And, as always, don't forget to sign-up for regular email updates from this very blog. Your trusty APHA Annual Meeting bloggers will soon begin posting regularly and we're looking forward to seeing you in San Francisco!
Tuesday, August 7, 2012
Start the countdown...
The August heat is sweltering, which means that APHA's 140th Annual Meeting & Exposition is just around the corner! Ocean views and historic cityscapes will provide the backdrop for this year's Annual Meeting, which convenes Oct. 27–31 in that beautiful city by the bay, San Francisco. Visit APHA's meeting site for everything you need to know about this year's meeting, its theme and how to register.
And, as always, don't forget to sign-up for regular email updates from this very blog. Your trusty APHA Annual Meeting bloggers will soon begin posting regularly and we're looking forward to seeing you in San Francisco!
And, as always, don't forget to sign-up for regular email updates from this very blog. Your trusty APHA Annual Meeting bloggers will soon begin posting regularly and we're looking forward to seeing you in San Francisco!
Thursday, June 28, 2012
Closing session: 'Let's evolve and let's do it together'
The last time this blogger felt such hair-raising excitement at an APHA meeting, civil rights philosopher Cornel West had whipped attendees into such a social justice tizzy that I thought 13,000 public health practitioners were going to spill into the Denver streets and start building healthier communities right there on the spot. But here in Charlotte at the smaller Midyear Meeting, I'd say the excitement (and sheer relief) were even bigger, more powerful and entirely motivating.
As many of the more than 400 folks at this year's Midyear Meeting came into the ballroom of the Westin Hotel for the closing session, the scroll from scotusblog.com was being projected onto a giant screen in the front of the room. It was pretty tense before the ruling came down; folks were standing around in groups, staring at the screen with the worried looks of parents whose daughter just left for the prom. Let's just say it was nerve-wracking.
Then the blog scroll popped up: "The individual mandate survives as a tax." And the crowd goes wild. And I mean wild. Even our very own Dr. Benjamin was seen wiping tears of joy from his face. It was a very good day for public health.
So, as you could imagine, it was a little hard to herd hundreds of jubilant public health practitioners to their seats to begin the closing session, but Dr. Benjamin managed to do it. Lisa Simpson, president and CEO of AcademyHealth, then came to the lectern to begin moderating a discussion on the "Path to the New Public Health."
First up was Lydia Ogden, director of the Health Reform Strategy, Policy and Coordination Office at the Centers for Disease Control and Prevention. She began by noting that the forces that drive change in the health care system aren't going away. Such forces are synergistic, she said, with the first being demographic changes. For example, between 8,000 and 10,000 people turn 65 years old everyday in the United States and that will happen every day for the next 18 years — "that's a profound change," Ogden said.
Another force of change will be the growing federal deficit, she said, noting that the feds borrow 41 cents of every dollar they spend. In turn, Ogden said this is one of the most fundamental questions we need to ask ourselves: Is what we're about to do worth borrowing 41 cents plus interest?
Looking ahead she said it's critical that public health and clinical practitioners not only partner, but take the time to better understand each other's work and challenges. To illustrate her point, she told a little story. Imagine public health came to you and said it wanted to marry health care. But because the two were pretty ignorant of each other, you'd have some qualms as to the longevity of the partnership. The moral: "If you want to be understood seek first to understand," Ogden said.
"One size won't fit all but if we keep focusing on our differences, we won't be able to learn as efficiently as we need to," she said. "Let's evolve and let's do it together."
Arkansas Surgeon General Joseph Thompson, director of the Arkansas Center for Health Improvement, began his time at the lectern with a Supreme Court-induced "WHOOP!" Then he asked the audience to join in with their own "WHOOPS" and they happily obliged.
Thompson said he never uses the term "public health" outside a room of fellow public health practitioners. For those outside the field, the term can come with too many preconceived notions. People, he said, may simply tune you out. But that doesn't mean people don't want to get in on the public health game, even if that's not what they call it.
"We have new players who are thinking about denominator medicine," Thompson said. "We don't need to argue about whether it's public health."
