Category Archives: Public health agencies
Recovery after a disaster can take years or even decades—but what most people don’t realize is that recovery starts even before the disaster occurs. Resilience is about how quickly a community bounces back to where they were before a public health emergency—and only a healthy community can do that effectively.
NewPublicHealth recently spoke with Alonzo Plough, PhD, MPH, Vice President, Research-Evaluation-Learning and Chief Science Officer at the Robert Wood Johnson Foundation, about taking steps toward recovery even before a disaster occurs.
NewPublicHealth: What are some important aspects of preparedness that help prepare responders and the community for recovery from a disaster?
Alonzo Plough: Connectivity between organizations, between neighbors, between communities and formal responder organizations is absolutely critical to building community disaster resilience. This allows recovery to go more smoothly because the partners who have to work together in recovery have been working together and connecting to communities prior to a disaster event. Managing the long tail of recovery is easier if there has been recovery thinking in the preparedness phase.
NPH: One of the issues for the panel at the recent Preparedness Summit is the impact of the news spotlight when a disaster occurs, and then the impact of that spotlight turning off. How does that focus impact recovery?
Plough: Often the initial media frames are to wonder why there weren’t preventive mechanisms. In the case of the mudslides in Washington State, for example, why weren’t there zoning restrictions or regulatory restrictions? That initial media frame often will point a finger to ask why houses were allowed to be built in an at-risk location. Why were building permits given at all?
But none of that really addresses the long-term issues of communities working toward recovery, regardless of the specific event. There is a disruption of life as people know it in a disaster that goes on for a long, long period of time. The media doesn’t really capture the complexity of that while they’re focused on the short-term outcomes. When the media focus goes away, the appropriate agencies and organizations who need to be engaged continue their engagement.
A recent survey by the Federal Emergency Management Agency (FEMA), found that only 34 percent of Americans said they would have access to financial, insurance and other records if they had to evacuate in a disaster. Now that hurricane season has begun, that slim response is pushing FEMA regional directors to promote financial preparedness along with other safety reminders.
“Don’t hinder your recovery if disaster strikes. Take the time now to ensure critical documents are safely stored, valuables are adequately insured, and potential spending needs are planned for,” said Andrew Velasquez III, regional administrator for the FEMA Midwest region.
Among FEMA’s tools and advice:
- FEMA has created an Emergency Financial First Aid Kit which provides reams of information, including documents to store online or on a flash drive, such as household bills, credit card statements and loan information. That information can help stabilize your financial status after a disaster and can be critical for avoiding fines if you are late on bills and for certain loans and grants.
- FEMA also recommends enrolling in online banking, direct deposit for paychecks and Go Direct for online deposits of federal benefits such as social security. This will help people avoid disruptions in income due to a disaster.
- FEMA recommends people keep some cash or traveler’s checks in a plastic bag in their Go Kit. After many disasters power outages keep ATMs offline, just when many businesses—also without power to process credit card transactions—were often requiring payment in cash only.
- Take the time now to print out a copy of Recovery after Disaster: The Family Financial Toolkit, developed by the University of Minnesota Extension and North Dakota State University Extension Service after disasters in those states. The toolkit is full of critical information such as what information you’ll need to show to secure a small business loan if your business is destroyed. The kit also has fill-in logs that help keep track of assistance you’ve requested and responses.
>>Bonus Link: The 2014 Consumer Action Handbook has information on avoiding financial scams including many that people can fall prey to after a disaster.
Millions of people have now seen their phone shake and heard it wail with news of an impending tornado or other disaster. Two years ago the wireless industry rolled out a free service known as wireless emergency alerts, and wireless carriers representing more than 98 percent of subscribers agreed to participate.
People with older phones, however, may not be able to access the alerts. Brian Josef, general counsel for the CTIA—The Wireless Association in Washington, D.C., recommends checking for the capability when buying a new phone and. For your current phone you can check with your carrier’s customer service office to see whether you automatically get the alerts.
People who can’t receive the texts, or who want a double layer of information, can sign up with local emergency management offices and get alerts via phone, text, email and in some cases Twitter—although sessions at the recent Preparedness Summit in Atlanta indicated that while Twitter is growing, it is still not used by many local and state health departments. Check the bottom of your health department home page to find the Twitter handle, if there is one.
Josef also points out that you may find that a neighbor got an alert and you didn’t—but that’s because the alerts are geo-targeted. If you and your neighbor were a few miles away from each other when an alert went out, only the one in harm’s way would get pinged.
But the apps won’t do you much good if your phone loses its charge. Preparedness experts recommend keeping a charged extra battery and portable charger on hand, and some emergency radios also include phone/device chargers.
Other tips to conserve your smartphone battery, according to Mary Clark, Chief Marketing Officer of the mobile technology company Syniverse, include:
- Reduce the brightness of your screen
- Close unnecessary apps
- Use text messages to communicate with friends and family
- Send an initial text to those most important detailing your plans
- Turn off unneeded options such as Wi-fi and Bluetooth
Center for Community Health and Evaluation Releases First National Evaluation of HIAs: Q&A with Tatiana Lin
Health impact assessments (HIAs) are evidence-based analyses that estimate future health benefits and risks of proposed laws, regulations, programs and projects. They provide decision makers with an opportunity to minimize health risks and enhance health benefits. HIA practitioners say the tool allows for more informed—and potentially healthier—decisions related to land use, transportation, housing, education, energy and agriculture.
The Center for Community Health and Evaluation, a division of Group Health Research Institute, a nonprofit based in Seattle, recently published a national study on HIAs that looked at their utility and potential improvements.
