Category Archives: Faces of Public Health
As the weather gets warmer, parks departments across the country are beginning to ready pools, pavements and pathways for their community residents, many of them simply adding another set of offerings to the fall classes and leagues. The Denver Parks and Recreation Department, for example, offers adaptive fitness classes for people with disabilities as well as a host of other fitness classes including yoga, martial arts and a weekly drop-in basketball game. Parks and recreation departments have long had a history of a commitment to social change and physical fitness in the United States. NewPublicHealth spoke with Bill Beckner, research director of the National Recreation and Park Association about projects and changes within the departments and the communities they have served for more than 100 years.
NewPublicHealth: Tell us a bit about the history of parks and recreation departments.
Bill Beckner: Well, the actual start of the park and recreation movement goes back to the 1800s in the inner cities, which were seeing a great deal of crime and disease and rising numbers of orphans. Settlement houses provided health, social and recreational services including playgrounds. The American Playground Association, a precursor to our organization, formed in 1906 and promoted the idea of giving children healthy outlooks, healthy conditions, air, parks and greenery, which was so different from the environment many of them lived in.
Will The Lorax, a film version of the Dr. Seuss book, which opens tomorrow, prompt kids everywhere to plant gardens and eat healthier? That’s the hope of Kelly Meyer, the founder of American Heart Association Teaching Gardens, a project that teaches kids how to plant seeds, care for their plants and harvest the produce. The Lorax tells the story of a boy in search of his young love’s “heart’s desire,” a truffala tree, only to find that all the trees have been chopped down to create a new invention. A theme of environmental preservation and connection with nature runs throughout the story, and ends with a single seed meant to rebuild the forest.
NewPublicHealth spoke with Meyer, who brought a group of young gardeners to the film’s premiere in Los Angeles last week to showcase a special Teaching Garden that will be donated to local schools.
NewPublicHealth: How did the Teaching Gardens program come about?
Kelly Meyer: For me, it was a wonderful opportunity to address a health issue, childhood obesity, while connecting kids to nature and teaching them about a food source in a real, three-dimensional way. And so, I started the program with just one garden, and had the good fortune to have the program adopted by the American Heart Association. Now we’re in over 100 schools across the country and I have a real infrastructure to help push this program forward.
>>Read more on childhood obesity from the Robert Wood Johnson Foundation.
NPH: What have you seen the kids get out of the experience?
Kelly Meyer: They learn what it takes to grow food that’s healthy for you and they learn teamwork. They have a much more real-life picture of science. We had one child in the program who was tasting a clementine from a tree she helped plant. She had never tasted one before, and when you see the expression on her face—she was prepared for it to be sour and awful, and instead it was sweet and juicy and beautiful. When we harvest the garden and prepare salads, I think the kids are shocked at how good it tastes.
>>Watch a video on the Teaching Gardens program, including footage of the young girl trying a Clementine for the very first time.
And the kids take [the message] home to their parents. I’ve gotten so many photos from kids who’ve gone home and made a little bit of space in the back and planted a tiny garden of their own. They take ownership.
NPH: How did the association with the film come about?
Kelly Meyer: I have a relationship with Universal Pictures and with the producer of the film and they gave us this opportunity to set up a beautiful garden at the premiere, and the kids got to plant and then they went to the movie and they learned it’s ultimately just about that one seed, whether it’s the literal seed for growing the last tree or the seed of an idea and its growth and how important it is to protect that.
When the movie was over, the kids ran and they couldn’t get back to the garden fast enough, and they wanted to plant more. And then, when we left the garden, we sent them all home with seedlings and I got many emails that kids had planted gardens with their parents and now they’re going to be growing vegetables together in their back yard. That was really exciting.
NPH: What’s next for you?
Kelly Meyer: I’m going to continue to focus on the Teaching Gardens because I want it to be successful. It’s not automatic. You don’t just ship it off and it’s done, it requires a lot of attention. I’d also like to broaden the concept that maintaining your environment and the environment of your body is directly related and connected to our general health.
A look at laws intended to reduce youth sports-related concussions was a focus of the recent Public Health Law Research annual meeting. Public Health Law Research is a Robert Wood Johnson Foundation program at Temple University.
