Sunday, October 28, 2012

Harnessing hope


Gail Sheehy probably had a hand cramp after signing so many copies of her book “Passages in Caregiving” for Annual Meeting attendees. Her messages of hope for those caring for elderly, chronically ill family members resonate with so many.

“Those who suffer so much are caregivers, and I think she’s identified that and experienced it and is what I’d consider an expert in the field,” said Sara Johnson, who bought a book for herself and another for a friend who is a caregiver.

“I didn’t even want to read the book, honestly,” said Pamela Luna, of Riverside, whose mother has stage-four lung cancer and father is on oxygen and suffers from chronic obstructive pulmonary disease. Yet when she checked it out at the library, she found an encouraging message. “This is really a book about hope.”

Betty Daniels bought a book for her sister, who is caregiver for her 96-year-old mother. Susan Colman purchased one for herself and one for her sister-in-law, both caregivers for her 82-year-old mother-in-law who has Alzheimer’s disease.

Scott Morrow said he was afraid he’d break down in tears when asked why he bought the book. He hopes it offers support to his stepfather, who is caring for his mother, who has dementia, as well as his developmentally disabled brother. Morrow flies monthly from California to Florida just to help for a few days.

“There’s no answer to this,” Morrow said about the stress of family caregiving. “She talked about the circle of care, and that’s what they really need.”

“How do we take care of our late-living parents and in-laws without depriving men and women in midlife?” Sheehy said as the long line formed. “There is no support for caregivers who have this job. I’m happy there’s more attention to this, but I don’t see any real movement in health care” to address the problem. “Where’s the money, and where’s the will?”

Karen Hiller’s mother suffered a fall two years ago, leading to her placement in a nursing home. The first to get her copy of the book signed, Hiller told Sheehy, “listening to you today really helped me know I’m normal.”

Check out the book and other engaging public health titles at APHA Press in the Everything APHA Booth, #1925.

— D.C.

Above, Gail Sheehy talks with meeting attendee Karen Hiller at Sunday's book signing. Photo by Donya Currie

It's a public health circus! Literally!






After today's Opening Session, surprise entertainers led Annual Meeting attendees over to the Public Health Expo in Moscone Convention Center South. Halloween's come early to APHA!

Top four photos by Jim Ezell/EZ Event Photography; last photo of an Annual Meeting attendee getting her groove on by Charlotte Tucker

Health reform history is hilarious


It might look like a comic book from the outside, but in reality, the new book authored in part by APHA's executive director is both entertainment and an important teaching tool.

"The Quest for Health Reform: A Satirical History," is a collection of editorial cartoons tracing the movement for universal national health reform.

APHA's Georges Benjamin co-authored the book with Theodore Brown, Susan Ladwig and Elyse Berkman, and all four authors were on hand today to sign copies of the book at the Public Health Expo at the Annual Meeting.

"It presents information in a way that is interesting to me," said Khalid Almutairi, an associate professor at King Saud University in Saudi Arabia.

Almutairi said he will use the book in his class to help his students understand the movement for health reform in the United States.

"The way we look at the U.S., it's like a benchmark," he said, holding his signed copy of the book. "We can benefit from the experience of the U.S., so we need to watch what (you) do. It's a great way for our students to have experience with what's going on in the West."

For Jean Demmler, chair of APHA's Mental Health Section, the book will be a prize. At a Section gathering during the Annual Meeting, she'll present it as a gift to one of the Section's 40-year members.

"I just think it's a fun way to see (health reform) from a new perspective," she said.

"The Quest for Health Reform: A Satirical History" is for sale at the APHA Press booth, #1925, in the Public Health Expo.

— C.T.

Above, book authors sign copies of "The Quest for Health Reform: A Satirical History" at the Public Health Expo. Photo by Charlotte Tucker

Opening Session: 'This is the time for celebration of what you are'





If you were at today's Opening Session, you probably feel a little bit more appreciated than usual. Nearly every speaker who came to the stage talked about what an honor it was to be surrounded by APHA Annual Meeting attendees — the people who've dedicated themselves to making the world a better place for everyone one community at a time.

APHA Executive Director Georges Benjamin started the trend, asking attendees to stand up and be recognized. In fact, he called on attendees to clap loud enough so all of San Francisco would know that for the next four days, the Moscone Convention Center would be home to that great and determined force that is public health.

