Meeting by the sea

Already getting ready for APHA’s 136th Annual Meeting in October in San Diego? So are we. And not only are we looking forward to some hot topics inside the convention center, we’re looking forward to the hot weather outside the convention center (and not lugging our big winter coats from room to room). We can already smell the salty breeze......

But before you pack your favorite beach towel, don’t forget to subscribe to the Annual Meeting daily blog so you can begin receiving updates via e-mail in the fall. Daily postings will begin shortly before the Annual Meeting starts and go throughout the meeting, covering scientific sessions, social events and much more.

And don’t forget your sunscreen!

Until we meet again

Another year, another successful APHA Annual Meeting.

Final counts put this year’s meeting attendance at more than 14,000 people — that’s 14,000 people who may be more motivated to contact their legislators and advocate for public health; 14,000 who could have learned a new, innovative way to improve their community’s health; 14,000 who made new public health friends; and 14,000 who hopefully returned home with a renewed sense of mission.

APHA’s new president, Linda Degutis, DrPH, MSN, certainly seemed energized during her remarks at yesterday’s Closing Session, calling on attendees to be public health advocates and educate decision-makers about public health’s critical role. She emphasized that public health must be the voice for those who are too sick, too scared or too young to speak for themselves. Degutis spoke loud and clear: denying State Children’s Health Insurance Program coverage for uninsured kids is unacceptable; sending troops into war and then denying them access to care upon their return is unacceptable; and keeping maternal health services out of reach for undocumented immigrants is also unacceptable.

Step into the advocacy arena, she told attendees, and don’t be “intimidated by those with more money and power.”

Speaking of advocacy, CNN’s Sanjay Gupta, MD, broke some good news at the closing, announcing that this week Texas voters passed Proposition 15, a $3 billion bond plan to support cancer research and prevention. Tuesday’s vote on Proposition 15 was the reason Gupta, a member of the Lance Armstrong Foundation board, replaced original session speaker Lance Armstrong, who was in Texas gathering support for the measure.

Gupta told attendees that now — more than ever before — cancer is an important topic in presidential candidate circles. In fact, a number of top White House contenders recently spoke at a presidential forum hosted by the Lance Armstrong Foundation, he said. And they should be talking: “Cancer is and continues to be a national threat,” Gupta noted.

At the Closing Session’s end, APHA’s Executive Director Georges Benjamin, MD, FACP, sent his public health colleagues home with a not-so-small homework assignment: to help pass a strong SCHIP bill, eliminate health disparities and continue supporting a robust public health infrastrucutre.

“It can be done — it must be done,” he said.

On that positive note, see you next year in San Diego for APHA’s 136th Annual Meeting, “Public Health Without Borders.”

— K.K.

The body politic

Abortion. The HPV vaccine. Maternal mortality. Three very different issues, but all serving as poignant examples of the inherent dangers of allowing politics to supersede women’s health.

These three topics were the central issues discussed in today’s special session, “Women’s Health: In the Political Crossfire,” which shined a spotlight on the detrimental health effects of allowing politics and ideology to dictate evidence-based public health practices.

Abortion — perhaps the most obvious women’s health issue that finds itself overshadowed by politics — was discussed within the slippery-slope framework of increasing regulation. As noted by panelist Louise Melling, a lawyer with the American Civil Liberties Union’s Reproductive Freedom Project, the 2007 Supreme Court ruling on partial-birth abortion — which upheld a federal ban on the procedure — demonstrated the degree to which the nation’s highest court has reversed course since 1973’s landmark Roe v. Wade. Melling provided telling examples to support the idea that increased limitations on a women’s right to choose fly in the face of efforts to protect and improve women’s health.

