Nearly 40 percent of private-sector employees in the United States do not have access to paid sick days, making it difficult for them to miss work when they are ill or have a doctor’s appointment. Those who do stay home often suffer lost wages and risk being fired from their jobs. To avoid financial insecurity, employees often go to work while sick, according to the Network for Public Health Law.

Paid sick days, on the other hand, allow employees to stay home or seek preventive care without risking a family’s income or endangering the health of co-workers, customers and others. In fact, one study found that 7 million workers were infected with H1N1 in 2009 because their co-workers came to work sick. To combat this trend, some U.S. cities and one state (Connecticut) have enacted laws requiring employers to provide paid sick days, which was a topic explored in a webinar earlier this year from the Network for Public Health Law.

But as some cities are making moves toward paid sick leave, some state-level legislation is cropping up that could prevent cities and counties from passing their own paid sick days standards and enacting other workplace protections. Such preemption laws are being considered in at least six states, according to a post by Vicki Shabo, Director of Work and Family Programs, for the National Partnership for Women and Families.

"No matter where you live or work, no one should have to choose between job and family because he or she cannot earn paid sick days," said Shabo in the post.

>>Read the full blog post on paid sick leave preemption laws.
>>Read more on preemption.

While this is the first year that the American Public Health Association has used “return on investment” as the theme for National Public Health Week, which runs through April 7, it’s far from the first time that public health practitioners have made the case to policymakers that the work of public health can save lives and money.

Research on the impact of public health services includes the critical fact that spending just $10 per person in programs aimed at smoking cessation, improved nutrition and better physical fitness could save the nation more than $16 billion a year, according to the Trust for America’s Health. That’s a nearly $6 return for every $1 spent.

Over the last two years, NewPublicHealth has reported frequently on the value of investing in public health. Some of our favorite ROI articles, reports and other resources include:

• >>UPDATE: Trust for America's Health released Investing in America's Health: A State-by-State Look at Public Health Funding and Key Health Facts today. The report examine public health funding and key health facts in states around the country, finding inadequate and cut funding and wide variation in health outcomes by state and county.
  
• Making the Case for Prevention: A Q&A with James S. Marks, Senior Vice President, Robert Wood Johnson Foundation, about the great potential for investing in prevention.
  
• National Prevention Resources Starter Guide:
  A collection of resources that showcase how different fields can work together and take action to prioritize prevention.
  
• Strategies to Move from Sick Care to Health Care: The  Trust for America's Health identifies high-impact steps that the nation can take to prioritize prevention and improve Americans' health.
• Workplace Wellness Perspectives: A Q&A with two very different businesses—one big, one small; one academic, one industrial—on creating healthier workplaces.
• Employers Join Community Health Movement: A Q&A with Trust for America’s Health and the National Business Coalition on Health about the critical role of employers in community prevention efforts.
• Stories of the value of investing in prevention from Wyandotte County, Kan., and Hernando, Miss.

>>Read more on the value of prevention from RWJF.org.

Organization and business leaders across the country are realizing that every sector needs to join the fight—or at least the conversation—to create healthier places to live. While altruistic motivations play an important role in this movement, a growing body of research also points to the idea that better health is a major driver for a healthier economy.

Recently, GlaxoSmithKline (GSK) partnered with The Atlantic to host “A Conversation on Community Health”—a series of events in U.S. cities across the country to explore what it means, and what it takes, to create a healthy community. NewPublicHealth checked in with GSK’s Senior Vice President and Corporate Medical Director, Robert Carr, MD, MPH, FACPM, to get his take on why businesses should care about community health, and why a broad, cross-sector dialogue is a critical next step.

>>Read more on communities that were recognized for innovations that are improving the health and lives of their residents, with the 2013 RWJF Roadmaps to Health Prize.

NewPublicHealth: What prompted you and GSK to start thinking about community health?

Dr. Carr: As an HR executive and medical director of a global business, I’m acutely aware that employees are—first and foremost—members of families and communities. The places where they live and the choices made by the people around them profoundly influence the health of our employees. We regularly hear that our employees want to know not only what they can do to lead healthier lives but also what we can do as a company to improve the health of their own community. They want us to dig in and find out what’s needed. Similarly, we recently conducted some research about what Americans are looking for more broadly, and we learned that they want the same thing from GSK.  They want us to do more in their communities.

We heard them loud and clear, and we are digging in, starting with understanding what it means and what it takes to be a healthy community.  Last year we kicked off a program we call “Healthy Communities.”  As part of this attempt to learn more, directly from those on the ground in different American cities, we partnered with The Atlantic for “A Conversation on Community Health.”

NPH: What’s the focus of the “Conversation on Community Health” series?

