The APHA Annual Meeting can be an overwhelming experience. I have attended five of them and finally developed a plan of attack! The key is to stay consistent and focused on one or two topic areas. This year the conference was held in Washington, D.C. in November - a time when California’s health reform debate seemed to be over despite lots of community organizing efforts. So I went to the conference with a predilection to learn more about how public policy actually does change given so many strong forces that maintain the status quo. I ended up finding answers (or perhaps more questions) as a result of attending conference sessions, meeting with colleagues, and exercising around the National Mall. Below is a snapshot of my takeaways that I put together on the plane ride back to California.
Advocacy efforts and influence strategies are alive and well in Washington, D.C. They live just beyond the Capitol walls. They exist in the monuments around the National Mall, in the photography exhibits of Ansel Adams and Annie Liebowitz, and in the upcoming PBS series called Unnatural Causes www.unnaturalcauses.org.
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| Photo courtesy Unnatural Causes: Is Inequality Making Us Sick? www.unnaturalcauses.org |
As we enter a new year, I am inspired to think about ways we can support ‘alternative’ advocacy efforts – ones that move people to think, feel, and behave differently than they have in the past. This approach may stray from the traditional advocacy strategies that rely on the theory of change that if you educate and harp on policy-makers, then they will adopt your policy agenda. An alternative approach to advocacy may require the development and use of new tools and more creative frames for messages.
For example, the story of the health care delivery system and health outcomes in popular media needs to change. Currently it appears that only the poor get sick and it is because they are lazy, illegal, don’t have access to meds, won’t go to the doctor, or have bad genes. The story needs to be about changing the conditions/environment that we work and play in so we can live healthier lives. Policy change needs to focus on the dangerous conditions in which we were born into or live in.
A new story will be told through the premiere of Unnatural Causes, a seven-part PBS series, in March 2008. I saw segments of this series at the conference and felt so hopeful that the general public may begin to shift their thinking and practices from the medical model to a public health model to address health issues. There was some discussion at the conference about the impact this film could have on county health department workers and planners. County health departments are charged with making regulatory changes to create health equity. There is an assessment tool being used to measure, compare, and correlate across counties the change that is/isn’t occurring around creating health equities. Counties will need to create new regulations and reallocate funds to create health equality. Structural changes within the counties are needed and will require work across silos (unfair housing, employment, racism, etc). Right now DHHS spends 97 percent of funds on treatment and 3 percent of funds on prevention (and upstream approaches). How about spending 20 percent on prevention by 2020?!
As usual, I left the conference feeling inspired by all the good work public health workers are doing to make the world a healthier place for everyone. Conference sessions and colleagues from around the country provided me with useful, stimulating information that will help me push boundaries and advocate for positive changes in new and different ways.
By Wendy Todd, MPH, Secretary Elect