In his discussion of recent attempts to mandate HPV vaccinations, panelist Lawrence Gostin, JD, LLD, a professor of global health law at Georgetown University, also argued that politics present real dangers to women’s health. Gostin, who feels that mandating the vaccine should be a last resort, argued that issues of social justice arise when a vaccine is mandated for one group and not another. This is significant, he said, because although men and women are equally affected by HPV, states that do mandate vaccination only require women to get immunized. And though the vaccine has been approved by federal safety agencies, the HPV vaccine has not been subjected to large-scale, long-term clinical trials.

The final panelist, Deni Robey, JD, added a global perspective to the discussion. Robey works for Americans for UNFPA, an organization that works to build American support for the United Nations Population Fund, which provides critical reproductive health services to women worldwide. She discussed how U.S. politics not only affect women domestically, but globally. Looking specifically at the disturbingly high rates of maternal mortality around the world, Robey illustrated the connection between the current U.S. administration’s refusal to fund certain international contraceptive programs and the continued numbers of women dying — needlessly — during childbirth. The U.S. government — the only government that won’t contribute to UNFPA because of ideological differences — has withheld close to $200 million in funding since 2002. That’s $200 million less that can be used to help the upwards of 16 per 100 women who die while giving birth in nations with the worst maternal mortality rates.

In the end, women’s health and politics will probably continue to mingle in the same circles for quite some time, but the question remains: What will we do to change the situation?

— B.L.

Best in show

Before the events of the past few days begin to fade from memory and we all slide back into our usual routines, let us know what your favorite part of the 135th APHA Annual Meeting was. If everyone will look to their right, you'll see a conveniently placed poll to help you answer that question. Was it the Public Health Expo, the scientific sessions, a Section social...or the curious "other." (If it was "other," please satisfy our curiousity and leave us a comment.)

And don't forget to check in with this blog on Thursday for highlights from the Closing Session as well as last-minute news from meeting.

A side of subsidy with your veggies?

What does the government tell us we should eat more of? Fruits, vegetables and whole grains. What foods does the government support with the vast majority of its food subsidies? Dairy and meat products.

What’s wrong with this picture? In the quest for a modern federal farm bill, public health experts need to be at the table, said the speakers at yesterday’s panel entitled “Farm Bill Renewal: Going Forward with Nutrition and Food Policy Outcomes.”

You’ve heard statistics on the rising rates and costs of obesity and chronic disease in the United States. Yet the government provides our most vulnerable populations — those who rely on federal nutrition assistance programs — with high-cholesterol, high-fat foods from subsidized agriculture.

As panelist Hope Ferdowsian, MD, MPH, of the Washington Center for Clinical Research and George Washington University, put it: “As public health professionals, we need to be adamant about shifting subsidy supports to more healthful foods. It’s up to us to at least get in there and participate in the conversation.”

While the farm bill is obviously very complicated and requires input from multiple sectors, it makes sense to base agricultural subsidies on health considerations and eliminate subsidies that promote unhealthy foods, Ferdowsian said. In Poland, changes in subsidy regulations led to increased fruit imports and was actually associated with a reduced incidence of heart disease, she added.

Roni Neff, PhD, SM, of the Johns Hopkins University Bloomberg School of Public Health (and the school’s Center for a Livable Future), linked the concept of the human right to food with food agricultural policy. Analyzing the issue within a human rights framework establishes policy responses as obligations rather than charity or economic strategy, and holds countries to standards that protect individuals, Neff said. The right-to-food approach considers sustainability, economic access, energy conservation and nutrition programs to overlap with the overall goals of the farm bill.

Thus far, Neff noted, the right-to-food ideology has been irrelevant to policy development, and agricultural stakeholders continue to dominate the debate.

“I believe nobody in Congress would necessarily think about the right to food, or care, unless we in public health and our allies make them care,” Neff said.

Currently, the federal farm bill, which includes funding for nutrition and food security programs, is being debated on the floor of the U.S. Senate. To take action and encourage your senators to support a healthy farm bill, visit APHA’s advocacy site.

Extra food for thought: In the United States, the average vegetable travels 1,500 miles from farm to plate.

