APHA Action Board member Joyce Cappiello writes on sequestration, already suffering public health services; a look at lessons that can be learned from the late C. Everett Koop; and late-stage breast cancer on the rise for women between the ages of 25 and 39. These stories and more top public health headlines on Wednesday, Feb. 27, 2013.

Fosters Daily DemocratLetter to the Editor: Balance
To the editor: On March 1, core government functions, including critical public health activities such as food safety inspections, HIV testing and response to emergencies and disease outbreaks will face damaging cuts under an arcane budget tool known as sequestration. If lawmakers can’t put politics aside, these cuts will compromise our nation’s health, security, and economy endangering millions of American jobs. Already underresourced public health departments will continue to struggle to protect the health of our communities and the public will be at greater risk for infectious disease outbreaks, food-borne illnesses like E. coli and health-care associated infections from routine hospital stays. Essential public health services such food safety inspection and disease prevention and control are not the drivers of our nation’s debt, and they have already done more than their part to reduce the deficit. I urge Senator Shaheen, Senator Ayotte and Rep. Carol Shea-Porter to work with their colleagues in Congress to find a balanced approach to deficit reduction. Only through balance can we avoid these devastating cuts and put our nation on a sustainable fiscal path while continuing to adequately protect the public’s health.
Joyce Cappiello, Nurse Practitioner, Barrington

Associations NowWhat associations could learn from C. Everett Koop
One of the most-recognized figures in public health in the United States, C. Everett Koop, never let personal convictions get in the way of public service. Here’s what you can learn. When former Surgeon General C. Everett Koop entered public office, it was under a cloud of controversy. When he left it, he was widely respected, even by his critics. While Koop, who died Monday at 96, was known as a groundbreaking figure in pediatric medicine, he made his greatest impact as surgeon general in the administrations of Ronald Reagan and George H.W. Bush. Despite the controversy surrounding his 1981 appointment—based largely on his conservative views on social issues—Koop became a household name and authoritative voice on public health by the time he left the post in 1989.Associations can learn a number of lessons from his work.

Fox NewsLate stage breast cancer on the rise in younger women
The incidence of metastatic breast cancer – the most advanced stage of the disease – is on the rise in younger women between the ages of 25 and 39, an analysis of breast cancer trends revealed. However, the slight increase is unique to the younger demographic, as the rising trend does not correspond to the older female population. Conducted by researchers at the University of Washington, Seattle and St. Charles Health System in Bend, Ore., the study reveals a bizarre anomaly in cancer rates, which could have serious implications for women in this age group. “It’s a concern because of the poor survival of metastatic breast cancer compared to other stages,” lead author Dr. Rebecca Johnson, a pediatric oncologist at Seattle Children’s Hospital and University of Washington, told FoxNews.com.  “…Between patients who were diagnosed with (metastatic) disease and patients diagnosed with either regional or localized disease, the difference in survival is around 55 percent.”

GoverningSequestration’s impact on public health
March 1 is the deadline for President Barack Obama and congressional Republicans to reach an agreement to avoid the automatic federal budget cuts, known as ‘sequestration’, that both signed off on as part of the 2011 Budget Control Act. If those cuts are allowed to take full effect, an across-the-board slash of 8 percent to non-defense discretionary spending, public health advocates warn that the impact could be devastating to the country’s safety net. Now, that’s a big ‘if’ — the president and Congress could quite easily reach an agreement on, say, March 5 or even 15 that is retroactive to March 1, and the effects would be minimal. But there is some concern among local officials that if the cuts, intended to reduce the federal deficit by $1.2 trillion over the next 10 years, are officially enacted, the politicians in Washington might let them stay. After all, they’ve been supposedly working to avert sequestration for more than a year and haven’t been able to do it.