Section Newsletter
Fall 2005

Message from the Chair

In the aftermath of hurricane Katrina, the Section is concerned about the population health and about Section members and students in the affected areas. More than 20,000 health professionals, including epidemiologists, have signed up through the DHHS Web site to assist with recovery and rebuilding of the area. APHA staff is working closely with Sections, SPIGS, and Affiliates to keep them abreast of public health efforts in the area and the necessary changes in venue and dates of the APHA Annual Meeting. I would like to commend them for the frequent Web site updates, e-mails, and conference calls. It has been an ‘all hands’ effort across the APHA staff and much appreciated by Section leadership. Of course, a change in venue and location has also increased the workload for our Program Planner for the Section, Louise-Anne McNutt, and Planner-in-Training Linda Hazlett. With the capable help of Shazia Hussain, they are rescheduling and notifying presenters about the necessary changes.

The Section is pleased to announce that the GEICO-funded student memberships to the APHA Epidemiology Section have been awarded to Kitt Woods, an epidemiology student at the Oregon Health and Sciences University in Portland, Oregon, who is active in her state affiliate; Nadia Ennis, a CDC-intern from Clayton College and State University in Georgia, and Robert Levine, an undergraduate and former Young Epidemiology Scholars (YES) award winner now at Middlebury College. We thank GEICO for their support of these awards.

There will be a special pre-conference newsletter sent to all Section members in November. Please be sure to look for it so you have the latest details for the annual meeting!


Update on APHA Annual Meeting: Philadelphia, Dec. 10-14, 2005


In the midst of the suffering that is occurring on the Gulf Coast, we are asking everyone to be flexible in light of moving the annual meeting from New Orleans to Philadelphia.  As information in this newsletter was written in mid-September, please be sure to check the APHA Web page <http://www.apha.org/meetings/new_orleans_update.htm> at least twice per week for updates on such topics as airline and hotel reservations. Below are answers to frequently asked questions regarding the new meeting location. To access answers to more frequently asked questions, please visit <http://www.apha.org/preparedness/AM_Faqs.htm>.

What should you do to let us know you are coming to Philadelphia?
Watch for e-mails from APHA and also check the APHA Web site periodically.  Make sure your travel arrangements have been confirmed and that you are registered for the meeting.  If you need specific information about the Epidemiology Sessions, please contact the program co-chairs via e-mail at apha_epi@yahoo.com.  We look forward to seeing you.

What should you do if you cannot attend the meeting?  If you are a presenter?
All presenters have until September 30, 2005 to confirm whether they will cancel their presentation. Instructions will become available on the APHA Web site.  Additionally, you may e-mail the Epidemiology Section directly at apha_epi@yahoo.com 

All pre Katrina registrations will be fully refunded for any requested cancellations.  All cancellations must be received in writing by Nov. 11, 2005 by APHA/Laser Registration. Send your written cancellation via fax (888-424-1669) or by e-mail to APHA@laser-registration.com.

Registration deadlines changed
Anyone who has not registered may still take advantage of the discounted registration fees that have been extended until Nov. 4, 2005. 

Will Hurricane Katrina be address in the Annual Meeting?
APHA is working to develop multiple sessions to discuss the public health issues related to the disaster in the Gulf Coast Region.  In addition to the previously scheduled sessions, discussions of the immediate health effects of the disasters, the effects of domestic spending policies revealed during the response to the disaster, and long term public health planning will take place.

Where will the Epidemiology Sessions be held?
The majority of the Epidemiology Sessions will be held at the Philadelphia Downtown Marriott, which is connected to the Pennsylvania Convention Center. 


Special Edition Newsletter Focusing on Annual Meeting

The Epidemiology Section will distribute a special edition newsletter in November, which will focus on the APHA Annual Meeting. This newsletter will include details on Section-sponsored activities and opportunities, including a special session that is being planned to highlight and discuss the Hurricane Katrina response efforts. The newsletter will also feature information on the newly elected Section leadership.

