Closing Session: 'Social justice is the foundation of our field'

The promise of health reform is not safe — that was the message during this year's Closing Session in Denver, which opened its mountainous arms to more than 12,000 APHA Annual Meeting attendees.

Despite its potential to expand coverage to millions, its historic investment in prevention and wellness, and projections that it will save billions of dollars in the long term, the nation's landmark health reform law is vulnerable — especially in light of the recent congressional elections.

"This is a good bill, not a perfect bill," said session speaker Paul Jarris, executive director of the Association of State and Territorial Health Officials, who described the new health reform law as a substantial step forward.

Still, the fight for the law's survival isn't over, he noted. Almost half of states are suing the federal government over health reform, 40 different bills have been introduced in state legislatures to prohibit some aspect of reform and with a number of new governors poised to take office at a crucial time in reform's implementation process, problems are sure to arise. The answer? Become advocates, he said.

"Do you know this bill," Jarris asked. "Do you know how to talk about it in a way that everybody can understand?"

Maryland Secretary of Health and Mental Hygiene John Colmers, who described himself as a "passionate incrementalist," also called on session attendees to use storytelling to advocate for health reform.

Colmers cautioned that budget and deficit issues are going to drive much of the ongoing reform debate, adding that when "I think about public health (budgets), I shudder."

Unfortunately, reform supporters never convinced enough people of the notion that it's a good thing to pay into a system that will provide care for themselves and their families, said session speaker Sara Rosenbaum, chair of the Department of Health Policy at George Washington University. The great communication task before us is to bring the issue of health reform back to an everyday level — to help people grasp the enormous opportunity before us that we may be in danger of losing, she said.

"It's very clear we have work to do," said APHA Executive Director Georges Benjamin, who asked the Closing Session audience what they would do to ensure the promise of reform when they return home.

He called on them to do three things: Meet with your local elected officials and tell them what you want; when they don't vote the way you think they should, remind yourself that they work for you; and get off the bus and get into the streets. Demand health, Benjamin said, demand social justice.

Well, it's been an amazing meeting — the best that this blogger has had the privilege to attend. The energy to bring public health's unique form of social justice to communities worldwide has been palpable.

Let's bring that energy with us next year to the nation's capital for APHA's 139th Annual Meeting, which will have a theme of "Healthy Communities Promote Healthy Minds & Bodies."

"We reaffirmed that social justice is the foundation of our field," said new APHA President Linda Rae Murray at the Closing Session. "This attempt to drive our nation backward should not be a surprise. But I'm not worried. We're public health — we won't be bamboozled."

See you next year in Washington, D.C.!

— K.K.

Above, Closing Session speakers from left to right: Sara Rosenbaum, Paul Jarris, John Colmers and session moderator Joanne Silberner of National Public Radio. Photo by Kim Krisberg

Go for launch!

When Neil Armstrong took that one giant leap for mankind on the moon’s surface more than four decades ago, he probably had no idea how the space program would turn into a public health Hercules.

The NASA Applied Sciences Program links data gathered from space to projects that track malaria, forecast dust storms that can trigger asthma attacks, predict possible influenza outbreaks and more. A key focus is to monitor ways climate change is impacting health because, as NASA’s John Haynes said during a Wednesday Annual Meeting session, air quality, water and other things tracked from space “have a direct impact on public health issues across the globe.”

NASA satellites orbit the Earth and gather “slices of data” on weather patterns, vegetation density and countless other factors “much like you’re peeling an apple,” Haynes said during the session “NASA: A Unique View of the Earth for the Study of the Environment and Possible Associations with Disease Occurrence.”

The satellite data is not just for seasoned public health professionals. NASA has a student research program designed to help undergraduate, master’s level and even high school students get involved in harnessing space info for the greater health good. Students work with a NASA mentor to use data that can then be used for community-based projects like education outreach on the threats of tick-borne diseases.

Also, a pilot program in three U.S. cities is working to go further than National Weather Service heat advisories and target people at high-risk for heat-related illness and link them with services. One presenter talked of his projects aimed at giving advance notice to school nurses about dust storms and tracking pollen blooms that often set off asthma and allergy attacks.

“We’re looking at the best science,” said Stanley Morain of the University of New Mexico. “We’re really trying to get to the heart of our ability to do these things.”

Talk about a giant leap for mankind.

— D.C.

Above image courtesy NASA photo galleries

When disaster strikes

It’s been nearly seven months since one of the worst environmental disasters in U.S. history, and still the Gulf Coast oil disaster has left us in very murky waters, not to mention leaving behind a number of ongoing health challenges.

Today’s special session on "The Public Health Implications of the Gulf Oil Disaster" featured public health leaders who worked directly on the recovery and clean-up efforts in the aftermath of the explosion of a BP oil rig last spring. The first-hand accounts and pictures of the scene reminded participants of the magnitude of the disaster and why Gulf Coast residents and recovery workers are still reeling.

John Howard, director of the National Institute for Occupational Safety and Health, explained that there's not a whole lot known about the long-term health effects of crude oil. Even following the notorious Exxon Valdez oil spill in 1989, there was not much research done on the chronic health effects related to the spill. However, NIOSH is doing its part to lead efforts in ensuring worker safety and encouraging future research on this obvious knowledge gap.

Howard said a lesson learned after Sept. 11, 2001, was that there was no existing roster of workers that would allow health professionals to follow up on the possible health problems related to cleanup. So, NIOSH led efforts to develop a roster of workers responding to the recent Gulf Coast oil disaster, which includes 55,000 people. This roster is now available to researchers.

