Each day during National Public Health Week, Public Health Newswire will feature guest commentary from our members focusing on the day’s theme. Here are a collection of vignettes promoting Wednesday’s theme, “Get out ahead.”
Saving lives through prevention: Ensuring equal access for all
by Chari Cohen, APHA Public Health Education and Health Promotion Section, Asian and Pacific Islander Caucus for Public Health
A recent study found that the current childhood immunization schedule will save 42,000 early deaths, 20 million cases of disease, and a total of $68.8 billion in societal costs for a single cohort. These numbers are astounding, and exemplify the incredible success of public health prevention programs.
However, we need to remember the communities across the U.S. that are less likely to benefit from prevention programs due to limited health care access. Individuals with limited English proficiency, who are unable to easily navigate our complicated health care system, could wind up being left out and they will not be able to reap the benefits.
Moving forward we need to ensure that all children and adults have equal access to preventive care, including vaccination and screenings. Public health professionals can make a difference by listening to the communities that we serve. We need to pay attention to the social, cultural and economic factors that come into play every day to frame their health care experiences and may limit their access to preventive services. Together, we can work to provide equal access to preventive services for all!
Public Health Nurses Making a Difference: National Public Health Week
by Jessica Dalton, APHA Public Health Nursing Section
Every day we put ourselves at risk for chronic diseases like diabetes, heart disease, and obesity by making poor choices or more commonly uneducated choices. But there is one strategy at our disposal to protect and maintain our health and wellbeing.
As a public health nurse, or PHN, my job is to teach and inspire healthy living through prevention. I administer immunizations to children and adults to prevent them from contracting deadly contagious diseases. I focus on maternal and infant health and safety through our home visiting program called Health Start. My duty as a PHN also allows me to visit my community’s public library to perform blood pressure screenings, teach basic nutrition, and provide different community resources to the patrons. I partner with other colleagues from our health department to offer our community family planning services, tobacco prevention and cessation services, and childcare consultation.
Education is the tie that strings everything I do together. I believe knowledge is power and while I might be teaching something as simple as hand washing, I know what I am really doing is empowering. I am giving my community authority over their health and wellbeing. I am offering them a way to stand up to and take charge of their life by giving them the guide map. I know as a PHN I am planting the seeds of prevention in hopes to see my community blossom into a healthy Pima County.
Healthcare crisis for the intellectually disabled
by Lyubov Slashcheva, APHA Oral Health Section; and David Fray
The U.S. Centers for Disease Control and Prevention estimates that 13.87 percent of US children 3-17 years old are affected by an intellectual/developmental disability, or IDD. In the past three decades states have closed large institutions providing comprehensive medical/dental care for persons with IDD. The resulting loss of healthcare providers in institutions was not replaced by the private sector due to poor reimbursement for home/community-based systems of care for this vulnerable population.
It is difficult for both children and adults with IDD to find health providers trained to meet their unique behavioral and health needs. The Federal Maternal and Child Health Bureau defines children with special healthcare needs, or CSHCN, as those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition, and who also require health and related services of a type or amount beyond that generally required for all children. It has been reported that children with IDD included within the CSHCN designation experience significant health disparities and are vulnerable.
The U.S. surgeon general, the American Medical Association and evidence in literature have formally acknowledged these deficiencies in care quality and indicate a healthcare crisis that should be addressed by defining the problem in public health policy for government programs. The American Academy of Developmental Medicine and Dentistry urges professional groups to accept a resolution that recognizes IDD individuals as a Medically Underserved Population. We believe that this first step will facilitate effectively addressing the existing health disparities.
Won’t you join us in this effort?
Get out ahead
by Martha Dewey Bergren, APHA Inter-Sectional Council Steering Committee
The APHA School Health Education and Services section embraces the concept that prevention starts with children and promoting healthy behaviors before lifestyles and choices lead to chronic diseases.
The health of the 48 million children who spend most of their waking hours at school depends on healthy food choices and physical activity throughout the school day. Fifty-five percent of preschool children spend most of their waking hours at day care, preschool or Head Start.
Where do you fit in?
Investigate opportunities to become involved with your neighborhood school wellness committees or on the advisory board of your local early childhood education centers. Use the CDC’s School Health Index to plan for healthy investments in your school’s environment. The American Academy of Pediatrics provides resources for selecting child care facilities that promote health and for implementing healthy practices within the centers.
It is never too early to promote health and to prevent illness and chronic diseases.
Getting ahead of gun violence!
by APHA Maternal and Child Health Section members Jennifer Bronson, Marie Crandall, Wendy Ellis, Lianne Estefan, Yvonne Freeman, Judith Katzburg, Woodie Kessel, Susan Robbins and Whitney Witt
Despite the indisputable toll gun violence has taken on this nation, prevention is rarely included in conversations about gun violence. Gun violence is preventable and yet continues to occur in our schools, streets and homes. Advancing prevention is at the core of public health.
