APHA Annual Meeting Blog

Keep washing those hands

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Wed, 11 Nov 2009 19:04:00 +0000

“It may be that, given the size of this convention, that a couple of people are about to get sick from H1N1,” said Richard Schieber of the Centers for Disease Control and Prevention’s H1N1 Community Mitigation Task Force.

Does that mean you should have been holed up in a hotel room the past few days instead of attending scientific sessions? Should you avoid airplanes because of an increased infection risk?

“Those are very good questions,” he told about 200 people gathered for a late-breaker session on H1N1 lessons learned on Wednesday morning.

Gee, thanks, Dr. Schieber.

What he and other CDC personnel did tell us was that the H1N1 flu pandemic has provided a lot of federal-level lessons to help guide public health practice in the future. And, as most of us know, it’s also been a bumpy ride.

This blogger is like a lot of frustrated parents out there. My 6-year-old son has asthma so is considered one of the 42 million people at highest priority for H1N1 vaccination. Only problem is, he wasn’t eligible for the nasal mist administered at his elementary school because he has asthma. His pediatrician hasn’t received any doses of the injectable vaccine.

His 9-year-old and 11-year-old sisters did get the nasal vaccine. So at least two of my three children are covered. Except the 9-year-old will need a second dose for what CDC officials consider a “robust immune response.” Anybody want to guess how likely it is that a second dose will be available anytime soon?

“We’ve done what we could to get the vaccine out quickly,” said Jay Butler, who leads CDC’s H1N1 Vaccine Task Force. “It’s still a trickle. We’re trying to make it faster, but it’s still a trickle. It’s absolutely maddening.”

Schieber did unveil a bit of good news during the session. Recent surveys show a majority of people are following infection-control advice on washing their hands regularly and avoiding touching their face. CDC plans a major flu communications blitz in airports starting Nov. 19.

Check the latest on the federal H1N1 and seasonal flu response and guidance at www.cdc.gov/flu, www.pandemicflu.gov and www.cdc.gov/flu/weekly.

— D.C.

Safe (and healthy) travels

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Wed, 11 Nov 2009 18:51:00 +0000

On the last day of the meeting, while everyone’s preparing to head home by plane, train or automobile, this blogger went to one final session — on the topic of healthy transportation policies.

Interestingly, injury prevention advocates are starting to advocate the same type of measures that environmentalists and active transport proponents have been preaching: better land-use planning, mixed-use design and public transportation. It’s not just about making the roads safe with safer cars and responsible drivers, it’s about getting more people off the roads altogether.

“We need to break down silos, even within the health field,” said session presenter Janani Srikantharajah of the Prevention Institute.

Injuries are not “accidents,” Srikantharajah said, and they can be prevented. While the nation is justifiably outraged at the estimated 45,000 annual U.S. deaths attributable to lack of insurance coverage, they should also be outraged by the 41,000 annual deaths caused by traffic crashes, she said. The financial toll of traffic injuries is staggering as well, at $230 billion or about 2.3 percent of our GDP.

We need to work together, speak the language of planners, and start spouting phrases like "complete streets," "multimodalism," "context sensitive design" and "smart growth," said Todd Litman of the Victoria Transportation Policy Initiative in Canada.

Litman said transportation is a public good that should be about all its users, not just drivers. It’s about social justice and goes beyond affordable transportation to encompass affordable housing in walkable neighborhoods, “urban villages” with schools, parks and grocery stores.

Other session speakers talked about efforts to reduce driving on college campuses and create healthier food environments with the help of smart transportation policies. For more on how healthy food and transportation policies intersect, here's a similar presentation from one of today’s speakers, Kami Pothukuchi of Wayne State University.

And for more on healthy transportation policies, check out the new report put together by Policy Link, the Prevention Institute and the Convergence Partnership: “The Transportation Prescription: Bold New Ideas for Healthy Equitable Transportation in America.”

Safe travels everyone!

— P.T.

Image by Diego Bervejillo, courtesy iStockphoto

Something's in the water

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Wed, 11 Nov 2009 18:33:00 +0000

Max Zarate-Bermudez, an epidemiologist with the Centers for Disease Control and Prevention, cites many more cases and deaths caused by waterborne disease outbreaks than those caused by foodborne outbreaks. Still, for some unknown reason, food safety seems to be a much sexier topic, gaining a higher degree of media and public attention.

Thankfully, Wednesday morning’s session on preventing food and waterborne illness detailed efforts by CDC to build an Environmental Health Services Network, or EHS-Net, at the national level and, in the word’s of pop star Justin Timberlake, bring sexy back to environmental health.

The federal government doesn’t even have a true grasp on the actual numbers of outbreaks in the states, part of the impetus to create EHS-Net. According to Vince Radke, a sanitarian at CDC, the challenge is that each state houses multiple agencies that handle water-related issues (for example, New York has 12, nine for Tennessee). Information and data on waterborne disease is often parsed out among many agencies and utilities.

