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APHA adopts new public health policy statements

Date: Jan 19 2024

Contact: Media Relations

At APHA's Annual Meeting and Expo, the premier gathering of public health professionals to address pressing issues and foster proactive solutions, APHA’s Governing Council adopted seven new policy statements focused on the critical issues of vaccine equity, youth physical activity programs, incarcerated patient care, forcible displacement of people living unsheltered, fall prevention in older adults and public health requests within enduring international conflict. These policies will help shape APHA's position on legislation and regulations and be utilized to write briefs, fact sheets, reports and statements on these public health topics.

The following policy statements were adopted by the Governing Council on Nov. 14, 2023:

20231 Partnering with Faith-Based Organizations to Improve Public Health and Vaccination Equity — The COVID-19 pandemic underscored the vital role that vaccination plays in preventing the spread of infectious diseases and supporting social and economic security. At the same time, years of progress made in achieving and maintaining high vaccination coverage rates have been reversed due to a convergence of factors related to the pandemic. This coupled with rising vaccination hesitancy and politicization of public health has created an urgent need to engage across sectors to recover and build forward a stronger, more resilient vaccination ecosystem. The faith community, including faith-based organizations (FBOs), is one such example that has helped improve awareness of the value of vaccination, strengthen vaccination confidence, and improve vaccination equity. Based on strong evidence, this policy statement urges that FBOs be prioritized as critical partners in supporting vaccination efforts. This can be done by ensuring that these organizations are critical thought partners in strategy development from the local to the national and global levels, enabling funding opportunities to support FBO-led vaccination initiatives, investing in culturally appropriate strategies and messaging, implementing concrete programs targeting vaccination hesitancy through multiple outreach channels, and building the capacity of religious leaders to respond to and emphasize together with public health professionals the importance of and need for routine vaccination across the life course.

20232 Supporting Youth Physical Activity Opportunities in Out-of-School Time Programs — According to the World Health Organization, out-of-school-time (OST) activities are a key avenue to supplement youth physical activity (PA) levels. Research has shown that PA taking place after school hours achieves 36% of the recommended 60 minutes of moderate-to-vigorous PA (MVPA) per day. OST PA could occur at clubs, intramural programs, informal play on school grounds, and OST programs. OST programs are defined as formal and supervised care programs located on or off school grounds that school-age youth (5 to 18 years) regularly attend outside of school hours as well as summer breaks. These programs (e.g., residential camps and not-for-profit clubs such as the Boys & Girls Clubs of America) come in many forms but often provide time and space for homework and snacks or meals as well as structured and unstructured PA. This policy statement calls for action to support improvement of PA opportunities in OST programs as well as increased access to such programs for all youth to facilitate attainment of 60 minutes per day of MVPA and healthy development. All youth should have access to PA opportunities in these OST programs to reduce disparities in youth PA attainment and related health outcomes. 

20233 A Call to End Shackling Incarcerated Patients Seeking Health Care — Incarcerated people are often shackled while seeking health care simply because of their criminal legal status. (In this statement, we define incarcerated people as those whose health care access is determined by the criminal legal system. This may include people in custody of local, state, territorial, federal, or other criminal/legal facilities [jail, prison, and other detention]; people detained by U.S. Immigration and Customs Enforcement [ICE] or in ICE detention centers; people detained in medical facilities or other locations as a result of legal or executive order or ordinance; people detained under community correctional supervision; and/or people held pending legal determination or adjudication of alleged charges. While we understand this is an unconventionally broad definition, our goal is to encapsulate everyone who lacks agency in their access to, choice of provider of, and/or provision of health care.) Shackling in health care settings involves physical, medical, or mechanical methods of restricting a patient’s body or movements for reasons that are not clinically necessary. Although justification for shackling is typically centered around safety, shackling is a violent practice with detrimental effects on both patients and health care providers. The practice has been recognized as a human rights violation among pregnant/perinatal incarcerated people, but the same dignity has not been extended to all people incarcerated. Therefore, APHA recommends the following actions to end the practice of shackling during health care: (1) legislative action, (2) national research efforts, (3) clinical guidance, and (4) clinical practice.    

20234 Protecting the Health and Well-being of People Living Unsheltered by Stopping Forcible Displacements of Encampments — Forced removals or displacements of encampments, sometimes called “sweeps,” endanger the health and well-being of people experiencing unsheltered homelessness and impair access to safe, stable housing or shelter. Forcible displacement of encampments is a temporary cosmetic fix and does little to effectively connect unhoused people to services and housing. People experiencing unsheltered homelessness deserve to have their health and well-being protected, their choices respected, and an opportunity to choose their own plans for accessing safe, stable, and permanent housing. Many evidence-based solutions offer bridges into permanent housing without violently uprooting encampments, residents, and their personal property. Instead of forcible displacement, cities and states would be more successful by adopting, practicing, and investing in Housing First approaches, permanent supportive housing and rapid rehousing models, sanctioned encampments, and/or safe outdoor spaces.

20235 Fall Prevention in Adults 65 and Over: A Call for Increased Use of an Evidence-Based Falls Prevention Algorithm — Falls in adults 65 years and over have been recognized as an urgent national public health crisis. As a result, the Centers for Disease Control and Prevention responded by creating a national initiative aimed at preventing falls among community-dwelling adults 65 years and over. In this policy statement, we aim to educate health care and public health professionals on the importance of fall screenings, fall risk assessments, and interventions. Also, we aim to promote the inclusion of other members of the health care team (in addition to primary care staff ) in employing evidence-based algorithms to prevent falls.

The two following latebreaker statements were not subject to the same review process and are therefore considered interim policy positions until reevaluated by the Governing Council in the regular 2024 review cycle.

LB23-01 Immediate Cease Fire in Hamas-Israel War — In light of the continuing escalating of civilian casualties in Gaza and Israel and the collapse of the healthcare infrastructure in Gaza, APHA calls upon President Biden and Congress to urgently demand an immediate cease-fire and call for de-escalation of the current conflict by securing the immediate release of the hostages and those detained; by restoring water, fuel, electricity and other basic services; and by passing adequate humanitarian aid to the Gaza Strip.

LB23-02 Meeting the Health and Psychosocial Needs and Ensuring the Human Rights of Refugees From Nagorno Karabakh — Wars of all types are harmful to health, but wars aiming to remove entire populations are particularly threatening. While the term “ethnic cleansing” has garnered varied definitions over the years, the United Nations describes it as a purposeful policy designed by one ethnic or religious group to remove, through violent and terror-inspiring means, the civilian population of another ethnic or religious group from a certain geographic area. The Armenians of Nagorno-Karabakh, in the mountains of the South Caucasus, are in need of a coordinated set of interdisciplinary approaches to address their health and psychosocial needs. The public health community calls on political powers at all levels to protect health and save lives by providing security and protection, human rights monitoring, humanitarian aid, refugee support, medical assistance, psychosocial support, education, peace mediation, amnesty and legal support, sanctions and diplomacy, reconstruction and economic support, accountability, and regional cooperation. 

These policy statements address pressing public health concerns and advocate for actionable measures. The full policy statements are available on


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