APHA Adopts Policies on Climate Change, Trans Fat, Abortion Services and More

Washington, D.C., February 14, 2008 – The American Public Health Association (APHA) recently adopted 20 policies addressing a broad range of issues in public health from tobacco-free schools and global climate change to including eye care in disaster preparedness and a ban on lead-based paint.

Following are descriptions of the measures approved by the Association’s Governing Council during last year’s 135th Annual Meeting in Washington, D.C., Nov. 3-7. The descriptions are brief summaries; to read the full 2007 policies please click here.

• 20071 - Smoking cessation to prevent vision loss — Recommends that the U.S. surgeon general warn of vision loss and potential blindness on cigarette packages, that insurance carriers cover smoking cessation and that health education materials include information on the increased risk of blindness associated with tobacco use and secondhand smoke. Also urges that national professional health care organizations support providing information about the link between smoking and eye diseases in prevention counseling and that tobacco cessation materials include information on the link between smoking and secondhand smoke exposure and an increased risk of blindness.

• 20072 - Addressing obesity through nutrition, agricultural policy — Supports increased access to healthy vegetables, fruits, legumes, grains, vegetarian foods and healthy nondairy beverages in school lunches and food assistance programs, urges Congress to increase subsidies for products low in fat, cholesterol, sodium and sugar, and urges the federal government to change laws that promote agricultural interests over the interests of nutrition. Also urges the federal government to assure that federal standards for competitive foods in schools in the United States do not pre-empt more stringent local standards for limiting fats, saturated fat, cholesterol, sugar and salt content in food.

• 20073 - Reducing obesity disparities through environmental justice — Recommends federally funded or directed studies into eliminating health disparities related to environmental injustice — such as hazardous waste facilities disproportionately placed in poor and predominantly racial and ethnic minority neighborhoods — obesity, healthy eating and physical activity. Recommends studies to develop comprehensive and environmentally focused obesity prevention interventions for economically and racially and ethnically diverse communities. Urges lawmakers to include community residents in decision-making about neighborhood design features such as crosswalks, bicycle lanes and quality of sidewalks. Urges lawmakers to help establish state and community surveillance systems to monitor community conditions such as access to parks and healthy foods.

• 20074 - Douching and adverse health outcomes — Urges schools of public health, pharmacy and medicine to include specific education around the adverse impact of douching on reproductive and maternal outcomes. Supports increased public health efforts to provide culturally competent education to women about the risks associated with douching. Recommends increased public health promotion efforts — including public service announcements on radio, television and in newspapers — that are culturally and linguistically appropriate and explain the reproductive and maternal risks of douching. Also urges the Food and Drug Administration to review existing data and require additional studies on the safety of douching and the prevalence of adverse health outcomes.

• 20075 - Agent Orange — Recommends President Bush direct the secretary of veterans affairs to continue to address the enduring psychological and physical health effects of Agent Orange, also known as dioxin, on American veterans of the Vietnam War and their families. Pushes for federal support for research and active involvement of schools of public health, medicine and dentistry for the study of the health consequences of the Vietnam War on those affected by dioxin. Urges the United States and chemical companies to be responsible for clean-up in areas of Vietnam that still contain high levels of dioxin.

• 20076 - Tobacco-free schools — Calls for strengthening the Pro-Children Act and similar laws by incorporating the Centers for Disease Control and Prevention’s definition of a tobacco-free school and prohibiting tobacco promotional items at schools. Urges state legislatures and boards of education to adopt tobacco-free school laws or policies. Calls on the Federal Trade Commission and U.S. surgeon general to support efforts to track tobacco marketing and advertising abroad, especially those that specifically target children. Supports tobacco cessation interventions for employees of school districts and schools.

• 20077 - Toxic substances — Urges lawmakers to restructure the Toxic Substances Control Act of 1976 to emphasize the obligation of chemical producers and users to fund epidemiological research of exposed workers by government, labor and industry. Calls for the restructured law to require all chemicals now in commerce be assessed by the Environmental Protection Agency — using a hazard-based rather than a risk-based approach — to identify those that pose potential or actual risk to human health and the environment as well as those that may serve as safer substances for riskier chemicals.

• 20078 - Global climate change and public health — Declares the long-term threat of global climate change to global health as extremely serious and notes that scientific literature demonstrates convincingly that anthropogenic greenhouse gas emissions are primarily responsible for the threat. Urges the public health community to advocate for mitigation and avoidance of climate change and to assess and communicate the potential public health benefits and adverse public health impacts of mitigation strategies. Urges U.S. policy-makers to immediately take steps to reduce U.S. emissions of greenhouse gases, including carbon dioxide, to avert dangerous climate change.

• 20079 - Public health infrastructure and physical activity — Urges support for the design and implementation of educational curricula, courses, training certificates and degree programs in schools of public health to prepare practitioners and researchers to develop and utilize the evidence needed to increase population physical activity and for the dissemination of effective physical activity promotion approaches. Supports federal and state public health agencies in efforts to fund and institutionalize physical activity promotion within local health departments. Calls for state taxes to be levied on products that promote sedentary behavior to fund state and local physical activity intervention efforts.

• 200710 - Improving coding in hospital discharge data — Recommends that all states require recording external cause of injury codes in hospital records for each admission for which an injury is the principal diagnosis. Recommends data quality assurance programs be developed and implemented at the state level with a goal of improving the completeness and accuracy of external cause of injury codes. Recommends that professional organizations join with APHA and other groups in endorsing the importance of complete and specific external cause coding in statewide hospital discharge databases. Calls for a national effort led by the Centers for Disease Control and Prevention to develop a strategy to improve external cause coding in hospital discharge databases.