EHS-Net is working on many fronts to develop multi-state projects and participating states are also managing their own individual projects. And why should states and localities care about surveillance for waterborne disease? As CDC’s Zarate-Bermudez explained, “waste and contamination of water sources can deeply impact the water cycle.”

On an even scarier note, research presented by Mansoor Baloch, also of CDC, shows that between 1948 and1994, 40 percent of waterborne disease outbreaks resulted from unknown water contamination sources.

To confront these challenges and prevent future water-related outbreaks, CDC is also promoting a new systems approach via water safety plans and watershed-based health systems. Such efforts will better protect the public health and provide long-term change and process improvement in water management.

Sounds like a win-win all around.

— M.S.

A little birdie told me so: Tweet of the Day

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Wed, 11 Nov 2009 18:13:00 +0000

Wednesday's Tweet of the Day from Annual Meeting Twitterers using the hashtag #apha09 comes from Twitter user R71:

"Just ran a few miles in the rain w/twisted ankle not smartest thing I've done but now rejuvinated for final day at #apha09."

man, the things people do in the name of public health :)

Kicking the can

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Wed, 11 Nov 2009 17:32:00 +0000

It’s not news that kids in the United States, and adults for that matter, are drinking too much soda.

It’s also not news that soda is one of the easiest culprits to blame for overweight and obesity, as the “liquid candy” is so ubiquitous and nutritionally barren. But presenters at yesterday afternoon’s session on reducing consumption of sugar-sweetened beverages are doing something about it. They shared their interventions to improve kids’ diets and offered some lessons learned.

It sounds simple, but encouraging after-school programs to serve water instead of soda or juice can lower overall calorie consumption, as the calories from beverages are typically not replaced by other foods. Caregivers can be encouraged to institutionalize this change, which is important because of the high turnover rates of after-school programs. Simple, repeated messaging and reinforcement of the cost savings of water compared to sugar-sweetened beverages is also an effective tactic. Overall, something as straightforward as encouraging a switch to water at places where kids learn and play can be a tool for preventing obesity and encouraging positive dietary habits at a young age.

While one intervention focused on promoting the virtues of water, an effort in the San Francisco Bay Area took the alternate approach — urging people to pledge to cut out soda for an entire summer.

The Bay Area Nutrition and Physical Activity Collaborativ e (BANPAC) conducted a “Soda Free Summer” campaign during the summer of 2008, urging area residents to take a pledge and “rethink their drink.” BANPAC involved more than 100 organizations in the six bay area counties and distributed pledge cards, promotional materials and hosted educational workshops on how to “Be Sugar Savvy.”

Post-intervention interviews found that the majority of those surveyed remembered the campaign, and two-thirds of respondents said they made a behavior change toward better health during the campaign. Almost half, at 47 percent, reported drinking less soda and sports drinks.

Liz Craypo, of Samuels and Associates, who helped organize and evaluate the “Soda Free Summer” campaign, said the campaign was a successful model that can be used as a foundation for further healthy food policy changes.

Addressing year-round change was one recommendation by campaign organizers and residents alike.

Regardless of the season, “there’s really no place for soda in a kid’s diet,” Craypo said.

— P.T.

Image by Brandon Glenn, courtesy iStockphoto

All you need is love

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Wed, 11 Nov 2009 13:51:00 +0000

There’s a lot of talk this year about budget constraints and the squeeze on grant-funded research and health improvement projects.

Luckily, the Native Health Initiative doesn’t rely on dollars to improve the health of American Indians.

“What is our funding source? It’s love,” said Shannon Fleg during an informal initiative meeting in the convention center yesterday. “It’s a human-to-human element of wanting to serve others.”

Founded in 2004, the initiative is “a partnership to address health inequities through loving service.” It began in North Carolina and now has sites in New Mexico, California, Minnesota and Arizona. Some projects include grants to help young American Indians carry out community improvement efforts as well as a cultural approach to tobacco education, prevention and cessation called “Decolonize Tobacco — Breathe Tradition, Not Addiction.” Tribal communities have hosted college student interns for five consecutive summers to work on tribal community health projects.

It’s one of those miraculous projects where the interns and volunteers take away as much as the community members they are “helping.” It’s a cultural exchange and just a way of “going back to the ways our people already know,” Shannon said.

“A lot gets done when no one cares who gets the credit,” said Shannon’s husband and group-co-founder Anthony Fleg, a primary care physician in New Mexico. “We’re a partnership — a linking entity.”

The initiative is important because of the significant health disparities so painfully prevalent in many American Indian communities, not to mention the lack of exposure for many health professions students to American Indian communities and issues. There’s also been long-standing under-representation of American Indians in the health professions, untapped resources in the communities themselves, and a lack of effective partnerships between universities and communities to improve health.

