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.

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.