Category Archives: Q&A
The Center for Public Health Readiness and Communication (CPHRC) at the Drexel University School of Public Health in Philadelphia recently re-launched DiversityPreparedness.org, a clearinghouse of resources and an information exchange portal to facilitate communication, networking and collaboration to improve preparedness, build resilience and eliminate disparities for culturally diverse communities across all phases of an emergency. The site had originally been developed by Dennis Andrulis, now at the Texas Health Institute, and Jonathan Purtle, who co-writes a blog on public health for the Philadelphia Inquirer.
- Read a previous NewPublicHealth interview with Dennis Andrulis
- Read a previous NewPublicHealth interview with Jonathan Purtle
NewPublicHealth recently spoke with Esther Chernak, MD, MPH, the head of CPHRC, about the re-launched site and her work in preparedness.
NewPublicHealth: Tell us a little bit about your background and how you came to lead the Center for Public Health Readiness and Communication.
Esther Chernak: I’m an infectious disease physician by training and pretty much have been working in public health since I finished my infectious disease fellowship in 1991 at the University of Pennsylvania. I started working in the Philadelphia Department of Public Health in its city clinic system doing HIV/AIDS care, and then became the Clinical Director of HIV Clinical Programs for the health centers back in the early ’90s when the epidemic was obviously very different. I then moved to working in infectious disease epidemiology as a staff doctor in the acute communicable disease control program and was involved in infectious disease surveillance and outbreak investigations for a number of years.
Then in 1999, I took a job with the City Health Department in what was then called bioterrorism preparedness. That was the time when major cities in the country were just beginning to be funded to do bioterrorism response plans. Groups that were involved in bioterrorism preparedness recognized relatively quickly that despite the fact that we were dealing with planning for novel strains of influenza and pandemic preparedness and SARS and smallpox, we were also dealing with many, many really significant infectious disease outbreaks, and then ultimately non-infectious disease related issues that had huge impacts on public health, such as earthquakes and hurricanes. Those links helped prepare me for my role at the Center.
Future of Public Health is an ongoing series focused on the emerging faces in the world of public health. We spoke with Patrick Ten Eyck, MS, a PhD candidate in the Department of Biostatistics at the University of Iowa’s College of Public Health, about what helped lead him to the field, his work in biostatistics to determine the impact of anti-bullying policies and where he hopes to go from here.
NewPublicHealth: What encouraged you to pursue a degree and career in public health?
Patrick Ten Eyck: I received my undergraduate degree in math because it’s been an interest of mine and then I got my Master’s in statistics because I found it to be the most interesting. I wasn’t really interested so much in the theory of statistics as much as the application. So, when I decided to pursue my PhD I thought biostatistics would be the perfect route because it applied my knowledge of statistics to really practical applications in the real world, especially public health. It’s convenient that the Biostatistics Department is in the College of Public Health at the University of Iowa. I have the opportunity to collaborate with other departments and help share our knowledge of statistics. Together, we can make sense of large data sets and hopefully get some very useful results out of it.
NPH: Do you have primary interests on the public health side of biostatistics?
Ten Eyck: Actually, when I started at the program I really didn’t have any particular area that I was that interested in researching. Obviously, one of the big areas that the Biostatistics Department pursues is medical data, but we also work with more broad areas than just medical data. We help out with occupational, environmental, community and behavioral health topics, too. These topics opened many more doors as far as piquing my interest in different areas. So, I still don’t have a particular area that I’m focused on, but I like to get involved in a lot of different areas because it’s really interesting to see what’s going on in the different fields.
NPH: Tell us more about the work you’ve done to analyze the bullying data in the Iowa Youth Survey?
Ten Eyck: Obviously, bullying has been quite a large focus, especially in the media lately with many stories of students being bullied in schools. So, the Iowa Youth Survey looks at data from 2005, 2008 and 2010 and now we just got the data set for 2012. There was an anti-bullying law passed in 2007 in the state of Iowa that outlines what bullying is and helps teachers to recognize bullying and intervene to prevent it as best as possible. A survey was given to sixth-, eighth- and eleventh-grade students throughout the state of Iowa and more than 250,000 students filled out the survey and gave information.
