Category Archives: Faces of Public Health
The American Public Health Association (APHA) is currently accepting applications through April 8 for the association’s one-year Public Health Fellowship in Government. Fellows work in a congressional office on legislative and policy health issues. The position gives Fellows the opportunity to learn about the legislative process in Washington, DC, which can be a critical skill once they return to their positions in public health, since policies are an important tool that can be used to protect Americans and their communities from preventable, serious health threats. And it also allows Fellows to provide critical input, drawing on their knowledge and experience, on the decisions that impact public health at the national policy level.
To get some background on the role of a Fellow and the impact that public health practitioners can have when working in the national policy arena, NewPublicHealth recently spoke with Fern Goodhart, current legislative assistant to Senator Tom Udall (D-New Mexico), who spent the tenure of her fellowship working in the office of Senator Robert Menendez (D-New Jersey). Ms. Goodhart was the first person awarded the APHA policy fellowship and served in 2007-2008.
NewPublicHealth: What was your background before you took the fellowship?
Fern Goodhart: I have worked in public health for 30 years including at a state health department; as director of health education at an ambulatory center; as a medical school instructor; as a member of an autonomous board of health; and as a member of my city council. So I’ve had the opportunity to see how policy was made on the local level and the state level. What brought me to the APHA Fellowship was the desire to see firsthand how policy was made at the federal level.
NPH: What kind of work did that involve?
Today, New York State Health Commissioner Nirav R. Shah, MD, MPH, released the 2013-17 Prevention Agenda: New York State’s Health Improvement Plan—a statewide, five-year plan to improve the health and quality of life for everyone who lives in New York State. The plan is a blueprint for local community action to improve health and address health disparities, and is the result of a collaboration with 140 organizations, including hospitals, local health departments, health providers, health plans, employers and schools that identified key priorities.
Dr. Shah, the architect behind today’s prevention agenda, was confirmed as New York State’s youngest Commissioner of Health two years ago. The state’s governor, Andrew Cuomo, had three critical goals: reduce the state’s annual Medicaid growth rate of 13 percent, increase access to care and improve health care outcomes.
Shah, a former Robert Wood Johnson Foundation Physician Faculty Scholar and Clinical Scholar, has already made important inroads in all three goals and the prevention agenda builds on that. NewPublicHealth spoke with Dr. Shah about prevention efforts already underway in the state, and what it takes to partner health and health care to achieve needed changes in population health.
NewPublicHealth: How does improving the social determinants of health help you achieve your goals in New York State?
Dr. Shah: New York’s Medicaid program covers 40 percent of the health care dollars spent in the state. We were growing at an unsustainable rate, and we needed a rapid, but effective solution. So, we engaged the health care community, including advocates, physician representatives, the legislature, unions, management, and launched a process that enables continuous, incremental, but real change toward the Triple Aim—improved individual health care, improved population health and lower costs.
Collectively, these efforts resulted in a $4 billion savings last year in the State’s Medicaid program, increased the Medicaid rolls by 154,000 people, and resulted in demonstrable improvements in quality throughout the system.
NPH: What opportunities do you see for public health and health care to work together in New York State?
Washington State Secretary of Health Mary Selecky has announced her retirement from state service. Selecky has served under three governors since her initial appointment as acting secretary in October 1998. She also served two terms as president of the Association of State and Territorial Health Officials, served on the board of the National Association of County and City Health Officials and is a past president of the Washington State Association of Local Public Health Officials. In 2010, Selecky received the American Medical Association's Nathan Davis Award for Outstanding Government Service.
NewPublicHealth Health spoke with Mary Selecky about her public health career and accomplishments.
NewPublicHealth: Your tenure has spanned many public health game changers. What stands out to you as the greatest triumphs and greatest threats in Washington State?
Mary Selecky: In terms of greatest triumphs, a key one is that we took on the issue of tobacco use in Washington State. Tobacco would be at the top of my list because of the health impact it has had and because it really is something that can be prevented by getting the right information out to people. It has taken us decades for the public to get it that smoking kills.
We had an announcement about tobacco yesterday, in fact. Among our 10th-graders, 9.5 percent used a cigarette in the last 30 days, and our rate has dropped from two years ago, even though across the nation the rate has flattened. So we’re doing something right. We’re a smoke-free state—not just tobacco-free but smoke free. And that really has the most profound influence on people’s health.
