Inspired by the 2012 American Public Health Association (APHA) Annual Meeting, the Robert Wood Johnson Foundation recently talked with a range of national thought leaders to discuss what’s needed—and what works—to achieve better health.

Today, we're featuring video interviews with Mel Kohn, MD, MPH, Public Health Director and State Health Officer for Oregon.

Kohn spoke with us about the important roles that law and policy will play in the future of public health—especially as health care reform continues and expands.

He also explained how injury prevention, while a relatively new area of practice in the world of public health, can help to dramatically reduce human and financial costs for both individuals and communities.

Inspired by the 2012 American Public Health Association (APHA) Annual Meeting, the Robert Wood Johnson Foundation recently talked with a range of national thought leaders to discuss what’s needed—and what works—to achieve better health.

Today, we're featuring video interviews with Ron Chapman, MD, MPH, Director of the California Department of Public Health.

Chapman spoke with us about the current national opportunity to transform public health by making quality improvement and performance management “a way of life.”

He also discussed how collaborating with city planners, the business community, transportation officials and others can enable us to build healthier communities from the ground up.

Inspired by the 2012 American Public Health Association (APHA) Annual Meeting, the Robert Wood Johnson Foundation recently talked with a range of national thought leaders to discuss what’s needed—and what works—to achieve better health.

Today, we're featuring video interviews Alex Briscoe, director of the Alameda County Health Care Services Agency.

In the first video, Briscoe talks about the connection between health, wealth, race and class. Briscoe says, "it's now harder to get out of poverty than in the history of our civilization." Watch the video:

Briscoe also talked about how we can shift the power dynamic that exists between consumer and physician. How can we empower patients to realize that they are their own best clinician? Briscoe shares his ideas:

Finally, Briscoe talks about "the trump card" in achieving better health outcomes: the resilience of communities and individuals. Watch the video:

Back in 2003, officials from the city of Oakland approached the head of the Alameda County Public Health Department to figure out how to collaborate to tackle the growing problem of violence. They began working together, and with the community, to figure out what was going on. Through a series of rigorous, door-to-door community surveys and community forums, they discovered a complex web of interrelated community issues—as well as a number of powerful community assets and existing partnerships.

Alameda County public health officials presented at the APHA annual meeting on a session about the role of community partners in community-based public health.

Alameda is a county of opposites, according to Liz Maker, Evaluation Specialist at Alameda County Public Health Department—some very poor, some doing amazingly well and in some cases those sections are separated only by a block or a fence.

The City-County Neighborhood Initiative, a partnership between the Alameda County Public Health Department, the City of Oakland, neighborhood resident groups, community-based organizations, the Oakland Unified School District and the University of California, Berkeley, was created to empower residents and support grassroots efforts to create safer neighborhoods and reduce inequities. Partners include a homeowners association, a large community reform church, and local neighborhood committees.

Hurricane Sandy could be the biggest storm to hit the United States mainland in recent history, and some are calling the storm unprecedented. The storm poses a major threat to portions of the Mid-Atlantic and Northeast, and residents from New England to New York, Pennsylvania, New Jersey, Delaware, Maryland, Virginia, West Virginia and eastern Ohio are being urged to prepare.

Public health departments play a critical role in preparing and responding to disasters, particularly in galvanizing work across sectors. Earlier this Fall, NewPublicHealth spoke with Umair Shah, MD, Deputy Director of Harris County Public Health and Environmental Services in the Houston, Texas area, about partnerships for preparedness, including how public health and medical and response teams can work together. His experiences preparing for Hurricanes Ike, Rita and Katrina, as well as other emergencies such as H1N1, are more critical to share now than ever and just as relevant as the nation prepares for another emerging threat.

NewPublicHealth: What is your preparedness role for the health department?

Dr. Shah: As the deputy director of the health department, I work with our executive team that takes preparedness efforts very seriously. We wear two hats—our day job and then as a preparedness team, always ready. We have an incident command structure in place to use for any emergency—anything from a hepatitis scare to a rabies death, as well as identifying other citizens who may have been exposed. Some of the larger scale emergencies have included looking after 27,000 people housed in the Houston astrodome after Hurricane Katrina. And when Hurricane Rita hit just a short time later, we moved the Katrina evacuees and prepared for a potential landfall. During Hurricane Ike, three years later, we dealt with long power outages. And during H1N1, we worked with multiple partners. My role is really to work with our executive team and our response team to manage the health department’s responses, regardless of number of people affected.

