Category Archives: APHA

Nov 19 2014
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Adding Diversity to the Ranks of Public Health Nursing Leadership: Q&A with Shirley Orr, MHS, APRN

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Today at the American Public Health Association annual meeting in New Orleans, Shirley Orr, MHS, APRN, a Robert Wood Johnson Foundation Executive Nurse Fellow and public health consultant, and Doris Brown of the Louisiana Department of Health, will be talking about opportunities for nursing leaders to implement the recommendations of a 2010 Institute of Medicine Report entitled “The Future of Nursing.” This report looks at ways that the nursing profession can transform itself in order to better align with population health and more effectively collaborate to create a healthier overall population.

NewPublicHealth recently spoke with Orr about how nurses can help improve community and population health. This interview has been lightly edited for clarity and length.

Orr Shirley Orr, MHS, APRN

NewPublicHealth: What does the nursing profession need to do in order to align itself with a focus on population health?

Shirley Orr: A couple of things in particular that stand out are education and diversity. We recently did a public health nursing enumeration that was funded by the Robert Wood Johnson Foundation, and we found two things in particular relating to the recommendations. First, that overall, public health nurses need new skills and they need higher levels of education to be able to function more collaboratively and within collaborations—both within health care and with other community partners.

Second, we found that nationwide, the demographic profile of public health nurses does not look like the population that we serve. Ethnic minorities are very much underrepresented among public health nursing—particularly in leadership roles.

We have a very urgent need to recruit more nurses of color into the ranks of public health nursing leadership.

NPH: Why is that necessary?

Orr: A core component of nursing curriculum today is culture competency. That being said, we also know that having nurses who understand populations very, very deeply by having a frame of reference for that population and being a member of that population really are able to help to get the highest level of engagement from the population. They’re also best prepared to understand the culture, the needs, the motivations about populations, so they’re really best positioned to be able to carry out in partnership strategies that are going to make a difference long-term in the health of populations. 

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Nov 19 2014
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New Research Shows How Sugary Drinks Are Marketed to Children in the Age of Social Media

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Beverage companies spent $866 million to advertise unhealthy drinks in 2013, and children and teens remained key target audiences for that advertising, according to a new report released today at APHA by the Yale Rudd Center for Food Policy & Obesity. The report “Sugary Drink FACTS 2014” highlights some progress regarding beverage marketing to young people, but also shows that companies still have a long way to go to improve their marketing practices and the nutritional quality of their products to support young people’s health.

“Despite promises by major beverage companies to be part of the solution in addressing childhood obesity, our report shows that companies continue to market their unhealthy products directly to children and teens,” said Jennifer Harris, PhD, Rudd Center’s director of marketing initiatives and lead author of the report. “They have also rapidly expanded marketing in social and mobile media that are popular with young people, but much more difficult for parents to monitor.”

Harris and her team examined changes in the nutritional content of sugar-sweetened drinks including sodas, energy drinks, fruit drinks, and others. They also analyzed marketing tactics for 23 companies that advertised these products, including changes in advertising to children and teens on TV, the internet, and newer media like mobile apps and social media. Researchers also examined changes in the nutrition and marketing of diet beverages, 100% juice, and water. The report was funded by the Robert Wood Johnson Foundation.

Learn more about the key findings of the report in the following exclusive interview with Harris. The interview has been lightly edited for clarity and length.

NPH:  You issued the first version of this new report in 2011. What are the changes since then?

Jennifer Harris: The biggest change that we saw was a very significant decline in advertising on television. Preschoolers are seeing 33% fewer TV ads for sugary drinks in 2013 than they saw in 2010. Children are seeing 39% fewer, and teens are seeing 30% fewer. So, that was really some great news to see, but some categories had bigger declines than others. Fruit drinks went down by about 50%, but advertising for energy drinks that kids see actually increased. So, there was some good news and some bad news. 