The new study outlines how HIAs change decision making and highlights evidence that HIAs can also lead to stronger cross-sector relationships, greater attention to community voices and longer-term changes beyond the initial decision the HIA is focused on.
Key findings of the Center’s evaluation include:
- HIAs can contribute directly to the decision-making process and help achieve policy outcomes that are better for health.
- There are opportunities to advance the HIA field in the areas of stakeholder and decision-maker engagement, dissemination and follow-up.
- Attention to specific elements can increase likelihood of HIA success.
A past HIA funded by a grant from the Health Impact Project, a program of the Robert Wood Johnson Foundation and the Pew Charitable Trusts, was conducted in 2012 by the Kansas Health Institute (KHI) and looked at the health impacts of building a casino in Southeast Kansas (a law that would move such a project forward was enacted last month).
NewPublicHealth recently spoke with Tatiana Lin, the author of the HIA and a senior analyst at KHI, about the recent HIA evaluation and lessons learned from the HIAs KHI has worked on so far.
The American Red Cross recently announced the opening of its second Digital Operations Center—the first one outside of its national headquarters in Washington, D.C.—in the organization’s North Texas Region. Both centers are funded by the Dell Computer Corporation. The new center, along with others to be opened in the next few years, expands the ability of the American Red Cross to engage in social media, especially during regional disasters.
The Center will “allow us to build a center of expertise through our digital volunteers who help provide social data for regional responses,” said Laura Howe, vice president of public relations at the American Red Cross. NewPublicHealth recently spoke with Howe about the impact of using social media to respond during disasters.
NewPublicHealth: How did the Red Cross social listening program begin?
Laura Howe: We started a social listening program for emergencies and disaster in a fulsome way after the Haiti earthquake. I walked out of my office and I had a bunch of staff members who were in tears. They were getting Twitter and Facebook messages from members of the Haitian diaspora community here in the United States giving them the exact locations of where people were trapped under rubble and where people needed help in Port au Prince. We were able to move that information to the U.S. Department of State and the U.S. Department of Defense to hopefully get people help on the ground. But, it showed us two things. It showed us the power of individuals to provide information that can help responders, but it also showed that there was a tremendous gap in the response system for being able to take in information and respond specifically to people who had an urgent emergency rescue need, and there really is no infrastructure to be able to do that.
But I do want to make clear that the Red Cross as an organization and Red Cross disaster workers are not going to be able to take in information off of social media and then send one of our people to come get you out of the rubble or to come rescue you. We are not acting as a 911 dispatch here. We are using social media platforms to provide people with preparedness information, emotional support and information that they can take action on. We’re also listening for information that can help us in our disaster response generally and help us better hone where we’re putting our resources during a disaster.
NPH: What are the criteria for an optimal American Red Cross digital volunteer?
Laura Howe: We want someone who is comfortable in a social space; understands social media platforms and how social communities work; and is comfortable engaging with the public, having done that previously. Volunteers don’t necessarily have to have professional experience with social media, but do have to have a personal comfort level. Our training follows up on those prior skills about how to engage on behalf of the Red Cross. We train the digital volunteers about how we take in the information and then move it to our decision makers in order to make operational decisions.
Despite certain positive shifts in overall health outcomes for residents in Alameda County, Calif., significant inequities exist, particularly among African-Americans, Latinos and Native Hawaiian/Pacific Islanders, as well as low-income residents.
The Alameda County Place Matters team works throughout Alameda County, including the City of Oakland, the largest city in the county.
Team Objectives include:
- Affordable housing
- Quality education
- Access to economic opportunities
- Criminal justice reform including reducing the incidence of incarceration
- Improvements to land use
- Accessible, safe and affordable transportation
Alameda County Supervisor Keith Carson initiated the Alameda County Place Matters team. The team is currently housed within the Alameda County Public Health Department and supported by health department staff. The initiative has numerous community partners that include community-based organizations; city and county government agencies; and nonprofits.
Among the critical issues the Place Matters team is currently focused on are displacement, the built environment, and development and how those impact health, according to team communications lead Katherine Schaff.
The team is working with community partners and planners on a healthy development checklist that the city of Oakland can use to take health considerations into account during city permitting and decision making to try to ensure more transparency and accountability to residents in that process. She said the goal is to have city planners go through the checklist before projects are approved. The checklist, said Schaff, might have allowed for more time for community comment before plans were authorized for a new crematorium that is expected to add to pollution and exacerbate asthma cases.
The Network provides assistance and resources to public health lawyers and officials on legal issues related to public health, including health reform, emergency preparedness, drug overdose prevention, health information privacy and food safety. More than 3,500 public health practitioners, attorneys, researchers, policy makers and others have joined the Network since it was formed in 2010 as a national initiative of the Robert Wood Johnson Foundation (RWJF).
“We are delighted that Ms. Levin, an experienced leader in public health law, will be joining a stellar Network team,” said Michelle Larkin, JD, assistant vice president for RWJF. “Laws and policies that help people lead healthier lives are among the cornerstones for building a culture of health. Through Ms. Levin’s leadership, we look forward to continued growth in the Network—a strategic resource for state and local public health officials.”
NewPublicHealth recently spoke with Levin about her new position with the Network.
NewPublicHealth: How does your previous work as the general counsel for a state health department help inform your goals for the Network for Public Health Law?
Donna Levin: During my decades at the Massachusetts Department of Health I saw the responsibility of the state health department grow exponentially. We were trusted by the legislature and given many new initiatives. So public health grew and grew and public health law has grown alongside it. So what informs my view is that the range of issues is so incredibly broad. And so I really know firsthand how the availability of technical assistance from the Network is so valuable both to lawyers working in the field and to practitioners.
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.
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.