NewPublicHealth: What kinds of partnerships are critical to ensure all efforts are coordinated and effective in the event of an emergency?

The Network for Public Health Law will sponsor the 2012 Public Health Law Conference, with the theme “Practical Approaches to Critical Challenges,” from October 10 through 12, 2012, in Atlanta. Follow NewPublicHealth during the conference for interviews and session updates. Goals of the conference include:

• Examining practical legal approaches to address priority public health issues
• Learning about helpful public health law resources and evidence-based research
• Discussing public health legal questions and answers
• Building partnerships to accomplish public health objectives and foster innovation

 According to the Network, target audiences for the conference include attorneys, local, state, tribal and federal public health officials and practitioners, policy-makers, advocates and academics and researchers.

NewPublicHealth spoke with Dan Stier, director of the Network for Public Health Law about the Network’s accomplishments since its founding two years ago, and upcoming goals.

>>BONUS: Read our earlier Q&A with Dan Stier, offering a sneak preview of what's to come at the 2012 Public Health Law Conference.

NewPublicHealth:  How much has awareness of the Network grown since you launched in 2010?

Dan Stier: The volume of the requests has grown greatly, as have the complexity and timeliness of the requests. The fact that people are becoming increasingly aware of us means that we really are addressing issues in real time. Dramatic current examples include legal questions on public health services related to West Nile virus and Hurricane Isaac in real time.

>>Read an interview with James Hodge of the Network on legal questions on these and other recent public health crises.

Other requests include longer-term issues like shared services among local health departments. State and local health departments face budget cuts and so they are figuring out ways to do things more efficiently and economically, and oftentimes, that involves shared service agreements between local health departments. We’ve seen much more activity along those lines. More recently we’ve gotten an increasing number of questions on maternal and child health, particularly with respect to the provisions relating to children in the Affordable Care Act, so we now advertise that as another area of specialty.

NPH: How have people become aware of what the Network offers? 

NewPublicHealth recently made its first foray into infographics with "Better Education=Healthier Lives," a visual exploration of the relationship between education and health. We plan to continue this infographic series with visuals exploring how other aspects of where we live, learn, work and play can affect the health of our communities.

In the meantime, we've been seeing public health infographics everywhere! Take a look at the repost of an interesting graphic below titled, "The World of Public Health," created by an Online MPH Degree site (tip of the hat to GovLoop, where we discovered the graphic). The infographic explores the wide-ranging impact of public health, and showcases both incredible successes as well as formiddable barriers. It also paints a picture of job and education prospects in public health.

The Harvard School of Public Health also released a graphic on, "The Dollars and Sense of Chronic Disease," which shows the economic and health toll of chronic disease.

>>WEIGH IN: Share your favorite public health infographics in the comments below.

The Transforming Public Health project supported by the Robert Wood Johnson Foundation (RWJF) and convened by RESOLVE brought together a group of local, state and national public health leaders to develop guidance for public health officials and policymakers in prioritizing critical public health functions in a changing political and funding landscape.

Recently, the Foundation hosted a webinar to discuss the Transforming Public Health project. Speakers included:

• Terry Cline, Oklahoma State Health Department
• David Fleming, Seattle-King County Health Department
• Abby Dilley, RESOLVE
• Abbey Cofsky, RWJF program officer
• Paul Kuehnert, senior program officer and director of the RWJF Public Health team

>>Read our recap of the discussion from the webinar.

But the conversation shouldn't stop there. We want to hear your thoughts on the future of public health. Below are some questions to get you started. Feel free to add your thoughts in the comments below, and help us chart the course for a new public health.

• How is your public health department adapting in the current changing landscape?
• How is your community prioritizing programs and services to take on new challenges in a time of declining resources?
• How have you engaged policy-makers and diverse partners in your community on issues critical to public health?

