Larry Cohen, founder and executive director of Prevention Institute, has been a public health and prevention advocate and pioneer for more than 40 years. In his latest book, “Prevention Diaries: The Practice and Pursuit of Health for All,” he explores the aspects of daily life that influence our health and argues that a prevention approach offers many common-sense solutions that save lives and money, and reduce human suffering.
APHA is a long-time partner of Prevention Institute. As APHA strives toward our strategic goal of creating the healthiest nation, how can a prevention approach lead to new ways of thinking about how to reach this goal?
We know that prevention works. We understand that health matters to everyone, but some communities have been systematically disadvantaged and affected more than others, and it’s time to build that into a system that advances prevention and equity. We understand that our bodies, our minds, and our environments need to be aligned for health. We can’t talk about asthma and ignore housing and traffic; it’s not just about getting individuals to adjust, but about ensuring safe housing and improved air quality. We can’t talk about high utilization and ignore mental health and trauma — and it’s not just about identifying individuals with adverse childhood experience but about transforming adverse community environments into healthier ones that promote resilience. It is time not only to recognize the importance of community well-being, but to fully engage and align with community. This means partnering far beyond health organizations and achieving new strategies. It means ensuring our policies and practices move our norms and environments. APHA plays a critical role in enabling new thinking and solutions to be shared, and their methodology understood. More importantly, APHA is a partner and a leader in promoting policy and practice changes across the country.
Read the full Q&A with Cohen in Public Health Newswire.
Victor Dzau, MD, has had an exciting term since assuming the presidency of the National Academy of Medicine in July 2014. For one thing, the organization was not called NAM when he came on board — its membership voted in 2015 to transform the then-Institute of Medicine into the National Academy of Medicine. Now, the independent NAM is branching even further into what it means to develop meaningful research to be used in health fields. Dzau spoke with The Nation’s Health about the future of the academy and its ongoing work.
What new NAM initiatives are you most excited about?
The one that we are very excited about…is called Vital Directions in Health and Health Care. A year ago, we were well aware that there’s going to be a change in U.S. administration. Our members, our council are saying, what would it look like under new administration? What are things that still haven’t quite been achieved? What are things that we need to think about going forward?
We convened a steering committee of 18 members, which commissioned over 100 experts to write papers, 19 in total, under the three themes: health and well-being, or health and wellness; health care delivery; and science and technology. Under those three themes are specific papers that look at life course management, social determinants of health, precision medicine, payment reform, science and technology for the future.
On Sept. 26, these reports were released by (the Journal of the American Medical Association) as what they call viewpoints. On the same day, we (had) public discussion we call a national conversation of the various Vital Directions. We can have authors and also non-authors to come and sit together and talk about what we believe are the issues that should inform the next U.S. administration and get input from the public. Following all this, we’ll have a synthesis paper that will bring together all these dialogues into one final paper, published in Perspectives and in JAMA. That’s going to happen around December.
We are thinking and hoping that this initiative will inform the next U.S. administration. Therefore, we are beginning to reach out to transition teams and to work with the next administration after the election, and begin to work with them in any fashion we can to help advise them.
Read the full Q&A with Dzau in The Nation's Health.
Jonca Bull, MD, FDA's assistant commissioner for minority health, talked with The Nation’s Health about some of the barriers to diversity in clinical trials and FDA’s efforts to spread awareness and show transparency about who is participating to inform outreach in the the future.
How diverse are U.S. clinical trials currently? Where are the biggest gaps?
I think it varies. The basic question is how much variability in terms of the disease burden, what patient characteristics are most critical that would raise the significance of diversity in a clinical trial.
Optimally, we are very interested in seeing populations, as stated in our policies, that reflect the population that use the products in the post-market environment.
There certainly are challenges. We live in a world where medical product development is a global enterprise. A real challenge for us is establishing that populations are adequately comparable so that the data that informs an approval decision is as accurate and close as possible to the population here in the U.S. will use the product.
Read the full Q&A with Bull in The Nation's Health.
Tens of thousands of residents have been affected by flooding in southern Louisiana, and Jamie Roques, MPA, MPH, APRN, is on the front lines of the public health response as a member of the state’s Disaster Medical Assistance Team. Roque — a member of APHA’s Council of Affiliates and member and Affiliate Representative to the Governing Council for the Louisiana Public Health Association — spoke to Public Health Newswire about what took place, the public health response, and how APHA can both help relief efforts now and prepare for health emergencies in the future.
The Baton Rouge floods continue to threaten the health and wellbeing of hundreds of thousands of people. How has public health supported affected families in its aftermath?
Affected families are way too overwhelming for the public health workforce in the area to address alone. It is estimated that 60,646 homes were damaged and approximately 30,000 people were rescued. With heavy hearts we did report 13 flood-related deaths to date. Ezra Boyd, who holds a PhD in geography from Louisiana State University, said that as many as 188,729 occupied houses and 507,495 people — 11 percent of the state’s population — were "affected" by the flood.