On Thursday, April 17, from 1-2 p.m. (ET), the Network for Public Health Law, Public Health Law Research and the American Society of Law Medicine and Ethics (ASLME) will be holding a free webinar around public health perspectives on regulating non-medical marijuana in states where it has been made legal or decriminalized. Whatever course a state may take, public health’s expertise and experience in public policy means it should be a major voice in the discussion surrounding legislation from the very start. The issue is a critical one now as Colorado and Washington State have legalized the commercial production, distribution and sale of marijuana for non-medical use and a number of other states are considering similar legislation.
“Policy-makers, advocates and others are grappling with how to process licenses, develop regulations and manage production in an industry that is still largely illegal both in the U.S. and around the world,” said Alexander Wagenaar, PhD, Professor in the Institute for Child Health Policy at the University of Florida who will be the moderator for the webinar.
The webinar’s aim is to provide an overview of issues related to non-medical marijuana regulation through, among other things, the lessons learned from decades of alcohol and tobacco regulation and through insights from Washington State’s recent implementation of a marijuana law with participant Laura Hitchcock, JD, Policy, Research & Development Specialist in the public health department of Seattle & King County in Washington State. Additional speakers include Beau Kilmer, PhD, Co-Director of the RAND Drug Policy Research Center and Amanda Reiman, PhD, the Policy Manager of the Drug Policy Alliance of California.
>>Register for the webinar Regulating Non-Medical Marijuana: Lessons Learned and Paths Forward.
Ahead of the webinar, NewPublicHealth spoke with Wagenaar about who in public health will find the webinar important, as well as public health’s role both before and after a jurisdiction considers legalizing non-medical marijuana.
NewPublicHealth: Who is the webinar primarily geared toward?
Alexander Wagenaar: There are lots of different audiences that are interested in this, including the public health research community such as academics, scientists, health department and agency staff who are looking at the issue or will be looking at it in the future.
Last month The George Washington University in Washington, D.C. announced three gifts totaling $80 million for the university’s School of Public Health and public health initiatives from the Milken Institute, the Sumner M. Redstone Charitable Foundation and the Milken Family Foundation. The public health graduate school is now called the Milken Institute School of Public Health and the university has also established the Sumner M. Redstone Global Center for Prevention and Wellness. Redstone is the executive chairman of Viacom and CBS Corp., while Michael Milken is an entrepreneur.
The gifts include:
- $40 million from the Milken Institute to support new and ongoing research and scholarships
- $30 million from the Sumner M. Redstone Charitable Foundation to develop and advance innovative strategies to expand wellness and the prevention of disease
- $10 million from the Milken Family Foundation to support the Milken Institute School dean’s office, including a newly created public health scholarship program
NewPublicHealth recently spoke with Lynn Goldman, MD, MS, MPH, and dean of the School of Public Health, about the impact of the gifts for the school and the public’s health both globally and in the United States.
NewPublicHealth: What changes will the recent gifts bring to the school?
Lynn Goldman: It’s no exaggeration to say the gift is transformational for our school. We have the opportunity to recruit the best talent in the country to work with our school, whether that might be students through the increase that we’ve received in scholarship funding or faculty members, and we have the opportunity to support our current faculty to be able to take their work to the next level.
It also allows us to establish the Sumner M. Redstone Global Center for Prevention and Wellness, which is a very exciting enterprise. We recently announced that William Dietz, MD, MPH, formerly the director of the Division of Nutrition, Physical Activity and Obesity at the U.S. Centers for Disease Control and Prevention (CDC), will be the first director of the Redstone Center. The initial focus of the Center will be childhood obesity. That is so exciting because Dietz was doing research on childhood obesity well before that became the flavor of the month. It has been his lifelong mission to prevent childhood obesity, and what we are charged to do with this center is to very directly engage in efforts that will result in reducing the rates of obesity in the United States and globally. The way we are going to be doing that is by bringing together the evidence that people are generating about efforts that are working and also efforts that are not working, and be able to sift through that research. I think Bill is the perfect person to be the leader of an effort such as this because he is very collaborative, and we want to do this in a collaborative fashion.