Lastly, Thompson called on those in health departments that provide direct clinical services to start learning how to bill for those services. He said it'll be next to impossible to maintain such services just with state funds — to have a viable financial future, we need to figure out how to bill.
Session speaker Cara McNulty, senior group manager at Target Corporation, said the company has a direct interest in the health and well-being of its more than 350,000 employees. In fact, McNulty said Target brought her onboard specifically to take on that issue. Her role, she said, is to look beyond health care and insurance plans to how to engage employees in staying healthy and happy. Like Thompson, she doesn't use the term "public health" when working with employers because they simply don't know what it means, she said. Instead, she keeps the conversation focused on improving the health of employees, which also improves the bottom line for employers.
"When working with employers, we need you to talk with them about policy, systems and environmental change," McNulty said. "Health isn't our primary business and we need your partnership."
Unfortunately, McNulty said she's never had someone from the local health department approach her about partnering, which she called on session attendees to start doing — "there's a huge opportunity to work with employers...if we're not all working collectively then we will never achieve population health."
"Be very clear in your language," she said. "Help us understand what you're trying to achieve because, believe me, as employers we want to improve health."
Then it was back to the news of the day, the 5-4 Supreme Court decision upholding the Affordable Care Act. (Though the court did rule that states can't be forced to participate in the law's Medicaid expansion and that Congress does not have the power to punish states that don't participate by withholding existing Medicaid funds. The court did, however, rule that the Medicaid expansion is constitutional.) Gene Matthews, with the Network for Public Health Law, called it a "breathtaking day." Still, many attendees as well as APHA's Dr. Benjamin cautioned against sitting on our laurels.
"We can take a victory leap but the fight and battle continue," said one attendee.
To see what others in the public health and health care arenas are saying about the ruling, visit APHA's Public Health Newswire.
And don't forget to register today for APHA's 140th Annual Meeting from Oct. 27–31 in San Francisco. This year's Annual Meeting theme is "Prevention and Wellness Across the Life Span."
See you next time in the City by the Bay!
As many of the more than 400 folks at this year's Midyear Meeting came into the ballroom of the Westin Hotel for the closing session, the scroll from scotusblog.com was being projected onto a giant screen in the front of the room. It was pretty tense before the ruling came down; folks were standing around in groups, staring at the screen with the worried looks of parents whose daughter just left for the prom. Let's just say it was nerve-wracking.
Then the blog scroll popped up: "The individual mandate survives as a tax." And the crowd goes wild. And I mean wild. Even our very own Dr. Benjamin was seen wiping tears of joy from his face. It was a very good day for public health.
So, as you could imagine, it was a little hard to herd hundreds of jubilant public health practitioners to their seats to begin the closing session, but Dr. Benjamin managed to do it. Lisa Simpson, president and CEO of AcademyHealth, then came to the lectern to begin moderating a discussion on the "Path to the New Public Health."
First up was Lydia Ogden, director of the Health Reform Strategy, Policy and Coordination Office at the Centers for Disease Control and Prevention. She began by noting that the forces that drive change in the health care system aren't going away. Such forces are synergistic, she said, with the first being demographic changes. For example, between 8,000 and 10,000 people turn 65 years old everyday in the United States and that will happen every day for the next 18 years — "that's a profound change," Ogden said.
Another force of change will be the growing federal deficit, she said, noting that the feds borrow 41 cents of every dollar they spend. In turn, Ogden said this is one of the most fundamental questions we need to ask ourselves: Is what we're about to do worth borrowing 41 cents plus interest?
Looking ahead she said it's critical that public health and clinical practitioners not only partner, but take the time to better understand each other's work and challenges. To illustrate her point, she told a little story. Imagine public health came to you and said it wanted to marry health care. But because the two were pretty ignorant of each other, you'd have some qualms as to the longevity of the partnership. The moral: "If you want to be understood seek first to understand," Ogden said.
"One size won't fit all but if we keep focusing on our differences, we won't be able to learn as efficiently as we need to," she said. "Let's evolve and let's do it together."
Arkansas Surgeon General Joseph Thompson, director of the Arkansas Center for Health Improvement, began his time at the lectern with a Supreme Court-induced "WHOOP!" Then he asked the audience to join in with their own "WHOOPS" and they happily obliged.