On the other hand, tobacco is also our greatest threat, because the tobacco companies continue to spend more than $140 million in this state to get you to use their product or to switch products, and we know they’ve moved to point-of-sale marketing. If you go into the smaller stores particularly, you’re greeted by all these tobaccos posters on the windows, inside the shop and on the counter. Those kinds of things are going on every single day—and every year there’s a new crop of 10th-graders. So it disturbs me that so many of our states have reduced tobacco prevention programs and that, as a result, nationally we’re not making much headway.
Three months have passed since Hurricane Sandy hit the East Coast. And while the number of people displaced by the storm has gone down from tens of thousands to the hundreds in different communities, some people are still without power or a permanent place to live. Others face the daunting task of rebuilding businesses and homes while protecting against mold and dust, which can cause or exacerbate respiratory problems. For many, the stress has rekindled mental health issues that might have been at bay, or created new ones or just made tough times even worse.
NewPublicHealth spoke with Patricia Yang, DrPH, Chief Operating Officer and Executive Deputy Commissioner at the New York City Department of Health and Mental Hygiene.
NewPublicHealth: Hurricane Sandy hit just over two months ago. How’s the city doing now?
Dr. Yang: There are people in parts of the city for whom the storm is a distant memory, and their daily lives are virtually unaffected apart from what they might hear on the news or read in the papers. But in the areas that were most directly affected by the hurricane, life for many is far from normal and may never return to what it was pre-storm. Those areas in particular are parts of the Rockaways and Coney Island and Staten Island. So there are still thousands of people who don’t have basic utilities and for whom grid power and heat have not returned. And we’re heading into the coldest winter months.
NPH: What’s the role of the public health department both now to help people deal with the aftermath, and looking ahead to prepare for the next disaster?
The Robert Wood Johnson Foundation (RWJF) has announced a second round of grant winners for the Roadmaps to Health Community Grants. The grants support two-year state and local collaborative efforts among policymakers, business, education, health care, public health and community organizations, and are managed by Community Catalyst, a national consumer health advocacy organization. The goal of the grants is to create positive policy or systems changes that address the social and economic factors that impact the health of people in their community.
The grants build on the model of the County Health Rankings & Roadmaps program, which highlights the critical role that factors such as education, jobs, income and the environment play in influencing how healthy people are and how long they live. County Health Rankings & Roadmaps is a collaboration of RWJF and the University of Wisconsin Population Health Institute.
Four of the new grants have been awarded to projects spearheaded by United Way organizations in several states.
The Roadmaps to Health Community Grants are:
- Demonstrating how a range of partners from multiple sectors in a community can work together to take actionable data such as the County Health Rankings and begin addressing the multiple social or economic determinants of health in a community.
- Focusing on collaboration and action at the policy or system-change level.
- Getting grant partners in fields such as education, employment or community safety to think of themselves as part of the work of the public health community.
As we end the year and head into 2013, NewPublicHealth spoke with U.S. Centers for Disease Control and Prevention director Thomas Frieden, MD, MPH, about public health in 2012—and what’s ahead for 2013.
Dr. Thomas Frieden: Two really stand out. First, public health got even better at finding outbreaks quickly and stopping them. We saw that with Listeria, E. Coli, Salmonella and with the fungal meningitis outbreak. That is important because we are seeing that there are an ever-increasing number of ways that outbreaks can start and spread and we need to be on our guard. The second highlight that comes to mind immediately was the Tips from Former Smokers Campaign. This is the first-ever federally funded national anti-tobacco campaign and it was a stunning success. We had very ambitious goals for it. We hoped that half a million people would try to quit and at least 50,000 people would succeed for good. Based on calls to quitlines—and we will know more in the next few months—it looks like the campaign probably had at least twice that impact. This is a campaign that will have saved tens of thousands of lives and probably paid for itself in pretty short order in terms of reduced medical and societal expenses. It shows that when you invest in tobacco control you can make a big difference and save a lot of lives.
NPH: And your hopes for public health in 2013?
Frieden: There are a lot of things that are important and we can make progress on in the coming year. First is to be safer from threats whether they are from this country or abroad, and public health works 24/7 to keep us safe both at the federal level as well as the state and local level. We do have challenges, though, in terms of the fiscal climate that we are in, and we need to ensure that we have the resources needed to keep Americans safe from threats.
Last year, a new center to help promote physical activity among individuals with disabilities opened at the University of Alabama at Birmingham. NewPublicHealth spoke with James Rimmer, PhD, the center’s director, who has spent decades promoting the importance of people who are disabled engaging in physical activity for both their health and for fun.