Future of Public Health is an ongoing series focused on the emerging faces in the world of public health. We spoke with Erin Yastrow, a Bachelor of Science in Public Health candidate at the Tulane University School of Public Health and Tropical Medicine, about what helped lead her to the field, her work as a leader in Tulane’s undergraduate student government and where she hopes to go from here.
NewPublicHealth: What encouraged you to pursue a degree and career in public health?
Erin Yastrow: I’ve always been interested in the field of health. I was actually thinking about going into nutrition when I first started looking at undergraduate schools and I had a family friend at one school who had worked in nutrition, but then ended up working at the School of Public Health. When I met with her, she encouraged me to pursue public health with an emphasis on nutrition because it would give me more opportunities. From there, I started my exploration into what public health was and I realized how interesting and fascinating it was and how it was applicable to so many more areas besides just nutrition.
In the meantime, I had also applied to Tulane. I wasn’t really considering it that much because I didn’t know that much about it. My mom was looking through their brochure and told me that they have a great public health program. So, I started looking and I realized how established the Bachelor’s and graduate programs were. They also had an option where you could pursue a combined degree and it was really appealing to me.
NPH: Are you pursuing a Master’s as well?
Yastrow: Not currently, but I’m actually attending Johns Hopkins next year for a Master’s in Public Health. Tulane does have a really great program where you can do a combined degree with your Bachelor’s and Master’s. Part of my undergraduate core, which has now changed, included taking five graduate classes, so I took some classes at that School of Public Health here.
NPH: Within the field of public health, what are your primary interests and why?
Yastrow: That has also sort of shifted as I’ve learned more about public health. As I mentioned, I started out really interested in nutrition and obesity prevention. As I took more electives and did some internships, I became more interested in the similar patterns of risk factors that exist in obesity and other epidemics that aren’t always considered to be health problems, such as violence. That has developed into an interest about addressing inequalities in health and the social determinants, such as socioeconomic status, education and race and how those, to me, are unjust reasons that people are more likely to develop further health conditions.
The U.S. Food and Drug Administration (FDA) was a partner agency for last week’s Preparedness Summit in Atlanta. NewPublicHealth spoke with Brooke Courtney, Senior Regulatory Counsel in the FDA Office of Counterterrorism and Emerging Threats, about how the agency plans for disasters it hopes never occur. Previously, Courtney was the Preparedness Director at the Baltimore City Health Department and in that role oversaw all of the public health preparedness and response activities for Baltimore City.
NewPublicHealth: What did you speak about at the Summit last week?
Brooke Courtney: FDA views the summit as an unparalleled opportunity each year to engage with stakeholders at the state, local and federal levels—to share with them updates from the federal side and also for us to get feedback from them about challenges and successes. We engage with stakeholders on a regular basis, but this is really the meeting where the largest number of people involved in preparedness come together, and it’s a great opportunity to see people face-to-face.
We feel really fortunate to have been able to take part in the summit for the past few years. For this year’s summit FDA served on the Planning Committee and also participated in the medical countermeasure policy town hall with federal colleagues from the Office of the Assistant Secretary for Preparedness and Response, the U.S. Department of Homeland Security and the national security staff, all of whom we work with closely.
Another thing that we like to do at the summit each year is to give a more in-depth update through a session with the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department for Health and Human Services (HHS) legal counsel on the authorities that we have that we use related to the emergency use of medical countermeasures during emergencies. This year’s session was especially exciting for us because it was an opportunity for us to discuss with stakeholders some new authorities that were established in 2013 to enhance preparedness and response flexibility.