The issue is so critical that this year the MacArthur Foundation named a Kevin Guskiewicz, MD, a scientist involved in research to prevent catastrophic youth sports injuries as a MacArthur Fellow, which awards five-year, $500,000 grants to individuals “who show exceptional creativity in their work and the prospect for still more in the future.”
The 2011 fellows just began receiving their grant money last month, and Dr. Guskiewicz is one of several MacArthur Fellows whose works informs critical public health issues. NewPublicHealth will be speaking with these grant recipients over the next few months, and we begin that series with a conversation with Kevin Guskiewicz.
NewPublicHealth: Tell us about the scope of your work.
Dr. Guskiewicz: We’ve been studying recovery curves following concussions. We’re trying to better identify the best tools with which to assess concussions. More recently we’re trying to look at the biomechanics of concussion and the way in which youth athletes often lead with their head inappropriately. So they might predispose themselves to a concussion because they’re tackling incorrectly or hitting a soccer ball incorrectly or blocking incorrectly. I think we’ve done a good job of answering questions on what happens after they’ve had the injury. So now we want to try and focus on prevention.
NPH: How do you prevent concussions?
John Buse, MD, PhD, director of the Diabetes Care Center and chief of the Division of Endocrinology at the University of North Carolina at Chapel Hill School of Medicine, was just recently named the new chair of the National Diabetes Education Program (NDEP), a joint program of the National Institutes of Health and the Centers for Disease Control and Prevention.
The role of NDEP, established in 1997, is to foster public and private partnerships to improve diabetes management and outcomes, to promote early diagnosis, and to prevent or delay the onset of type 2 diabetes in the U.S. Currently, nearly 26 million Americans have diabetes, and 79 million have prediabetes, which puts them at increased risk for developing type 2 diabetes and heart disease. Over the next decade, an estimated forty million more U.S. adults could develop the condition.
NewPublicHealth spoke with Dr. Buse recently about his new position at NDEP.
NewPublicHealth: What innovations might you like to try at NDEP?
Dr. Buse: I think the program has been remarkably successful over almost 15 years. NDEP has developed a lot of materials, and the focus now is on working through partnerships to get the materials out there to a greater extent. Our research unit at UNC has done a lot of work with the pharmaceutical industry and clinical trials in diabetes and cardiovascular disease and I do think there’s an opportunity to partner with industry. They provide materials to primary care doctors and health care systems to use in patient education. They generally develop those materials themselves. I think there’s potentially an opportunity to have them use the NDEP materials with the NDEP being sort of an honest broker in developing educational programs free of undue influence from the pharmaceutical industry. So I think that’s a potential opportunity. The resources of NDEP are pretty modest compared to the scope of the diabetes problem, so leveraging our little tiny budget through partnerships is really the way to have an impact.
And as universal health care coverage is slated to come into existence in 2014, the improved access to care will create lots of opportunities to improve diabetes care and the education is really critical in that process. Health care systems and insurance plans and legislatures are looking more and more carefully at diabetes and obesity as major areas of cost and expenditures.
NPH: Can you tell us the key mandates of NDEP?
With the new year and many Spring school semesters starting, NewPublicHealth spoke with Harrison C. Spencer, MD, PhD, president and CEO of the Association of Schools of Public Health (ASPH) about what he sees ahead in 2012 for public health.
NewPublicHealth: Are you seeing increasing interest in the study of public health?
Dr. Harrison Spencer: Very much so. Both at campuses where there are schools of public health, as well as individual courses where there are not. The reasons for that include interest among students in academia, service and global health. The increasing interest is pushing us to rethink the continuum of public health education. As part of these efforts, in July, we released the final Undergraduate Public Health Learning Outcomes Model. ASPH gathered experts from public health and arts & sciences faculties to define what every undergraduate should know and be able to do to improve health and eliminate disparities in populations around the world.
We also convened the Summit on Undergraduate Education in Public Health in Washington, D.C. The summit brought together over 150 public health professionals and educators involved or interested in undergraduate education in public health to discuss emerging trends, curriculum models, education and career pathways, and more. We are already planning next year’s Summit on Undergraduate Education, which will be held October 27, 2012 in San Francisco.
