Good humor man

Who knew that former U.S. Surgeon General C. Everett Koop, MD, was not only a leading public health advocate and anti-smoking hero, but also a comedian. Last night, Koop, above, performed alongside entertainers with the Capitol Steps political comedy show at the Washington Convention Center.

Photo courtesy EZ Event Photography

Take two Wikis and call me in the morning

Blogs, Wikis, podcasts and virtual worlds. Public health workers have a wide range of new media available nowadays to help spread the word about public health. But do they work?

According to a panel of federal, educational and private sector health workers who spoke at a session at APHA’s 135th Annual Meeting this Monday, the answer is a resounding “yes!”

More and more health workers, educators and agencies are using new electronic media to reach out and connect with the public, with encouraging results. Among those setting the example for the rest of us in public health is the Centers for Disease Control and Prevention. Last year, CDC successfully used blogs, podcasts, webinars, photo-sharing sites and other media to publicize seasonal flu vaccinations, drawing 12,000 people to its seasonal flu Web site in just one week.

CDC planners even went so far as to set up a flu clinic on Whyville, an online virtual reality world for children, to give virtual flu shots and answer kids' questions, reported presenter Erin Edgerton of CDC. More than 134,000 Whyville visits were made to the “clinic,” and almost 20,000 kids received virtual shots.

Online virtual worlds such as Whyville and Second Life present a new opportunity to improve health education of the public, said presenter Lucy Annang, of the University of South Carolina. For example, CDC has a virtual public health office in Second Life where real staff answer users’ health questions. Other organizations that have a presence in Second Life include the American Cancer Society and Brigadoon, which addresses Asperger’s syndrome.

At the college level, public health students at the University of Michigan are tackling issues such as depression and eating disorders via a new health podcast series. Students have responded well to the podcasts, said presenter Sara Abelson, and new topics are being considered for future podcasts.

“Health educators have an opportunity to lead the field with creative use of podcasting technology,” Abelson said.

While such new media methods may not reach everyone — particularly older Americans and those who don’t have access to computers — they allow health workers the potential to reach more people and improve their health and lives, presenters underscored.

“We need to adapt to an evolving world,” Annang said.

— M.L.

Expo-nential opportunities

What do key chains, hand sanitizer and packet of dried plums have in common? They’re just a small sample of the bounty of giveaways available at the APHA Public Health Expo.

When the doors opened Sunday afternoon, flocks of APHA Annual Meeting attendees eagerly dispersed to hundreds of booths to speak with representatives, gather information and, of course, pick up lots of free goodies. It was like a public health free-for-all.

The Expo, which will continue through Wednesday, includes more than 700 booths where attendees can learn about public health careers, publishers, computer and pharmaceutical companies, schools of public health, health-related government agencies and other public health service and product-related organizations. Chatting with booth representatives today, Expo-goers had the chance to network and drop off resumes with prospective employers, learn more about public health research and opportunities, and collect souvenirs.

In Publishers’ Row, visitors swooped up Rand Corporation’s “Research at a Glance” briefs on topics ranging from reducing obesity to consumer-directed health care. Mingling in the row of schools of public health, visitors at the Drexel University School of Public Health booth learned about academic programs while snacking on pretzels. In the cluster of technology companies, visitors got an up-close look at the Gaumard Scientific Company Inc.’s life-size human simulators — don’t worry, they’re for educational uses only. And after gathering informational brochures and pamphlets from around the room, visitors relaxed in armchairs at the Department of Health and Human Services’ Office of Public Health and Science booth to read over their materials.

If you’re stopping by the Expo this week — and why wouldn’t you? — navigating the event need not feel overwhelming. Walk two steps in the door and a large map will help you plot your trip. Feeling adventurous? Then just pick a direction and wander. If you get lost, just look up for the giant signs pointing out general booth categories, such as “Schools of Public Health,” “Publishers” or “Everything APHA.”

And you might want to bring an extra bag with you — just in case your eyes are bigger than your tote bag.

— A.B.

Poster sessions: A one-stop shop

While it’s easy to get lost in the seemingly endless rows of booths at APHA's Public Health Expo, it’s worth the effort to make your way to the poster sessions alllllllllll the way in the back of the room.

Stopping by the poster sessions is a great way to get an overview of the important initiatives and research happening at universities, departments of health and other public-health minded organizations. Tailor your visit to your needs by fast-forwarding through all the posters, or lingering with the presenters for an in-depth explanation of a few studies.

Take it as an opportunity to speak with researchers on a topic you’re already working on, or learn about a new issue that you may not have time to attend a full session on.

Here are just a few highlights from Sunday afternoon’s poster session:

• The Orange County Health Department in Florida pioneered postpartum nutrition education programs for Hispanic and black women, tailoring the programs to the groups separately to account for cultural differences. Ninety-four percent of women who completed the 24-week “Better Weight for a Better You” program lost weight.