“The best solutions for improving the health of communities will always come from the communities themselves,” Anthony said.

At this point in the meeting, this blogger raced back to grab her camera out of the press office, as Shannon said some the tribal elders might show up.

They didn’t, but I did meet the Fleg’s 15-month-old daughter Nizhoni, a name that means “beautiful” in Navajo, who is a delightful little child who acts like she’s never met a stranger. She smiled easily for me and grasped my hand like an old friend, even offering me a bite of her pretzel. May we all be so warm and welcoming to our fellow humans.

— D.C.

Above: Nizhoni Fleg, the youngest member of the Native Health Initiative (she really is a member), illustrates some loving kindness.

Encore

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Wed, 11 Nov 2009 13:37:00 +0000

It's the last day of the 137th APHA Annual Meeting, and I'm still hearing people talk about how much they liked Sunday's Opening Session speakers. So, here they are one more time: From left are Surgeon General Regina Benjamin, APHA's Georges Benjamin, EPA Administrator Lisa Jackson and filmmaker Celine Cousteau.

Photo courtesy Jim Ezell/EZ Event Photography

Unacceptable...and totally preventable

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Wed, 11 Nov 2009 13:19:00 +0000

The ladies of Tuesday afternoon’s Martha May Eliot forum on water and maternal and child health are putting a positive spin on toilet talk. In fact, they urge more conversation around sanitation and the magnitude of the public health risks associated with diarrhea.

The stats are quite staggering: 1.5 million children die every year of diarrhea and 88 percent of diarrheal deaths worldwide are attributable to unsafe water, inadequate sanitation and poor hygiene. Still, according to each speaker, there’s real need to elevate the status of these issues as funding, public awareness and intervention on these fronts seem to have taken a backseat to the fight against HIV/AIDS.

In an effort to raise the profile of diarrhea and its significant impact on child survival, UNICEF and the World Health Organization recently released a report in October on “Diarrhea: Why Children Are Still Dying and What Can Be Done?” The report provides a seven-point plan for stemming the unfortunate, preventable problem.

In many countries, the greatest sanitation challenges result from having to change social norms in order to advance healthier communities, and a big part of these efforts are in education and maintaining sensitivity to cultural norms. Another big challenge, according to presenter Therese Dooley of UNICEF, is the “issue around privacy and dignity for women and girls, which is why these issues don’t get addressed.”

One participant from Bangladesh noted that many schools in her region don’t even provide safe restrooms for students.

“We put our children in schools for six to eight hours a day,” Dooley said. “Shouldn’t we ensure it’s the safest and healthiest place it can be? We really need to stop the avoidance of talking about toileting.”

To find more on this issue, visit UNICEF.

— M.S.

Wednesday's Have You Heard

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 23:19:00 +0000

Cover that cough (with your elbow): Looking for the latest data on the H1N1 epidemic? Attend session 5093, “Latebreaker: 2009 H1N1 Influenza — Status Update and Lessons Learned from CDC,” from 10:30 a.m. to noon in Marriott Grand Ballroom Salon G.

Where’s the beef (been)?: If you’re planning to go with meat for lunch, this may not be the best session to attend right before lunchtime. But, on the other hand, you should probably have those veggies anyway. You decide at session 5104, “Meat Matters: Effects of Industrial Meat Production on Human & Environmental Health,” in room 103C of the Pennsylvania Convention Center.

Pride in health: Unfortunately, gay, lesbian, bisexual and transgender youth often suffer from disproportionate rates of certain health problems, especially when it comes to mental health. To hear about some best practices in reaching out to and helping this vulnerable population, consider attending session 5170, “LGBT Youth: Research, Policy and Health Outcomes,” from 12:30 p.m. to 2 p.m. in room 111A of the convention center.

Federal send-off: Before you hop in your trains, planes and automobiles, don’t forget to attend the Annual Meeting’s Closing Session from 2:30 p.m. to 4 p.m. in Ballroom A of the convention center. This year, the send-off session features panelists Howard Koh, assistant secretary for health at the U.S. Department of Health and Human Services; Mary Wakefield, administrator of the Health Resources and Services Administration; and Yvette Roubideaux, director of the Indian Health Service.

A woman's burden

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 22:20:00 +0000

The postcard image of a woman balancing a water jug on her head might at first seem exotic and mysterious, but in reality it is anything but.

In many developing nations, the burden of insufficient water often falls — literally — on the shoulders of women. According to speakers at a Tuesday morning session on water and women’s health, collecting and managing a household’s water supply puts women at risk for a host of illnesses and injuries, including head and back injuries related to carrying the 40-pound jugs on their heads.