The NewPublicHealth National Prevention Strategy series is underway, including interviews with Cabinet Secretaries and their National Prevention Council designees, exploring the impact of jobs, transportation and more on health. “Stable Jobs = Healthier Lives” tells a visual story on the role of employment in the health of our communities.

Some highlights:

• Since 1977, the life expectancy of male workers retiring at age 65 has risen 6 years in the top half of the income distribution, but only 1.3 years in the bottom half.
• 12.3 million Americans were unemployed as of October 2012.
• Laid-off workers are 54% more likely to have fair or poor health, and 83% more likely to develop a stress-releated health condition.
• There are nearly 3 million nonfatal workplace injuries each year.
• The United States is one of the few developed nations without universal paid sick days.

Also check out our previous infographics exploring the connection between transportation and health, and education and health.

>>For more on employment and health, read a related issue brief.

View the full infographic below.

New York Declares Public Health Emergency for Flu
The state of New York has declared a public health emergency due to the increasingly severe flu season, which has reached epidemic levels. The declaration allows pharmacists to administer flu vaccinations to patients between six months and 18 years of age and suspends for the next 30 days the state’s law that limits the authority of pharmacists to administer vaccinations only to people 18 and older. "We are experiencing the worst flu season since at least 2009, and influenza activity in New York state is widespread, with cases reported in all 57 counties and all five boroughs of New York City," said Governor Andrew Cuomo, according to Reuters. According to the U.S. Centers for Disease Control and Prevention, nine of the ten regions of the United States have “elevated” flu activity. Last week the city of Boston, Ma., declared a public health emergency in response to the flu. Read more on influenza.

High Noise Levels in Sports Stadiums Hurts Workers, Spectators
High noise levels in the workplace—especially in nontraditional workplaces such as sports stadiums—are often unappreciated and can lead to permanent hearing loss, according to two new studies in the Journal of Occupational and Environmental Hygiene (JOEH). The can also be damaging to spectators. “While severe traumatic injuries and degenerative brain disorders due to concussive blows are recognized as severe hazards among athletes, exposure to high noise likely affects far more individuals (spectators and referees), and the resulting permanent hearing loss decreases the quality of life of those affected,” said JOEH Editor in Chief Mark Nicas, PhD, CIH. Read more on business.

Simple Traffic Changes Make Streets Safer, Save Pedestrian Lives
Traffic changes around schools in New York City helped cut child pedestrian injuries by 44 percent during “school travel” hours, according to the results of the National Safe Routes to School program published in the journal Pediatrics. "The study shows that safety programs really do work," said Kate Carr, president and CEO of Safe Kids Worldwide, according to HealthDay. "Making common sense improvements around schools by adding sidewalks and speed bumps, improving signage, and creating more visible crosswalks prevents injuries and saves lives." Safer streets also encourage kids and their parents to get more physical activity. Read more on safety.

New York City Board of Health Passes Law to Limit Size of Sugary Beverages
The New York City Board of Health has enacted a law to limit the size of sugary beverages sold in food service establishments to 16 ounces. The board says it approved the  measure  in order to combat the growing obesity epidemic in New York City.

The new regulation goes into effect on March 12, 2013, and requires that sugary beverages with more than 25 calories per eight ounces be sold only in sizes of 16 ounces or less. The regulation will apply to any food service establishment that is regulated by the Health Department: restaurants, mobile food carts, delis and concessions at movie theaters, stadiums and arenas. Read more on obesity.

Investment Firm and American Heart Association Collaborate on Workplace Wellness
Investment firm Kohlberg Kravis Roberts & Co. (KKR) and the American Heart Association have launched a research collaborative to study the effectiveness of workplace wellness initiatives offered at KKR and its portfolio companies. The research effort will be based on data collected  on employees enrolled in the KKR Wellness Works program.

According to KKR, Wellness Works provides a best practice model which participating companies follow in developing their individual wellness programs. At a minimum, the companies commit to providing employees with incentives of $250 or more, for completing certain wellness requirements, including completing an annual biometric screening. Resources can include access to health coaching, incentives tied to making lifestyle changes and tools for tracking and reducing health risks. Read more on what businesses are doing to keep employees and communities healthy.

Smokers May Get Less Sleep
A recent study in the journal Addiction Biology compared length of sleep time and asked questions about disturbed sleep of both smokers and non-smokers, and found that smokers tended to get fewer hours of sleep and had more disturbed sleep than non-smokers. One reason for the difference may be the stimulating effects of nicotine. Read more on tobacco.

James S. Marks, MD, Senior Vice President of the Robert Wood Johnson Foundation, recently spoke on a keynote panel at the annual ASTHO meeting in Austin, Texas, on making the case for prevention. NewPublicHealth spoke with Dr. Marks about the great potential for investing in prevention.

NewPublicHealth: What do you think are the big issues facing state health officers across the country?

