Category Archives: Public health agencies

Oct 17 2014
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Recommended Reading: Culture of Health Prize Winner Brownsville on Health Affairs

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Earlier this year, Brownsville, Tex., was chosen by the Robert Wood Johnson Foundation as a Culture of Health Prize winner for its efforts to improve community health. As part of a new ongoing series, Health Affairs blog has featured a piece by local Brownsville leader Belinda Reininger on the community’s health successes.

Brownsville is a mostly Spanish-speaking town on the Texas border. The community, which is home to approximately 180,000 people, is also among the poorest metropolitan areas in the country. Approximately 48 percent of its children live in poverty, 80 percent of its population is obese or overweight, 30 percent have diabetes and about 67 percent have no health insurance.

However, over the last decade it has also become a “robust, bike-friendly city” that also promotes health through community gardens and the world’s largest Zumba class, according to Reininger. This is thanks in large part to the University of Texas’ decision to open its School of Public Health in Brownsville and the formation of Community Advisory Board that brings together 200 people and organizations, from private citizens and elected officials to business executives and nonprofits.

The board’s members “carry the message of wellness into their homes and businesses, and they’re able to affect policy and environmental changes by voting and leadership—and that’s how we have been able to include the community, by engaging them every single step of the way,” said Reininger, DrPh, to NewPublicHealth earlier this year.

Brownsville’s efforts include:

  • Using data to assess the community’s health issues and then to engage with community members in a way that is both informative and beneficial to their health.
  • Creating diverse programs — from Brownsville in Motion to promote physical activity through safe access to trails and bike lanes, to the Brownsville Farmers’ Market and Community Garden—to address the relationships between health, poverty, education and the economy.

To learn more about Brownsville’s prize-winning efforts to improve public health, read the Health Affairs blog post.

>>Bonus Links: Learn more about the 2014 RWJF Culture of Health Prize winners and read NewPublicHealth coverage of the prize announcement.

>>Bonus Content: Watch a NewPublicHealth video on Brownsville's efforts to build a Culture of Health.

Oct 16 2014
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Faces of Public Health: Jim Blumenstock, ASTHO

People tuning into news coverage of the Dallas Ebola cases have come to recognize David Lakey, the Texas state health officer. Every state has a similar position and those officials are charged with improving population health—from holding immunization clinics to responding to potentially fatal illnesses. The Association of State and Territorial Health Officers (ASTHO) is the professional association of the 50 state health officers. Jim Blumenstock is the chief program officer of ASTHO’s public health practice division. NewPublicHealth spoke to Blumenstock this week about state and federal coordination on Ebola detection and case treatment.

NewPublicHealth: What is ASTHO’s role in dealing with preparedness for Ebola in the United States and with the current cases?

Jim Blumenstock: In a crisis or a public health emergency like we’re experiencing with Ebola, ASTHO’s role principally is to do two things. Number one is to sort of be the glue or the hub that helps pull together the 50 states, the nine territories and the District of Columbia as an integrated, harmonious component of our public health infrastructure. The second feature is to provide a solid interface between federal efforts and state efforts. So, that’s our role with any significant public health issue.

During the H1N1 outbreak several years ago, both ASTHO and the National Association of County and City Health Officials (NACCHO) had key staff embedded in the U.S. Centers for Disease Control and Prevention’s (CDC) Emergency Operation Center because it was recognized that the value of the insight of a national organization that represents all the states and locals was so critical to the federal planning and response process. That was the first time it was done.

We’re on standby to do it and we’re sort of functioning in that capacity right now, but sort of in a virtual or remote area. For example, I’m not today embedded in CDC’s Emergency Operation Center. However, I would say I’m on the phone with them at least six to eight times a day—including last evening—and have had email exchanges already this morning, not only to get information, but also to be part of some planning and problem solving efforts they’ve requested our help on, or a request for our help on state consensus around a strategy or a tactic or an approach on a particular matter.

And our other critical roles are to help our members; to talk to federal public health officials; and to educate and inform the public. 

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Oct 13 2014
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PBS Series ‘Frontline’ Examines Antibiotic Resistance

In light of the ongoing Ebola outbreak, NewPublicHealth recently launched an in-depth look at the current state of several infectious diseases and efforts to stem Ebola and other outbreaks. Tomorrow night the PBS documentary series Frontline will air “The Trouble with Antibiotics” (10 p.m. EST), taking a look at antibiotic use on American farms and the death of a patient being treated at the National Institutes of Health (NIH) three years ago who succumbed to a superbug the NIH was unable to treat.

According to the program’s correspondent, David Hoffman, a former journalist with the Washington Post, 70 percent of U.S. antibiotics are used on farms and are linked to at least some of the two million people who become ill and the more than twenty thousand people who die of antibiotic resistance each year.