-P.T.

APHA: Climate change is public health

APHA announced that it’s putting itself front and center in the movement to educate people on the current and future effects of climate change, unveiling 2008’s National Public Health Week’s theme: “Climate Change: Our Health in the Balance.”

At a news conference held earlier today, APHA Executive Director Georges Benjamin, MD, FACP, put his proverbial “foot” down, telling reporters that “today, we are taking our seat at the table.” In other words, climate change is already having and is expected to have serious effects on people’s health and so public health must make its voice known — it’s public health workers that have the experience, technique and knowledge to prepare people for an environmentally uncertain future.

Jonathan Patz, MD, MPH, who spoke at the news event and has been a lead author of Intergovernmental Panel on Climate Change reports (the IPCC shared the Nobel prize with Al Gore this year), noted that climate change is more than political — it’s a moral issue too. It’s disadvantaged, vulnerable populations in the developed and developing world — the people who bear the least responsibility for emitting greenhouse gases into the air — who will bear the brunt of climate change’s health effects: heat waves, floods, more severe weather events and rises in vector-borne diseases, such as malaria.

Patz noted that it wasn’t until the risks of secondhand cigarette smoke became well known that smoking bans really gained momentum. And like secondhand smoke, our highly consumptive lifestyles and greenhouse gas emissions are having a negative health effect on those who bear little — if no — responsibility for the current crisis.

Thankfully, some local public health agencies are already building their seat at the climate change table. In Multnomah County, Ore., health department Director Lillian Shirley, MPH, MPA, said workers are already talking about what climate change-affected diseases should be on their radar, how they should prepare for more severe floodwater and snowmelts and whether their region will be susceptible to rises in vector-borne diseases.

At the news conference, Shirley said Multnomah health workers are putting public health preparedness methodology to work to get ready for climate change as well as talking about the positive incentives needed to promote behavior change. All the little things can add up, she said, like an employer who installs on-site showers to motivate employees to walk or bike to work. Shirley called on her public health colleagues to be vigilant locally where people work, play and live.

“The canary in the coal mine is local jurisdictions,” she said.

More information on 2008’s National Public Health Week, which runs April 7–13, 2008, will be available in December online. For information now, stop by the National Public Health Week booth at the Public Health Expo, booth number 535.

— K.K.

Being healthy is, like, totally cool

The eclectic group of presenters at this morning’s “Health Promotion and Young Adults” session was “in true APHA fashion,” said moderator Michelle Chuk, MPH. From binge drinking to disaster preparedness, the topics were varied, but a recurring theme was the importance of using the media to get messages out to youth and their parents.

When it comes to preparing college students for natural disasters or other emergencies (recent teachable examples include the San Diego wildfires and the Virginia Tech shootings), Judith Taylor, EdD, said it’s important to include young people in the discussion and planning stages. Developing individualized plans within families, schools and other groups instills the need for personal responsibility in planning for the worst (while hoping for the best). Taylor’s survey of students found that just 43 percent of participants had discussed with family how to prepare for a disaster, and only 22 percent had developed a formal plan. Taylor’s recommendation? “Make a plan, develop a kit, stay informed.”

Switching gears — what does the rock band Queen have to do with health education on STDs, depression and eating disorders? Well, the band’s HIV/AIDS awareness benefit concert in 1992 was the inspiration for Benjamin Levy, a fourth-year medical student at Emory University, and his friends to start Music Inspires Health, a non-profit organization educating youth on health issues through collaboration with musicians in concerts, videos and on the Web. With advice from an advisory board of doctors and with help from the music industry, Levy and his partners plan to launch a health education Web site and multimedia-based concert tour that entertains and informs. Striving to be like a “cool, older sibling” and getting out health information in an accurate, interactive and nonjudgmental way, Levy wants to focus on topics that teens are already curious about, but haven’t found the answers to in health class or elsewhere.