Fetching heavy loads of water also puts women at risk of encountering violence and abuse at the water source, being involved in pedestrian road fatalities, sustaining injuries from falling, developing pregnancy complications and losing opportunities related to education and employment. In one study, women in India even said the heavy jugs wore off their hair.

In more than two dozen developing countries, collecting water is predominantly a woman’s responsibility, said presenter Gopal Sankaran of West Chester University of Pennsylvania , who noted that it takes about three hours a day to collect enough water to meet the drinking, cooking and basic hygiene needs of a family of six. Fetching the water requires women to carry the jugs over mountainous terrain, and once home, the water is often allocated first to the men in the household, even to the exclusion of infants and children.

In many developing nations, children start carrying water at an early age, said fellow presenter Padmini Murthy, of New York Medical College School of Public Health and who's also covering the APHA Annual Meeting on Medscape's public health blog.

“They start training the girls at about age 4, and will start with a little bowl of water and work up,” Murthy said, noting that the age at which water-carrying begins varies by region.

“Immediate gains from nearby access to safe drinking water will result in improvement in women’s health and reduced women’s workload,” said Susan Sorenson of the University of Pennsylvania in Philadelphia.

— T.D.J.

No bailouts here

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 21:55:00 +0000

Tuesday afternoon’s session on the economy and public health was timely for the APHA Student Assembly to take on in light of this country’s financial woes.

However, the topic that caught this blogger’s attention was on the protective health benefits of microfinance in the developing world.

I’ve heard a little about microfinance, made famous by Professor Muhammad Yunus’ Grameen Bank, but I hadn’t heard about it in the context of public health. Empowering people to use their own skills to free themselves from the depths of poverty using modest loans? Sounds good to me! And it may help improve health outcomes associated with poverty, malnutrition, lack of immunizations and poor sanitation? Even better!

According to presenter Chethan Bachireddy, a medical student at Yale University, microfinance can be a powerful tool to lift people out of poverty and improve health outcomes. Bachireddy studied the use of microfinance as a coping mechanism during Indonesia’s financial crisis. He found that even in dire economic times when loans were scarce, individuals who had previously used microfinance were better able to save money. Ultimately, they tended to weather the economic crisis better than others.

Bachireddy said the poor need more safety nets, as illustrated by his example in Indonesia.

“I find it counterintuitive that the poor are the most vulnerable, yet they are the least likely to have access to things like health care and credit,” he said.

For more on microfinance, check out the Financial Access Initiative, a consortium of researchers from New York University, Yale and Harvard who are looking into ways the financial sector can help low-income families in developing nations. What are your thoughts on microfinance as a means of reducing poverty and improving health status?

— P.T.

A little birdie told me so: Tweet of the Day

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 21:22:00 +0000

Tuesday's Tweet of the Day from Annual Meeting Twitterers using the #apha09 hashtag comes from Twitter user Kate_Morrison:

"Overheard at #apha09 'everyone has purell not candy this year'"

Nice to see public health workers walkin' the walk and talkin' the talk!

World Health Day 2010: 1,000 Cities, 1,000 Lives

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 21:10:00 +0000

Turns out our Annual Meeting presenters aren’t only leaders in public health, but some are comedians as well. At a Tuesday afternoon session on megacities and health, presenter David Vlahov opened with a quote from a “14th century” mystic.

“Make me one with everything,” the mystic said….as he ordered a hot dog. (The audience cracked up, with the guy sitting behind me calling it a “zen moment.”)

But on to non-laughing matters. Vlahov, director of the Center for Urban Epidemiologic Studies at the New York Academy of Medicine, spoke about tackling health issues in megacities (generally defined as cities with more than 10 million residents) and growing cities. The topic seems especially pertinent, as 60 percent of the world’s population will be living in cities by 2030.

While there are some diseases that may flourish in cities, there’s no “urban genotype,” Vlahov said, which is why health workers and researchers must focus on improving the living conditions and other social determinants that affect health.

“We have to think about health beyond health services,” Vlahov said.

To learn more about this growing issue, visit the Megacities and Health Project Blog, which is also a space for people interested in a proposed book about megacities that would be published by APHA Press. You can also visit the International Society for Urban Health. Or you can start getting ready for World Health Day 2010, which will focus on urban health with a theme of “1,000 Cities, 1,000 Lives.”

— K.K.

Reach out and touch someone

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 20:38:00 +0000

If you’re trying to expand your online and social media outreach to improve public health, I have a nice little inside scoop for you.

The folks at the Office of Disease Prevention and Health Promotion are coming out with a “Health Literacy Online” guide to developing user-friendly Web sites and other online tools in January. Want to be on the distribution list? Send an e-mail to Health Literacy Fellow Sean Arayasirikul at sean.arayasirikul@hhs.gov (and, yes, he said it was OK for me to post his e-mail address on our blog).