Thompson said he never uses the term "public health" outside a room of fellow public health practitioners. For those outside the field, the term can come with too many preconceived notions. People, he said, may simply tune you out. But that doesn't mean people don't want to get in on the public health game, even if that's not what they call it.
"We have new players who are thinking about denominator medicine," Thompson said. "We don't need to argue about whether it's public health."
Lastly, Thompson called on those in health departments that provide direct clinical services to start learning how to bill for those services. He said it'll be next to impossible to maintain such services just with state funds — to have a viable financial future, we need to figure out how to bill.
Session speaker Cara McNulty, senior group manager at Target Corporation, said the company has a direct interest in the health and well-being of its more than 350,000 employees. In fact, McNulty said Target brought her onboard specifically to take on that issue. Her role, she said, is to look beyond health care and insurance plans to how to engage employees in staying healthy and happy. Like Thompson, she doesn't use the term "public health" when working with employers because they simply don't know what it means, she said. Instead, she keeps the conversation focused on improving the health of employees, which also improves the bottom line for employers.
"When working with employers, we need you to talk with them about policy, systems and environmental change," McNulty said. "Health isn't our primary business and we need your partnership."
Unfortunately, McNulty said she's never had someone from the local health department approach her about partnering, which she called on session attendees to start doing — "there's a huge opportunity to work with employers...if we're not all working collectively then we will never achieve population health."
"Be very clear in your language," she said. "Help us understand what you're trying to achieve because, believe me, as employers we want to improve health."
Then it was back to the news of the day, the 5-4 Supreme Court decision upholding the Affordable Care Act. (Though the court did rule that states can't be forced to participate in the law's Medicaid expansion and that Congress does not have the power to punish states that don't participate by withholding existing Medicaid funds. The court did, however, rule that the Medicaid expansion is constitutional.) Gene Matthews, with the Network for Public Health Law, called it a "breathtaking day." Still, many attendees as well as APHA's Dr. Benjamin cautioned against sitting on our laurels.
"We can take a victory leap but the fight and battle continue," said one attendee.
To see what others in the public health and health care arenas are saying about the ruling, visit APHA's Public Health Newswire.
And don't forget to register today for APHA's 140th Annual Meeting from Oct. 27–31 in San Francisco. This year's Annual Meeting theme is "Prevention and Wellness Across the Life Span."
See you next time in the City by the Bay!
A little birdie told me so: Tweet of the day
On this last and very exciting day of APHA's Midyear Meeting, the Tweet of the Day goes out to Twitterer @shannonmace, who reminds us that parts of the Supreme Court decision still need to be carefully examined:
"Piece that needs to be carefully parsed out is that states option not to participate in Medicaid expansion w/o penalty" #APHAmid12
"Piece that needs to be carefully parsed out is that states option not to participate in Medicaid expansion w/o penalty" #APHAmid12
'A victory for us all'
 |
| The live feed from scotusblog.com was up in the Midyear Meeting's closing session room. This update was received with thunderous applause. |
If we had bottles of champagne here in Charlotte, the corks would still be popping and the celebratory bubbly flowing. This blogger can't imagine a better place to be right now than surrounded by fellow folks who believe that health care should be a human right and not a privilege. Here are just a few quotes from some very happy APHA members.
"I think this is fantastic. It's surprising...but I'm very proud of the court. Now we can go forward. It's a fantastic decision for the health of the American public." — Past APHA President Deborah Klein Walker
"It's a victory for us all." — Cheryl Johnson Benjamin, South Carolina's United Way of the Midlands
"I'm amazed that logic has won out. It's so amazing to celebrate with all these public health people." — Kerry Burch, North Carolina's Mecklenburg County Health Department
"It's why I went to public health school. It's about time." — Adele Amodeo, executive director, California Public Health Association-North
"The Prevention Fund is constitutional and Congress ought to leave it alone." — Georges Benjamin, executive director, APHA
Read APHA's news release for a full statement from Benjamin on the Supreme Court's ruling.