• A poll of voters in Ohio found that helmet use among all-terrain vehicle riders would double if a law were passed to require helmet use. The Columbus Children’s Research Institute found high public support for safety initiatives, including legislation requiring helmet use, safety classes, as well as age and passenger restrictions.

• A study of racial and ethnic disparities in gestational diabetes mellitus in Oregon found that Asian and Pacific Islanders had higher rates than some other groups. However, misidentification of other ethnic groups, namely American Indians, may play a role in this outcome. Regardless, 70 percent of women with gestational diabetes will eventually develop type II diabetes, which can be used as a justification for glucose testing in postpartum health care, according to the research from Oregon Health and Sciences University.

From college binge drinking to baseball injuries to ageism in hospitals, there was something new for all public health professionals. If you missed today’s poster sessions, be sure to check out future poster presentations in the coming days (and at dinner that night, you can wow your colleagues with an array of statistics, such as the rate of pertussis in the United States).

Preview the upcoming poster sessions in the online schedule.

— P.T.

A bright future for public health?

Like many public health workers, Julie Gerberding admits that sometimes the burden can feel too big — that sometimes it helps to seek out a different view.

That view, she told attendees at the Annual Meeting’s Opening Session on Sunday, can be seen from her garden, where sometimes she said she feels like reveling and other times, she feels like wielding a hatchet. Some nights, though, the director of the Centers for Disease Control and Prevention said she looks over her garden and notices fireflies hovering about — and she thinks of her fellow public health colleagues. Like fireflies, public health workers represent “flashes of brilliance” — and the efforts of such workers are extraordinary, she said. But while each worker flashes their own “light,” public health workers as a collective haven’t been able to link together in a sustainable way, Gerberding said.

Part of the reason is because of the country’s failure to invest properly in the public health system as well as its failure to truly address health inequities. Even though the United States is the wealthiest nation on the planet and we spend the most on health care, our health indicators lag far behind those of other industrialized countries. However, Gerberding noted that the time is ripe to establish a “new vision” for America’s health, to move toward creating a health — not health care — system driven by two principles: health protection and health equity. Such a system may seem far off, but it’s not “pie in the sky,” Gerberding said. Public health workers, she said in her closing remarks, can help “create an illumination that will change the world.”

Following Gerberding, award-winning public health author and practitioner Laurie Garrett spoke before the audience of thousands on the seemingly overwhelming state of global public health. The gaps in indicators like life expectancy and maternal mortality between the wealthiest and poorest nations is only getting wider and simply throwing money — even lots of money — at the problem won’t solve the issues, Garrett said. For example, many on-the-ground programs in Africa working on HIV/AIDS simply don’t have the infrastructure or the workers to effectively administer massive amounts of funds. One organization said it had spent more than a third of its funds just to build a road from the clinic to the community, Garrett told Opening Session attendees.

Garrett said one of the biggest obstacles to truly improving global health is the massive shortage of health care workers in places like sub-Saharan Africa — and the United States isn’t helping. Faced with our own shortage of nurses, Garrett said U.S. policy-makers have failed to invest more in nursing education or make sure nursing professors are paid a decent salary (a comment to which the audience gave a round of applause) and are instead recruiting health workers from abroad. In short, “we don’t have an HIV crisis, we have a health care worker crisis,” she said. A crisis that could be mitigated by investing in community health workers, Garrett said.

The billions of dollars already in the global public health pot must be used more effectively, Garrett said. Organizers must step away from the traditional charity model and move toward models that encourage dignity, self-reliance and sustainability.

Before Gerberding and Garrett took to the stage, previous speakers spoke of the need to continue building a strong public health movement, supporting fair public health policies and working to create unity among traditional and non-traditional public health partners. Opening Session speaker and APHA President Deborah Klein-Walker, EdD, seemed to sum up the Annual Meeting’s overriding theme best: “I am committed to public health because it is the practice of social justice.”

Did the Opening Session speakers talk to your concerns about the future of public health? Will it change your outlook as you spend the next few days learning about new ways to improve the health of your community?

— K.K.

For another take on APHA's 135th Annual Meeting Opening Session, visit the Pump Handle public health blog.

Gerberding photo courtesy EZ Event Photography

Lost childhoods

A tin miner in Bolivia, a welder in India, bricklayers in Nepal and workers in a Guatemalan firecracker factory — all hazardous occupations and all performed by children.

The lives of such children were the focus of a presentation during Saturday’s activist summit organized by APHA’s Occupational Health and Safety Section and attended by workplace safety and health advocates. During the presentation, David Parker, MD, MPH, a medical epidemiologist, showed photographs from his book, “Before Their Time: The World of Child Labor.”

