Category Archives: ASTHO
For the last few years, each annual meeting of the Association of State and Territorial Health Officials has kicked off a yearlong President’s Challenge that focuses on a particular health issue impacting all states. Judith Monroe, MD, now the director of the Office for State, Tribal, Local and Territorial Support at the Centers for Disease Control and Prevention used her Presidential Challenge in 2008 to highlight the need to “walk the talk” by promoting wellness in health department worksites.
In 2010 Paul Halverson, director of the Arkansas Department of Health, devoted his President’s Challenge to injury prevention, a topic prominent at this year’s ASTHO annual meeting as well. And last year John Auerbach, state health commissioner in Massachusetts and ASTHO’s outgoing president, made health equity his cornerstone initiative. The focus on these health issues has extended well beyond the challenge year and health officials continue to make them a priority.
For the 2011-2012 President’s Challenge, incoming president David Lakey, MD, commissioner of the Texas Department of Health, is focusing on healthy babies because too many are born too soon, often resulting in developmental and health issues that impact their entire lives.
NewPublicHealth spoke with Lakey about his President’s Challenge, why preventing preterm birth is such a critical issue and key partners across the country to help accomplish his goal to reduce prematurity in United States by 8 percent by 2014.
NPH: How did you come to focus on healthy babies for your President’s Challenge this year?
Lakey: About a year and a half ago when we were discussing the challenges that all of us were facing in the southern part of the United States, Regions 4 and 6, all of us brought up the challenge that we have with prematurity and infant mortality.
I guess the other part of my interest is my background. I’m an infectious disease physician but I did pediatric training and spent time helping to care for premature babies and the consequences that come with that, whether it was intellectual disability or problems with the lungs or other abnormalities.
So we saw this as an issue that we needed to put some focus on. It is also an area that has significant ethnic disparities. If you look at the rates in the African American community, they’re about twice as high as in other populations. And we also started to understand not only the human aspect but also the economic aspect that prematurity is a driver of our Medicaid budgets in our states. We can not only improve health outcomes and improve people’s lives but also do it in a way that saves money for the states and helps us drive our health costs in our system down.
NPH: What are some of the proven strategies for improving these health outcomes?
Hispanics are three times as likely to get pregnant as teens. Infants born to black women are up to three times more likely to die than infants born to women of other races and ethnicities. American Indians and Alaska Natives born today have a life expectancy that is 5.2 years less than the U.S. average. And lower income residents report fewer healthy days across all races and ethnicities (according to a Centers for Disease Control and Prevention report). The statistics are striking and disturbing – health disparities persist.
John Auerbach, MBA, outgoing president of ASTHO and commissioner of the Massachusetts Department of Public Health, helped to make health equity a priority for health officials with his year-long President’s Challenge to reduce disparities [read a Q&A with John Auerbach on the Challenge here]. Yesterday at the ASTHO Annual Meeting, he led a discussion with Anna Whiting-Sorrell, MPA, director of the Montana Department of Public Health and Human Service and Joshua Sharfstein, MD, MPH, secretary of the Maryland Department of Health and Mental Hygieneon progress in advancing health equity in the last year and challenges still ahead.
“Health equity needs to be part of the public health DNA – a thread that runs through the core activities we pursue in public health,” said Auerbach.
Topics in the discussion included how to talk about racism (if you’re talking about it at all, you’re headed in the right direction), and efforts to make the public health workforce better reflect the people it serves. Another major theme of the discussion was how to measure programs that address health equity.
“We have to decide what is success. Is it just how many people call the quit-line? Or is it broader health?” said Whiting-Sorrell.
The conversation showcased some of the videos and campaigns targeted at reducing health disparities. Sharfstein discussed a video his office created to address infant mortality.
“We tried to understand the striking data in infant mortality. Every year there would be 20-25 preventable deaths per year, almost all African American babies, often because of unsafe sleeping patterns,” said Sharfstein. “We decided the mothers who’d lost children were the best conduit to get the message out.”
This moving video was the result:
Injuries are the leading cause of death for people ages 1 through 44 in the United States, according to the latest data from the Centers for Disease Control and Prevention. Many of those injuries could be prevented – a key issue for the Association of State and Territorial Health Officials, which released an injury prevention guide for health officials and devoted a president’s challenge to the issue two years ago.
A survey by the Network for Public Health Law found that only 10 states have comprehensive injury prevention authority. NewPublicHealth caught up with Daniel Stier, JD, director of the Network for Public Health Law, about injury prevention at the ASTHO Annual Meeting.
NewPublicHealth: What is the focus of your talk at the ASTHO meeting?
Daniel Stier: It’s a broad view of injury prevention. Starting a number of years ago, I was contacted by Dr. Mel Kohn, who is the state health officer in the state of Oregon, and he was concerned about the lack of injury prevention authority in Oregon’s statutes and said he was advised by his lawyer to go rather slow on injury prevention activities because of this. So he and I and others have been working together to really study what’s going on at the state level in injury prevention and we found that only a handful of states are mandated to conduct comprehensive injury prevention activities including surveillance assessments and policy development.