Upheld!!!
The scene here is absolutely ecstatic. This quote says it all from attendee Mona Sarfaty, a former staffer for U.S. Sen Ted Kennedy and a professor at Thomas Jefferson University in Philadelphia:
"Forty years of work. I'm laughing and crying at the same time."
Above, photos of the Midyear Meeting attendees reacting to the Supreme Court ruling upholding nearly all of the Patient Protection and Affordable Care Act.
Countdown for health reform
Alright folks, just about an hour until we know the fate of the Affordable Care Act. Stay tuned to the APHA Meetings Blog for reactions from the Midyear Meeting here in Charlotte. Talk about nervous energy...
Community prevention: Where the rubber meets the road
We’re all waiting with baited breath for the Supreme Court to hand down its ruling on the Affordable Care Act on Thursday morning, but essentially we’ve been implementing it for the past two years. And a huge component of the law is all about prevention.
In a Wednesday afternoon session, “Innovations in Community Prevention,” panelists shared just how they’ve been putting prevention to work. As we’ve heard throughout this meeting, assuring the future health of the next generation relies on innovation and building community partnerships. So, let’s hear how the experts are doing just that.
“Local relationships are where it’s at,” presenter Jeffrey Engel reminded attendees.
According to Engel, the policy director of North Carolina’s state health department, the Tarheel state has received the fourth largest Community Transformation Grant award in the nation. It’s been using the money to develop policy addressing tobacco-free spaces, active living by design, healthy eating and clinical preventive services.
In 2006, one out of 60 of the state’s community colleges was tobacco-free. Ironically, Engel pointed out, that campus happened to be located in the tobacco-rich Raleigh-Durham area. Now, thanks in no small part to the state’s prevention grants, virtually all are tobacco-free.
But Mary Balluff was quick to point out that some states and cities don’t have such a grand cache.
Balluff, of the Douglas County Health Department, shared how they’ve applied their grant dollars in Omaha, Neb., a city that at one point was ranked 142 out of 183 largest cities in terms of health risks. Balluff saw this as room for improvement.
Through the work of its Communities Putting Prevention to Work Grant — most appropriately branded “Douglas County Putting Prevention to Work” — the county recruited 19 partners across nine initiatives, from a traffic safety campaign to a healthy corner store initiative.
Balluff touted the steps she and her colleagues employed for community engagement: a common agenda, shared measurement, mutually reinforced activities and continuous engagement.
Next up was Terrence Roach, who spells prevention: “Y-M-C-A.”
“The table had been set, but we weren’t there,” said Roach, senior director of organization and community change of YMCA of the USA, referring to the important role the “Y” could play in community prevention.
“The Y's strength has historically been in the primary prevention stage. But, with the rise of chronic disease, we needed to move the Y’s focus further down,” he said. (Think more secondary and tertiary levels of disease prevention.)
So through its Healthy Communities Initiatives, which Roche said served as a basis for Community Transformation Grants, the Y developed diabetes and childhood obesity prevention programs.
“If you weren’t overweight or didn’t have risk factors, you weren’t eligible to be a part of that program,” he told attendees.
The Y now boasts a robust policy program and lobbying arm. Through its work, it has helped create hundreds of healthy corner stores, more than 1,000 safe routes to school and community parks, and more than 2,000 tobacco-free buildings in communities across the country.
“When we first started, the table was set and we weren’t there,” he said. “Now over a decade later, we’ve set the table and are asking others to join us.”
In a Wednesday afternoon session, “Innovations in Community Prevention,” panelists shared just how they’ve been putting prevention to work. As we’ve heard throughout this meeting, assuring the future health of the next generation relies on innovation and building community partnerships. So, let’s hear how the experts are doing just that.
“Local relationships are where it’s at,” presenter Jeffrey Engel reminded attendees.
According to Engel, the policy director of North Carolina’s state health department, the Tarheel state has received the fourth largest Community Transformation Grant award in the nation. It’s been using the money to develop policy addressing tobacco-free spaces, active living by design, healthy eating and clinical preventive services.