According to the book, 320 million children worldwide younger than 16 work, with 150 million employed in hazardous industries. Throughout the book, Parker discusses the detrimental health outcomes of child labor, not only from the hazardous effects of industrial substances, such as lead, on a developing body and mind, but from having to forfeit an education so a child can help support her or his family.

During the question-and-answer period, a participant commented that the reality is that many families would face starvation without their children’s extra income. Poverty, the participant said, is at the heart of child labor. Parker agreed, adding that a strong public health system must also be central in the movement to curb child labor. Public health systems are needed so families, especially mothers, can stay healthy, he said. Increasing access and support for reproductive health services is particularly critical. Women in developing nations face a disproportionately high maternal mortality burden, and many fathers don’t care for their children if the mother dies, leaving many kids to seek dangerous work to survive, Parker said.

Unfortunately, as social support systems are stressed more and more under the weight of preventable disease and death, child labor numbers will continue to rise, Parker noted. Economic development, he said, won’t solve the child labor problem on its own — public health must be part of the solution.

Visit Parker’s Web site for more information and to view photos from his book.

— K.K.

Making sure no one is left behind

When public health emergencies strike, how do we meet the needs of different populations, and in particular, people living with disabilities?

Those attending yesterday’s Student Assembly meeting on improving public health preparedness systems, heard from Eileen Elias, MEd, deputy director of the Office on Disability at the U.S. Department of Health and Human Services, and Leon Larson, senior program analyst in the HHS Office of the Assistant Secretary for Preparedness and Response, on just that subject. The presenters described the limited mechanisms currently in place at the federal, state and private levels to enforce comprehensive preparedness planning that addresses the unique challenges facing people with disabilities.

Elias pointed to Hurricane Katrina as a case-in-point for the major challenges people with disabilities may face during emergencies. When Katrina struck the U.S. Gulf Coast, Elias said, many people with disabilities were separated from their caregivers, service animals, needed prescriptions and other social supports during evacuations and while they stayed at shelters.

However, to ensure that the needs of people with disabilities are met when future emergencies occur, HHS’s Office on Disability has formed a partnership with the Office of the Assistant Secretary for Preparedness and Response. The two offices are jointly offering emergency planning and response documents, including a “shelter assessment tool” and an “emergency planner toolkit,” as a part of their efforts.

During the question-and-answer session with Elias, Student Assembly Chair-elect Tamar Klaiman noted that Hurricane Katrina as well as the attacks of Sept. 11 not only “brought home” the reality of disasters striking on American soil, but also led to increased funding for research into public health emergency preparedness, providing the necessary resources to develop an effective knowledge base.

Visit the APHA Annual Meeting site to find more scientific sessions on public health and emergency preparedness.

— A.B.

Public health students 'get ready'

APHA’s Student Assembly helped kicked off the 135th Annual Meeting today with “Get Ready: Improving Public Health Infrastructure and Infectious Disease Prevention.” Welcoming students from a variety of public health schools, student meeting Director Bryn Bird and Student Assembly Chair Darren Mays, MPH, opened the meeting with a few helpful tips for Student Assembly members to help them make the most of their time at the meeting.

For starters, Mays recommended that students check out the Student Assembly booth, number 1422 in the schools of public health section of the Public Health Expo. There, attendees can learn more about the Assembly and how to get involved with volunteer opportunities as well as in Assembly committees. Information at the booth will also be available for those interested in visiting Capitol Hill on Monday, Nov. 5, and advocating on behalf of public health.

Also, an official student welcome and orientation event on Monday will provide an overview of the Student Assembly for those new to APHA. The event, which takes place from 12:30 p.m. to 2 p.m. in room 202A of the Washington Convention Center, will include a discussion with APHA’s president-elect candidates, an awards session and an informal candidate roundtable.

After Bird’s and Mays’ welcoming remarks, Lynn Goldman, MD, MPH, professor and chair of the Interdepartmental Program in Applied Public Health at Johns Hopkins University Bloomberg School of Public Health, presented the keynote address at the student gathering. She discussed the need to improve the public health infrastructure to better support emergency preparedness activities, citing examples of poor public health preparation and management during Hurricane Katrina and the terrorist attacks of Sept. 11, 2001.

When such emergencies occur, Goldman said, it is crucial that the voice of science reaches key decision-makers, and that risk communication is effectively and accurately relayed to the public.

“People want information that holds up, not spin control,” she said.

Goldman stressed the importance of the Student Assembly in focusing the public health agenda on current and “real” issues. She advised Assembly members heading into the public health work force to be “clear, grounded and forceful” when talking to the media to ensure that necessary health information reaches the public. Preparing the public to be “responders” and to take preventive measures is a key goal of public health, she said.

— A.B.