Category Archives: Idea Gallery

Apr 7 2011

Economic Shocks and Public Health Decision-making: How Can Research Help?

Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. Today’s contributor is Glen P. Mays, Professor and Chair and director of research for the Department of Health Policy and Management in the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences.

The economic downturn — combined with a shifting political landscape and changing policy priorities — is forcing state and local public health professionals to confront difficult choices on a daily basis.

This raises a series of critical questions:

  • As budget cuts are made, how should public health officials make decisions on which activities to reduce and eliminate so as to minimize population health risks and harm?
  • Are there alternative ways of organizing, staffing and delivering core public health services, so that officials can better produce efficiencies and reduce resource needs?
  • Are there alternative ways of re-allocating the division of labor among state and local agencies, as well as among governmental and private-sector organizations, so as to maximize health protections and minimize costs?
  • How much discretion do public health officials have in using evidence and economic imperatives to reconfigure their delivery systems?

The many uncertainties surrounding these issues create an urgent demand for new research to inform policy and practice. Next week in Lexington, Ky., the 2011 Public Health Systems and Services Research (PHSSR) Keeneland Conference will provide a unique forum for research and practice communities to brainstorm, share preliminary findings and identify improved approaches for applying this type of evidence to the real world.

Among other research, the event will showcase the work of RWJF’s Public Health Practice-Based Research Networks (PBRN), which fields real-time and relevant studies to inform public health decision-making in a time of economic shocks and resource constraints:

  • A recent study from North Carolina demonstrates how local health departments have responded to reduced Medicaid support for maternity case management services by improving delivery efficiency rather than cutting services or clients.
  • Research underway in Colorado demonstrates how public health agencies are utilizing multi-organizational coalitions to deliver chronic disease prevention activities effectively and efficiently.
  • New research from Wisconsin shows that the public health activities most vulnerable to economy-related cuts are those financed through local taxes and not mandated by state law.
  • Research from Florida finds that cross-cutting, infrastructure-related public health capacities (such as surveillance and health assessment) are least likely to be funded by categorical funding streams — and therefore especially vulnerable to economy-related funding reductions.


Several other PBRN studies to be presented at the conference will address barriers and facilitators to evidence-based public health decision-making in the face of economic constraints.

These Keeneland Conference sessions will likely stimulate considerable discussion and debate concerning the health and economic impacts of changes in public health service delivery across the United States, as well as how research can be used to estimate and learn from these effects. Estimating these effects undoubtedly will require longer time lags and additional analytic horsepower, but studies to accomplish these tasks are already underway.

PBRNs are a relatively new concept within public health, operating “below the radar” in many communities. Nevertheless, they may prove to be the missing ingredient needed to drive science-based improvements in practice and practice-relevant advances in science. Researchers and practitioners who share this vision of an evidence-producing community of practice should be sure to attend the conference sessions and get involved.

Follow coverage of the 2011 PHSSR Keeneland Conference on and Scutch’s Blog.

Throughout the conference — April 12-14 — you can also get real-time updates on Twitter from @RWJF_PubHealth and @CPHSSR. Use the hashtag #PHSSRKC11.


Mar 31 2011

Idea Gallery: Major League Baseball Must Ban Smokeless Tobacco

Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. Today's contributors are Matthew Myers, President of the Campaign for Tobacco-Free Kids, and Cheryl Healton, President & Chief Executive Officer of Legacy.


Every summer, millions of American children go to baseball stadiums across the country to watch their heroes play the national pastime. And even more kids watch the games on TV.

That means millions of kids see Major League Baseball players chewing and spitting out harmful tobacco products – creating the false impression that smokeless tobacco use is cool and athletic. About one-third of current Major League Baseball players use smokeless tobacco.

To protect the health of ballplayers and the kids who look up to them, we urge Major League Baseball and the Major League Baseball Players Association to ban tobacco use by players, managers, coaches and other team personnel at ballparks. The current talks on a new collective bargaining agreement give baseball a unique opportunity to make a powerful national statement about health.

Tobacco use is the number one preventable cause of death in the United States. Public health experts have concluded that smokeless tobacco is very addictive and causes cancer and other serious illnesses. And smokeless tobacco use among high school boys is spiking – it’s increased 36 percent since 2003 and an alarming 15 percent of high school boys currently use smokeless products.

In spite of these disturbing statistics, the tobacco industry still spends huge sums – more than $350 million per year at last count – to market smokeless products and often promotes them as a substitute for smoking. Tobacco companies continue to advertise these products in magazines that appeal to youth.

Baseball banned tobacco use in the minor leagues 18 years ago. The NCAA and the National Hockey League also prohibit tobacco use. Ending tobacco use in Major League Baseball would be another important step to help teach kids that tobacco use — in any form — is dangerous and can lead to serious diseases. It will also help keep our kids’ heroes healthy.

Matthew Myers, President of the Campaign for Tobacco-Free Kids, and Cheryl Healton, President & Chief Executive Officer of Legacy.

NewPublicHealth invites you to join and advance this conversation. Please share your comments below. We look forward to hearing from you.