NewPublicHealth recently spoke with Hoffman about the project.

NewPublicHealth: What made you interested in the topic of antibiotic resistance?

David Hoffman: In 2012, the Clinical Center at the National Institutes of Health disclosed the details of an outbreak of resistant bacteria in the hospital during 2011. It was a remarkable story in which advanced genomics from an NIH institute were used to unravel the mystery of how the organism had spread, and the hospital took extraordinary measures to combat it. This led to a 2013 Frontline film about the growing problem of resistance in human health, “Hunting the Nightmare Bacteria.” While working on “Hunting.”’ we heard a lot about antibiotics in animal agriculture. But the issues were complex and needed time for serious examination. We decided to devote our next film to answering some of the questions and that process took about a year.

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Sep 25 2014
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Preparing for Ebola in the U.S. Makes Good Public Health Sense

U.S. public health officials have continually said that it is highly unlikely that the Ebola virus will spread in the United States, even if infected travelers land here. Officials at the U.S. Centers for Disease Control and Prevention (CDC) say that the disease is most contagious when people come into contact with the bodily fluids of someone who is ill—and someone that ill would be very likely be identified by border and airline personnel quickly. If hospital admission became necessary, U.S. infection control procedures could stem an outbreak, according to Tom Frieden, MD, the CDC’s director and the point person for the U.S. government on the current Ebola outbreak. Frieden has discussed the issue repeatedly during several news conferences in the last few weeks.

Of course, that changes if the virus becomes transmissible through the air, rather than just via bodily fluids, as Michael T. Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, suggested in the New York Times last week. While Osterholm often addresses the direst potential outcomes of infectious disease outbreaks, it’s prudent to at least know what to do, which is why agencies such as the CDC and the Network for Public Health Law say what’s needed is information and procedures...but not panic.

Last month, the Network held an online webinar on preparedness measures and Ebola which was watched by more than 1,200 public health officials. Following the webinar, Network experts posted answers to follow-up questions, including one about the right of public health or hospital workers to refuse to care for/help with someone suspected of having Ebola.

The Network also recently created an online primer on preparedness and legal issues surrounding the Ebola outbreak, both for public health officials engaged in the response overseas and for those with current or future responsibility for handling Ebola-related issues in the United States.

>>Bonus Link: Richard Besser, MD, now the chief health editor for ABC News, was formerly the CDC’s head of disaster response and led the early response to the H1N1 outbreak in the United States several years ago. In a recent opinion piece for the Washington Post, Besser laid out what’s being accomplished and what still needs to be done to stem the Ebola outbreak in West Africa.

Sep 19 2014
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Faces of Public Health: Q&A with Joshua Sharfstein, MD

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In the last few months, several prominent national and state public health leaders have announced plans to move on to new things, including David Fleming, MD, MPH, the former Public Health Director in Seattle & King County Washington, who NewPublicHealth spoke with last month. We also recently spoke with Joshua Sharfstein, MD, secretary of Maryland’s Department of Health and Mental Hygiene, who will leave his post at the end of the year to teach at the Bloomberg School of Public Health at Johns Hopkins University as part of the faculty of the School of Health Policy and Management.

Earlier this year, Sharfstein gave the commencement address at the graduation ceremony of the University of Maryland School of Public Health, and had this to say about the importance of ensuring the public’s health:

“The premise of public health is that the well­being of individuals, families and communities has fundamental moral value. When people are healthy, they are productive, creative and caring. They enjoy life and have fun with their friends and families. They strengthen their neighborhoods and they help others in need. In short, they get to live their lives.”

NewPublicHealth: What prompted you to move to academia at this point in your career?

Joshua Sharfstein: It's a chance to help train hundreds of new public health leaders as well as work in depth on issues that are important to me. I am especially looking forward to getting to work closely with so many talented faculty at the Johns Hopkins Bloomberg School.

NPH: How have your research and teaching skills benefitted from your time as deputy director of the U.S. Food and Drug Administration (FDA) and your position with the state of Maryland?

Sharfstein: I've seen a lot of public health in action at the local, state and federal level. My goal will be to show students how important, interesting, engaging and—at times—strange public health can be. I have a research interest in why certain policies are pursued and others are not—and how public health can be successful in a difficult political and economic climate.

