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Nov 19 2014
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Adding Diversity to the Ranks of Public Health Nursing Leadership: Q&A with Shirley Orr, MHS, APRN

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Today at the American Public Health Association annual meeting in New Orleans, Shirley Orr, MHS, APRN, a Robert Wood Johnson Foundation Executive Nurse Fellow and public health consultant, and Doris Brown of the Louisiana Department of Health, will be talking about opportunities for nursing leaders to implement the recommendations of a 2010 Institute of Medicine Report entitled “The Future of Nursing.” This report looks at ways that the nursing profession can transform itself in order to better align with population health and more effectively collaborate to create a healthier overall population.

NewPublicHealth recently spoke with Orr about how nurses can help improve community and population health. This interview has been lightly edited for clarity and length.

Orr Shirley Orr, MHS, APRN

NewPublicHealth: What does the nursing profession need to do in order to align itself with a focus on population health?

Shirley Orr: A couple of things in particular that stand out are education and diversity. We recently did a public health nursing enumeration that was funded by the Robert Wood Johnson Foundation, and we found two things in particular relating to the recommendations. First, that overall, public health nurses need new skills and they need higher levels of education to be able to function more collaboratively and within collaborations—both within health care and with other community partners.

Second, we found that nationwide, the demographic profile of public health nurses does not look like the population that we serve. Ethnic minorities are very much underrepresented among public health nursing—particularly in leadership roles.

We have a very urgent need to recruit more nurses of color into the ranks of public health nursing leadership.

NPH: Why is that necessary?

Orr: A core component of nursing curriculum today is culture competency. That being said, we also know that having nurses who understand populations very, very deeply by having a frame of reference for that population and being a member of that population really are able to help to get the highest level of engagement from the population. They’re also best prepared to understand the culture, the needs, the motivations about populations, so they’re really best positioned to be able to carry out in partnership strategies that are going to make a difference long-term in the health of populations. 

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Nov 19 2014
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New Research Shows How Sugary Drinks Are Marketed to Children in the Age of Social Media

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Beverage companies spent $866 million to advertise unhealthy drinks in 2013, and children and teens remained key target audiences for that advertising, according to a new report released today at APHA by the Yale Rudd Center for Food Policy & Obesity. The report “Sugary Drink FACTS 2014” highlights some progress regarding beverage marketing to young people, but also shows that companies still have a long way to go to improve their marketing practices and the nutritional quality of their products to support young people’s health.

“Despite promises by major beverage companies to be part of the solution in addressing childhood obesity, our report shows that companies continue to market their unhealthy products directly to children and teens,” said Jennifer Harris, PhD, Rudd Center’s director of marketing initiatives and lead author of the report. “They have also rapidly expanded marketing in social and mobile media that are popular with young people, but much more difficult for parents to monitor.”

Harris and her team examined changes in the nutritional content of sugar-sweetened drinks including sodas, energy drinks, fruit drinks, and others. They also analyzed marketing tactics for 23 companies that advertised these products, including changes in advertising to children and teens on TV, the internet, and newer media like mobile apps and social media. Researchers also examined changes in the nutrition and marketing of diet beverages, 100% juice, and water. The report was funded by the Robert Wood Johnson Foundation.

Learn more about the key findings of the report in the following exclusive interview with Harris. The interview has been lightly edited for clarity and length.

NPH:  You issued the first version of this new report in 2011. What are the changes since then?

Jennifer Harris: The biggest change that we saw was a very significant decline in advertising on television. Preschoolers are seeing 33% fewer TV ads for sugary drinks in 2013 than they saw in 2010. Children are seeing 39% fewer, and teens are seeing 30% fewer. So, that was really some great news to see, but some categories had bigger declines than others. Fruit drinks went down by about 50%, but advertising for energy drinks that kids see actually increased. So, there was some good news and some bad news. 

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Nov 18 2014
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APHA 2014: A ReFreshing Collaboration is Building Better Health in New Orleans

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If we as a nation are to succeed in building a Culture of Health that benefits every individual, it will require collaboration across sectors, open communication among diverse organizations and a willingness to step out of traditional practices to find effective interventions.

On Monday, Robert Wood Johnson Foundation Vice President Michelle Larkin showcased one example of this innovative collaboration that is occurring on the edge of a low-income neighborhood in New Orleans, just a few miles away from this year’s American Public Health Association (APHA) annual meeting.

At the corner of North Broad Street and Bienville Avenue sits The ReFresh Project—an innovative fresh food hub located in a former warehouse that had been vacant since Hurricane Katrina struck the city nine years ago. Today the site is home to a Whole Foods Market, Liberty’s Kitchen, The Goldring Center for Culinary Medicine and an onsite farm.

The goal of the hub, according to project founder Jeffrey Schwartz, is to create new eating, working, exercise and community living cultures.