APHA Urges Medicaid Reformers Not to Undercut Public Health

APHA prepared a white paper in advance of the Sept. 1, 2005 report from the Medicaid Commission. The APHA paper outlines four priorities policy-makers should protect when considering Medicaid reform.

The full text of the white paper is available on APHA's Web site, <http://www.apha.org/medicaidwhitepaper/medicaidwhitepaper_full.pdf>. The executive summary can be found at <http://www.apha.org/medicaidwhitepaper/medicaidwhitepaper_summary.pdf>.

High School Student Advocates for National Organization of Epidemiology Clubs

Epidemics are as devastating to our society as the worst natural disasters. However, unlike with other natural catastrophes, we have ways to control epidemics, and the science of epidemiology is our key. I was fortunate enough last year to be exposed to this marvelous field through the YES Competition. Through the competition, I understood the immense potential of epidemiology to improve human conditions, and realized that the more peers involved, the greater the achievements. Thus, I started an epidemiology club at my school. The club has the double mission of exposing students to the fields of epidemiology and public health as career choices and of informing the community about various epidemics and ways of keeping healthy. Members discuss the latest groundbreaking news on epidemics, hear prominent speakers in the field of epidemiology, and even reach out to their peers and the community, informing them about epidemics through posters, bulletins, etc.

Many epidemics, however, are not localized in one community. Some of the most devastating epidemics, such as AIDS, violence, and smoking, are prevalent in the entire nation. Therefore, a national club would be needed to coordinate the efforts of local epidemiology clubs. It would thus improve the health of people all throughout the United States by improving health community by community. Members of such a national club could even put their ideas into action by organizing activities/conventions in communities all across the country or by reporting health care problems in their communities to health officials and making a change. Motivated by this dream, I wanted to contact a national organization to try to make my vision come true. Because the College Board is a national organization that has close connections with high school students - and because it sponsors the YES Competition, which inspired me in the first place - I went to them for help. The College Board was very enthusiastic about this club. The representatives have been extremely helpful and supportive, and we are working very hard in making this vision come true.

Ershela Duressi

Editor's Note: Ershela Durresi attends Baton Rouge Magnet High School in Baton Rouge, Louisiana, and runs an epidemiology club at her high school. In addition to advocating for a national organization of high school epidemiology clubs, Durresi was a 2004-2005 regional finalist in the Young Epidemiology Scholars (YES) competition. The title of her abstract was “Using Network Topologies Against Bioterrorist Attacks".

Health-Related Quality of Life Data Available

Health-related quality of life (HRQOL) prevalence and trend data for U.S. adults from the 1993--2003 Behavioral Risk Factor Surveillance System (BRFSS) is now available on the Centers for Disease Control and Prevention HRQOL Web site, including:

• Eight health status and HRQOL measures derived from the first four questions on the BRFSS.
• Trend charts and prevalence estimates for each of 11 years.
• Estimates with 95 percent confidence intervals.
• Each state and nationwide.
• Annual age, sex, or race/ethnicity breakdowns.

To see the graphs and trend data for a particular state or nationwide, go to the CDC HRQOL Web site at <http://www.cdc.gov/hrqol/> and click on the "Prevalence Data" link in the left column.

RE-AIMing Your Research!

Improved translation and integration of health behavior research into practice and policy is the purpose behind a new Web site, <http://www.re-aim.org>.

With funding from the Robert Wood Johnson Foundation, members of the Behavior Change Consortium developed a resource to publicize methods targeted at enhancing research design and evaluation of health care interventions. RE-AIM is based on five dimensions proposed as key elements for understanding the potential public health impact of interventions:

• R each or saturation into the target population
• E fficacy or effectiveness of interventions
• A doption by target settings or institutions
• I mplementation—consistency of delivery of intervention
• M aintenance of intervention effects in individuals and sustainability in populations over time

RE-AIM offers a systematic way for researchers, practitioners, and policy makers to design and evaluate interventions at multiple levels (e.g., individual, clinic or organization, community) and to determine the public health or population-based impact of a program or policy. The Web site offers practical research translation tools, resources, and support to help guide evaluation efforts as well as anticipate and overcome likely barriers.