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Nov 18 2014
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APHA 2014: A ReFreshing Collaboration is Building Better Health in New Orleans

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If we as a nation are to succeed in building a Culture of Health that benefits every individual, it will require collaboration across sectors, open communication among diverse organizations and a willingness to step out of traditional practices to find effective interventions.

On Monday, Robert Wood Johnson Foundation Vice President Michelle Larkin showcased one example of this innovative collaboration that is occurring on the edge of a low-income neighborhood in New Orleans, just a few miles away from this year’s American Public Health Association (APHA) annual meeting.

At the corner of North Broad Street and Bienville Avenue sits The ReFresh Project—an innovative fresh food hub located in a former warehouse that had been vacant since Hurricane Katrina struck the city nine years ago. Today the site is home to a Whole Foods Market, Liberty’s Kitchen, The Goldring Center for Culinary Medicine and an onsite farm.

The goal of the hub, according to project founder Jeffrey Schwartz, is to create new eating, working, exercise and community living cultures.

Each aspect of the Refresh Project is designed to realize these goals. 

WholeFoods The ReFresh Project in New Orleans, La.
  • At the Whole Foods market, which anchors the Refresh project development, products are specifically chosen to be both high quailty and affordable. Specifically, the store carries more store-line products and often has more sale items than other stores in the Whole Foods chain. Two healthy eating educators are also located on-site to answer questions, craft recipes, and host tours.
  • At Liberty’s Kitchen, a culinary work readiness and leadership program for at-risk youth, New Orleans youth ages 16-24 who are out of work and out of school are given an intensive and hands-on food service training, case management, job placement services and follow-up support. Ninety percent of Liberty’s Kitchen Youth Development Program participants are employed on graduation out of the program and 80 percent are still employed at the six-month benchmark, according to the organization.

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Nov 18 2014
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Looking at Health Departments’ Ever-Changing Future: A Discussion of the Recent Findings of the Public Health 2030 Project

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From the dramatic impact of extreme weather events such as Hurricanes Katrina and Sandy, to the rapidly changing policy landscape of health care providers, the functions, missions and futures of public health agencies continue to change.

To help health departments plan for an uncertain future, the Institute for Alternative Futures—with support from the Robert Wood Johnson Foundation and the Kresge Foundation—recently worked with state and local health departments, leaders and experts in the field to look forward to the year 2030 and analyze public health scenarios in order to offer pathways to expectable, challenging and visionary futures for public health.

On Tuesday afternoon at APHA, Clement Bezold, PhD, the Founder and Chairman of the Institute for Alternative Futures, and Terry Allan MPH, will discuss theses scenarios and findings and insights gained.

Prior to their presentation, NewPublicHealth sat down with Bezold for an exclusive preview of his presentation.

NewPublicHealth: How did your APHA presentation come about?

Clement Bezold: The presentation is based on the Public Health 2030 project, and that project came about following scenario reports on primary care, on vulnerability, social and economic vulnerability in the United States and on health and health care.

NPH: What are some of the key points about the Public Health 2030 project?

CB: With Public Health 2030, there are a host of challenges and opportunities facing health departments. There are the ongoing fiscal issues at the state and local governmental levels, there’s increased infectious disease, there are climate-change-related changes that communities are facing. 

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Nov 17 2014
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At APHA 2014 Opening Session, Key Leaders Talk Culture of Health

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Healthography—or the health of the place where you live—is the theme of this year’s American Public Health Association (APHA) annual meeting, which is taking place in New Orleans this week.

During the opening session, Georges Benjamin, MD, Executive Director of APHA, announced that APHA’s goal is to create the healthiest generation in American history within one generation. Benjamin’s announcement was coupled with announcements from local and national public health leaders that collectively took another step forward in that effort.

For example, the Partnership for a Healthier America announced a new Healthier Campus Initiative, which calls on colleges and universities to adopt recommended guidelines on food, nutrition and physical activity.