Each aspect of the Refresh Project is designed to realize these goals. 

WholeFoods The ReFresh Project in New Orleans, La.
  • At the Whole Foods market, which anchors the Refresh project development, products are specifically chosen to be both high quailty and affordable. Specifically, the store carries more store-line products and often has more sale items than other stores in the Whole Foods chain. Two healthy eating educators are also located on-site to answer questions, craft recipes, and host tours.
  • At Liberty’s Kitchen, a culinary work readiness and leadership program for at-risk youth, New Orleans youth ages 16-24 who are out of work and out of school are given an intensive and hands-on food service training, case management, job placement services and follow-up support. Ninety percent of Liberty’s Kitchen Youth Development Program participants are employed on graduation out of the program and 80 percent are still employed at the six-month benchmark, according to the organization.

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Nov 18 2014
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Looking at Health Departments’ Ever-Changing Future: A Discussion of the Recent Findings of the Public Health 2030 Project

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From the dramatic impact of extreme weather events such as Hurricanes Katrina and Sandy, to the rapidly changing policy landscape of health care providers, the functions, missions and futures of public health agencies continue to change.

To help health departments plan for an uncertain future, the Institute for Alternative Futures—with support from the Robert Wood Johnson Foundation and the Kresge Foundation—recently worked with state and local health departments, leaders and experts in the field to look forward to the year 2030 and analyze public health scenarios in order to offer pathways to expectable, challenging and visionary futures for public health.

On Tuesday afternoon at APHA, Clement Bezold, PhD, the Founder and Chairman of the Institute for Alternative Futures, and Terry Allan MPH, will discuss theses scenarios and findings and insights gained.

Prior to their presentation, NewPublicHealth sat down with Bezold for an exclusive preview of his presentation.

NewPublicHealth: How did your APHA presentation come about?

Clement Bezold: The presentation is based on the Public Health 2030 project, and that project came about following scenario reports on primary care, on vulnerability, social and economic vulnerability in the United States and on health and health care.

NPH: What are some of the key points about the Public Health 2030 project?

CB: With Public Health 2030, there are a host of challenges and opportunities facing health departments. There are the ongoing fiscal issues at the state and local governmental levels, there’s increased infectious disease, there are climate-change-related changes that communities are facing. 

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Nov 18 2014
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Public Health News Roundup: November 18

Financial Incentives Double Smoking Quit Rates
Offering small financial incentives doubles smoking cessation rates among low-income smokers, according to research from The University of Texas Health Science Center at Houston. The study was published in the American Journal of Public Health. Participants in the intervention group could earn up to $150 in gift cards over four weeks. Progress was monitored for 12 weeks following the quit date. A control group received only cessation information, no incentives. The researchers found that quit rates were 49 percent for those in the incentive group but only 25 percent in the control group. Read more on tobacco.

Two Thirds of Parents Would Take Kids out of Daycare if Other Children Don’t Have Their Immunizations
A national survey of parents with children ages 0-5 found that three quarters of them would take their children out of daycare if at least one quarter of the children at daycare were not up to date on their vaccines. The researchers say the scenario is realistic since about 25 percent of preschool children in the United States are not fully vaccinated, according to national statistics. Just over 40 percent of survey responders also said that children missing vaccines should be asked to leave daycare until they are up to date. Read more on vaccines.

Three Drugs During Pregnancy Better Than Current Complicated Regimen for Preventing Mother-to-Baby HIV Transmission
For HIV-infected women in good immune health, taking a three-drug regimen during pregnancy prevents mother-to-child HIV transmission more effectively than taking one drug during pregnancy, another during labor and two more after giving birth, according to a new study funded by the National Institutes of Health. Read more on maternal and infant health.

Nov 17 2014
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At APHA 2014 Opening Session, Key Leaders Talk Culture of Health

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Healthography—or the health of the place where you live—is the theme of this year’s American Public Health Association (APHA) annual meeting, which is taking place in New Orleans this week.

During the opening session, Georges Benjamin, MD, Executive Director of APHA, announced that APHA’s goal is to create the healthiest generation in American history within one generation. Benjamin’s announcement was coupled with announcements from local and national public health leaders that collectively took another step forward in that effort.

For example, the Partnership for a Healthier America announced a new Healthier Campus Initiative, which calls on colleges and universities to adopt recommended guidelines on food, nutrition and physical activity.

“We know that going to college is a time of change for many students—we also know that means it’s a time when new habits are formed,” said Peter Soler, the partnership’s CEO. “By creating healthier food and physical activity environments today, campuses and universities are encouraging healthier habits that will carry over into tomorrow.”

Guidelines being adopted by participating campuses include promoting the consumption of water instead of soda on campus, offering a bicycle sharing program for all students and providing certified personal trainers and registered dietitian nutritionists on campus.

