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

Nov 19, 2014, 11:39 AM

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.

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

Nov 18, 2014, 1:13 PM

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. 

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

Nov 17, 2014, 12:57 PM

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.

This commentary originally appeared on the RWJF New Public Health blog.

Faces of Public Health: Georges Benjamin, MD, APHA

Nov 14, 2014, 2:38 PM

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?

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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What's New in Schools and Programs of Public Health? Q&A with Harrison Spencer

Nov 11, 2013, 4:03 PM

file Harrison Spencer, Association of Schools and Programs of Public Health (image courtesy of Tulane University)

The Association of Schools and Programs of Public Health (ASPPH), like the American Public Health Association, held its annual meeting in Boston last week. NewPublicHealth spoke with Harrison Spencer, MD, MPH, executive director of the ASPPH, from Boston about the meeting and what’s ahead for students of public health.

NewPublicHealth: How was the meeting and what were some of the key sessions?

Harrison Spencer: Our meeting this year was the first one held since we formed our new organization, the Association of Schools and Programs of Public Health, on August 1. The new organization is now comprised of all accredited public health academic institutions, both schools and programs. We’ve got 93 members now, an increase from 57 members before, so this was a wonderful and exciting and dynamic annual meeting with lots of energy and lots of promise.

Among the highlights were Harvey Fineberg, MD, PhD, president of the Institute of Medicine, who gave us an inspirational talk about public health leadership, and Laura Liswood, Secretary General of the Council of Women World Leaders, who led a discussion on diversity as a way to make organizations and institutes stronger.   

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Ending Healthcare Waste, Improving Healthy Lives: Q&A with the L.A. Department of Public Health’s Jonathan Fielding

Nov 11, 2013, 3:03 PM

In a report released last year, the Institute of Medicine found that the United States wastes billions of dollars each year on such unnecessary spending as inefficiently delivered services, excess administrative costs, fraud and missed prevention opportunities. In response, a group of senior public health scholars at the UCLA Fielding School of Public Health, led by Jonathan Fielding, MD, MPH, a professor at the school and the director of the Los Angeles Department of Public Health, published an article in the American Journal of Preventive Medicine on the improvements to population health the country might realize if only the wasted money was devoted instead to the social and environmental determinants of health. If the government could reap 45 percent of the wasted medical care costs, argues Fielding and his co-authors, and invested those resources in sectors such as education, jobs, healthier foods and transportation infrastructure, the health of millions could be markedly improved and society would see additional social benefits.

Jim Marks, Senior Vice President and Director, Health Group at the Robert Wood Johnson Foundation echoed this approach at the recent American Public Health Association (APHA) annual meeting in Boston.

"We know lots about the cost of illness, but very little about the value of health,” he said.

Marks also said that focusing on health as the ultimate goal tends to eclipse some of the social determinants that can have enormous impact on people’s lives. “Most people don’t want good health as their outcome, they want a quality life. They want to travel, take care of grandkids, have a rich family and social life—you can only do that if you’re healthy,” said Marks. “It’s unrelated to good quality medical care. It’s related to education, safe neighborhoods, [and other social factors].”

According to Marks, improving public health isn’t about curing individual diseases or fixing specific injuries. Rather, it’s about everything; the diseases are the end result of the system we live in. And with all the data we have available, we know it’s a system that needs fixing, said Marks.

Marks’ thoughts came at an APHA panel Fielding moderated in a closing day session about the health impact of investment in major social and environmental policies and interventions; information gaps and how they can be filled; and how the discussion of health spending can be re-framed so that U.S. resources can be invested most productively.

NewPublicHealth spoke with Fielding about better uses for the wasted health care spending just before the start of the APHA meeting.

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APHA 2013: Update on Public Health Department Accreditation

Nov 8, 2013, 1:52 PM

A full house of American Public Health Association (APHA) annual meeting attendees got an update on health department accreditation this week from Public Health Accreditation Board (PHAB) president and CEO Kaye Bender, RN, PHD, FAAN; board chair Carol Moehrle; and vice chair Leslie Beitsch, MD, JD. Right now, Moehrle told the crowd, 19 health departments—local, state and tribal—have been granted the credential and more than 200 departments are in various stages of their applications.