Speaker Reed Tuckson, executive vice president and chief of medical affairs at UnitedHealth, followed the trend, noting that it "is an extraordinary honor to be in your presence." He began by noting the "tsunami" of preventable disease now threatening to destroy the health care system and the disaster it represents for all payers of health care services. But to overcome this towering problem and achieve the vision of this year's Annual Meeting, "Prevention and Wellness Across the Life Span," it'll take four steps, he said.

The first: Organize a new vision for our work and be willing to sustain even when things become uncomfortable for our individual activities. Dismantle our myopic silos, Tuckson said — we need a new kind of visionary leadership that knows how to mobilize all pieces of the puzzle. Second: Data and analytics are key to realizing this vision. Without data, he said, we won't be able to identify individual risk, need, preferences and cultural values. Fortunately, we're now living in an era in which there's so much rich data coming from so many sources, but we need to be able to put it all together to tell a "novel" about a person's life. But, he warned...

"Do we have the ability to ensure that individual's data will flow with the person across the continuum and across the lifespan...(but still) guarantee trust and protection and security," he asked. "Once you lose trust, it is very, very difficult to get it back. So we must redouble our efforts...to make sure we never violate it."

Third, we need the ability to successfully engage people, families and communities so they'll take the necessary prevention and wellness steps. And fourth, we need to recruit and coordinate multidisciplinary health teams...and "blow up the artificial silos" between the public health and medical sectors. Tuckson said he spends a lot of time preaching to his medical colleagues about the importance of reaching out to public health, noting "public health deserves to have more resources, not less." Tuckson also noted that this year's America's Health Rankings report, which UnitedHealth releases annually in partnership with APHA and Partnership for Prevention, will celebrate public health workers.

"This is the time for celebration of what you are," he told attendees.

After Tuckson came a surprise speaker: U.S. Rep. and House Minority Leader Nancy Pelosi! She began by thanking Dr. Benjamin and APHA for supporting the Patient Protection and Affordable Care Act and helping to ensure its passage into law. She said the day after the House of Representatives passed its version of health reform, she was talking with President Barack Obama on the phone, who said he was happier that night than the night he was elected president (how cool!). Pelosi said that during the run-up to the law's passage, she and her colleagues in Congress committed to go up to any fence in their way and push it open; if it didn't open, they'd climb over it; if it was too high to climb, they'd pole vault; and if it's too high to pole vault, they'd parachute. Of course, today we all know the happy outcome.

"We were successful because we were not alone," Pelosi told attendees. "When we pushed opened that gate, you were right there with us."

A little bit later APHA President Melvin Shipp gave a truly beautiful talk, alluding to the metaphor represented in the simple dash between the birth and death dates that appear on our headstones. The dash represents our life span, he said, and where we live, work and play impacts the quality of that dash. A dash can mean a dash of salt, a short distance or that extra emphasis in a sentence — a dash is small, but so important, Shipp said.

He ended by applauding passage of the Affordable Care Act. 

"Remember, we must remain mindful of those who would seek to dismantle these gains," he said. 

Speaking of the Affordable Care Act, U.S. Assistant Secretary for Health Howard Koh came to the stage to accept the 2012 APHA Presidential Citation on behalf of its winner, President Obama. In accepting the award, Koh said that no president in recent history had done more for the health of Americans than Obama.

"On behalf of the president, I thank you for this honor and gratefully accept this award for him," Koh said.

Keynote speaker Gail Sheehy, best-selling author of "Passages," which was first published in 1976, spoke on how the passages in our lives are changing. People are taking longer to grow up and much, much longer to die, she said. She illustrated the vivaciousness of today's golden years as she read the dating ad of an older man who bragged about having "many new parts." Even after our very young years, we continue to go through passages and transitions and turmoil — and it's these times of passages that are ripe for exploration, Sheehy said. These passages are the perfect time to reach out to people with healthy messages too, as they're already in the midst of re-evaluating their lives, she said.

"It's in these times of passages when we need to make constructive changes," Sheehy said.

She said age 50 is the infancy of "our second adulthood" — a time when we can start over. (In fact, she referenced a recent survey in which respondents said being old is when a person turns 79.)