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Aug 15 2014
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Ebola Roundup: NewPublicHealth Looks at the Latest News on the West African Outbreak

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The worst Ebola outbreak in history has now claimed 1,145 lives, according to the World Health Organization (WHO). In the two days to August 13, 76 people died and there were 152 confirmed, probable and suspected new cases in Guinea, Liberia, Nigeria and Sierra Leone. NewPublicHealth has been following the outbreak in West Africa closely. You can read our ongoing coverage of the Ebola epidemic here. Below is a look at the latest news on the outbreak:

  • While stating its belief that the magnitude of the outbreak has been “vastly” underestimated, WHO continues to partner with individual countries, disease control agencies, agencies within the United Nations system and other organizations to combat the Ebola epidemic. “Practical on-the-ground intelligence is the backbone of a coordinated response,” the global health organization said in an update, noting that the U.S. Centers for Disease Control and Prevention (CDC) is providing computer hardware and software that should enable real-time reporting and analysis. The World Food Programme is also delivering food to the more than one million people living in quarantine zones; the food shortage has been compared to a “wartime” situation.
  • The medical charity Médecins Sans Frontières (MSF) estimates that it will take public health officials at least six months to bring the Ebola outbreak under control. "In terms of timeline, we're not talking in terms of weeks, we're talking in terms of months,” said MSF President Joanne Lui, according to the BBC. “We need a commitment for months, at least I would say six months, and I'm being, I would say, very optimistic."
  • Kent Brantly, MD, one of two U.S. aid workers infected in Liberia who received an experimental Ebola treatment, continues to improve and hopes to be “released sometime in the near future.” He is being treated at Emory University Hospital in Atlanta, Ga. The family of Nancy Writebol, a missionary from Charlotte, N.C., said she also continues to improve and doctors remain optimistic.
  • The U.S. Department of State has ordered family members of staff members at the U.S. embassy in Freetown, Sierra Leone, to evacuate the country, announcing the order as part of reconfiguring of resources to better respond to the Ebola outbreak. The order stated: “We remain deeply committed to supporting Sierra Leone and regional and international efforts to strengthen the capacity of the country’s health care infrastructure and system—specifically, the capacity to contain and control the transmission of the Ebola virus, and deliver health care.”

>>Bonus Links: You can also find the latest information on the Ebola outbreak at the websites for the CDC and WHO.

Aug 13 2014
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The Mission of Public Health: Q&A with David Fleming, Seattle and King County in Washington State

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This week, David Fleming, MD, MPH, stepped down as public health director of Seattle and King County in Washington State after seven years leading the public health agency. Over that period, among many other accomplishments, he led the department’s efforts to sign up more than 165,000 residents under the Affordable Care Act and oversaw a 17 percent drop in obesity rates in partnering schools.

NewPublicHealth spoke with Fleming about his views on the mission of public health.

NPH: How has public health changed since you began your career?

David Fleming: The mission of public health has not changed—and that's to prevent unnecessary illness and death—but what has been changing is what the nature of that prevention is. Increasingly, it is in chronic diseases, injuries and, importantly, the driving force of underlying social determinants of health. So public health has changed from being more of a direct service agency where we have frontline public health workers who are out there providing treatment to people and preventing infectious diseases, to really more of a collaborative kind of agency where we need to be working with a wide range of partners outside of the traditional domains of public health to help them implement the changes that need to happen. It's a fundamental shift, I think, in the business model of public health that we're in the process of witnessing today.

NPH: When you point to some of the achievements that you've had, whether they're specific changes in the state or specific models of examples that you've given to other states, what would you point to?

Fleming: First off, I think it's important to say that public health is a team sport, and so when I talk about accomplishments, I'm talking about accomplishments of the department in which I work on this and the staff that work here. I think that we have been successful at pivoting to that future that we were talking about a moment ago, at looking at how health departments can attack the underlying social determinants of health.

Increasingly, it is health disparities that are driving poor health in this country. We have been successful here in beginning to figure out how to partner with other sectors—the education sector to reduce obesity in our poorest school districts, for example. We’ve also worked with the community development sector to begin making investments in our poorest neighborhoods to increase the healthiness of our communities, so that people who live in them can be healthy, as well. At the end of the day, I think that we have been trying to lead this new path where public health is a partner in communities with all of the other entities that are capable of influencing health and figuring out how to make that happen.

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Aug 7 2014
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Columbia’s Public Health ‘Summer School’

Close to fifty college undergraduates got a bird’s-eye view of public health careers this summer during the Summer Public Health Scholars Program (SPHSP), a partnership with Columbia University’s College of Physicians and Surgeons, College of Dental Medicine, School of Nursing and Mailman School of Public Health.

“I’ve learned that public health isn’t just about medicine,” said 2014 participant Richmond Laryea, a junior at the University of Central Florida. “It’s about things like the security and safety of public parks, places for farming, transportation, and education—it really takes place in every sector."

>>Bonus Content: Watch participants in last year’s program talk about their public health internships. 

