A Look Ahead at ASTHO: Q&A with Paul Jarris
The Association of State and Territorial Health Officers (ASTHO) will be meeting in Austin, Texas, this week for their annual conference. NewPublicHealth spoke with ASTHO’s executive director, Paul Jarris, MD, about the key themes of this year’s meeting and the critical issues state health officers currently face.
>>Follow our ASTHO Annual Meeting coverage throughout the week.
NewPublicHealth: What are the key issues the state health officers attending the ASTHO annual meeting will hear about in Austin?
Paul Jarris: I think there are two major areas we’ll be talking about. One will be last year’s ASTHO Presidential Challenge that Dr. David Lakey, the outgoing president of ASTHO, launched on healthy babies. This was a challenge to all the state health officials to make a pledge to lower preterm births by 8 percent by 2014. We’re pleased to say that 49 states have committed or pledged as well as Puerto Rico and Washington, D.C. Michael Lu, associate administrator of maternal and child health of the Health Resources and Services Administration, and the president of the March of Dimes, Jennifer Howse, will be speaking along with Dr. Lakey and other health officials about the tremendous progress that has been made and the work that needs to continue to actually decrease the preterm birth rates.
The incoming ASTHO president, Jose Montero, the public health director in New Hampshire, will speak about his presidential challenge—the integration of public health and health care, as well as Paul Wallace, who chaired the Institute of Medicine report on the topic. ASTHO co-sponsored a meeting with the IOM and many stakeholders from both health care and public health to develop a three-year strategic plan for integration of public health and primary care.
NPH: What are examples of that intersection?
Paul Jarris: The public health infrastructure supports and assures the appropriate health care and quality of health care in many areas. We work in close partnership around infectious disease, whether that’s our vaccine infrastructure or investigation of disease outbreaks, such as the West Nile outbreak occurring in Texas and other states. It also includes assistance in oversight with healthcare-acquired infections such as the outbreak of hepatitis C that’s been occurring in New Hampshire and as well as many other places. We work together on tuberculosis, and when it’s detected, it’s often a public health laboratory that does that. Many state health departments now have roles in assuring that adverse events are identified, tracked, trended, corrected and action plans are put in place.
With regard to primary care, there are many opportunities to make sure that providers have the information and support they need at the health departments such as being aware of whether it’s a foodborne outbreak or some other outbreak, that’s ongoing in the community. Conversely, it’s also about engaging the primary care providers in reporting to the health department when they suspect a food outbreak or some other disease of public health interest. And then, of course, there are all the larger areas – issues around obesity and tobacco, physical activity and things like that that we need to work closely with the clinical sector to enlist their support in looking at the environmental and policy determinants of those conditions. And the state health departments and the state health officials have a very unique bully pulpit to engage public and private partners and mobilize them around these initiatives as we saw with the healthy babies challenge.
NPH: What are some other key sessions to note?
Paul Jarris: Another important session is about working with hospitals to improve prevention and public health. Sister Carol Keehan who is the president and CEO of the Catholic Health Association will be speaking, and they have been the leader in this country on hospitals doing health promotion. We also have the director general of the Bureau of Health Promotion from Taiwan who is speaking about not only the work in Taiwan, but also the International Network of Health, which is a World Health Organization group that works across the globe on hospitals improving health in the communities they serve.
James Marks, senior vice president of the Robert Wood Johnson Foundation, will be focusing on how do you make the case for prevention. That case has to demonstrate that it’s the right thing to and that it does bring about health improvements, but very importantly now we need to show savings—specifically savings to Medicaid so as to resonate at the state level. I think we all recognize in public health we don’t have nearly enough of the actuarial and economic expertise to make that case as well as we should. So, this conversation will be about different experiences from Jim’s perspective at the national level to some of the state health officials at their local level and how they make that case.
In public health, we’ve been doing prevention work for many years, and we tend to do it and feel good although we wish we could do more. What we haven’t done as well is learn to speak to the policy-makers, the private sector and the health care sector about recognizing the importance of prevention at the public health level. Often when we hear the word prevention used, people talk about clinical prevention. They’re not really talking about the types of things done at the public health level all the way from social determinants through environmental change, access to food and physical activity, the built environment and changes in social norms.
NPH: What other topics do you think the state health directors will talk about among themselves?
Paul Jarris: I think clearly the economy and the status of funding both at the state level and federal level is critically important because we’ve continued to see cuts. Additional cuts would tremendously compound what’s happened at the state level already, so that clearly is on people’s minds, and as part of that, how do we continue to assure essential public health services and have the staffing and expertise and infrastructure to meet the needs of the public going forward.
The impact of health reform is also so important. And the opportunity in particular to have a closer and better working relationship with the health care sector is going to be important, both because we feel that we have a responsibility to assure access and quality of care within health care, but also we think that we can save health care a tremendous amount of money and resources. We want to ensure that that is appreciated by the health care sector, and in fact, supported to the extent appropriate by Medicaid. We’re talking with the hospitals and others about how to build those relationships.