>>Read more on workforce issues, and potential undergraduate training solutions, in our Q&A with Paul Jarris, Executive Director of the Association of State and Territorial Health Officials.
NPH: What other public health education changes have come about recently?
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.
Cigarette and alcohol use by teens are at their lowest point since the Monitoring the Future survey began polling teenagers in 1975, according to this year’s survey results. But good news is tempered by a slowing rate of decline in teen smoking and continued high rates of abuse of hookahs, small cigars and smokeless tobacco, as well as marijuana and prescription drugs. According to the current survey, conducted annually by researchers at the University of Michigan Institute for Social Research and funded by the National Institute on Drug Abuse, more teens continue to abuse marijuana than cigarettes, and alcohol is still the top substance of choice.
Close to 50,000 students from 400 public and private schools participated in this year's survey. NewPublicHealth spoke with the survey’s principal investigator, Lloyd Johnston, PhD.
NewPublicHealth: What were key results in this year’s survey?
Lloyd Johnston: I think the most important stories were related to the most widely used products—tobacco, alcohol and marijuana. The decline in use among teens continued in all three grades we studies. For example, smoking declined from thirteen percent down to 12 percent, and while that’s a small decrease it translates into a lot of lives saved—perhaps 30,000 to 40,000 fewer kids smoking now.
NPH: What makes teens think marijuana is relatively safe?
The redesign of the Centers for Disease Control and Prevention (CDC) website home page, launched last week, is a small part of the CDC’s social media efforts. NewPublicHealth spoke to Karen Morrione, Senior Adviser for Research and Strategy in the electronic media branch at CDC, about new efforts and the reasons they are important for helping improve health in the U.S.
NewPublicHealth: Why did CDC recently redesign its home page?
Karen Morrione: We wanted a much more modern look and I think we got it. We also wanted to make sure that we incorporated our social media into the home page.
NPH: What makes exposing site users to social media so prominently so critical?
Karen Morrione: One of the things we’ve learned from recent research is that people who need health information are typically getting that health information as much online and through social media as they are from their physicians. So, it’s important for CDC to be where people are looking for information. In fact, that has been our guiding vision in electronic media for quite some time. We want to be where our citizens are. We want to make sure that they have access to us no matter what channel they’re looking at and no matter how they prefer to consume their information. Electronic media is successful when it helps people make positive behavior change. And the most important thing is to have information that is evidence-based and is credible.
Melvin D. Shipp, dean of The Ohio State University College of Optometry, was elected to a two-year term as president of the American Public Health Association (APHA) at the organization’s recent annual meeting in Washington, D.C. Dr. Shipp has served on the APHA Executive Board of Directors and was founding chair of the APHA Education Committee. Dr. Shipp has also been an adviser to the Food and Drug Administration, the National Eye Institute and the Centers for Disease Control and Prevention. In 2006, he co-chaired the development of a CDC-sponsored vision health initiative, Improving the Nation’s Vision Health: a Coordinated Public Health Approach.
Dr. Shipp is a former Robert Wood Johnson Health Foundation Policy Fellow and during the fellowship, served as a health legislative assistant to Senator Donald Riegle, Jr. (D-MI).
NewPublicHealth spoke with Dr. Shipp after his election as APHA president.
NewPublicHealth: What’s key as you begin your presidency?
Dr. Melvin Shipp: The public health system for a very long time has had a track record of making major changes in the health status of people in this country and throughout the world. Although much has been done, there’s still yet much to do. Recent studies show that the U.S. spends more than many other countries on health care but the health status of too many people in the U.S. is at or below that of most developed countries. I think the biggest reason we have those differences is because of the health disparities that exist in our country. And I think one way public health workers can make a difference in those disparities is with a focus on primary prevention.
NPH: What else?
CeaseFire is a unique, interdisciplinary, public health approach to preventing violence that is based at the University of Illinois at Chicago School of Public Health. The project, which was presented at a session at APHA today and is active in cities and states across the country, is based on the idea that violence is a learned behavior that can be unlearned. Violence is viewed and treated like a disease that spreads from person to person, and CeaseFire employs prevention techniques focused on stopping gun shootings and killings that are modeled on effective methods of preventing infectious diseases from spreading.
