The keynote speaker for APHA's 2020 Annual Meeting and Expo opening session, Shankar Vedantam is a National Public Radio correspondent and host of the "Hidden Brain" podcast. The Nation's Health spoke with him about how biases shape human behaviors in the context of issues and events shaping public health this year.
COVID-19 will likely still be with us in the U.S. even after a safe and effective vaccine is administered. Many people will probably still practice better hygiene in coming years, but what other ways might human behavior change given the broad impact of the pandemic on people's lives?
Beyond large-scale changes, the pandemic has certainly brought out some of the best and words in people. (Some) human beings have responded with great generosity, while others have responded with fear and suspicion.
Viruses have long been adept at identifying fault lines in societies, of revealing vulnerabilities in our cultures and in the underlying structures of societies. The optimistic side of me wants to believe we will learn from this pandemic, and that we will work to build a more equal world where we recognize we really are all in this together.
Read the full Q&A with Vedantam in The Nation's Health.
In the U.S., racism is reflected in the very air people breathe. Because of structural racism, minorities have had to live in unhealthy areas near power plants and industries that pollute the air. Blacks, Hispanics and Asians have a higher risk of premature death from particle pollution than whites in the U.S. The Nation’s Health spoke with NAACP Environmental and Climate Justice Program Director Jacqui Patterson, MPH, MSW, about racial and energy justice.
What is energy justice, and how does it fit within the wider environmentalist movement?
Energy justice is about shifting the undue burdens that people of color face in terms of being impacted by the pollutants from energy production.
Whether it’s coal-fired power plants, pipelines, oil and gas refineries, fracking and incinerators — all the different ways that digging, burning and dumping disproportionately affects our communities.
Those types of environmentally damaging practices and facilities are not only harming our environment and contributing to the greenhouse gas emissions that advance climate change, but they are also disproportionately located in low-income communities and in communities of color.
Read the full Q&A with Patterson in The Nation's Health.
Carter Blakey is deputy director of the Office of Disease Prevention and Health Promotion at the U.S. Department of Health and Human Services. The office manages the Healthy People initiative, which since 1980 has supported health improvements in the U.S. by setting objectives to meet over the next decade, tracking prevention efforts and measuring success. State and local health programs use the objectives as a benchmark to learn how their communities compare and guide their work. On Aug. 18, the office launched Healthy People 2030, which boasts new objectives and emphases.
How will Healthy People 2030 help reduce health disparities in the face of COVID-19?
Over the next several months, we will start to add health disparities data to our website. We’re working with the HHS Office of Minority Health and CDC’s National Center for Health Statistics to examine how to analyze and display this data in a way that empowers users to make decisions.
For example, one of our objectives related COVID-19 aims to increase the proportion of adults with broadband internet. Access to broadband internet has been crucial to maintaining work, education and health care for many Americans during the pandemic. Disparities data for this objective will help inform where to target efforts to increase access to broadband.
Many of our objectives related to COVID-19 are developmental or research objectives, meaning that they represent national priorities, but don’t yet have baseline data or evidence-based resources that meet the criteria of our core — or measurable — objectives.
Read the full Q&A with Blakey in The Nation's Health.
Keon Gilbert, DrPH, MPA, MA, is an associate professor in behavioral science and health education at Saint Louis University’s College for Public Health and Justice, and co-editor of “Racism: Science & Tools for the Public Health Professional,” published by APHA Press. The death of George Floyd at the hands of Minneapolis police officers in May sparked a wave of protests around the nation as well as calls for police reform and interventions to root out systemic racism. Gilbert talks about social change and racism in America.
Where does systemic racism cut the deepest in America?
It’s really hard to say. And the reason why I say that is because it’s embedded in so many systems that work together to produce systemic racism.
I am reminded of a quote from the writer Audre Lorde: “There is no such thing as a single-issue struggle, because we do not live single-issue lives.”
We can do an analysis, an antiracist analysis, for example, within institutions, but it’s very difficult to do that unless you start to look at the overlap or the interconnectedness between one institution and another.
You have to be able to look across systems. And that’s the difficulty of unpacking systemic racism.
Read the full Q&A with Gilbert in The Nation's Health. And tune in to Reborn Not Reformed: Re-Imagining Policing for the Public's Health, the third in APHA's Advancing Racial Equity webinar series.
Rear Admiral Michael Weahkee was confirmed April 21 by the U.S. Senate as director of the Indian Health Service, an agency within the U.S. Department of Health and Human Services. He has served in various roles at IHS since 1998, and was appointed principal deputy director in 2017. IHS provides health care services to 2.6 million American Indians and Alaska Natives in hospitals, clinics and other settings. The coronavirus pandemic has created new challenges within American Indian and Alaska Native populations, but health successes point to a hopeful future.
With physical distancing enacted due to the pandemic, how is IHS health care adjusting?
Our challenges with COVID include how we ensure that patients with chronic health conditions continue to get the treatment and the medications they need.
We’ve expanded prescription fills from 30 days to 90 days to help alleviate the need for them to see their physician and spread out the physical in-person meetings as best we can.
We’ve also worked hard to expand telehealth so that patients can connect with their care teams without the requirement to come into the hospital or the health center.
Read the full Q&A with Weahkee in The Nation's Health.
