Oct 31 2012
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Living and Learning at the American Public Health Association Annual Meeting

Myra Parker, JD, PhD, is acting instructor at the Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington and a Robert Wood Johnson Foundation (RWJF) New Connections grantee. This post is part of a series in which RWJF scholars, fellows and alumni who are attending the American Public Health Association annual meeting reflect on the experience.

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I took my seven-year-old daughter to help me pick up my registration materials at the Moscone Center. I was thrilled to map the American Indian, Alaska Native and Native Hawaiian (AI/AN/NH) sessions and discover they are located in one of the central buildings this year! It’s terrific to be able to attend the general sessions AND those specific to my community, which has not always been the case with AI/AN/NH sessions held in off-site hotels last year in Washington, D.C.

My daughter was amazed and excited to see the performances outside the convention center. The artistic displays added to the air of festivity as American Public Health Association (APHA) attendees took over the Moscone area. I was excited to see the diversity of attendees across many different professional backgrounds and ethnic/cultural communities.

We attended the American Indian, Alaska Native and Native Hawaiian Caucus General Membership Business Meeting. This was the first time I had the opportunity to attend the business meeting, which included officer elections for the upcoming two years, introductions of members and visitors, and updates on the caucus budget and events. The caucus was able to fund six undergraduate, masters, and doctoral students from AI/AN/NH communities to attend APHA this year at $2,000 each. This is a wonderful new opportunity for these students, each of whom also applied to present a poster at the conference. I plan to attend the caucus social on Monday evening, which includes a silent auction of native art! This fundraiser contributes to the cost of providing caucus-specific sessions as well as to the student scholarship fund. I also learned that if we pack a room at the conference, there is a higher chance the caucus will be able to offer these sessions next year.

Outside APHA Street performers outside San Francisco's Moscone Center at the APHA's 2012 meeting.

I had planned to attend the American Indian, Alaska Native and Native Hawaiian Caucus Poster Session - From Traditions to Technology and then the RWJF New Connections social, but due to some family illness, we had to postpone these activities for next year.

The poster session included exciting projects such as Summative Evaluation of a Tribal Telemedicine Project, presented by Tosha Zaback, MPH, William E. Lambert, PhD, Mark Dignan, PhD, Steven Mansberger, MD, MPH and Thomas Becker, MD, PhD, and Adaptation of a computer-based HIV, STD, teen pregnancy prevention program for American Indian and Alaska Native Youth, by Jennifer Torres, MPH, Ross Shegog, PhD, Stephanie N. Craig-Rushing, PhD, MPH, Gwenda Gorman, Cornelia Jessen, MA, Jessica Leston, MPH, Travis Lane, David Stephens, Ebun Olubukonla Odeneye, MPH, Melissa Peskin, PhD and Christine Markham, PhD.  Please do contact these folks for more information!

Monday, October 29, 2012

Today was all about staying focused. The APHA conference is a wonderful place to network – yesterday I saw Dr. Donald Warne crossing the street and met a former student who I worked with at the University of Arizona and Inter Tribal Council of Arizona through the American Indian Research Center for Health in Phoenix. However, because they are so rare and precious, these reunions can be a bit of a distraction to soaking up all of the cutting edge knowledge.

My first session, since I am working on an evaluation of a tribal home visitation grant funded under the Affordable Care Act through the Administration for Children and Families, was Protecting the Health of Our Children and Families – Examples of Maternal and Child Health in Indigenous Communities. It was standing room only!! The first presenter focused on a national campaign to raise awareness about Sudden Infant Death Syndrome within AI/AN communities, entitled: Lessons from designing a campaign to address infant mortality among urban American Indians and Alaska Natives, by Shira P. Rutman, MPH and Crystal Tetrick, MPH. Being in Seattle and being Native, of course I am aware of the groundbreaking work done at the Urban Indian Health Institute based at the Seattle Indian Heallth Center. It was a treat to hear about one of their efforts and you can learn more here: http://www.uihi.org.