In 2006, one out of 60 of the state’s community colleges was tobacco-free. Ironically, Engel pointed out, that campus happened to be located in the tobacco-rich Raleigh-Durham area. Now, thanks in no small part to the state’s prevention grants, virtually all are tobacco-free.
But Mary Balluff was quick to point out that some states and cities don’t have such a grand cache.
Balluff, of the Douglas County Health Department, shared how they’ve applied their grant dollars in Omaha, Neb., a city that at one point was ranked 142 out of 183 largest cities in terms of health risks. Balluff saw this as room for improvement.
Through the work of its Communities Putting Prevention to Work Grant — most appropriately branded “Douglas County Putting Prevention to Work” — the county recruited 19 partners across nine initiatives, from a traffic safety campaign to a healthy corner store initiative.
Balluff touted the steps she and her colleagues employed for community engagement: a common agenda, shared measurement, mutually reinforced activities and continuous engagement.
Next up was Terrence Roach, who spells prevention: “Y-M-C-A.”
“The table had been set, but we weren’t there,” said Roach, senior director of organization and community change of YMCA of the USA, referring to the important role the “Y” could play in community prevention.
“The Y's strength has historically been in the primary prevention stage. But, with the rise of chronic disease, we needed to move the Y’s focus further down,” he said. (Think more secondary and tertiary levels of disease prevention.)
So through its Healthy Communities Initiatives, which Roche said served as a basis for Community Transformation Grants, the Y developed diabetes and childhood obesity prevention programs.
“If you weren’t overweight or didn’t have risk factors, you weren’t eligible to be a part of that program,” he told attendees.
The Y now boasts a robust policy program and lobbying arm. Through its work, it has helped create hundreds of healthy corner stores, more than 1,000 safe routes to school and community parks, and more than 2,000 tobacco-free buildings in communities across the country.
“When we first started, the table was set and we weren’t there,” he said. “Now over a decade later, we’ve set the table and are asking others to join us.”
Wednesday, June 27, 2012
Getting ready to face the future
Judith Monroe kicked off today's afternoon session with jellyfish. Not actual jellyfish (though that would've been one seriously memorable session). A story about jellyfish.
Monroe, who's deputy director of the Centers for Disease Control and Prevention, told the story of Jellyfish Lake, which is located in the Rock Islands of Palau. Millions of years ago, Jellyfish Lake formed as a landlocked saltwater lake, and the jellyfish got trapped, never to go to the ocean again. So they began to adapt. Their new environment didn't have the same old predators, so the jellyfish lost their stingers. They freely swim to the top of the lake to get sunlight and to the bottom to get rich nitrogen. The jellyfish have the lake to themselves — as Monroe said, they have a pretty good life.
Of course, this isn't a story entirely about jellyfish. Monroe was using it as a metaphor for the kind of adaptation and transformation that public health must undergo as well. During the Wednesday afternoon session on "Visions of the Future: A Leadership Challenge," Monroe, who moderated the session, said public health has to contemplate three things: What should we continue doing, what should we start doing and what should we stop doing.
Massachusetts Health Commissioner John Auerbach told attendees how his state has been transforming and adapting. Six years after the state adopted its own health reform law, 98 percent of Massachusetts residents, including 100 percent of children, are insured. But there's still work to be done, Auerbach said. He said there are five new challenges and skills that public health needs to work on.
First, zero in on the social and economic conditions that affect people's health and employ effective policy to shape those conditions. Second, hone new skills, enhance analytical skills and learn about health information technology. Third, clarify who the payers are and what the responsibilities of public health are. Fourth, be better at demonstrating the value of public health work, particularly prevention (ideally, he said public health should be able to show insurers the return on investment within 18 months). And fifth, link population health and clinical care, and provide input on what quality care entails.
Lillian Shirley, president of the National Association of County and City Health Officials, noted that each jurisdiction will have to struggle according to its own circumstances to make progress. Then Shirley made a well-received shout-out to her fellow nurses, calling on attendees not to overlook the contributions of the nursing workforce. (For example, she said folks in her state of Oregon are "hysterical" over a Medicaid expansion because they say there's not enough doctors; to which Shirley says: what about the role of nurses? Cue more applause.)