For example, we can now clearly issue emergency use authorizations in advance of emergencies, which is really a critical medical countermeasure tool for preparedness purposes. Through these flexibilities, for example, we’ve issued three emergency use authorizations in the past year for three different in-vitro diagnostic tests to address the emerging threats of H7 and 9 influenza and MERS-CoV.
NPH: What are the key responsibilities the FDA has in helping to prepare the United States for possible disasters?
Courtney: As an agency of the U.S. Department of Health and Human Services, the FDA, at its core, is a public health agency. FDA’s mission is to protect and promote public health in a number of critical ways. We’re responsible for regulating more than $1 trillion in consumer goods annually, ranging from medical products such as drugs and vaccines to tobacco and food products.
At this year’s Preparedness Summit, which met last week in Atlanta, the American Red Cross was a first-time partner for the annual event which brings together more than 1,000 preparedness experts from around the country.
“It was important for us to partner with the American Red Cross because they have a major role and responsibility in disasters,” said Jack Herrmann, the Summit chair and Chief of Public Health Preparedness at the National Association of County and City Health Officials (NACCHO), the lead partner for the Summit. “We felt that it was important that the public health and health care communities understand the Red Cross’ role and authority during a disaster and look for ways to foster and build partnerships [among] local health departments, state health departments and American Red Cross chapters across the country.”
Just prior to the Summit, NewPublicHealth conducted an interview by email with Russ Paulsen, Executive Director, Community Preparedness and Resilience Services of the American Red Cross.
NewPublicHealth: What are the key issues that communities should focus on now to get themselves better prepared for a disaster should it occur?
Russ Paulsen: Everyone has a role to play in getting communities better prepared for disasters.
As a first step, individuals, organizations and communities should understand the problem: What hazards are in their area? How likely are any of these hazards to become actual disasters? What have people already put in place to deal with them? Local Red Cross chapters can help with this assessment.
Once people understand the problem, the next step is to make a plan. Plan what to do in case you are separated from your family or household members during an emergency, and plan what to do if you must evacuate your home. Coordinate your household plan with your household members’ schools, daycare facilities, workplaces and with your community’s emergency plans.
Each year during the first week of April, the American Public Health Association (APHA) hosts National Public Health Week, an opportunity to help communities across the United States highlight issues that are critical to improving the health of the nation. This year’s theme is “Public Health: Start Here”—entry points for making us a healthier nation. Each day this week has its own theme and NewPublicHeatlth will have a post about each one:
- Monday, April 7: Be healthy from the start. From maternal health and school nutrition to emergency preparedness, public health starts at home. Let us show you around. (Read a previous NewPublicHealth post, County Health Rankings — Nurse-Family Partnership: Q&A with Elly Yost, about how Rockingham County, N.C. is working to improve maternal health.)
- Tuesday, April 8: Don't panic. Disaster preparedness starts with community-wide commitment and action. We're here to help you weather the unexpected.
- Wednesday, April 9: Get out ahead. Prevention is now a nationwide priority. Let us show you where you fit in.
- Thursday, April 10: Eat well. The system that keeps our nation's food safe and healthy is complex. We can guide you through the choices.
- Friday, April 11: Be the healthiest nation in one generation. Best practices for community health come from around the globe.
In observance of National Public Health Week, NewPublicHealth spoke with Georges Benjamin, MD, executive director of the American Public Health Association about National Public Health Week 2014.
NewPublicHealth: Tell us about the 2014 National Public Health Week.
Georges Benjamin: We have an overarching theme, and it’s “Public Health: Start Here.” The intent is to get people to “just do it.” Often all of us have a tendency to kind of ruminate over what we want to do to improve the public’s health, and what we’re trying to emphasize this year is that there is enormous opportunity for people just to get up and do it. The evidence base is there, the opportunity is there, and so we’re just getting people to start improving their health.