For more information visit <http://www.re-aim.org>.

Recruitment Challenges in Local Public Health: One Strategy that Works

Recruiting future public health leaders is a challenge, given the resource constraints typically experienced at the local level. Health departments must create new and innovative ways to entice the best and brightest from schools of public health. One way that the DeKalb County (Georgia) Board of Health (DCBOH) overcomes this challenge is by partnering with the Rollins School of Public Health at Emory University through the Student Outreach and Response Team (SORT).

The need for SORT arose following the 2001 anthrax cases and the “white powder” incidents that occurred in our community. The DCBOH’s epidemiologists struggled to respond to these threats. This experience made it clear that if there were a significant health threat, such as an emerging or re-emerging disease or intentional event, having a system in place for epidemiological surge capacity would improve our ability to respond efficiently. We drew on the experience of the Bloomberg School of Public Health of Johns Hopkins University, which had a program in place called “Student Outbreak and Response Team.” This graduate student-run organization assists local and state public health agencies in conducting outbreak investigations. In 2002, the DCBOH’s Center for Public Health Preparedness and key Rollins staff, along with several graduate students, developed a pilot project.

Since 2002, the SORT program’s scope and purpose have changed dramatically. The changes reflect the need not only to develop epidemiological surge capacity but to recruit future professionals from all program areas into local public health practice. SORT’s mission is: “To promote future public health leadership by providing students with hands-on experiences that contribute to improved community health.”

The SORT program has a significant impact on students. They gain valuable insights and perspectives about the public health system and have opportunities to network with experienced public health officials. In addition, they contribute to improved community health by participating in outbreak investigations and community events such as influenza immunization clinics. The DCBOH’s primary benefit is that we have a means to identify and recruit public health workers. We hope that by presenting a wide variety of activities and experiences for the students to participate in, they will find their niche and choose a career with our organization upon graduation.

Interest in the SORT program is increasing. For example, the program received second place in the 2005 Linkage Awards. Presented annually by the Council on Linkages Between Academia and Public Health Practice, the awards recognize exemplary community-based collaborative activities between public health practice agencies and academic institutions. Our hope is that programs like SORT are replicated in communities like yours. This will help ensure a cadre of well-trained public health personnel and increase your ability to recruit talented staff.

For more information about the SORT program, contact the Center for Public Health Preparedness, DeKalb County Board of Health by phone at (404) 294-3866 or via e-mail at <cphp@gdph.state.ga.us>. For help in getting a SORT program started, visit <http://www.dekalbhealth.net/cphp/products.htm>.

North Carolina Preparedness Center Kicks Off New Field Epidemiology Program

The beginning of the fall semester brought a new opportunity for epidemiologists to develop their skills. The University of North Carolina (UNC) at Chapel Hill opened a new online Certificate in Field Epidemiology on August 30, with 99 students enrolled in the program.

The students — from 27 different U.S. states, Canada, the Virgin Islands, Indonesia, and Kenya — will move through the program in a cohort and complete the course requirements next fall. The curriculum addresses the core functions of outbreak investigation, surveillance systems and methods, infectious disease epidemiology, and field epidemiology methods. All courses in the 12-credit program of study are taught by faculty in the Department of Epidemiology in the UNC School of Public Health.

As the practice of public health changes, so do the educational needs of public health practitioners, particularly in the area of field epidemiology. However, a 2001 survey by the Council of State and Territorial Epidemiologists showed that many epidemiologists in state and territorial health departments had no formal training in epidemiology. The Certificate in Field Epidemiology was designed to address this training need and offer an educational program available to working practitioners across the nation.