“We know that going to college is a time of change for many students—we also know that means it’s a time when new habits are formed,” said Peter Soler, the partnership’s CEO. “By creating healthier food and physical activity environments today, campuses and universities are encouraging healthier habits that will carry over into tomorrow.”

Guidelines being adopted by participating campuses include promoting the consumption of water instead of soda on campus, offering a bicycle sharing program for all students and providing certified personal trainers and registered dietitian nutritionists on campus.

In addition, Louisiana’s Secretary of Health and Hospitals, Kathy Kliebert, discussed the state’s “Well-Ahead” initiative, which promotes and recognizes smart choices that are made in the spaces and places where people live and work, and which make it easier to live healthier lives. Kliebert told the audience that Well-Ahead promotes voluntary changes without imposing new taxes or creating new rules.

Within the host city of New Orleans, a couple of initiatives to improve health within the Crescent City were also discussed at APHA’s opening session.

One such initiative to combat obesity—known as Fit Nola—now has 100 miles of bike lanes throughout the city. Also, next week legislation will be introduced to ban smoking in the city’s bars, casinos and public spaces.

APHA’s opening session ended with a talk by Pulitzer Prize winner Isabel Wilkerson, who spoke about her book “The Warmth of Other Suns.” A book 15 years in the making, “The Warm of Other Suns” describes the migration of African Americans in the 20th century from the South to the North for a better life for themselves and their children. For example, the parents of Olympian Jesse Owens worried their son would not have the strength to work in the fields, so they moved north to Cleveland, Ohio, where he started running track—a sport that would take him around the world and across the global stage.

Whether the generation of migrants profiled in Wilkerson’s book realized it, their stories epitomize the power of place, and the influence of geography on health, wellbeing and opportunity of every individual. 

>>Bonus Link: Also in attendance at yesterday’s opening session was Peter Salk, son of the world famous Jonas Salk, MD, who was on hand to accept a posthumous award from APHA for his father’s discovery of a vaccine for polio. Watch the trailer above for the film “The Shot Felt Round the World” to learn more about the elder Salk’s successful search for a cure.

Nov 14 2014
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Faces of Public Health: Georges Benjamin, MD, APHA

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The American Public Health Association (APHA) annual meeting begins next week in New Orleans, the first return to the area for the 15,000-strong meeting since Hurricane Katrina nine years ago. This year’s theme is Healthography, or, as APHA Executive Director Georges Benjamin, MD, recently said, “where you live matters.”

Earlier this week, Benjamin spoke with NewPublicHealth about key issues and presentations for this year’s meeting. The following interview has been lightly edited for clarity and length.

NewPublicHealth: “Healthography”—what is it and why is important especially right now?

GeorgesBenjamin Georges Benjamin, MD

Georges Benjamin: We know for sure that place matters, and I think New Orleans is an excellent example of that truth. It’s a wonderful city, but certainly has had huge health challenges. In our annual America’s Health Rankings survey that we do with the United Health Foundation and Partnership for Prevention, Louisiana consistently ranks as one of the lowest states in the nation for health. When you also consider the environmental tragedies that the state had—two storms in short succession and then the Gulf oil spill—the challenges of place and health become especially clear.

So the concept of the geography in which you live and your health is taking center stage as we head to New Orleans. As just one example, our opening session speaker, Isabel Wilkerson, wrote the book “The Warmth of Other Suns,” which deals with the great migration of Americans who moved from one place to another to try to achieve a better life.

NPH: What are some of the other highlights of this year’s meeting?

Benjamin: We’ve got the acting U.S. Surgeon General coming, Dr.Boris Lushniak, and he is going to talk a great deal about health and place. He’s an amazing speaker around the issues of place-based health, how we build our communities and things that we can do to make the healthy choice the easy choice.

In addition, Risa Lavizzo-Mourey, the president and CEO of the Robert Wood Johnson Foundation, will be the keynote speaker for the closing session on Wednesday, where she will talk about the foundation’s new Culture of Health and how they are playing a leading role in building a future where every American has the opportunity to live the healthiest life possible, regardless of where they live.