He and his colleagues have done a lot of study into how to reach people with low health literacy. A redesigned www.healthfinder.gov site, which took five years from conception to launch, shows some fruits of that labor. Pages are less text-heavy and give visitors easy-to-follow small steps to improve their health. We can all get behind that.

“We all kind of want to be snazzy when we present information, but a linear, simple approach works best,” Arayasirikul said at a Tuesday afternoon session on health literacy in the digital age.

While only 37 percent of U.S. adults with less than a high school education use the Internet, more than 94 percent of adolescents and young adults go online regularly. That means any public health education message and other outreach had better have an online presence in the near future because that’s the way to reach people, whether it’s via a computer, smartphone or other device.

“Information, because it can be accessed anywhere, I think, can be leveraged more,” said Ana Tellez, who works with Arayasirikul at the ODPHP.

Session attendees brainstormed on the challenges of using social media and other online tools to expand public health outreach, and one common gripe was the fact that many workplaces aren’t exactly hip to the happenin’. Some bosses ban Facebook use in the office, and the review process for online postings can bog down efforts to get credible information out there quickly.

Be persistent, Tellez said, and take it one bite at a time.

“Don’t ask for a whole cake,” she said about expanding social networking and other online efforts. “Ask for a little sliver.”

— D.C.

Hit 'send' for better health

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 19:42:00 +0000

Talk about looking into the future of public health. This public health blogger was transfixed by the innovative, amazingly creative ideas discussed during a Tuesday morning session on mobile technology and health. With more than 4 billion mobile phones globally (and that number probably changed in the two seconds it took me to write that), it makes perfect sense to use the platform to reach people with what can be life-changing health information.

Paul Meyer, head of Voxiva, a company dedicated to “mobile centric information solutions,” offered the most insightful quotes of the session. While the United States is a leader when it comes to the Internet, in mobile health, “we’re the followers,” he said. The rest of the world went mobile much quicker than us in the United States because the Internet is simply not accessible for much of the world’s people, he said.

“So, even if you have the world’s greatest Internet strategy, you’re still only halfway there,” Meyer said, adding that soon it won’t be a matter of if you should have a mobile strategy, but a matter of defending “why you don’t have a mobile strategy.”

After all, he said: “The best Web site in the world isn’t going to remind you to take your pill in the morning.”

Meyer’s new endeavor, Text4Baby, is scheduled to launch this January. Created in partnership with groups such as HHS and the National Healthy Mothers, Healthy Babies Coalition and supported by telecom companies, the free service (in fact, the first free mobile texting service in the United States) will send expecting moms three healthy messages per week, and after giving birth, the mobile service will start sending different tips, like info on child vaccine schedules. (Wanna copy of Meyer’s Annual Meeting presentation? Send a text to 311411.)

Finally, presenter Josh Nesbit, head of FrontlineSMS: Medic, told the story of his journey to the forefront of the mobile health movement. Working in Malawi, Nesbit observed how difficult and burdensome it was for community health workers to keep connected with the region’s tiny (very tiny) handful of physicians. So, with a small grant and a creative touch, Nesbit provided the workers with cell phones and the know-how to keep in touch with not only the physicians, but with each other. With the new mobile technology, the workers could do things like text a patient’s HIV/TB drug adherence report to a doctor. How freaking cool is that?

The big lesson, Nesbit said, is making sure the technology works for the people using it.

“If it doesn’t work for the end user, then it doesn’t work, period,” he told session attendees.

Find out more by visiting FrontlineSMS: Medic and read how text messaging is literally saving people’s lives. You can also visit CDC’s mobile health site for info on how the nation’s top public health agency is using cell phones to improve health here and around the world.

Wanna donate your old phone to help others? Visit Hope Phones to find out how to donate your old cell phone to a medical clinic in a developing country.

And one more thing: For more in-depth coverage of this new frontier, check out these two recent stories from The Nation’s Health, APHA's newspaper: "RU healthy? Public health efforts take on text messaging" and "Cell phone popularity a barrier for public health data collection: More Americans forgoing phone landlines."

— K.K.

Image courtesy iStockphoto

The collective well

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 19:34:00 +0000

Forget the old adage "don’t try this at home." Tuesday morning’s session on “Public Health and Global Water Issues: From Policy to Collective Action” defied the age-old golden rule.

The session featured an outstanding group of speakers from various organizations working collectively to pool human capital and expertise on water resource management to drive collective action through the Philadelphia Global Water Initiative.

PGWI President Stanley Laskowski envisions the organization as a model and hopes other cities will duplicate its efforts to build their own networks around global water supply issues. He stressed the need to “connect more nodes and build collaboration.” PGWI is pitching in to help the world meet the UN Millennium Development Goals for water and sanitation on a global scale, and they’re doing some pretty cool work.