Moehrle gave some “heads–ups” on what’s upcoming for accreditation in 2014, including revised application standards and measures—called version 1.5—as well as the establishment of several additional PHAB think tanks to help expand the issues health departments are asked about when they apply for accreditation. Information from the previous think tanks informed the development of the Guide to Public Health Department Accreditation Version 1.0 and the PHAB Standards and Measures Version 1.0. New topics for PHAB think tanks will include the U.S. Army.

Moehrle also announced that the new version will be released on the PHAB website in January 2014, and those new standards and measures become effective for health departments' seeking accreditation beginning on July 1, 2014. To apply under the 1.0 version, health departments must submit their application by 11:59 PM Eastern Time on June 2, 2014.

Moehrle said that PHAB is recommending that health departments review the proposed changes to the standards and measures before they automatically decide that they will apply under Version 1.0, because version 1.5 is designed to “enhance, strengthen, expand, and clarify the Standards and Measures document,” including the following:

  • Number of examples needed and timeframes for required documentation
  • Edits to version 1.0 for clarity and consistency, based on frequently asked questions from applying health departments
  • New measures and revised content to advance public health practice based on suggestions from PHAB Think Tanks conducted on special topics, including health equity, communication science, public health informatics, public health ethics, public health workforce and emergency preparedness

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Social Media and Hurricane Sandy: Q&A with Jay Dempsey and Vivi Abrams Siegel

Nov 7, 2013, 3:11 PM

Hurricane Sandy made landfall last year during the American Public Health Association’s (APHA) annual meeting in San Francisco. Several sessions at the annual meeting this year in Boston, one year after the storm, focused on the response during the hurricane that killed dozens, injured hundreds and destroyed thousands of homes.

In a key session Monday, communications specialists from the U.S. Centers for Disease Control and Prevention (CDC) reported on a study of new media preparedness and response messaging implemented before and after the disaster. As Hurricane Sandy approached landfall, the CDC’s National Center for Environmental Health (NCEH) assisted state and local public health partners by developing and sharing storm-related messaging across several social media channels, including an SMS text subscription service to directly reach people affected by the storm.

CDC determined what topics would need coverage each day, ranging from preparing for the storm's arrival to post-storm safety and clean-up. Once messages were posted, they were retweeted across several CDC Twitter feeds and on social media channels of local health departments. The recent CDC study found that leveraging social media turned out to be very important for driving a steady increase in traffic to CDC emergency response web pages. For example, a message about safe clean-up of mold produced 14,881 visits. The number of NCEH Twitter followers also increased—there were 4,226 twitter followers at the beginning of October before the storm, and that grew to 5,215 followers—a 23 percent increase—once the storm hit.

>>NewPublicHealth was on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Find the complete coverage here.

Ahead of the APHA meeting, NewPublicHealth spoke with Jay Dempsey, a health communications specialist in the National Center for Environmental Health who presented the data at the APHA meeting and Vivi Abrams Siegel, a health communications specialist in the CDC Office of Public Health Preparedness and Emergency Response about the findings and the growing importance of social media before, during and immediately after disasters.

NewPublicHealth: What’s most important about the recent study on social media and disaster preparedness and response?

Jay Dempsey: The case study is an overview of the lessons that we learned from using social media to disseminate emergency and preparedness messaging ahead of and during and immediately following Hurricane Sandy. Some of the things that we knew going in during the response to Hurricane Sandy was that a growing number of people are using social media to get information just before and during a disaster or an emergency. So knowing that, we leveraged our social media channels and the first thing we saw was a pretty substantial increase in web traffic. We’re able to track the number of page visits that come exclusively from social media and make a determination of approximately how much social media drove traffic to those particular pages.

