Why Should YOU Join the Chiropractic Health Care Section of the American Public Health Association? by  Cheryl Hawk, DC, PhD  (2002)

Public health has never been a popular topic in chiropractic—maybe because to most of us it connotes nothing but microorganisms and sewage treatment.

So what IS "public health," and why should DCs care about it?

Public health represents the efforts made by a society to protect, promote and restore health. Yes, microorganisms and sewage treatment are part of these efforts. Public health supports clean water, clean air and safe communities—certainly something all chiropractors already support. Public health also supports prevention and health promotion—and we certainly support that! Why should we go further than supporting public health in principle—and make the effort to join with our communities to actively support it? First, we can increase our impact on society by adding our skills and knowledge to those of the rest of the public health community; this is one of our main responsibilities as health care professionals. Second, we can help our individual patients even more by utilizing the extant information on prevention and health promotion. Third, we can help members of the public health community understand how chiropractic supports health and wellness.

Here are some facts we would all like to see change:

• Only 11% of Americans use chiropractic, even less worldwide.
• Most people seek care for spine-related pain, not general health or wellness.
• Insurance does not reimburse for chiropractic wellness care.

Getting involved in the mainstream public health community may be one way to change these facts, by emphasizing that chiropractic is really about health and wellness, and not just pain relief. Getting involved in public health policy-making is another way to work toward new utilization patterns for chiropractic. Both these involvements can be achieved by joining a powerful public health organization.

The principal public health organization in the U.S. is the American Public Health Association (APHA). APHA is over 125 years old and has over 30,000 members—the oldest and largest public health organization in the world. Although chiropractors have been involved in APHA since at least the 1970’s, in 1995, the profession increased its role in the organization with the formation of the Chiropractic Health Care Section.

Membership in the Chiropractic Health Care Section of APHA allows you to:

• influence public health policy.
• network with other health professionals and government agencies.
• represent our profession’s interests to the government, industry, health care system and public.

You might respond: "We already have organizations to represent our interests; why bother with APHA?" A little reflection will tell you that it can’t hurt to have the oldest and largest public health organization in the world on your side—and that being a member of an organization tends to put it on your side. This point is best illustrated by the story of how chiropractic first became involved in APHA.

It started in 1969. The Department of Health, Education and Welfare (DHEW), at the instruction of Congress, had conducted a study of chiropractic and came to several far-reaching conclusions which were subsequently adopted by APHA:

• "Chiropractic theory and practice are not based upon the body of knowledge … accepted by the scientific community."
• "The scope and quality of chiropractic education do not prepare the practitioner to make an adequate diagnosis and provide appropriate treatment."
• "Therefore, it is recommended that chiropractic services not be covered in the Medicare program."

APHA’s response was: "It appears that the practice of chiropractic constitutes a hazard to the health and safety of our citizens." APHA therefore urged that Congress cut Medicaid and Medicare for chiropractic; states exclude it from health programs and consider further restricting or abolishing chiropractic licenses; and that professional and consumer groups educate consumers on the hazards of chiropractic.

This was clearly an emergency situation for us! Action was necessary—but what should it be? Enter: Rand Baird, DC, MPH, private practitioner and public health instructor at Cleveland Chiropractic College, Los Angeles (CCCLA). In 1979 Dr. Baird initiated actions that had a significant impact on both APHA policy and on the future of the chiropractic profession.

He began with these facts:

• Like any organization, APHA wants to gain and keep members.
• Members, even student members, determine APHA policy.

His conclusion was: If you can’t beat ‘em—join ‘em! He proceeded to recruit CCC-LA students and initiate a letter-writing campaign by DC and student APHA members. This was a far more strategic, and effective, move than letter-writing by non-members.

Soon…Chiropractors were the fastest-growing new membership segment in APHA. Dr. Baird and colleagues were granted a place on the agenda of the APHA Governing Council meetings to dispute the policy statement against chiropractic.

Finally…In 1983, APHA issued a new policy statement on chiropractic superseding the previous one, stating that "…available scientific evidence makes it reasonable to assume that spinal manipulation performed by chiropractors can be a safe and effective service modality in the clinical management of certain disorders of the neuromusculoskeletal system, especially the low back…" Although some may feel that this is still not where we want to be, it is light-years away from the original policy!

At the present time, due to the actions by a dedicated core of chiropractors in APHA, chiropractors:

• serve on APHA’s Governing Council and other leadership positions.
• can propose APHA policy change.
• have even served on APHA’s Executive Board

BUT…Chiropractic Health Care Section membership is now down to only about 200 members, less than one-half of one per cent of the total number of US DCs! Section membership determines how strong a voice we have in policy-making, which can affect government and industry at the national level. Furthermore, a chiropractic presence at APHA conferences helps our credibility, communication, integration, and networking.

What YOU can do. If less than one-half per cent of U.S. chiropractors were able to reverse an anti-chiropractic policy at APHA, how much more could 1%, or 5% or 10% do? EVERY member has a voice, but the more members we have, the stronger our voice will be.

Invest in your future and in the future of the profession: join the Chiropractic Health Care Section of APHA now!.

Annual memberships include a free subscription to the American Journal of Public Health and to The Nation’s Health and reduced registration to the APHA annual meeting.

For information on all membership benefits, visit http://www.apha.org/about/membership/. You can complete a membership application online or contact the membership chair.