Human rights activist and founder of Traveling Mercies, Aldo Magazzeni, is one of PGWI’s collaborators who has done extensive work throughout Afghanistan building water systems so that villages have access to clean and safe drinking water. His presentation was a composite of remarkable images of the villages and people he's helped over the years. He told stories of the impacts that sanitation, hygiene, and safe drinking water have on the communities he’s served. And although he claims his work is only a drop in the bucket, over the past seven years, Aldo has helped build 14 large water systems in Afghanistan.

Why is all this so important? Because the statistics are just unacceptable: Did you know a child dies every 15 seconds from a water-related problem? Even worse, in the countries where the needs are greatest, organizations don’t have the resources or technology to handle these water crises. And according to Bob Giegengack, of the University of Pennsylvania’s Department of Earth and Environmental Science, “a large number are suffering from avoidable water shortages.”

“There is enough water to go around,” he said. “We must use it more responsibly.”

— M.S.

Soldiering on

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 18:43:00 +0000

“Winter soldiers,” a term coined as a result of a 1776 writing by Tom Paine, describes people who stand up for the soul of their country, even in its darkest hours:

“These are the times that try men’s souls. The summer soldier and the sunshine patriot will, in this crisis, shrink from the service of their country; but he that stands it now, deserves the love and thanks of man and woman.”

Thus, it is fitting that winter soldier is also the name of a documentary filmed at an event of the Iraq Veterans Against the War in 2008. The resulting film, “Winter Soldier: Iraq and Afghanistan,” was screened at APHA’s Annual Meeting this morning, part of the meeting’s many film and technology sessions.

In the film, former servicemen and women describe, in brave detail, their experiences during and after their military services. With raw emotion on display, they took on torture, sexual harassment, veterans’ health care services, post-traumatic stress disorder and suicide attempts.

Their anger, disappointment and shame shone through as they told filmmakers about picking up the pieces of their lives after the military failed them. Several veterans described the stigma associated with seeking mental health treatment (the so-called “suck it up and drive on” mentality) — a mentality so powerful that many servicemen and women stay silent for fear of destroying their careers if they were to admit to suffering from PTSD or depression.

Perhaps the strongest voices speaking out against the wars in Iraq and Afghanistan are those who were there and can articulate the human tolls they personally witnessed and suffered. Let them tell you about it themselves — video segments of “Winter Soldier” are available online.

To find more APHA Film Festival events, check your program for "Film and Technology" sessions.

— P.T.

Eye of the tiger

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 16:33:00 +0000

Thanks to unseasonably mild temperatures and some of the most cheerful personalities I’ve ever come across, the second annual APHA Physical Activity Special Primary Interest Group 5K Fun Run/Walk really lived up to its name this morning.

I’m not kidding. It really was fun.

Turnout was about equal to last year’s inaugural event in San Diego, with 50 or so sleepy-eyed but energetic APHA-ers gathering in the pre-dawn darkness to squeeze in some exercise before a day of meetings. Another draw this year was the chance to run those “Rocky” steps at the Philadelphia Museum of Art. They’re not as tough as they look, especially if you take them one at a time.

We had to contend with some city traffic (groups of us stopped at red lights along the route and figured it was interval training). That gave us a chance to talk public health, which is always a good thing.

APHA member Dick Wittberg told me about a project in his home state of West Virginia that found school kids learn better when they’re fit. Jessie Kimmick, who so graciously let me snap her photo on the way back down the Rocky steps, was enjoying the mild morning because back home in Minnesota, running outside this time of year takes layers of technical fabrics and lots of steely resolve to brace the icy chill.

But we all figure if President Obama can find time to exercise, we can too. We know obesity is a big killer in America. The SPIG folks are working to bring attention to the need to incorporate physical activity into public health policy and advocacy. They also want us to be moving every day. You can do it!

Special thanks to SPIG Chair Steven Hooker and member Genevieve Dunton for organizing this year’s run. I’m looking forward to running with them in Denver in 2010.

Kick off the last day of this year’s Annual Meeting by joining SPIG members for a water aerobics session tomorrow morning at 6:30 a.m. (I know, but then you’ll be alert for the rest of the day) at the Hyatt Regency, 210 S. Christopher Columbus Blvd.

— D.C.

Top photo: Jessie Kimmick shows off her "Rocky" muscles during the Physical Activity SPIG's 5K Run/Walk. Bottom photo: Runners celebrate completing their run. Photos by Donya Currie

Open wide

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 16:14:00 +0000

American Dental Association President Ron Tankersley showed grace under fire when a packed room of oral health advocates pressed him on why his organization has opposed the use of dental health therapists to increase access to care.

APHA policy, as well as the majority of people at the oral health session yesterday, supports the Alaska Dental Health Aide Therapist program and other outside-the-box solutions to the continuing access to oral health care crisis in the United States. The American Dental Association initially opposed the creation of the dental therapist program, which takes members of Alaska Native tribes and trains them on providing oral health services in communities where oral health services can be a plane ride away.