Game on! In after-school programs, getting adolescents to exercise is more than just providing a gym with a basketball and a jump rope. The approach of program organizers is crucial to success and overcoming barriers such as gender expectations, attitudes, space and finances, according to Tracy Nichols, PhD. She found that actively engaging adolescents in activities they are receptive to is more effective than trying to force new activities on them. But cultural, economic and age differences between the adolescents and providers can negatively affect the provider’s expectations. Thus, Nichols said that the providers themselves should be targeted for education — not just on the importance of physical activity for health and its associated fringe benefits, but also on how to implement successful programs without perpetuating assumptions such as girls like to sit on the sidelines or cheerlead so they don’t mess up their hair, and boys are competitive and aggressive and don’t like activities like dancing.

The remaining two panelists tackled college binge drinking. Natoshia Askelson, MPH, studied media coverage of drinking in college, and whether newspaper articles discussed strategies parents could use to reduce their child’s alcohol use. Turns out, parents have a lot more influence than they realize — but they grossly underestimate their child’s sexual activity and alcohol use. Ryan Martin, MS, discussed his study of protective behavioral strategies among college drinkers that limited negative consequences of alcohol use such as lower academic performance and overdoses. Martin said universities should actively promote protective behavioral strategies such as alternating alcoholic drinks with non-alcoholic drinks, using a designated driver and eating while drinking alcohol.

Now that you’ve read about efforts to educate youths on a variety of topics, what do you think are the best ways to target teens and young adults for health messages? And how do these methods differ from successful approaches to other age groups?

— P.T.

Click and shoot: Photos of war

They say actions speak louder than words, but sometimes pictures can leave you speechless.

That was the feeling this blogger felt walking among photographs at Monday’s opening reception for “Unembedded: Four Independent Photojournalists on the War in Iraq.” Presented in the lobby of the AFL-CIO building downtown, the photographs depict the effect of the war on Iraqi lives in a stark and truthful way — a way that often only photojournalists can capture.

I can’t speak for how others at the reception felt as they took in the 60 images and coinciding captions explaining the photos, but I’ll take a guess that a few emotions were pretty common: anger, frustration, sadness, motivation to do something … a bit of hopelessness. But no matter how you feel, the photos will move you in a very visceral way. Here is just a handful of what you’ll witness:

A father holding his child amid the rubble of his city; angry residents gathering together after a missile is accidentally launched and kills nearby residents; an Iraqi boy celebrating after setting fire to a U.S. vehicle; a young Iraqi amputee, civilians fleeing in fear and an Iraqi psychiatric patient afraid she’ll be stuck in a hospital for life.

Posted throughout the photo exhibit are the facts and figures of war. Here are a few:

— After the 2003 U.S. invasion, Iraq’s only long-term mental hospital was looted, and the 1,200 patients left — 600 have not returned.

— One in 10 U.S. soldiers who qualify for disability compensation are 100 percent disabled.

— Thirty-five percent of returning U.S. troops visited a mental health clinic during their first year back.

— Acute malnutrition among Iraqi children has more than doubled from 2003 to 2005.

— The estimated $456 billion spent on the Iraq war through 2007 could have provided 195 million U.S. kids with health care, 3.6 million affordable housing units and 75 million university scholarships.

A speaker at last night’s reception seemed to put everything in perspective: “Right now, the world is in a state of emergency.”

The Unembedded exhibit will be on display at the AFL-CIO building, 815 16th St., NW, through Thursday, Nov. 8, from 7 a.m. to 7 p.m. each day. The exhibit is presented by APHA as well as the Association’s Peace and Labor caucuses. Anyone who would like to donate to support the cost of the exhibit, can send checks made payable to APHA (note Unembedded) to Pamela Wilson, c/o Department for Professional Employees, AFL-CIO, 1025 Vermont Ave., N.W., Suite 1030, Washington, D.C. 20005.

K.K.