James Marks: The thing that I am most struck by is that we all know that public health, like so many of our sectors, is struggling in these tough economic times. But I’m seeing state health officers look increasingly at how they and medical care can connect and integrate and support each other as something we need increasingly in this country. They have to ask where they are going to get the best value in health. Sometimes it will be in medical care, many times it will be in prevention and public health, and they should be working to create common purpose. 

NPH: What is the training of health officers for that?

United Way of North Central Florida is focused on the building blocks that lead to a good quality of life – education, income and health – recognizing that communities are stronger when children are successful in school, families are financially stable and people are healthy. One of their primary roles is as a convener, to bring hundreds of organizations together across diverse sectors to set priorities and create change.

As part of our series looking at the work of United Ways across the nation in creating healthier communities, we spoke with Debbie Mason, President and CEO of the United Way of North Central Florida, and Mona Gil de Gibaja, Vice President of Community Impact, about their community planning process, strategies for effective partnerships, and the role of critical partners such as businesses and the local health department.

NewPublicHealth: What is the planning process you’re engaging in to set priorities around education, income and health?

Debbie Mason: Our major focus is education, but this is so inextricably linked to income and health. No matter where you start, you still wrap into the other two.

Faces of Public Health is a recurring editorial series on NewPublicHealth featuring individuals working on the front lines of public health and helping keep people healthy and safe.

The CDC Foundation, established by Congress in 1995, connects the Centers for Disease Control and Prevention (CDC) with private-sector foundations, corporations, organizations and individuals to help build public health programs. Since its inception, the CDC Foundation has provided $350 million to support CDC’s work and launched more than 600 programs around the world. The support is typically financial, but also can include expertise, information or leadership.

One key initiative from the Foundation, in partnership with CDC and the Robert Wood Johnson Foundation, was the Meta-Leadership Summit for Preparedness—a model approach for bringing communities together to improve emergency preparedness and build community resilience. From 2006 through 2011, initiative partners organized and hosted 36 Summits across the country, training 5,000 business, government and nonprofit leaders in meta-leadership concepts. While the initiative has concluded, the Meta-Leadership Summit Resource Centerprovides resources to help communities initiate or continue meta-leadership activities.

NewPublicHealth spoke with Charles Stokes, president and CEO of the CDC Foundation, about the Foundation’s partnerships and successes, including those around meta-leadership and more.

NewPublicHealth: What kind of work did you do before becoming president and CEO of the CDC Foundation?

Charles Stokes: For the prior 22 years, I worked with the Missouri state department of health. The last 10 of those I was deputy director or acting director of the state health agency. In that role I had the opportunity to chair an American Public Health Association workgroup that developed Healthy Communities 2000: Model Standards where we set model goals and objectives for state and local health departments to use in reaching the national goals ofHealthy People 2000. That connected me with CDC.

NPH: What was the impetus behind the creation of the CDC Foundation?

“Record-breaking heat will continue to make headlines” is how the National Weather Service began its forecast for the weekend and into next week. So it’s a good time for a reminder about taking hot weather precautions, especially for outdoor workers, in this blistering weather.

The Occupational Safety and Health Administration is continuing the campaign it began last year to help protect outdoor workers in extremely hot weather. In 2011, 30 workers died of heat-related causes and thousands became ill. Each year tens of consumers die of heat-related illnesses.

OSHA maintains a frequently updated website as part of its outreach campaign to raise awareness among workers and employers about the hazards of working outdoors in hot weather. Resources include training tools and posters for employers and many are aimed at workers with limited English proficiency.

OSHA is also partnering with the National Oceanic and Atmospheric Administration (NOAA) on weather service alerts. NOAA’s Heat Watch page now includes worker safety precautions when extreme heat alerts are issued.

Drinking water often, taking breaks and limiting time in the heat can help prevent heat illness for outdoor workers and anyone else spending time in the heat.

Watch a video with David Michaels, PhD, MPH, Department of Labor Assistant Secretary for Occupational Safety and Health, on protecting workers working during extreme heat.

And the hot temperatures around the country beg precautions by non-workers as well.

The Centers for Disease Control and Prevention reminds people that during high humidity sweat does not evaporate as quickly, which can keep your body from releasing heat as fast as it may need to. In addition, age, obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn and prescription drug and alcohol use can interfere with sweating and being able to cool off in very hot water. Not cooling off can cause body temperature to rise and can result in severe illness and even death.

Pay attention to these precautions:

• Stay in an air-conditioned indoor location.
• Drink plenty of fluids.
• Wear loose, lightweight, light-colored clothing and sunscreen.
• Schedule outdoor activities carefully.
• Pace yourself.
• Take cool showers or baths to cool down.
• Check on a friend or neighbor and have someone do the same for you.
• Do not leave children in cars.
• Check the local news for health and safety updates.

>>Bonus Link: Read a CDC Frequently Asked Questions page about extreme heat.