Now the House version of the federal health reform bill includes a provision forbidding the Indian Health Service from setting up the dental health therapist program anywhere but Alaska. Huh?

The continued opposition to “unsupervised” dental health work force members, be they dental hygienists or dental health therapists or others with oral health training, “is neither evidence-based nor good for public health,” said Scott Tomar, president of the American Association of Public Health Dentistry and a University of Florida professor (go Gators!).

Tankersley, who did get a round of applause and even a hug after being grilled by session audience members, said the American Dental Association understands “that by having allied personnel do more, everyone would be more effective.”

“The ADA takes a lot of hits because we tend not to be nimble enough,” Tankersley said. “We are cautious, I admit.”

The session, by the way, was centered on an Institute of Medicine Oral Health Workforce Report released in August that calls for innovative solutions to the oral health access problem. As with many issues, “we really are short on data that helps us make good policy decisions,” said Marcia K. Brand, deputy administrator of the Health Resources and Services Administration, which now is funding an oral health study.

“There is no doubt that we’ve got to collaborate,” Brand said. “It’s going to take everyone to increase access.”

— D.C.

Feeling green?

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 15:56:00 +0000

Mitigating the effects of climate change and its negative impacts on human health requires a strong cross-section of public health advocates. Monday afternoon’s session on climate change, nursing and public health brought together a core group of public health experts hoping to confront these challenges.

The session brought together lead researchers, experts and practitioners to first provide a broad federal climate change framework and then hone in on specific (and successful!) instances of state and local actions that demonstrate momentum on reducing our emissions.

John Balbus, of George Washington University’s School of Public Health , noted how changed the climate (pun intended) is this year when it comes to discussions of global warming and proposed federal climate legislation. In contrast to the landscape during last year’s APHA Annual Meeting, the urgency for passing climate legislation has stemmed, he said.

Balbus described how the election and the new Congress really changed the game.

"There was lots of momentum last year and then health care reform happened,” he said.

Despite the slowdown (and the recent economic meltdown), the session speakers expressed strong optimism. Balbus detailed examples of federal regulations as well as Environmental Protection Agency efforts through its soon-to-be released endangerment finding that highlight lots of “activity on all fronts that can have cascading health benefits if done right.”

M. Kathleen Murphy, health services coordinator for Milwaukee Public Schools, provided a poignant case study of how the Milwaukee school system worked to effectively limit pollutants that disproportionately affect the city’s lower-income communities. As one of the leading U.S. cities with poor air quality and high rates of asthma, the city sought real reform. Milwaukee officials conceived and more recently implemented a host of strategies to limit bus emissions and other efforts to improve the region’s air quality. For example, they have stipulations in contracts with city delivery trucks and buses that reduce emissions by incorporating anti-idling requirements in most transportation vehicles. What a simple, yet awesome idea.

Balbus’ closing remarks captured the important role the public health community has in facilitating real change on such issues.

“We’ve come a long way,” he said. “There’s a lot of work that needs to be done. A lot of advocacy is needed. The health care sector is needed to continue to demonstrate its own greening and that these goals can be reached.”

— M.S.

So much free stuff, so little time

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Tue, 10 Nov 2009 15:03:00 +0000

Only two days left to make your way around the more than 700 booths at the Public Health Expo. Hope you have your walking shoes on...

Photo courtesy Jim Ezell/EZ Event Photography

Tuesday's Have You Heard

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Mon, 09 Nov 2009 22:58:00 +0000

Cool runnings: For all you early birds, APHA’s Physical Activity Special Primary Interest Group is hosting its second annual 5K Fun Run/Walk. Runners and walkers should meet at 6:15 a.m. in the lobby of the Downtown Courtyard Hotel, the corner of Arch and N. Juniper Streets, and the route will take you along the Benjamin Franklin Parkway to the museum steps made famous in “Rocky.” (Yo Adrian!)

Water women: As water is the theme of this year’s Annual Meeting, check out session 4005 on “Water and Women’s Health,” from 8:30 a.m. to 10 a.m. in Marriott Franklin 11. Those that get to the session on time can hear an especially interesting presentation on the health effects that women in developing nations encounter from having to carry water over long distances — a burden that “literally and figuratively” weighs such women down.

Harvest time: This blogger is lucky to live in a city with more than a handful of local, fresh farmer’s markets. But not everyone is so fortunate to have regular access to fresh, affordable fruits and vegetables. Learn how you can bring locally grown foods to your community (and help support local farmers) by attending session 4284, “Locally Grown: Strategies to Support Local Economies and Public Health,” from 2:30 p.m. to 4 p.m. in room 107B of the Pennsylvania Convention Center.