I know the public health community has worked through churches, nonprofit organizations and social media sites to help others in need, including donating; purchasing and sorting personal care items and clothing; collecting household cleaning supplies and other demolition materials for sheet rock and insulation removal; volunteering to wash clothing for neighbors, friends and families; and cooking hot meals for the workers.
Basically whatever the call, people are ready and willing to help. I am not involved in the environmental response but I know it is massive. There have been some water boil advisories issued to consumers in affected communities. Another major concern in many communities is mold in homes and its effects on those exposed to it.
As of Aug. 23, many people returned to work at the public health units and started providing their usual services to those in need. A mobile team of mental health professionals from the Louisiana Department of Health, Capital Area Human Services District have been going to the general population shelters doing assessments and trying to identify those who would benefit from psychiatric evaluations and professional counseling.
Find out how you can help. Check out the Get Ready fact sheet on preparing for floods (PDF). And read the full Q&A with Roquest in Public Health Newswire.
Planned Parenthood President Cecile Richards will be the opening keynote speaker at APHA's 2016 Annual Meeting, and she said there is much for public health advocates to be proud of — and more work still to be done
What are some recent victories for Planned Parenthood and public health, and what battles do we still need to fight?
We just had the recent Supreme Court decision, which of course struck down some of Texas’ new abortion restrictions. It’s impossible to overstate the importance of this decision not only for people in Texas, but now for people all across the country. The court really recognized that the laws that were passed in Texas under the guise of helping women in fact did just the opposite. What we’ve seen since that decision is that restrictions in six states have already been stopped. It has absolutely made a huge difference in particularly some of those states, like Mississippi and Alabama, where we’ve been a health care provider for a long time. These are states where there is very little access to safe and legal abortion as it is.
There are still enormous barriers to women to access safe and legal abortion, particularly for women who are low-income, for women who live in parts of the country that have legislatures and/or governors that have been unfriendly to their rights, and so there is a ton of work left to do.
I think the other big victory that has happened in the last few years was of course the Affordable Care Act, which writ large was probably the single biggest piece of progress for women’s health that I can remember...
I’d say probably the biggest challenge that we are focused on at Planned Parenthood, we are really focused on creating health care equity in America. Even as we make progress on types of medicines, availability, insurance coverage, we are seeing still enormous inequity in the ability to access this care. Women of color, immigrants, LGBT people are disproportionately impacted by restrictions on health care access. And for too many people, birth control services, transgender services, abortion services are out of reach because of folks’ income or because of where they live or because of just the environment or, frankly, their employer. There are other issues that are related — including maternal and infant mortality, rates of unintended pregnancy, prevalence of HIV infection, STDs — that people of color experience in disproportionate numbers.
It is unconscionable that so many people are going without health care. We have to do more as a country. That is really I think our biggest call to action.
Read the full Q&A with Richards in The Nation's Health.
No longer applying bandages to problems that only get worse, the New Orleans Health Department is working to address social determinants of health, the roots of many public health issues in the Crescent City. Taking a neighborhood-by-neighborhood approach, Director Charlotte Parent told The Nation’s Health about how she and her team are working to make their communities healthier and stronger than ever before.
What lies ahead for the health department and health in New Orleans?
We are working on our programs that we put in place to ensure that they stay here. But, we are also focused on health equity. That’s our latest initiative that we have in place. As an accredited health department, we’ve been trying to figure out how do we take our staff forward to understand what equity is.
It wasn’t only about how we bring new initiatives. We want to make sure that whatever we’re putting forward is touching everyone in the way that will be the most effective for everyone. For those that need more, we’re making sure that we do that. Those who maybe not need as much, we’re also touching them, too.
So, equity is our next stand. And hopefully in the next couple of years you’ll hear more about New Orleans around health equity, and equity in general.
Read the full Q&A with Parent in The Nation's Health.
Because of factors such as a history of racial discrimination, many Americans are locked into a cycle of unfavorable health outcomes and face unequal opportunities to factors that can support a better life, such as access to quality education and safe housing. The W.K. Kellogg Foundation’s Truth, Racial Healing and Transformation enterprise is creating fact-finding forums across the U.S. where people who struggle with health disparities can reach common ground. Gail Christopher, DN, vice president of the enterprise, talked with The Nation’s Health.
How does racial inequity lead to health inequity in the U.S.?
We have known for some time that there are just consistent and persistent…racial health disparities and inequities. Many of those disease conditions are directly linked to stress and key environmental factors or the social determinants of health and well-being.
Because of our residential segregation and our lack of equitable investment in communities and in neighborhoods, there is more adversity, there is more stress oftentimes that takes the form of violence.
Sometimes it takes the form of just chronic unemployment and the lack of access to resources. This translates into physiological and biochemical precursors for altered body function. The link between adversity and trauma and disease is much better known and understood today than it was 50 years ago. So there’s that sort of pre-disposition, if you will, to illness that’s aggravated by the social conditions in which people live. But there’s also a lack of access to equitable health care because of the residential segregation and the inequality that shows up on the ground with a disinvestment or patterns of disinvestment within communities.
Read the full Q&A with Christopher in The Nation's Health.