The program, which is funded by the U.S. Centers for Disease Control and Prevention’s Office of Minority Health and Health Equity, is designed to show students the range of public health practice. Students typically spend three days at an internship, one day in the classroom and one day on a field trip to places such as the Harlem Children’s Zone. Each student is also mentored by the Mailman School’s associate dean of Community and Minority Affairs.

Laryea said his career plan is to become a cardiothoracic surgeon, but with some time spent gaining a public health degree, as well.

“With my experience in public health, I’ve learned that I want to look into a community approach to help others as a whole, instead of just helping an individual person,” he said.

Public health agencies where students are performing fieldwork this summer include the Northern Manhattan Perinatal Partnership, BOOM!Health, the South Bronx Overall Economic Development Corporation and New York City’s Correctional Health Services

Aug 5 2014
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Ebola Update: NIH Testing of a Potential Ebola Vaccine Set to Begin this Fall

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The National Institute of Allergy and Infectious Diseases (NIAID), a division of the National Institutes of Health, is set to begin an early-stage clinical trial for a vaccine to protect against the Ebola virus. The trial should begin as early as September. The vaccine to be tested was developed by the NIAID’s Group Health Research Center in Seattle and does not contain infectious Ebola virus material. Instead, it’s what is known as an adenovirus vector vaccine containing an insert of two Ebola genes. The vaccine works by entering a cell and delivering the new genetic material, causing a protein expression that activates an immune response in the body. Researchers have seen success with studies in primates.

The vaccine being tested is not the experimental serum that was used on two Ebola-infected health workers recently evacuated from Liberia. In those cases, Samaritan’s Purse, the aid organization that sent the health workers to Africa, contacted officials from the U.S. Centers for Disease Control and Prevention (CDC) in Liberia to discuss the status of various experimental treatments they had identified through a medical literature search. CDC officials referred them to an NIH scientist in West Africa familiar with experimental treatment candidates who was then able to refer them to pharmaceutical companies working on experimental treatments. The serum being used is made by Mapp Biopharmaceutical of San Diego, Calif.

Read more on NIAID Ebola vaccine research.

>>Bonus Content: The CDC has released a new Ebola infographic.

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>>Bonus Links:

Jun 18 2014
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Health Beyond Health Care: RWJF-Sponsored Washington Post Live Event Sparks Conversation on Creating a Culture of Health

“Health Beyond Health Care” was the focus of a Robert Wood Johnson Foundation (RWJF)-sponsored  Washington Post Live Forum today that looked at how creative minds in traditionally non-health fields—such as bankers, architects, designers and educators—are working together to build a Culture of Health in the United States.

“No matter where you live and how much money you have, you should have the opportunity to live a Culture of Health,” said RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA.

>>View the full archived live stream of the forum.

Lavizzo-Mourey said RWJF began its work on the concept of a U.S. Culture of Health in 2009, when the foundation’s Commission to Build a Healthier America released a report recommending the concept. Last year, the Commission came together to see what progress had been made. Among the sites embracing the concept is Marvin Gaye Park in Washington, D.C. Once known as “Needle Park,” the community has transformed itself through lighting and landscaping. This was possible “because the community embraced the principles of a Culture of Health and demonstrated how, from the ground up, people partnering can change the nature of their community and make it healthier,” she said.

Pointing to the most recent Commission report, Lavizzo-Mourey said that looking at communities undergoing changes pushed the Commission to conclude that in order to improve health as a nation, we have to change communities—especially low-income communities—so that people can make healthy choices every day. That also means that health care has to connect with non-health care.

“Each of you,” she told the audience of thought leaders and policy makers, “is uniquely positioned to make changes that can get us to a nationwide Culture of Health.”

The day’s speakers spoke about innovations in their fields that are helping to create local changes in health, and which are often scalable for communities across the country.

“The most successful projects are those that start with bringing communities together to first assess the need, and then prioritize them and move forward with a particular project,” said Sister Susan Vickers, RSM, Vice President of Community Health, Dignity Health, who added that just about all the loans that Dignity Health has made to nonprofits in the community have been repaid.

Why a focus on health? “Health summarized all [of the other factors],” said David J. Erickson, PhD, Director, Center for Community Development Investments, Federal Reserve Bank of San Francisco. “The best predictor for future health for a third grader is whether they are reading on a grade level. Community development is big, but not big enough, and the medical system is not big enough either. We need to start aligning all of these sectors so we’re all working in the same direction to turn these neighborhoods around.” [Editor’s Note: Read a previous NewPublicHealth Q&A with Erickson.]

“We have to treat health as a national treasure—a natural resource—and put it up on the level of the seriousness of the economy,” said Rear Adm. Boris D. Lushniak, Acting U.S. Surgeon General. “The economy doesn’t do anything without a healthy people.”