In addition, Louisiana’s Secretary of Health and Hospitals, Kathy Kliebert, discussed the state’s “Well-Ahead” initiative, which promotes and recognizes smart choices that are made in the spaces and places where people live and work, and which make it easier to live healthier lives. Kliebert told the audience that Well-Ahead promotes voluntary changes without imposing new taxes or creating new rules.

Within the host city of New Orleans, a couple of initiatives to improve health within the Crescent City were also discussed at APHA’s opening session.

One such initiative to combat obesity—known as Fit Nola—now has 100 miles of bike lanes throughout the city. Also, next week legislation will be introduced to ban smoking in the city’s bars, casinos and public spaces.

APHA’s opening session ended with a talk by Pulitzer Prize winner Isabel Wilkerson, who spoke about her book “The Warmth of Other Suns.” A book 15 years in the making, “The Warm of Other Suns” describes the migration of African Americans in the 20th century from the South to the North for a better life for themselves and their children. For example, the parents of Olympian Jesse Owens worried their son would not have the strength to work in the fields, so they moved north to Cleveland, Ohio, where he started running track—a sport that would take him around the world and across the global stage.

Whether the generation of migrants profiled in Wilkerson’s book realized it, their stories epitomize the power of place, and the influence of geography on health, wellbeing and opportunity of every individual. 

>>Bonus Link: Also in attendance at yesterday’s opening session was Peter Salk, son of the world famous Jonas Salk, MD, who was on hand to accept a posthumous award from APHA for his father’s discovery of a vaccine for polio. Watch the trailer above for the film “The Shot Felt Round the World” to learn more about the elder Salk’s successful search for a cure.

Nov 17 2014
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Public Health News Roundup: November 17

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Ebola Patient from Sierra Leone Dies of Virus in U.S.
A doctor from Sierra Leone who arrived in the United States on Saturday for treatment for Ebola has died. The doctor was taken to the Nebraska Medical Center in Omaha, one of four U.S. hospitals with specialized units prepared to treat patients with the virus. News reports say the physician may have been sicker than other patients treated for Ebola so far in the United States. Read more on Ebola.

Disparities in Treating Black Children for Ear Infections Actually Results in Treatment that Meets Guidelines
Black children are less likely to be diagnosed with ear infections and less likely to receive broad-spectrum antibiotics for ear infections than are white children, according to a new study in the journal Pediatrics. But the discrepancy in prescribing fewer broad-spectrum antibiotics means black children actually are more likely to receive care in line with recommended guidelines for treating ear infections. Read more on prescription drugs.

Secondhand Marijuana Smoke May Damage Blood Vessels as Much as Tobacco Smoke
Breathing secondhand marijuana smoke could damage heart and blood vessels as much as secondhand cigarette smoke, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2014 meeting this week in Dallas. In the study, blood vessel function in lab rats dropped 70 percent after 30 minutes of exposure to secondhand marijuana smoke. Even when the marijuana contained no tetrahydrocannabinol (THC)—a compound in marijuana that produces intoxication—blood vessel function was still impaired. Reduced blood vessel function may raise the chances of developing atherosclerosis and could lead to a heart attack. “Most people know secondhand cigarette smoke is bad for you, but many don’t realize that secondhand marijuana smoke may also be harmful,” said Matthew Springer, PhD, senior author of the study and cardiovascular researcher and associate professor of Medicine at the University of California, San Francisco’s Cardiology Division. Read more on environment.

Nov 14 2014
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Faces of Public Health: Georges Benjamin, MD, APHA

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The American Public Health Association (APHA) annual meeting begins next week in New Orleans, the first return to the area for the 15,000-strong meeting since Hurricane Katrina nine years ago. This year’s theme is Healthography, or, as APHA Executive Director Georges Benjamin, MD, recently said, “where you live matters.”

Earlier this week, Benjamin spoke with NewPublicHealth about key issues and presentations for this year’s meeting. The following interview has been lightly edited for clarity and length.

NewPublicHealth: “Healthography”—what is it and why is important especially right now?

GeorgesBenjamin Georges Benjamin, MD

Georges Benjamin: We know for sure that place matters, and I think New Orleans is an excellent example of that truth. It’s a wonderful city, but certainly has had huge health challenges. In our annual America’s Health Rankings survey that we do with the United Health Foundation and Partnership for Prevention, Louisiana consistently ranks as one of the lowest states in the nation for health. When you also consider the environmental tragedies that the state had—two storms in short succession and then the Gulf oil spill—the challenges of place and health become especially clear.

So the concept of the geography in which you live and your health is taking center stage as we head to New Orleans. As just one example, our opening session speaker, Isabel Wilkerson, wrote the book “The Warmth of Other Suns,” which deals with the great migration of Americans who moved from one place to another to try to achieve a better life.

NPH: What are some of the other highlights of this year’s meeting?