NewPublicHealth: Tell us about the new center.
Rimmer: When I moved here from the University of Illinois/Chicago, there was a large donation made to support the needs of people with disabilities in all areas of physical activity, sport and recreation, by the Lakeshore Foundation, a non-profit organization that provides health and fitness services to people with disabilities. They brought me in to build an enterprise between the University of Alabama at Birmingham and the foundation, which is called the UAB Lakeshore Research Collaborative. Subsumed under that are two national centers that have been funded by the Centers for Disease Control and Prevention and the National Institute on Disability and Rehabilitation Research. The first center is the National Center Health, Physical Activity and Disability. The second center is the Rehabilitation Engineering Research Center.
NPH: You have been working in this field for decades. What will be new about your initiatives and efforts in 2013?
What’s the right age to be an advocate for better health? “It’s never too late but the younger you start the longer you have,” says Irene Pollin, MSW, PhD (Hon), who has done so all her life and runs Sister to Sister, the organization she founded in memory of her daughter, Linda Joy, who died at age 16 of a heart condition. Pollin, who together with her husband, Abe, owned sports teams including the Washington Wizards basketball team and the Washington Capitals hockey team, aims to increase women’s awareness of heart disease, provide free cardiac screenings, and empower women to take charge of their health. As the nation’s largest provider of free heart disease screenings for women, Sister to Sister has traveled to nearly 20 U.S. cities and screened over 100,000 women since its start in 1999.
NewPublicHealth spoke with Irene Pollin recently about her work, heart disease, the success of the foundation, and its message that although heart disease takes the lives of one in three women, it is preventable and even reversible.
NewPublicHealth: Would you tell us about Sister to Sister?
Irene Pollin: We started more than 12 years ago, and at the time, I was working in the area of chronic illness. I’m a psychiatric social worker and had been doing that for 25 years so I really was a specialist in all chronic illnesses. When I was speaking to a health PR firm, I learned that heart disease was the number one killer of women. I didn’t know that, and I couldn’t believe it. So I thought ‘If I don’t know it, who else doesn’t know it?’ The person who informed me of this fact challenged me and asked if I would be interested in doing the work with her to get the word out. So I accepted the challenge and established Sister to Sister.
NPH: How does your training as a psychiatric social worker impact your work?
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.
According to the U.S. Centers for Disease Control and Prevention (CDC), each year 1.3 million people are killed and 20 to 50 million are injured in car crashes around the world. Most of the crashes happen in low- or middle-income countries, and 25,000 of the deaths are among tourists. In fact, nearly half of medical evacuations back to the United States, which can cost $100,000 or more, are the result of a car crash.
According to the CDC, reasons for an increase in crashes in foreign countries include:
- More people driving cars and other motorized vehicles
- Poorly maintained roads
- Insufficient traffic laws and poor enforcement in some countries
- Insufficient emergency response capabilities in some countries
Rochelle Sobel knows the worst possible outcome of these crashes first hand. She founded the Association for Safe International Road Travel (ASIRT) in 1995, after her son, Aron, was killed in a bus crash in Turkey along with 22 other passengers from many countries, just two weeks before his graduation from the University of Maryland Medical School. The bus Aron was traveling on was speeding down the wrong lane of a narrow, poorly maintained road with no guard rail. The bus hit oncoming traffic and plunged down an embankment, landing on its side. Emergency medical crews were slow to respond, likely a factor in at least some of the deaths. After the crash the U.S. Ambassador to Turkey recommended the creation of a road safety organization to protect both American citizens abroad and residents of countries around the world.
NewPublicHealth spoke with Rochelle Sobel about ASIRT.
NewPublicHealth: ASIRT was started out of personal tragedy, the loss of your son Aron, in a bus crash in Turkey. How did you get started?
Rochelle Sobel: The first thing I did was talk to the U.S. embassy in Ankara, and I asked them if they could please tell me when such crashes occur again, and they said, “Mrs. Sobel, we’d be calling you constantly.” That led me to understand that this is indeed a health issue that was not getting the kind of public attention that it deserved. So I started to call different organizations, and unfortunately, it was not yet recognized as a health issue. So we decided to become the organization that would bring attention to the issue. We got help from the embassy; we got a lot of help from the State Department. We asked the State Department to start collecting data on the numbers of Americans who die abroad in road crashes by country, and they discovered that it was the single greatest cause of death for healthy Americans traveling abroad.
NPH: Is that still the case?
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?