The Certificate in Field Epidemiology was developed and is sponsored by the North Carolina Center for Public Health Preparedness in the North Carolina Institute for Public Health at the University of North Carolina at Chapel Hill. More information about the program and applications for fall 2006 are available online at <http://www.sph.unc.edu/nciph/fieldepi/>.

Team Epi-Aid Receives Award for Public Service

It’s not often that epidemiologists get awards and praise for doing their jobs. But the student epidemiology volunteers who make up Team Epi-Aid were recently recognized for their extraordinary public service to the state of North Carolina.

Team Epi-Aid was one of two recipients of the 2005 Office of the Provost Public Service Award, established in 2000 by Provost Richard Richardson to recognize university units and student organizations at the University of North Carolina at Chapel Hill.

Team Epi-Aid recruits and places students in the North Carolina Division of Public Health and local health departments throughout the state to assist with outbreak investigations and other short-term applied public health projects. More than 130 students from the Schools of Public Health, Medicine, Nursing, and Pharmacy have contributed nearly 3,000 hours of service since the program began in 2003.

The award is designed to honor service that is an example of excellence, including responsiveness to community concerns, strong community partnerships, and integration of the service into the teaching and research missions of the University. Team Epi-Aid does all this and more: students have the opportunity to gain practical public health experience by working closely with state and local health departments, while the health departments gain much-needed surge capacity and cutting-edge expertise.

From forming a public health response to Hurricane Isabel, to investigating an E. coli outbreak associated with the state fair, to conducting Hepatitis vaccination clinics, Team Epi-Aid students, faculty, and staff work with state and local public health professionals to respond to the health needs of the people of North Carolina.

Team Epi-Aid is coordinated by the North Carolina Center for Public Health Preparedness in the North Carolina Institute for Public Health at the University of North Carolina at Chapel Hill. For more information on Team Epi-Aid, call (919) 843-5561 or visit <http://www.sph.unc.edu/nccphp/teamepiaid/>.

Study to Assess Impact of Poor Oral Health on Nutrition and Quality of Life among Rural Elderly in North Carolina

Poor oral health is a major health problem that most affects older adults, ethnic minorities, and persons in rural communities. North Carolina ranks among the states with the highest rates of oral health deficiencies. This condition may play a major role in influencing nutritional status and quality of life in these high-risk populations.

To better understand these issues, a team of researchers from the Wake Forest University School of Medicine (WFUSM) and SciMetrika, LLC, is conducting a study funded by a grant from the National Institutes of Health. The research team is led by Sara Quandt, professor of public health sciences at WFUSM in collaboration with John Elter of SciMetrika. The study, called "Rural Elderly Nutrition and Oral Health Study" will be performed in Harnett and Robeson Counties to build on the research team’s eight-year history of health research in these counties. The study began in March 2005 and will last for four years.

“We are excited about the opportunity to work again with the people of Harnett and Robeson Counties to try to help address this serious problem,” Quandt said.

The study consists of two phases: In Phase I, one-hour in-depth interviews will be conducted with 36 older adults at least 60 years of age with some degree of oral health problems in the two counties. The interviews will be designed to help understand the ways in which older adults change their diet and social activities to compensate for their poor oral health. In Phase 2, a random sample of 750 older adults will be selected to participate in an in-home survey and oral health examination (for those with at least one natural tooth). The survey will consist of measures of oral health, quality of life, nutritional status, food related behaviors, social interaction and functional status.

The oral health examination will assess presence of natural teeth, gum disease, dental cavities, and presence and condition of dentures. Participants for both phases of the study will be selected to obtain equal representation from black, Native American and white men and women. Interviews for both phases of the study will be conducted by Rhonda Faircloth, a Robeson County resident, while the oral health examination will be conducted by a trained registered dental hygienist under the supervision of a dentist. Study participants will receive a small monetary incentive after the interviews are completed.

“This study will provide very useful information about the oral health of older adults in these communities. This information will help health care providers develop strategies to manage this major health concern,” Quandt said.