Benjamin: We’ve got the acting U.S. Surgeon General coming, Dr.Boris Lushniak, and he is going to talk a great deal about health and place. He’s an amazing speaker around the issues of place-based health, how we build our communities and things that we can do to make the healthy choice the easy choice.

In addition, Risa Lavizzo-Mourey, the president and CEO of the Robert Wood Johnson Foundation, will be the keynote speaker for the closing session on Wednesday, where she will talk about the foundation’s new Culture of Health and how they are playing a leading role in building a future where every American has the opportunity to live the healthiest life possible, regardless of where they live.

As RWJF clearly knows, when you design things, you get exactly what you design, and we’ve designed an environment and a culture around health that creates an unhealthy environment. So, if we redesign that culture to improve our health, we can make a big difference.

NPH: Why is building a Culture of Health so important?

Benjamin: Most people living in the United States are not as healthy as they can be, and so APHA believes that we need to build a movement to be the healthiest nation, and we think we can do that in a generation. So, this meeting is the first component of our new strategic direction which aligns very closely with RWJF’s strategic direction.

Our goal is for the United States to be number one and not be number 36 in terms of quality of our health. We think there’s an opportunity to do that through the kind of things that APHA does with education, policy development, legislative advocacy, and building grass roots and grass tops movements to get us there.

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Nov 14 2014
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Public Health News Roundup: November 14

More than 1 in 5 High School Students Currently Uses Tobacco
Almost 23 percent of high school students currently use a tobacco product, according to new data published by the Centers for Disease Control and Prevention (CDC.) “Nine out of ten smokers tried their first cigarette by age 18,” said Tim McAfee, MD, MPH, director of the CDC’s Office on Smoking and Health. “We must do more to prevent our youth from using tobacco products, or we will see millions of them suffer and die prematurely as adults. Fully implementing proven tobacco control programs would help keep our youth from falling victim to tobacco.” A review by CDC researchers of the agency’s National Youth Tobacco Survey (NYTS) found that in 2013, 22.9 percent of high school students and 6.5 percent of middle school students reported using a tobacco product within the last 30 days and nearly half of all high school students and 17.7 percent of middle school students said they had used a tobacco product at least once in their lifetime. The survey also found that 12.6 percent of high school students say they currently use two or more tobacco products. The researchers found that most young adults who use tobacco believe they will be able to quit, but about three out of four high school smokers continue smoking into adulthood. Read more on tobacco.

Climate Change Expected to Increase Airborne Allergens
Results of a new study by researchers at the University of Massachusetts Amherst strongly suggest that there will be increases in grass pollen production and allergen exposure up to 202 percent in the next 100 years, leading to a significant, worldwide impact on human health because of predicted rises in carbon dioxide. The researchers exposed grass plants to different atmospheric gas concentrations and found that high levels of carbon dioxide increased pollen production per flower by 53 percent. Read more on
environment.

Many Asthma Patients Would Like to Talk to Their Doctors about Cost Concerns
Asthma patients concerned about their ability to pay for medical care would like to talk about cost-related concerns with their physicians—but often do not get that opportunity, according to a new study by researchers at the University of Michigan School of Public Health. The study, published in the Annals of the American Thoracic Society, found that less than half of patients who expressed a preference for such discussions with their doctors reported having the conversations. “Financial burden from out-of-pocket health care expenses poses significant safety concerns and risk of poor outcomes to patients and society when patients utilize risky strategies, such as non-adherence, to address these burdens,” said Minal Patel, MD, U-M assistant professor of health behavior and health education and the lead author of the study. “Patients need to communicate with health care providers in order to access affordable options such as free samples, verification to access community assistance programs, and [a prescription change] or to adjust treatment recommendations.” Read more on access to health care.

Nov 13 2014
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BUILD: Going Upstream to Improve Community Health

Yesterday saw the launch of the BUILD Health Challenge, a national award program to create and improve partnerships among health systems, community-based organizations and local health departments with an aim of addressing upstream problems that impact the health of local residents.

On a webinar to announce the challenge yesterday, representatives of the founding partners of the challenge said they were embracing the challenge because “transforming health outcomes requires a coordinated effort to tackle such contributing factors as socio-economic conditions, transportation, housing, environmental issues and access to healthy food.” The evidence base underpinning the new initiative shows that partnerships among health systems, public health agencies and community organizations are the most effective ways to work toward that transformation.

The BUILD Health Challenge will award up to $7.5 million in both financial awards and low-interest loans over two years to support up to 14 community-driven efforts that take Bold, Upstream, Integrated, Local and Data-driven approaches to improving community health and promoting health equity.

BUILD’s partners include the Advisory Company, the deBeaumont Foundation, the Kresge Foundation and the Robert Wood Johnson Foundation.

>> Bonus Link: Read an FAQ about the Build Health Challenge.