• 200711 - Restricting trans fat — Urges federal, state and local lawmakers to require nutrition facts labeling on trans fatty acids on all commercial food products, to ban and monitor the use of partially hydrogenated oils in restaurants and to develop initiatives to bar the sale or availability of foods with more than 2 percent of industrially produced trans fat. Urges the Department of Health and Human Services and the Food and Drug Administration to begin rulemaking to revoke the “generally recognized as safe” and “prior sanction” status of partially hydrogenated oils. Urges public and private support for nutrition and health education on trans fat in the American diet.

• 200712 - Healthy, sustainable food system — Urges the public health community to increase its engagement in food system issues and to educate policy-makers, the media, food industry and health, nutrition and environment professionals about food systems issues such as sustainability, nutrition and justice. Urges Congress to include sustainable agriculture and other public health goals in legislation. Urges the U.S. Environmental Protection Agency to develop minimum environmental standards for agricultural facilities to receive government support and refuse to exempt industrial agricultural sites from regulations or enforcement; urges the Centers for Disease Control and Prevention to expand environmental public health tracking relevant to food system concerns; and urges the U.S. Occupational Safety and Health Administration to improve enforcement and strengthen penalties for workplace safety, among other recommendations.

• 200713 - Eye care in disaster preparedness — Strongly recommends the federal government, states, municipalities and industry include dedicated eye care professionals when devising disaster preparedness plans. Encourages eye care professionals to volunteer for emergency response teams. Recommends that the American Optometric Association and American Academy of Ophthalmology, in consultation with other associations, develop a manual of eye care first aid. Recommends education on eye protection for disaster and response teams, search and rescue participants and all other disaster workers.

• 200714 - Breastfeeding as a fundamental public health issue — Affirms that exclusive breastfeeding for the first six months of life with continued breastfeeding for at least the first one or two years of life is the biological norm, and that all alternative feeding methods carry health risks in comparison, with rare exceptions. Recognizes that breastfeeding is viewed as a public health issue and insists that maternal and child and comprehensive public health policies include attention to breastfeeding protection, education, promotion and support. Identifies the exclusive breastfeeding rate as a leading health indicator in the goals of the nation. Denounces aggressive marketing of human milk substitutes, particularly in health care settings.

• 200715 - School information sharing for public health — Recommends the 1974 Family Education Rights Privacy Act be amended so federal and state governments work with education and public health leaders to develop guidelines that allow schools to share personally identifiable health information with public health authorities for immunization compliance, infectious and chronic disease surveillance and other data collection activities essential to public health. Recommends federal and state governments establish common standards across all settings for the protection and confidentiality of personal health information, while allowing for information sharing for treatment, payment and public health purposes.

• 200716 - Securing Medicare — Calls on Congress to initiate a study of Medicare’s long-term financing; create a prescription drug benefit that is entirely within the traditional Medicare program and for which the program is able to negotiate drug prices; eliminate large Medicare-related subsidies to private insurance companies, such as overpayments to private Medicare Advantage plans; reject a proposed 45 percent cap on the general revenue component of Medicare funding; eliminate means testing in relation to Medicare Part B premiums; repeal the comparative cost adjustment demonstration project; and develop and disseminate a detailed review of the impact of health promotion, disease prevention and early intervention services on Medicare costs.

• 200717 - Preventing and controlling multi-drug resistant organisms — Encourages and promotes rigorous infection prevention and control practices in health care settings with a focus on clinically proven methodologies. Promotes the use of infection prevention and control “bundles” and “how to” implementation guidelines established by professional associations such as the Association of Professionals in Infection Control and Epidemiology and quality organizations such as the Institute for Healthcare Improvement. Stresses the need for additional infection prevention and control standards, alerts and patient safety goals focused on multi-drug resistant organisms.

• 200718 - Opposing U.S. attack on Iran — Calls on the U.S. government to clearly state it will not launch a pre-emptive military strike on Iran and to explicitly rule out use of nuclear weapons against Iran. Urges the U.S. government to vigorously pursue UN-authorized diplomatic initiatives to guarantee Iranian compliance with its Nuclear Non-Proliferation Treaty obligations not to develop nuclear weapons. Calls on the U.S. government to halt current plans to develop and deploy nuclear weapons and to reaffirm its historical commitment to international treaties aimed at curbing the development and proliferation of nuclear weapons and other weapons of mass destruction.

The following two policies were passed as latebreakers and will serve as interim policies until confirmed by the APHA Governing Council at its 2008 meeting.

• LB-07-01 - Lead ban in paint, children’s products, consumer products — Urges a worldwide ban on the continued use of residential lead-based paint, the removal of lead content in all paint and children’s products and the elimination of all non-essential uses of lead in all consumer products. Urges U.S. companies with ties to companies in other countries that produce leaded paints, children’s products and consumer products to cease immediately. Urges the Consumer Product Safety Commission and the American Society for Testing and Materials International to quickly complete a lead-in-vinyl standard.

• LB-07-02 - Safe, legal abortion services — Urges state lawmakers to repeal or oppose state laws that in any way limit access to safe abortion services, including mandatory delays and information or counseling that is not science-based; bans on specific abortion procedures, parental consent or notification requirements; targeted regulation of abortion providers; and limits for advanced practice clinicians in providing abortion services. Supports state laws that improve abortion access, including funding for abortion via state Medicaid funds and protecting health facilities and clinicians that provide abortion services.