Alabama Health Officer Donald Williamson described the oil spill as “an event that had a cataclysmic economic impact on the state of Alabama and continues to have a lasting impact on the health and well-being of residents.” Research shows higher rates of reported depression and anxiety among residents, especially considering the economic impacts for fisherman and those whose livelihoods depend on tourism.

Despite seafood testing and other efforts used to determine which areas could be safely reopened to fishing, research has shown that the public is still wary about eating Gulf Coast seafood and restaurants avoid serving seafood from Gulf Coast suppliers.

Session presenters stressed that improved communication and health messaging is still needed to communicate the public health role in the Gulf Coast recovery and respond to misinformation.

— M.S.

A little birdie told me so: Tweet of the Day

On this last day of another fabulous APHA Annual Meeting, the Tweet of the Day from those of you using the hashtag #apha10 comes from — who else? — Opening Session speaker and Twitterwer CornelWest: We're in this together - cross color, cross culture, cross class. Let your light shine.

A public health program with teeth

We all know prevention, promotion and education work. But it's still incredibly reaffirming to learn about a fairly new initiative that's already making huge inroads.

That was the case today during a session on "Cavity-Free At Three: An Oral Disease Prevention Program for Infants and Toddlers in Colorado."

Begun just a couple years ago, Cavity-Free At Three educates families and health providers on good oral health and cavity prevention, pushes for the integration of oral health into well-child visits, helps children find dental homes and trains health workers in oral health risk assessments. The program puts a special emphasis on reaching pregnant women, spreading the word that mom's oral health can affect the health of her baby and that it's perfectly safe for pregnant women to seek dental care. Like the name says, the initiative's goal is for all Colorado kids to have cavity-free smiles by age 3.

Session presenter Karen Savoie, who directs education for the oral health initiative, noted that dental caries is the most common chronic childhood disease — five times more common than asthma. Eighty percent of the disease is in 20 percent of the population and like many diseases, dental caries is often a disease of poverty. In Colorado, about 8 percent of kids have experienced some tooth decay by age 1, with that number going up to 70 percent by age 4, Savoie said. To reach as many children as possible, the initiative works hard to bring workers across various health disciplines together in the name of prevention.

"We will all gain strength by sharing the responsibility of early childhood caries," Savoie said.

So far, more than 600 workers in Colorado have received training via Cavity-Free At Three, with 24 sessions taking place in 2010, thousands of fluoride varnish and oral health kits have been distributed, and more than 10,000 Colorado infants and families are estimated to have received services through the program, according to presenter Jack Westfall, a family doctor involved in the effort.

"Primary care providers are uniquely positioned to help," Westfall said.

On the public health side, three Colorado counties have integrated the oral health program into their work with the help of technical grants from Cavity-Free At Three, said session president Melissa Broudy, who worked with Jefferson County Public Health on the effort. And the results have been impressive: Colorado's Eagle County served 253 children in 2008 (accounting for 15 percent of all kids younger than 5 in that county); Grand County served 256 children over a two-year period (or 33 percent of all kids younger than 5); and Jefferson County did more than 1,500 screenings, with an additional 500 screenings in collaboration with Head Start.

That makes me smile.

— K.K.

Above illustration courtesy iStockphoto

Honor society

Let's hear it for this year's APHA award winners! For more on APHA's many awards, which range from honoring those who excel in advocacy to recognizing outstanding public health students, click here.

Above, recipients of APHA's annual awards smile for the camera during Tuesday night's Public Health Awards Reception and Ceremony in the Colorado Convention Center. Photo by Kenneth Bordelon

Keep it simple

The H1N1 flu outbreak keeps bringing us public health lessons, especially when it comes to the best ways to get important information to the people who need it most.

Folks with the Centers for Disease Control and Prevention’s Division of Global Migration and Quarantine are constantly working to prepare for the next emerging health threat. What came out of recent evaluations of public information efforts during the H1N1 pandemic underscored the need to keep messages simple and easy to understand, no matter what the audience.

“During this event, we were able to incorporate lessons learned as we went,” said Amanda McWhorter, a CDC health communications specialist and presenter during the Tuesday afternoon Annual Meeting session “2009 Pandemic influenza (H1N1) Communication Activities at CDC: Focusing on Specific Audiences and Settings.”

Some of those lessons learned:

— Establish partnerships and channels (think websites and e-cards, but also handouts and posters)
— Coordinate messages to ensure consistency
— Adapt quickly
— Present messages in plain language

And those lessons hold true whether the audience is international travelers, the K-12 school system, child care providers, colleges and universities, or businesses.

When needed, public health communicators can step up their game to better respond to concerns in real time, said session moderator Gabrielle Benenson, also with CDC.

“There’s sort of this 'in an emergency’ thing that happens and then a ‘day-to-day’ thing that happens,” Benenson said.

A recently produced “How to Clean and Disinfect Schools to Help Slow the Spread of Flu” handout breaks it down by defining the difference between cleaning, disinfecting and sanitizing and even listing bulleted, step-by-step instructions. That’s an example, session presenter and CDC staffer Tiffani Phelps said, of how to present easily understandable and helpful health information.

How will you know what information people need? We keep hearing it, but it never goes out of style: Build relationships and partnerships, and get out there and ask.

Check out CDC's free flu resources here.

— D.C.

Say cheese!

Don't forget to stop by the Everything APHA booth at the Public Health Expo to grab a souvenir T-shirt from this year's Annual Meeting.

Photo by Michele Late