Tio Hardiman, the director for CeaseFire Illinois, has been with the program since 1999. In that time he has helped oversee expansion of the program from five Chicago-based community sites to 26 sites throughout Illinois and from 20 to 80 outreach workers. Hardiman also piloted a successful program innovation in 2004: the introduction of Violence Interrupters – highly specialized violence intervention experts who mediate conflict by using their reputations and connections in the community to give them access to leaders and influential decision-makers in street organizations. Many interrupters have belonged to gangs or spent time behind bars in the past, giving them unique street credibility when it comes to convincing people to walk away from committing violent acts. The year the program began, homicides declined in Chicago by 25 percent, to a total of 448 homicides, the fewest number of homicides in the city since 1965.
Before joining CeaseFire, Hardiman organized more than 100 block clubs to strategize community plans for public safety on behalf of the Chicago Alliance for Neighborhood Safety. NewPublicHealth recently spoke with Tio Hardiman about his work.
NewPublicHealth: So, what is CeaseFire all about?
Tio Hardiman: CeaseFire is a public health model. We implement the model in communities to help change mindsets and behaviors associated with violence. Dr. Gary Slutkin started the Chicago project in 1995. It’s all about changing behaviors. For example, with a seat belt campaign a lot of public education information was disseminated throughout the United States, and a lot more people are wearing seatbelts now. Our goal here at CeaseFire is to have a day come where someone pulls out a gun and people will say, “Look, we don’t do that anymore.”
We have five components to the CeaseFire model. One is community mobilization where we mobilize the community to help change the norm because in some cities throughout America, violence has become the norm. So we try to have everybody, community residents, faith based leaders, police personnel and the CeaseFire staff go out and respond to shootings when they take place in these communities within 72 hours in order for us to get the message out that the shootings are not the norm, shooting is abnormal, let’s change our behaviors. And as part of the community mobilization, we organize marches and rallies against violence. Component number two is made up of the outreach workers and the violence interrupters. They are “credible messengers” because they come from the communities in which we serve – in which we work. They understand the young guys out there and they can join the young guy’s world and bring them into their world because they’ve turned their lives around.
The third component is faith-based leader collaboration. We work with pastors and we organize peace summits at churches here in Chicago. We’ve organized 16 peace summits this year already where we bring anywhere from 75 to 1,000 young men and women to these peace summits and we call them behavioral change summits where we provide them with information and education on how we can think differently about violence.
Component number four is a strong public education campaign. We distribute materials in a community that communicate: don’t shoot, stop the violence. Sooner or later people start thinking about that because they’ll see this information everywhere. We’ve distributed over a million public education materials throughout the year in real high crime areas. CeaseFire is a data-driven initiative.
Out last component is partnering with law enforcement. They provide us with shooting and homicide data. They come out and secure our march routes for us, and we work together. Because everybody has to play a role in reducing violence.
NPH: Who makes up the staff that engages in the community?
Mary Selecky, Secretary of Health for the Washington State Department of Health is one of the longest standing state health officials in history. NewPublicHealth caught up with her at last week’s Association of State and Territorial Health Officials Annual Meeting to talk about her tenure in governmental public health, her advice for new health officials and who she’s worked with along the way, even beyond the traditional public health realm.
NewPublicHealth: What was your favorite session at ASTHO?
Mary Selecky: It was really important for us to have that session [with Andy Goodman] about story telling because we get a little too myopic and academic—and we really do need to tell this public health story, especially in these tough economic times.
NPH: How have you seen the current economy impact governmental public health? Is it the worst that you’ve seen it during your years in the field?
Mary Selecky: I’ve had the fortune of being in public health for 32 years; I learn something new every day and there’s always an opportunity and a challenge. Our state wasn’t able to buy vaccines for all kids—yet it presented an opportunity for us to sit down with different partners and our insurance company recognized that the partnership with government was a win-win. But I think this is a scary time for public health because what we in the field think of as core public health functions—making sure the water and food is safe, making sure kids are immunized and that we follow-up on the community’s health—aren’t going to be funded the same way. We have to let go of the old ways we’ve been doing something while we protect our successes. We have new challenges where we have to figure out how to take those on. So we really have to figure out how to do our business differently.
NPH: What does the future of public health look like in terms of the issues you see dominating our discussions over the new few years, besides budget?