As public health professionals, students, and everyday people we must get ahead and get serious about preventing needless deaths and injuries from gun violence in order that all Americans can enjoy healthier and safer communities. Get out and meet with maternal and child health professionals and community leaders including nurses, pediatricians, social workers, health educators, journalists, emergency responders, law enforcement, school administrators and counselors to form your own action plan. Check out APHA’s violence prevention page to learn more about gun violence in the U.S.
You may also contact the APHA MCH Gun Violence Prevention Working Group at GVPpolicy@gmail.com if you would like to learn what you can do in your community. Together we CAN prevent gun violence!
ACA and Health Care Reform: Where Do We Put Our Energies?
by Tammy Pulisuk, APHA Community Health Planning and Policy Development Section, Public Health Education and Health Promotion Section, Health Communications Working Group Section
2014 will be another defining year for health care reform because the most visible provisions, health care exchanges and expanded Medicaid coverage, actually start operation. This is a feat given all the political theater. Beyond misinformation campaigns, public health officials were prohibited from distributing ACA information in some states that did not sanction the law. Expect successes and failures to be examined, magnified and broadcasted.
Some public health colleagues point out that the ACA is a poor substitute for universal health care. As coauthor of APHA’s policy statement, “Public Health’s Critical Role in Health Care Reform,” I completely agree. The ACA is unlikely cure all our health care woes — key among them controlling costs, improving access and equity in underserved areas, and covering everyone.
So, what should health reform activists do? With the diverse and thoughtful APHA community, there is no one-size-fits-all-answer.
But here’s my two cents: The ACA is the largest federal health care reform passed in decades. It‘s a giant step forward, and perfect is the enemy of good. I think we owe it to the uninsured to help support its implementation now. Once rooted, it’s also our public health community duty to point out ongoing shortcomings in access to care. The good fight is far from over!
Assuming responsibilities: The key to oral and pharyngeal cancer prevention
by Vinodh Bhoopathi, Oral Health Section
Preventing the occurrence and progression of oral and pharyngeal cancer, or OPC — which claims thousands of lives each year —necessitates people assuming key responsibilities at three levels.
First, it is the individual’s and the public’s responsibility to reduce their risk for OPC. Avoiding the use of all forms of tobacco and using alcohol only in moderation helps prevent OPC occurrence. Human Papilloma Virus, or HPV, infection increases the risk for some forms of OPC, and HPV vaccination may reduce that risk.
The dental provider’s responsibility is to counsel patients on preventable risk factors for OPC and thoroughly examine a patient’s mouth and neck to identify all oral diseases, including OPC. Responsible dental providers should be highly motivated to learn about OPC and become competent in identifying and managing oral soft tissue lesions. If a dental health provider does not perform an OPC examination, the patient should request one.
Finally, it is up to policymakers to ensure that everyone has access to basic dental care, irrespective of gender, race/ethnicity or income. Through regular periodic dental visits the possibility of delayed diagnosis and the morbid or mortal consequences due to OPC can be averted. Prevention of most oral diseases, including OPC, can be achieved through the collective responsibilities of the public, health care providers and policymakers.
Advancing Data for Health Equity
by Winston Tseng, APHA’s Community Health Planning and Policy Development Section; Katie K. Lau, Kelsey A. Chun, and Dustin B. Bainto
Asian Americans and Native Hawaiians and Pacific Islanders constitute two of the fastest growing racial groups in the U.S., representing more than 50 ethnic backgrounds and over 100 language groups. However, they face many health disparities that are often overlooked.
Select major health concerns include:
- 12.5-37.5 times higher prevalence of Hepatitis B in Asian Americans compared to the total U.S. population;
- a 110 percent increase in diabetes prevalence for Native Hawaiians from 2000-2005, highest across all racial/ethnic groups; and
- 22.9 percent of Pakistanis, 22.5 percent of Bangladeshi, and 22.3 percent of Koreans lack health insurance compared to the 15 percent of the total U.S. population in 2010.
National data initiatives to fully understand AA and NHPI health fall significantly behind those of other racial/ethnic groups. Little or no national health initiatives have examined the major health conditions facing AAs and NHPIs and to fully understand the relevant prevention and health care strategies to improve their health.
There is also a lack of culturally and linguistically appropriate health services available. Key barriers to public health prevention and accessing health care services include poverty, low health literacy, lack of health insurance, immigrant status and limited English proficiency. Key solutions should include ensuring full language access, having an ethnic concordant workforce and having a stronger national voice to influence health policies.
Strategic data initiatives, especially involving ethnic community leadership, will be a critical for building the evidence base and fully defining the gaps and solutions. Advancing national AA and NHPI data initiatives can raise the visibility of their health issues and be a major step forward to ensuring that all Americans are counted.
Data advocacy is a critical stepping stone to ensuring prevention and health equity for all.