editors hope to reach, says Sutton.

“A couple of people said they already read it and were using it in their classes that are ongoing,” Sutton says. “That’s nice to hear. It means we’re hitting the right communities. Ultimately, I would like for it to resonate with the lay person, that they would find some nugget in there for them.”

“Our Communities Our Sexual Health” is available at the APHA Press booth, #941, and online.

— L.W.

Above, an Annual Meeting attendee poses with authors Madeline Sutton and William Jenkins, who signed copies of their book yesterday at the Public Health Expo. Photo by Lindsey Wahowiak

Addressing life expectancy at APHA’s codeathon

From apps that count steps to devices that monitor blood sugar, electronic gadgets have become an everyday part of health for many people.

During the APHA Public Health Codeathon in Chicago this weekend, teams of public health professionals worked with technology builders to create tools that can help people have lives that are not only healthier, but also longer.

Held in conjunction with APHA’s 143rd Annual Meeting and Exposition, the two-and-a-half day codeathon challenged teams to create tools centered around the theme of “Creating the Healthiest Nation: Addressing Life Expectancy.”

Four teams rose to the challenge, creating apps and programs that can help people estimate how long they will live, choose healthier food, manage their diabetes and make other behavioral health decisions.

The winning app, Text4Health, was designed to help people understand risky lifestyle choices and get insights on how to make changes. Users of the app would be able to enter personal data to see how long they would live based on their lifestyle and other factors, then get tips on how to improve their health.

“We all know that making change at the behavioral level is very difficult,” said Junaed Siddiqui, a member of the winning team, during the team’s presentation to judges. “People who want to make behavior changes don’t always have access to the resources that they need, and they don’t know how to go about finding out more.”

The first-place app was created by a team called Terps Care, with members hailing from the University of Maryland. This is not the first year a team from the school earned honors at an APHA codeathon. In fact, University of Maryland teams earned top honors at APHA’s past two codeathons as well.

Other tools created during the codeathon include Yumme, an app that would help parents shop for and prepare healthy food with their children, and Tinder Healthbot, which would allow users to receive information on sexual health while using dating apps. Another tool, AHRx, would help people with diabetes better manage their disease by monitoring electronic health information.

Codeathon judge Jay Bhatt, chief health officer at the Illinois Hospital Association, encouraged teams to continue developing their tools, noting that “the work, engagement and fun does not stop after this weekend.”

— M.L. 

Above, the Terps Care team from the University of Maryland took home this year's top prize at the Public Health Codeathon. Photo courtesy APHA Flickr