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Making a Collective Public Health Impact through Diverse Partnerships

Nov 7, 2013, 1:36 PM

It’s no secret that public health department budgets have been shrinking in the past few years. In the face of the recession, public health professionals must seek new and diverse partnerships in order to achieve greater impact despite the lack of funding. The topic of one session at the American Public Health Association (APHA) Annual Meeting held in Boston was just that—how to increase impact through strategic partnerships with unlikely partners.

“The need for austerity and efficiency opens up the conversation for collective impact,” said Joseph Schuchter of the University of California-Berkeley School of Public Health. Partnerships can include a wide array of non-public health entities, including non-profit organizations, businesses and schools. The APHA panel discussed different approaches to successful partnerships that advance public health programs.

Leadership Training

The Center for Health Leadership and Practice provides group leadership training for cross-sector teams that are working together to advance public health. “We may all be talking about the same thing, we’re just using different vocabulary and styles,” says VP of External Relations and Director Carmen Rita Nevarez. The Center provides existing partnerships with the tools and training needed to move forward in the same direction, while understanding that individual efforts may differ. More than 90 percent of program participants agree that the approach is effective in supporting intersectoral leadership development and most teams report regularly engaging other sectors as a result.

Networked and Entrepreneurial Approaches

Networked and entrepreneurial approaches to partnerships offer public health professionals with resources and allow them to reduce the negative externalities of the economy. The impact investment market constitutes an $8 billion industry that is eager to fund novel solutions to social problems. In order to succeed in these partnerships, the field of public health must work with social entrepreneurs and investors to highlight the potential return on investment for prevention programs and produce irrefutable outcomes.

Backbone Organizations

The Community Health Improvement Partners (CHIP) serves as a backbone organization for a larger, cross-sector childhood obesity initiative. Cheryl Moder of CHIP shared her insights into the role of such an organization and how to successfully grow a diverse partnership. A backbone organization must serve as mission leaders by recruiting and retaining partners and support aligned activities so that they connect to one another. In addition, backbone organizations must navigate the challenges of larger partnerships—such as developing and retaining trust, encouraging equal partner recognition and shared measurement and evaluation—in a way that suits the needs of partners from different sectors.

>>NewPublicHealth was on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Find the complete coverage here.

This commentary originally appeared on the RWJF New Public Health blog.

Regulating Tobacco: Q&A with FDA's Mitch Zeller

Nov 6, 2013, 3:05 PM

Tobacco featured prominently as a public health issue at the American Public Health Association (APHA) meeting this week, including a regulatory update from Mitch Zeller, JD, who became director of the U.S. Food and Drug Administration’s (FDA) Center for Tobacco Products earlier this year. Zeller previously worked on tobacco issues in government as associate commissioner and director of FDA’s first Office of Tobacco Programs, and also as a U.S. delegate to the World Health Organization (WHO) Working Group for the Framework Convention on Tobacco Control.

NewPublicHealth spoke with Zeller ahead of the APHA meeting.

Mitch Zeller, JD, Director of the FDA’s Center for Tobacco Products Mitch Zeller, JD, Director of the FDA’s Center for Tobacco Products

Mitch Zeller: I think most broadly my goals are to help give the center and the agency the greatest chance of fulfilling the public health mission behind the law passed in 2009 giving the Food and Drug Administration authority over tobacco. This really is an important piece of legislation. It’s really stunning that in 2013—with everything that we know about the harms associated with tobacco use—that it remains the leading cause of preventable death and disease both in this country and globally.

There are some very powerful tools that Congress has given FDA to use wisely and supported by evidence. That’s where I think, the greatest opportunity lies: to use the tools relying on regulatory science to try to protect consumers and reduce the death and disease toll from tobacco.

There are two areas where I think these tools can make a profound positive impact on public health. The first is something called product standards, which is basically the power to ban, restrict or limit the allowable levels of ingredients in tobacco or tobacco smoke. We are exploring potential product standards in three areas: toxicity, addiction and appeal. And we are funding research in all three areas and working very hard behind the scenes to find out what our options are for potential product standards in those three areas.

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