As RWJF clearly knows, when you design things, you get exactly what you design, and we’ve designed an environment and a culture around health that creates an unhealthy environment. So, if we redesign that culture to improve our health, we can make a big difference.

NPH: Why is building a Culture of Health so important?

Benjamin: Most people living in the United States are not as healthy as they can be, and so APHA believes that we need to build a movement to be the healthiest nation, and we think we can do that in a generation. So, this meeting is the first component of our new strategic direction which aligns very closely with RWJF’s strategic direction.

Our goal is for the United States to be number one and not be number 36 in terms of quality of our health. We think there’s an opportunity to do that through the kind of things that APHA does with education, policy development, legislative advocacy, and building grass roots and grass tops movements to get us there.

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Nov 25 2013
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Recommended Reading: Q&A with APHA President-elect Shiriki Kumanyika

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Today is Public Health Thank You Day 2013, when Research!America and other leading public health organizations recognize the public health professionals working to improve health where we all live, learn, work and play.

Among the biggest names in public health at the moment is Shiriki Kumanyika, PhD, MPH, a University of Pennsylvania professor who earlier this month became the president-elect of the American Public Health Association (APHA). In a recent Q&A on APHA’s Public Health Newswire blog, Kumanyika spoke about the overall landscape of public health and gave her thoughts on particular issues.

One of the big takeaways from the APHA annual meeting earlier this month—where she was named president-elect—was how APHA is shifting its focus to concentrate more on being an action- and goal-oriented organization, according to Kumanyika.

“We are going to be more convincing about the importance of a focus on prevention and wellness, while making better use of scientific evidence and creating a greater sense of urgency around health equity issues,” she said. “I think that, over time, this new positioning in the public arena will really enhance the sense of community among our thousands of diverse members, attract more members and align our combined efforts for greater overall impact.”

Kumanyika also has particular ideas on the greatest opportunities for improving health in African-American communities, especially when it comes to nutrition and obesity prevention. Not only are unhealthy foods too easily available in the average black community but, when compared to other communities, the situation is even more troubling, with black communities seeing more advertising for unhealthy food. The answer is targeted efforts to promote healthier alternatives.

However, she also noted how food and nutrition present their own particular public health obstacles.

“Food is a particularly complex area; we can’t treat it like tobacco and tell people to avoid it altogether. The changes we need are more complicated and will have huge implications across the spectrum from agriculture to environmental sustainability,” she said. “We have to make both a public health case and a business case for a healthier food supply and for marketing healthier foods and beverages. We have a tremendous opportunity to make progress that will change the food and health landscape for the population at large if we do our health diplomacy well.”

Read the full interview on Public Health Newswire here.

Nov 11 2013
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What's New in Schools and Programs of Public Health? Q&A with Harrison Spencer

file Harrison Spencer, Association of Schools and Programs of Public Health (image courtesy of Tulane University)

The Association of Schools and Programs of Public Health (ASPPH), like the American Public Health Association, held its annual meeting in Boston last week. NewPublicHealth spoke with Harrison Spencer, MD, MPH, executive director of the ASPPH, from Boston about the meeting and what’s ahead for students of public health.

NewPublicHealth: How was the meeting and what were some of the key sessions?

Harrison Spencer: Our meeting this year was the first one held since we formed our new organization, the Association of Schools and Programs of Public Health, on August 1. The new organization is now comprised of all accredited public health academic institutions, both schools and programs. We’ve got 93 members now, an increase from 57 members before, so this was a wonderful and exciting and dynamic annual meeting with lots of energy and lots of promise.

Among the highlights were Harvey Fineberg, MD, PhD, president of the Institute of Medicine, who gave us an inspirational talk about public health leadership, and Laura Liswood, Secretary General of the Council of Women World Leaders, who led a discussion on diversity as a way to make organizations and institutes stronger.   

