ASTHO Annual Meeting: NewPublicHealth Q&A with Paul Jarris
The annual meeting of the Association of State and Territorial Health Officials (ASTHO) begins tomorrow in Orlando, Florida. Attendees at the ASTHO annual meeting head to the same sessions and listen to the same speakers over three days, which helps create a common fluency with critical public health issues. It also creates cohesion among state health officers, who often work with each other during public health crises and learn from each others’ successful approaches to dilemmas such as budget cuts and entrenched chronic disease.
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Ahead of the meeting, NewPublicHealth spoke with ASTHO’s long-time executive director, Paul Jarris, MD, about the key issues participants will engage in during the 2013 ASTHO meeting.
NewPublicHealth: What are key themes at this year’s annual meeting?
Dr. Paul Jarris: There are a number of major health issues on the agenda for the conference, including an update on Healthy Babies are Worth the Wait, last year’s ASTHO presidential challenge. Together with the Health Resource Services Administration (HRSA) there’s an intention to roll out Healthy Babies learning collaboratives across the country, and we’ll be sharing successes of the initiative from the past year.
Another major area we’ll be talking about will be the reintegration of public health and health care. A lot of this work has been outgoing ASTHO president Dr. Jose Montero’s presidential challenge for the last year, and there’s been a lot of work going on, including the development of a national collaborative between public health and primary care that ASTHO is supporting. The collaborative involves more than 50 different health care and public health organizations, brought together for the purposes of improving the population’s health.
Incoming president Terry Cline will launch his Presidential Challenge, a major initiative on prescription drug abuse and misuse and overdose. There are more people who die from prescription drug overdose than from motor vehicle accidents in this country—and there’s much that can be done about it. We’ll also have the leadership from the Office of National Drug Control Policy speaking on this critical issue.
Medicaid and public health will also be on the agenda. We have been supporting the U.S. Centers for Disease Control and Prevention (CDC) in about 25 states that are working on state improvement grants from Medicaid to improve quality and affordability in the population’s health.
And the final topic area will be workplace wellness, where we feel very strongly that public health has a role. We spend a lot of time on where people live and where they learn, but where we don’t spend as much time is in the workplace. Dee Eddington, a key leader in the academic area of workplace wellness, will give an overview of the issue at the meeting.
And we’ll have some “late-breaker” sessions on areas including the fugal meningitis outbreak linked to compounding pharmacies.
NPH: What successes have you seen from the Presidential Challenges?
Jarris: We are seeing they are very helpful because they focus national attention on very critically important areas. That is not to say that work has not been done before. In the area of maternal and child health, for example, the focus of the President’s Challenge two years ago, for years maternal and child health directors, pediatricians and obstetricians have worked on reducing the rates of infant mortality in the United States. But with the Healthy Babies initiative that former ASTHO president David Lakey launched as his Presidential Challenge, it really brought together a lot of the policy leadership in the states, escalating the issue from a programmatic area to a strategic one. I had a veteran maternal child health director tell me that in her 25 years she has never seen preterm birth get the attention that it has since David Lakey launched that initiative.
And we look at the issues across cabinet areas in state government, as well as with the private and public sector, and we bring together the best minds in the area to develop strategic maps. We did that last summer around the issue of integration of public health and primary care, which has led to ongoing work in this area. We now have four and just started a fifth work group, co-chaired by a primary care representative and a public health representative. We’re really trying to collaborate between the two, to improve care and lower costs. Groups engaged in this include the American Medical Association, the American Academy of Family Practice, the American Academy of Pediatrics and the Institute of Medicine, among many others.
What we’re really looking forward to this year with the prescription drug initiative is the heightened attention it will bring. We’ve known for years from medical examiners about the extent of these deaths and we want to make this a large priority. There’s great work going on the issue in the United States, but we want to bring all these groups together. Just a few weeks ago ASTHO gathered key organizations involved in the issue—including ONDP, HRSA, the Substance Abuse and Mental Health Administration, CDC, the Centers for Medicare and Medicaid Services and the Justice Department, as well as academic and key leaders from public health—to come up with a 2-3 year strategy. So we’re really raising the bar.
NPH: How are budget issues continuing to impact state health departments?
Jarris: We continue to see budget cuts. States are stabilizing, but still cutting. And with the federal sequester and the Administration needing to find money to expand health services under the Affordable Care Act, there continue to be hits to public health, which is a challenge to public health agencies, who continue to rise to the challenges presented. For example, this year we had the fungal meningitis outbreak, and that was a significant challenge to coordinate across states and protect the public, and that was remarkably done and saved lives. We went from 50 percent mortality rate among people who contracted the infections to zero in just a few weeks, because public health kicked into action.
Health equity is continually an issue for health departments, and it’s a challenge to narrow the gap.
State health departments also have responsibility for some implementation of the Affordable Care Act, which has some specific public health provisions, although the vast majority of the act is health-care related. Examples of public health involvement include the Prevention and Public Health Fund, which has a goal, among others, on improving rates of childhood vaccinations, and in lab and epidemiology capacity. And the Fund also includes funds to improve quality in public health and promote public health department accreditation. Public health also has a role in meaningful use of electronic health records, such as allowing health care and public health to be able to talk back and forth on areas such as vaccination and reportable diseases.
We’ve also been supporting public health teams to include public health issues for Medicaid recipients such as lead and asthma abatement, and we hope to get a grant to create a primer on Medicaid and public health.
NPH: What do you want first time attendees to know about the ASTHO annual meeting?
Jarris: We keep our conference small, so there is a lot of interaction among participants. There’s a tremendous amount of learning that goes on. We focus on policy and cross-cabinet and cross-sector issues in order to support the visionaries attending the conference. We keep the group together to drive interaction and conversation.