As COVID-19 spread throughout across the U.S. this spring, it highlighted worsening health disparities faced by minority populations in the U.S., including Hispanics. In April, half of U.S. Hispanics said they or someone in their household had taken a pay cut, lost their job or both because of the coronavirus outbreak. Preliminary data has also shown that Hispanics make up an unequal proportion of coronavirus cases in some states. In a recent podcast, The Nation’s Health spoke with Amelie Ramirez, who is the director of Salud America.
How does COVID-19 impact Hispanics in the U.S. differently?
One of the reasons we think (we’re seeing a disproportionate impact) is our population, our Latino community, really has a lot of different co-morbidities that are making it more difficult perhaps to get the treatment that they need.
For example, we have higher rates of diabetes, obesity, cardiovascular disease, asthma in our community, so that if they are impacted by COVID-19, their cases are probably more complicated because of that.
Read more or listen to the full podcast.
APHA member Sandro Galea, MD, DrPH, MPH, dean and professor at the Boston University School of Public Health, was the keynote speaker at the Nov. 3 opening session of APHA’s 2019 Annual Meeting and Expo in Philadelphia. In addition to his academic leadership, Galea is a gun violence researcher, an outspoken advocate on social determinants of health and author of a new book, “Well: What We Need To Talk About When We Talk About Health.”
What do you think we get wrong — as a country — when we discuss health?
Right now, the way we understand health rests on a conflation of health and health care. And that conflation has real implications, because it means that we understand health as being the product of clinical intervention, when in fact, clinical intervention in health care is about healing people once they’re sick.
Health should be about keeping people healthy, and that means we need to invest in the forces that keep people healthy.
That means having opportunities for employment; having good education, primary education and secondary education; having stable, affordable housing; and having economic opportunities that lift people from poverty. Those are the forces that we ultimately should couple with our health.
It is the job of public health to create an understanding of the conditions that generate health, and we should take that job seriously
Read the full Q&A with Galea in The Nation's Health.
The Nation's Health talked with the assistant secretary for health at HHS about ending America's HIV epidemic.
What has happened since "Ending the HIV Epidemic: A Plan for America" was announced in February?
...Our latest total (as of mid August) shows we have interacted with 29 different jurisdictions, including 13 site visits and 42 listening sessions, because we really want to listen and learn and interact with the community.
This is not us coming to Jackson, Mississippi, and saying, “This is the way to do it.” We’re here to listen and learn.
This is really very important, because what we want is the communities to come together to understand what’s right in their communities — that they have the resources to do those planned grants so that when the money becomes available, hopefully with the new budget, that they’re ready to spend it and to actually start implementing in their community plan.
In addition to that, we’ve awarded $6 million to four jurisdictions for pilot sites. That’s DeKalb County in Georgia; Baltimore; East Baton Rouge, Louisiana; and the Cherokee Nation of Oklahoma.
These places met predefined criteria, and have made progress in this regard and have certain standards. We want to jump-start their effort, not only to get those communities started — but that they can serve as exemplars that all of the communities can learn from and we can learn from, as well.
So we’re not just sitting on our hands. We’re not waiting for new money. This is a serious initiative. We have all been on the road. Me, others and particularly Dr. (Robert) Redfield (head of the Centers for Disease Control and Prevention) have been out there working in communities.
Read the full Q&A with Giroir in The Nation's Health.
Dara Richardson-Heron, MD, is the chief engagement officer for the All of Us Research Program, a long-term federal study dedicated to building one of the largest biomedical datasets in the world. Heron leads efforts to engage 1 million people, including groups typically underrepresented in health science studies. The National Institutes of Health program launched in May 2018, and one year later, 80% of the 142,000 people who have signed up are from underrepresented groups, including over half who are racial and ethnic minorities.
How do you build the trust of underrepresented individuals so they are comfortable taking part in a federal health study? After all, the U.S. has a history of unethical research on minorities.
We are intentionally not shying away from these issues. Instead, we are partnering directly with key stakeholders who are our trusted community and provider organizations and participant partners.
And we are acknowledging and addressing these realities head-on and sharing the progress that has been made to prevent these historic transgressions and breaches of trust that have happened in the past, such as human subjects protection, education and training, institutional review boards, and other laws and policies that protect human research participants.
But simultaneously, we must share the great news that research has the potential to be a powerful change agent — one with the potential to begin chipping away at the really unacceptable health disparities that we see in many communities.
And certainly at the All of Us Research Program, we are doing our level best, with both our words and our deeds, to make it abundantly clear that we are committed to helping those who have concerns understand that the only way we can learn more about, and hopefully one day eliminate, health disparities, is to have much more robust and diverse participation in research and clinical trials. You really can’t have precision medicine for all if all of us aren’t reflected in the research.
Read the full Q&A with Richardson-Heron in The Nation's Health.
Centers for Disease Control and Prevention Director Robert Redfield, MD, recently spoke with APHA's Public Health Newswire about the state of public health and the agency’s plans for 2019.
We’ve seen a flood of headlines lately on falling vaccination rates and new cases of previously eliminated infectious diseases, such as measles. What’s the CDC’s approach to turning the tide on vaccination?
Immunizations are our strongest and most powerful public health tool. Vaccines have been so successful, many people have forgotten how serious vaccine-preventable diseases can be. The recent spate of measles cases is a wake-up call for Americans. CDC is redoubling efforts to reach out to vaccine-hesitant parents and public health leaders to remind them of the solid science behind recommended immunizations. The key is for individuals to embrace vaccination for themselves, their families, their communities, their schools, and their churches. Science that sits on the shelf has no value.
Read the full Q&A with Redfield in Public Health Newswire.