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Nov 11 2013
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Ending Healthcare Waste, Improving Healthy Lives: Q&A with the L.A. Department of Public Health’s Jonathan Fielding

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In a report released last year, the Institute of Medicine found that the United States wastes billions of dollars each year on such unnecessary spending as inefficiently delivered services, excess administrative costs, fraud and missed prevention opportunities. In response, a group of senior public health scholars at the UCLA Fielding School of Public Health, led by Jonathan Fielding, MD, MPH, a professor at the school and the director of the Los Angeles Department of Public Health, published an article in the American Journal of Preventive Medicine on the improvements to population health the country might realize if only the wasted money was devoted instead to the social and environmental determinants of health. If the government could reap 45 percent of the wasted medical care costs, argues Fielding and his co-authors, and invested those resources in sectors such as education, jobs, healthier foods and transportation infrastructure, the health of millions could be markedly improved and society would see additional social benefits.

Jim Marks, Senior Vice President and Director, Health Group at the Robert Wood Johnson Foundation echoed this approach at the recent American Public Health Association (APHA) annual meeting in Boston.

"We know lots about the cost of illness, but very little about the value of health,” he said.

Marks also said that focusing on health as the ultimate goal tends to eclipse some of the social determinants that can have enormous impact on people’s lives. “Most people don’t want good health as their outcome, they want a quality life. They want to travel, take care of grandkids, have a rich family and social life—you can only do that if you’re healthy,” said Marks. “It’s unrelated to good quality medical care. It’s related to education, safe neighborhoods, [and other social factors].”

According to Marks, improving public health isn’t about curing individual diseases or fixing specific injuries. Rather, it’s about everything; the diseases are the end result of the system we live in. And with all the data we have available, we know it’s a system that needs fixing, said Marks.

Marks’ thoughts came at an APHA panel Fielding moderated in a closing day session about the health impact of investment in major social and environmental policies and interventions; information gaps and how they can be filled; and how the discussion of health spending can be re-framed so that U.S. resources can be invested most productively.

NewPublicHealth spoke with Fielding about better uses for the wasted health care spending just before the start of the APHA meeting.

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Nov 8 2013
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Recommended Reading: An Introduction to 'Health-in-All-Policies'

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A session on health in all policies at the American Public Health Association (APHA) meeting in Boston gave prominent attention to a newly released publication on the topic: An Introduction to Health in All Policies: A Guide for State and Local Governments. The guide was issued collaboratively by APHA, the California Endowment, the California Department of Health and the Public Health Institute.

It was released last month and is geared, according to its authors, “toward state and local government leaders who want to use intersectoral collaboration to promote healthy environments.”

The guide includes a history of health in all policies, case studies, a glossary, messaging, resources and a list of critical thinking questions. It draws heavily on the experiences of the California Health in All Policies Task Force, which was created in 2010 by an executive order of the governor and grew out of a common interest among several California agencies in climate change, health and childhood obesity. The task force brings together non-government stakeholders and local government representatives in its “health-in-all-policies” work through workshops, meetings and opportunities for public comment and testimony.

The Guide emphasizes that there is no one “right” way to implement a health-in-all-policies approach, but puts forward five key elements:

  • Promote health, equity and sustainability
  • Support for Intersectoral collaboration
  • Benefit multiple partners
  • Engage stakeholders
  • Create structural or procedural change

>>Bonus Links:

  • Health Impact Assessments (HIA) are one of the key tools addressed in the new Guide. See a regularly updated map on HIAs in the United States created by the Health Impact Project, a collaboration of the Pew Charitable Trusts and the Robert Wood Johnson Foundation.
  • HIA was front and center at the American Public Health Association meeting, with more than thirty presentations this week. Read a summary of the HIAs discussed at the meeting, prepared by the Health Impact Project.

>>NewPublicHealth was on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Find the complete coverage here.