>>Read more: Check out these resources to get ready for the webinar and inform the discussion:

• Read the full Transforming Public Health report.
• Read a Q&A with Paul Jarris and Robert Pestronk on how the report’s findings can be implemented to help improve public health services and population health.
• Read our recap of the discussion during the webinar.

Crowds of public health officials thronged Mary Selecky, Secretary of the Washington State Department of Health since 1999 and a former ASTHO president, at the ASTHO annual meeting, likely for her wisdom as a long time health director grappling with some of the most critical problems facing public health.

NewPublicHealth caught up with Mary Selecky at the recent ASTHO meeting.

NewPublicHealth: What is the rest of the country learning from the recent pertussis (whooping cough) outbreak in Washington State?  

Mary Selecky: We have more than 4,000 cases confirmed. Sixty percent of cases are in school age kids, 20 percent in adults and 20 percent in kids under age five. The most worrisome statistics are the numbers of babies hospitalized. [Editor’s Note: Babies get whooping cough vaccines at ages two, four and six months and don’t have full immunity until after the last vaccine.] Most adults get a mild case—they don’t know they have it, they have a dry hacky cough and they’re spreading pertussis germs. One of our very fundamental pieces of information is to make sure your kids are vaccinated and up to date, and that teens and adults have gotten a booster shot. We know we’re reaching the public because our insurance companies are telling us that double the  amount of people have gotten the booster from last year. We know we’re getting some penetration there, but clearly not enough.  

It has not really gone away. We’re still seeing about 100 new cases every week. We are slowing down—it’s a little bit less every week. Nevertheless, 100 cases per week is still ten times more than it was a year ago. We reached out to the CDC to have their epidemiology investigators to come in and look at our data and see what is happening. They were able to show us that our 13- and 14-year-olds are getting hit hardest and many were vaccinated, so we are evaluating when the booster shot was given and how soon after they got pertussis and what we can learn.

We’re seeing more whooping cough in the U.S. than we have seen in multiple decades. Our own numbers are more than we’ve seen since 1941. It’s a bug, easily passed person to person. We do have an effective vaccine but what the CDC is able to glean may indicate that we need to give a booster more often.

NPH: While the CDC investigates, what’s your recommendation as a state health director? 

Jose T. Montero, MD, director of the Division of Public Health Services at the New Hampshire Department of Health and Human Services, was elected president of the Association of State and Territorial Health Officials (ASTHO) during the association’s recent annual meeting in Austin, Texas.

Dr. Montero began his medical career in Putumayo, Colombia, where he served as a local, county and state health official. He then went to teach family and preventive medicine and later became Colombia’s public health director. Dr. Montero began his service in New Hampshire in 1999 as chief of the New Hampshire Communicable Disease Section in the Division of Public Health. Before becoming director of the New Hampshire Division of Public Health Services, Dr. Montero was the state epidemiologist.  He is an adjunct professor of family medicine and a member of the preventive medicine residency advisory committee at Dartmouth Geisel School of Medicine.

NewPublicHealth spoke with Dr. Montero about the new ASTHO President's Challenge, which will focus this year on the integration of public health and health care.

NewPublicHealth: Why is so critical now to work toward the improved integration of public health and health care?

Dr. Montero: We keep talking about the health system but there is not much that is health-focused—it’s currently mostly about providing care after people becomes ill. From a public health perspective we’re trying to improve outcomes and quality, without spending the amount of money on health that we’re currently spending because we can’t sustain that. The system needs to continue changing and evolving, but we don’t yet know what exactly how it will look or how it should look. We need to create a new system. Based on the experiences of some states, such as Massachusetts and Oregon, we know gaining access to health insurance has expanded use, but we don’t know if they’ve achieved improved health outcomes yet. We’re working toward that. But we need to work on the right indicators that allow us to consistently measure total population health.

When you look across the country, you see that public health entities provide the continuum of care throughout the life cycle. We are already integrating health care and the public health system at several different places and levels, but it’s not consistent. To prepare ourselves for the future, we need to be able to look at public health and health delivery systems and integrate them philosophically. We need to capture examples, decode them, and see what works and what doesn’t and how to use which in different parts of the country. We have different cultures, different investment levels, and different expectations. We can’t just copy and paste.

NPH: What are the critical issues you’re looking at?