"How are we going to knit together all these really great things that are going on...and make it a system transformation," she said. "We have to put our shoulder to the wheel on that one."
Nancy Terwood, East Great Lakes regional director of the National Association of Local Boards of Health, called on attendees to "look at your board of health member as an untapped resource." She noted that board of health members "really are the voice of local public health...we can be your legs, your voices, your arms." Unfortunately, she said that a recent association survey found that boards of health members desperately need training in a variety of areas, including how to do self-assessments and how to advocate for public health. Boards of health members, she said, "want to learn about helping you."
When it comes to the health of American Indian communities, Paul Allis, director of public health programs at the National Indian Health Board, said there's been a lot of progress on partnerships between federal health officials and tribal ones. He noted that the movement toward accreditation is helping to elevate public health within tribal communities. Though he did say that tribal leaders want to interact with state, local or federal leaders, "from nation to nation."
Public health, Shirley said, attracts people to it because of its mission, vision and values. We're attractive to people who want to change the world, she said, so let's "capture that excitement."
Monroe, who's deputy director of the Centers for Disease Control and Prevention, told the story of Jellyfish Lake, which is located in the Rock Islands of Palau. Millions of years ago, Jellyfish Lake formed as a landlocked saltwater lake, and the jellyfish got trapped, never to go to the ocean again. So they began to adapt. Their new environment didn't have the same old predators, so the jellyfish lost their stingers. They freely swim to the top of the lake to get sunlight and to the bottom to get rich nitrogen. The jellyfish have the lake to themselves — as Monroe said, they have a pretty good life.
Of course, this isn't a story entirely about jellyfish. Monroe was using it as a metaphor for the kind of adaptation and transformation that public health must undergo as well. During the Wednesday afternoon session on "Visions of the Future: A Leadership Challenge," Monroe, who moderated the session, said public health has to contemplate three things: What should we continue doing, what should we start doing and what should we stop doing.
Massachusetts Health Commissioner John Auerbach told attendees how his state has been transforming and adapting. Six years after the state adopted its own health reform law, 98 percent of Massachusetts residents, including 100 percent of children, are insured. But there's still work to be done, Auerbach said. He said there are five new challenges and skills that public health needs to work on.
First, zero in on the social and economic conditions that affect people's health and employ effective policy to shape those conditions. Second, hone new skills, enhance analytical skills and learn about health information technology. Third, clarify who the payers are and what the responsibilities of public health are. Fourth, be better at demonstrating the value of public health work, particularly prevention (ideally, he said public health should be able to show insurers the return on investment within 18 months). And fifth, link population health and clinical care, and provide input on what quality care entails.
Lillian Shirley, president of the National Association of County and City Health Officials, noted that each jurisdiction will have to struggle according to its own circumstances to make progress. Then Shirley made a well-received shout-out to her fellow nurses, calling on attendees not to overlook the contributions of the nursing workforce. (For example, she said folks in her state of Oregon are "hysterical" over a Medicaid expansion because they say there's not enough doctors; to which Shirley says: what about the role of nurses? Cue more applause.)
"How are we going to knit together all these really great things that are going on...and make it a system transformation," she said. "We have to put our shoulder to the wheel on that one."
Nancy Terwood, East Great Lakes regional director of the National Association of Local Boards of Health, called on attendees to "look at your board of health member as an untapped resource." She noted that board of health members "really are the voice of local public health...we can be your legs, your voices, your arms." Unfortunately, she said that a recent association survey found that boards of health members desperately need training in a variety of areas, including how to do self-assessments and how to advocate for public health. Boards of health members, she said, "want to learn about helping you."
When it comes to the health of American Indian communities, Paul Allis, director of public health programs at the National Indian Health Board, said there's been a lot of progress on partnerships between federal health officials and tribal ones. He noted that the movement toward accreditation is helping to elevate public health within tribal communities. Though he did say that tribal leaders want to interact with state, local or federal leaders, "from nation to nation."
Public health, Shirley said, attracts people to it because of its mission, vision and values. We're attractive to people who want to change the world, she said, so let's "capture that excitement."
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