And the winner is: Come cheer on your fellow public health professionals during APHA’s annual Public Health Awards Ceremony and Reception from 6:30 p.m. to 8:30 p.m. in room 108A of the Pennsylvania Convention Center.

No butts about it

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Mon, 09 Nov 2009 22:23:00 +0000

Even if you’re an environmentalist or a tobacco control expert, you may not have thought much about the public health toll of the 1.6 trillion cigarette butts disposed each year worldwide.

More than just litter, cigarette butts are toxic waste that leaches cancer-causing chemicals into water and air.

The speakers at today’s session on “Banning Butts” are looking for ways to frame the issue, build scientific evidence and support regulations that will help alleviate the deluge of tobacco waste that pollutes our cities and enters our watersheds.

One consequence of this waste entering water supplies is the toxicity to marine life. One study discussed by investigator Rick Gersberg of San Diego State University found that a concentration of about one smoked cigarette butt per liter of water killed half the fish studied in a four-day period. Gersberg said potential sublethal effects and bioaccumulation should be considered in future studies, as well as the identification of the specific compounds responsible for the toxicity.

Elizabeth Smith of the University of California at San Francisco spoke about her very clever look into tobacco industry documents. She found out (spoiler alert!) that the last thing industry wants is for “antis” and “greens” to band together to support regulation of tobacco waste, which most likely would mean that industry would be responsible for paying for cleaning up disposed filters. She also found some unintentionally funny suggestions from a focus group of smokers that the cigarette industry convened. To deal with the filter waste, why don’t the companies give it another life by making it usable as food for animals or a breath mint for humans, perhaps? Yeah, sounds real appetizing.

For now, filters are still non-biodegradable toxic waste that isn’t regulated. Today’s speakers are trying to change that by building public awareness and supporting regulations that would make the industry that creates the waste financially responsible for dealing with it. That’d sure be another kick in the butt to the cigarette companies, wouldn’t it?

To get involved in getting rid of cigarette waste, visit the Cigarette Butt Pollution Project.

—P.T.

Strength in numbers

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Mon, 09 Nov 2009 22:02:00 +0000

Have you heard that African proverb, “When spider webs unite, they can tie up a lion”?

It’s true. Just ask anyone who’s successfully mobilized an advocacy campaign around a public health issue.

“Our strength is greater when we are united,” said Jirair Ratevosian, MPH, who shared advocacy tips during a Monday morning session on mobilizing a campaign around a public health issue.

One of his charges as deputy director for public policy at the American Foundation for AIDS Research has been to push for an end of the ban on federal funding for needle exchange programs.

Whether your issue is national, state or local, Ratevosian suggests breaking it down into bite-size steps:

1. Bring people together.
2. Set smart, measurable objectives.
3. Get the facts (these help determine your advocacy priorities).
4. Choose your targets (who has the power to make the change you want?).
5. Understand the policy- and decision-making process (this is especially important for voting timelines on legislation).
6. Build alliances and coalitions.
7. Choose your tactics (this could include letter-writing campaigns or Capitol step protests, depending on your group’s personality).
8. Renew, review and re-energize.

Step eight has been important in the needle exchange discussion, Ratevosian pointed out as he displayed an old 1987 letter from then-HHS Secretary Donna Shalala to U.S. Sen. Tom Harkin asking for an end to the federal funding ban.

Every presenter during the advocacy session said success hinges on consensus-building. But as Steven J. Huleatt said, it’s “not an easy process. It’s not necessarily a pretty process.” He was one of the local Connecticut health directors fighting a drastic funding cut this year.

APHA Governing Councilor Durrell Fox talked of the long effort to gain national recognition for community health workers.

“We had to find a way to find unity,” Fox said about community health workers, who are as diverse a group as you’ll find anywhere in public health. “A core, committed group was key to our mobilization efforts.”

Session moderator José Ramón Fernández-Peña would also like to remind us that signing on to APHA Action Alerts — “those annoying e-mails from the APHA Action Board” — is one easy way to tie up that lion.

— D.C.

Just tweet it!

noreply@blogger.com (APHA ANNUAL MEETING BLOGGER) — Mon, 09 Nov 2009 21:46:00 +0000

Today, APHA held its first-ever Tweet-up. What's that, you say? (No worries, I didn't know either.) It's a gathering of fellow public health Twitterers who get together to talk about social media and, of course, do a little tweeting from a common event. So, why should public health enter the Twitter and larger social media realm. Just ask Twitterer @healthpolicygroup.

"I think social media is an exciting realm," said @healthpolicygroup. "Twitter is especially interesting in that it makes you be precise and consice in what you want to communicate. And in public health, that's very important."

Twitterer @publichealth couldn't agree more: "There is a real benefit to using social media tools in public health, particularly in communicating information and interacting with other users."

Still wondering what Twitter is? Check out APHA's Public Health Twitter!