We have five themes for the week. Monday is around early health such as maternal and child health; school nutrition; and conversations at home about how to make every family healthier. Tuesday is focused on emergency preparedness and disaster preparedness. On Wednesday we’ll be on prevention, including clinical and community preventive health services. Thursday’s focus is on eating well with a focus on the nutritional aspects of health. And Friday we look at becoming the healthiest nation in just one generation. Like the Robert Wood Johnson Foundation, the American Public Health Association is focused on a creating a culture of health and creating a healthy environment for everyone.
Behavioral health was a frequent topic at this year’s Preparedness Summit in Atlanta for both presenters and attendees, who focus on helping people cope with stress during a disaster as well as on mental health conditions which can be exacerbated by the stress of an emergency. Thomas Bornemann, EdD, has been the director of mental health programs at the Carter Center in Atlanta since 2002. The Carter Center is the philanthropic foundation of former president Jimmy Carter and his wife, and focuses primarily on peace and health initiatives globally and in the United States.
NewPublicHealth spoke with Bornemann about the Center’s mental health programs and challenges that lie ahead. We spoke with Bornemann several days before the shooting this week at Fort Hood.
NewPublicHealth: What are the key mental health projects underway at the Carter Center?
Thomas Bornemann: We’re involved in a number of issues at the local level, national level and globally. One of our major global programs is a program in Liberia, West Africa, where we’ve been working on scaling up services in this post-conflict, low-income country. We are in our fourth year of five, and we’re providing three services: We’re training mental health workers because their mental health system was decimated after the war; we have helped them develop a national mental health policy plan and a national mental health law that will go to the legislature for approval this year we hope; and we’ve been working on the issues of stigma and discrimination against people with mental illnesses and helping to develop support for family caregivers who provide the lion’s share of the care.
In the United States we’ve been working for years on Mrs. Carter’s number one healthy policy priority, which has been the implementation of mental health parity legislation which passed in 2008. The U.S. Department of Health and Human Services has been working on final regulations since then which spell out the terms and conditions of parity. We’ve been working on monitoring that through the years, and we were very proud that in November Secretary Kathleen Sebelius came here to announce the release of the regulations out of respect for Mrs. Carter’s long commitment to parity legislation. We’ll continue to monitor the parity efforts as they become implemented through the Affordable Care Act.
Paul Biddinger, MD, FACEP, director of the Emergency Preparedness and Response Exercise Program at the Harvard School of Public Health, was a member of this morning’s opening panel on disaster preparedness at the 2014 Preparedness Summit. NewPublicHealth spoke with Biddinger ahead of the conference on what students and communities need to know and do to be best prepared for a disaster.
NewPublicHealth: Is it a requirement for students in graduate school for public health degrees to take at least one class in disaster preparedness?
Paul Biddinger: It is not. They have the option, but it is not a required element of what they have to take.
NPH: How do you think recent disasters have informed what students and public health staff members need to know about response?
Paul Biddinger: I think some of what students need to know has always been the case—but maybe has been underscored by recent events—which is that no matter what you do in public health you may be needed as part of the response, and whether you're working in maternal and child health or smoking cessation or HIV/AIDS, when a disaster happens it’s all hands on deck. And I think the hurricanes, the pandemic and other events have showed that often we need to reach well outside the traditional emergency response or preparedness work staff in public health, and so everyone has to be flexible, has to be able to participate in the response. I think in order to participate in the response you have to know that there is an emergency operations plan, what your role in it would be, how you would get information, to whom you would be responsible or to whom you would report. And those are things that you should know ahead of time.
I think the other thing we see when we see these wide-area disasters like we saw in Sandy, like we saw in Katrina, is the central role that public health can play in coordinating the health response—that multiple hospitals, long-term care facilities, out-patient facilities such as dialysis centers all need to be coordinated in their response to achieve the best possible health outcomes for the community. And public health is in a particularly strong place in the community to be able to help make sure that each of those individual participants is pointed in the same direction and is leveraging the community resources as best they can.