We also learned about an obesity intervention for AI/AN youth: Tulsa Healthy Lifestyle program: A program to reduce obesity among urban American Indian children, by Janis Campbell, PhD, Nancy O'Banion, MS, Jennifer Howard, MS, Alison Forsythe, MS, Tim Shadlow, BS, Kevin Heeney, BS and Courtney Clymer, BS. I was very interested to hear from Dr. Janelle Palacios on her dissertation work concerning AI conceptions of mothering roles from a qualitative research perspective. Her talk was entitled: Healing our families: A lifespan perspective of mothering among American Indian women. The quotations and findings will be incredibly useful in framing the home visiting project evaluation that I am working on in Seattle.

Dr. Jean Johnson also provided valuable context for conceptualizing my evaluation work in her talk entitled: `Ekolu `Eha `ike Pono: School Readiness Project, which focused on Native Hawaiian children and school readiness. Incidentally, continuing education credits were available for this session under the Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH), and Masters Certified Health Education Specialist (MCHES) areas.

I then attended the session: Health Equity: Are We Making Progress? Through a Social Justice, Women’s, Person’s with Disabilities, and LGBTQ Lens.

I really appreciated the opening speaker who stressed that we will achieve health equity when we advance and promote a culture of prevention and of coverage. Changing our culture in these areas will be our next great challenge. I also liked his “get it done” message! There is no time for deliberating – change is needed and we know where it needs to happen!

Dr. Kevin Fenton, MD, MPH gave an inspiring overview of the status of HIV across diverse communities in the United States. His presentation, entitled: The 4th Decade of HIV in The US: Urgency, Focus, Action forced us to think about where we are and how much further we have to go to address this epidemic. Some highlights from his talk:

  • There are 1.1 million living with HIV in the U.S.
  • There are 50,000 new infections and 18,000 deaths each year.
  • All groups are showing declines in HIV incidence except men having sex with men.
  • There has been an 89 percent decline in HIV transmission since the 1980s.

Dr. Fenton stressed that social and structural determinants of health play a critical role in determining HIV transmission. He noted that there are several determinants that need to be added to the existing models: the US correctional system; homelessness; sexual orientation; migration status; HIV/STI prevalence; sexual IDU networks; racism; sexism; and residential factors.  Black men have an incidence rate six times higher than White men, and Black women have an incidence rate 15 times higher than White women. Men who have sex with men comprise 2 percent of the U.S. population but 64 percent of HIV infections.

Dr. Fenton also noted the patterns of geographic inequities: four states account for 50 percent of those living with HIV diagnosis, and there is a greater concentration of the HIV epidemic in metropolitan areas with greater than 50,000 residents. Poverty is strongest determinant of HIV – especially in inner cities among heterosexuals. He stressed that making the right evidence-based interventions, tailored and scaled to the at-risk communities, is key in addressing HIV.

Dr. Frances Ashe-Goins, RN, MPH, Deputy Director for the Office of Women’s Health at the U.S. Department of Health and Human Services provided an overview on women’s health, including the major diseases across a wide variety of communities – Black, Asian American, AI/AN, and Latina. She noted that 50 percent of African American women are obese and these women are twice as likely to be diagnosed with diabetes than White women. Thirty percent of Latinas are uninsured and only one in five AI/AN women use the Indian Health Service. Asian American women have lowest rate of obtaining pap smear (65.6 percent in 2008) and one in five women are uninsured.

In Closing

The topics for health disparities at APHA have grown and diversified since I became a member as a student. I am wishing I could clone myself to be able to attend concurrent sessions such as: Health Disparities: Trends, Tracking, and Tools in Technology, Health Equity: Are We Making Progress through a Communities of Color Lens? and Power of Community Partnerships in Heath Disparities Research, to name just a few. Also check out the poster sessions! There are an amazing variety of disparities-related posters this year.

The Closing General Session will take place on Wednesday, October 31, 2012 and the keynote speaker, Angela Davis, will discuss her research into prison systems around the world and the importance of building communities of struggle for economic, racial and gender justice. I wish I could be there for the closing!! Thank you, New Connections, for this opportunity to attend!

Tags: APHA 2012, American Indian (incl. Alaska Native), Asian/Pacific Islander, Childhood Obesity, Diversity, New Connections, Public and Community Health, Voices from the Field