NPH: What issues are particularly critical in injury prevention?
National public health department accreditation, which launched last month, is a key topic among presenters and participants at the Association of State and Territorial Health Officers Annual Meeting, which began yesterday. Terry Cline, PhD, the Oklahoma Commissioner of Health, was among the speakers at today's session on accreditation and quality improvement.
At the ASTHO session today, Cline said, “It’s a way of thinking, it’s a way of constantly holding ourselves accountable. It’s really changing a mindset, which is incredibly powerful."
"This is the way we are going to raise the bar in population health," said Cline. NewPublicHealth spoke with Cline about the benefits of accreditation and the plans for pursuing the credential in his state.
NewPublicHealth: How has Oklahoma been involved in preparing for public health department accreditation?
Cline: We were actually the only state that was a beta test site for the state level, the local county health department level and the tribal level. So we have been marching down this path as big believers in the power of accreditation and the need for accreditation in public health. At the state and one county level, Comanche County, applications have already been filed.
NPH: What do you think the state and its local health departments stand to gain from accreditation?
Thomas Frieden, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), spoke at the Opening Session of the Association of State and Territorial Health Officials (ASTHO) Annual Meeting yesterday, with a focus on a vision for the public health of the future. NewPublicHealth caught up with Frieden to talk about the CDC’s efforts to move public health into the future, despite economic constraints.
NewPublicHealth: The theme of the ASTHO opening session is a vision for the "new" public health. What does this mean to you and the CDC?
Thomas Frieden: Public health has to consistently and newly demonstrate our value to society, both through the traditional efforts in communicable diseases and environmental health as well as the newer challenges of dealing with cancer, heart disease, stroke and diabetes. What we’ve tried to do is to identify Winnable Battles where we can save a lot of lives and save a lot of money with a big impact on health. We can succeed at these by getting many different parts of society working together. We’re encouraging stories from around the country of getting everything from school boards to housing projects to workplaces to WIC [Women, Infants and Children] programs involved in promoting health.
NPH: This year CDC and other partners launched the Million Hearts initiative to prevent 1 million heart attacks and strokes over the next five years. What are the strategies for accomplishing this goal?
Frieden: Million Hearts is, I think, an incredibly exciting initiative, and I’m confident that within five years, this initiative will prevent one million heart attacks and strokes. It will do that by reducing the number of people who need treatment and improving the quality of care for those who do need treatment. It will reduce the number of people who need treatment through tobacco control and improved nutrition, particularly reducing artificial trans-fats and excess sodium intake.
And it will improve the quality of care by addressing the ABCS – Aspirin, Blood Pressure, Cholesterol and Smoking Cessation. Currently the U.S. does very poorly on the ABCS. Less than half of the people who should be on aspirin are on it, less than half of the people with high blood pressure have it under control, only a third of people with high cholesterol have it under control and less than a quarter of smokers who see their doctor get advice to quit. Now what we know is that highly performing systems can do dramatically better. They can do that by focusing on key outcomes like using health information technology and getting all members of the healthcare team to be used to their fullest potential.
NPH: What will be happening at the community level to meet these goals?
Today, public health leaders from across the country are gathered in Portland, Ore., for the start of the Association of State and Territorial Health Officials (ASTHO) Annual Meeting. This year’s meeting, and today’s Opening Session, focuses on the vision for the “new” public health. The Opening Session features perspectives on this vision from the federal, state and local levels.
John Auerbach, MBA, president of ASTHO and commissioner of the Massachusetts Department of Public Health, said this has been a challenging year for public health with budget and staff cuts, but this year has also represented a number of new opportunities, including the Patient Protection and Affordable Care Act and Community Transformation Grants.
Lillian Shirley, MPH, MPA, president of the National Association of County and City Health Officials and director of Multnomah County Health Department talked about what state and local public health can do together – and why that collaboration is so important. Shirley reflected on the lesson in collaboration learned during the H1N1 outbreak.
Whether you're in Portland, Ore., or anywhere else around the country, you can follow and contribute to the ASTHO 2011 conversation by following and using the Twitter hashtag #ASTHO2011. You can also follow it right here on NewPublicHealth. This post will update dynamically throughout the week, pulling in all the #ASTHO2011 tweets. As always, follow @RWJF_PubHealth on Twitter for public health information and discussion.
The annual meeting of the Association of State and Territorial Health Officials (ASTHO) begins next week in Portland, Oregon, bringing together chief health officials and other key public health leaders to talk about public health issues in the U.S. NewPublicHealth will be on the ground throughout the meeting covering workshops, sessions and keynote speeches, as well as speaking with program speakers and conference attendees. Follow the coverage here.
In advance of the conference, NewPublicHealth spoke with Paul Jarris, M.D., ASTHO’s executive director, about the meeting’s priorities and goals.
NewPublicHealth: About how many new state health officers are there this year?
Dr. Jarris: I’d say by January we’ll have 32 new health officials. So it was a major turnover. We count 59 members including the US territory, so 32 new officials are quite a few.
NPH: What is different for them than the post might have been five or ten years ago, and are there any particular strengths you can cite that they might be bringing to the job this year?