But even though the many transitions in people's lives represent such great opportunity, she said we're also facing two great emergencies: the stress and lack of support for caregivers and the epidemic of Alzheimer's disease. In regard to caregiving, she said it's critical that caregivers have a network of support, noting that every family member who develops Alzheimer's will cost somebody $1 million. Talking about Alzheimer's, she said that while the wave of the future is nonpharmacological treatment, the epidemic isn't going to be solved by treadmills and crossword puzzles — it'll be solved in the lab. And we need to advocate as loudly as HIV advocates did to find a treatment for Alzheimer’s. (To read more with Gail Sheehy, check out this Q&A with Sheehy in The Nation's Health.)

"Our time in life is longer than we ever dreamed it would be," Sheehy said.

— K.K.

Above from top to bottom, Opening Session speakers Reed Tuckson; Nancy Pelosi; Gail Sheehy; and APHA President Melvin Shipp presenting the APHA Presidential Citation to Howard Koh, who accepted on behalf of President Obama. Photos courtesy Jim Ezell/EZ Event Photography

A little birdie told me so: Tweet of the day

On the official launch day of APHA's 140th Annual Meeting, today's tweet of the day shout-out goes to @albertatrebla, who tweeted: Hallelujah - a conference center with free wifi that works! 

Us bloggers second that!

Speak up for public health!

Feeling inspired after today's Opening Session to take action on behalf of public health and its vital role in all of our lives? Then put tomorrow's APHA advocacy sessions on your schedule: Session 3213, "The Who, What & How of Advocacy," starts at 12:30 p.m. in Marriott Marquis Golden Gate C2; and session 3314, "Mobilizing a Public Health Campaign," starts at 2:30 p.m. also in Marriott Marquis Golden Gate C2.

And check out this new and way awesome infographic from APHA on the value of investing in public health. It's below for your viewing pleasure, but you can also click here to download it and help APHA spread the word.


Insights & inspirations

“I’ve never done anything like this in my entire life,” said new APHA member Arletha Howard, from Mississippi. Yet here she is at the Annual Meeting presenting about a Healthy Start program serving rural teens in the Mississippi Delta and hoping to glean some knowledge from fellow public healthers about maternal and child health issues.

William Keck, a 40-year member from Akron, Ohio, has been to more meetings than he can count but is as excited as a first timer about the knowledge he hopes to share and take away. For one, he’s looking for mentors to help students who attend medical school in Cuba — a country with universal access to care — and then return to the states to provide care in underserved communities.

“They’re trained in the Cuban way, they’re bilingual, they’re trained to provide care in underserved communities in a way that melds medicine and public health,” Keck said. He hopes to find mentors and residency programs “that will lust for them,” he said with a laugh.

Pat McGovern of the University of Minnesota in Minneapolis is here for maternal and child health but also environmental and occupational health.

“I find that it is a very engaging mix of scientists and public health practitioners,” McGovern said just outside the Annual Meeting registration area this morning. “I always get inspired by people who really want to make a difference in their science and in their practice. It’s the integration of both of those that’s really unique to APHA.”

Hildemar Dos Santos of Loma Linda University in Redlands, Calif., is here for his first Annual Meeting and said he has “no idea what is going to happen.” But the Brazil native who works in prevention is looking forward to learning about new programs and networking with other prevention centers.

His biggest concern for the future of public health? “I think public health has to be included in the medical system because more prevention is needed in this field.”

McGovern said we in public health need to help improve public opinion.

“There is so much misinformation, this election in particular, about the role of government,” she said. “My concern is those of us who are in public health continue to communicate the necessity for government to (support) public health as a priority both in science and practice.”

Keck’s concern is “making the transition from accountable care organizations to accountable care communities” to help ensure a shift to improving care for entire populations. And Howard, who sees barriers when it comes to rural residents finding transportation to medical appointments and other needs, said “my biggest concern for public health is that we’re not taking the services to the community.”

Student member Rebbie Timmons of Meharry Medical College in Nashville said communicating public health to clinicians “is the biggest challenge for public health.”

Timmons, who like Dos Santos and Howard, is attending her first Annual Meeting, was a bit daunted by the massive program spread out in front of her at a table this morning. Help find your way by attending the New Member/First-Timer Orientation today from 3:30 to 5:30 p.m. in MCC West Room 2011. What do you hope to take away from this year’s meeting?

— D.C.

Welcome to the family!

A new member of APHA's growing social media family, our Storify page is an easy way to view all the Annual Meeting happenings in one place. It's got news, tips and comments from Twitter, Facebook, Flickr, YouTube, this very blog and much more. Below is a Storify round up of what happened yesterday here in San Francisco. Visit storify.com/apha for more.