On Earth Day: Local efforts are making a difference on climate change

By Gretchen Musicant, BN, MPH, Commissioner, Minneapolis Health Department
and Patrick Hanlon, Director of Environmental Programs, City of Minneapolis

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The world-wide scientific consensus is clear: climate change is real, it is being driven by human causes, and we must act now to avoid its worst effects. However, it also clear that leadership in the fight against climate change will not come from Washington, D.C. anytime soon. The EPA is being targeted for huge budget cuts, and the U.S. withdrew from the Paris Climate Accord. In a heartening trend, businesses, community organizations, non-profits, states, counties and cities are stepping up to fill this leadership vacuum. Within this growing coalition there is one player that is often overlooked: local Health Departments. We have a unique perspective and the community connections to play a significant role in helping our communities adapt to the effects of climate change while also fighting against its causes.

In Minneapolis, we have set ambitious goals including the Climate Action Plan’s goal to reduce greenhouse gas emissions 30% by 2025. The Mayor and City Council joined together with our two local utilities for a first-in-the-nation Clean Energy Partnership. The Mayor and Council will soon bring forward a 100% Renewable Energy Resolution that lays out a road map to a desired future. Our long-term comprehensive plan embeds energy and carbon reduction throughout it. The Minneapolis 2040 Plan reads “To sustain a high-quality and climate-resilient Minneapolis, the City must also aim for greater energy performance from the city’s physical structures and environmental systems. This means ensuring all buildings, infrastructure and modes of transportation significantly reduce energy consumption and carbon production.”

The Minneapolis Health Department is playing a critical role in implementing and connecting these visions on the ground. Climate change will have a significant impact on the health of people in our community: high heat days, significant storm events, increases in disease vectors, and increases in air pollution are all likely to increase as the climate continues to change. Moreover, strategies to slow and prevent climate change will also make us more resilient to its effects, and even improve our current air quality.

In 2012, we started a unique program called the Green Business Cost Share Program (a NACCHO Model Practice) to address pollution. The program reinvests pollution fees that businesses pay back into a cost share model that helps businesses overcome financial challenges to positive change. It fostered partnerships with our dry cleaners that have made Minneapolis the first “perc-free” city in the country. Through this program we have worked with over 100 businesses—from dry cleaners and auto shops to larger industry—and have reduced over 65,000 pounds of criteria pollution annually throughout the city. In 2017, the Health Department applied this tool to our fight against climate change through energy efficiency work.

Photo by StevenGaertner/iStock / Getty Images
Photo by StevenGaertner/iStock / Getty Images

In 2018, we started our first solar energy incentive program because of the direct connection between cleaner energy use and our health. The program has received unprecedented response from solar developers, community organizations and businesses. We have increased our city-wide solar production nearly eight-fold in less than a year. That’s exponential change that outpaces the market. We have leveraged $15 million in solar investment within city limits. In just two years of increasing scope in energy work we have already reduced over 19 million pounds of CO2 emissions. That’s equivalent to taking 1,888 cars off the road annually. This is a good start but we are looking for ways to both significantly scale up and broaden this approach to drive even more impactful change.

The next step is in Green Housing, reinvesting pollution and energy fees into housing solutions that impact residential utility bills, improve health, and reduce greenhouse gas emissions. These are all promising steps that need to scale up to truly drive change.

As we roll out these ambitious goals we look at the work through a health equity lens. Minneapolis has developed Green Zones, or environmental justice areas, to recognize areas that are overburdened by pollution. We are investing more deeply in these areas that are overburdened and that were intentionally underinvested in for decades. We work with community-based organizations in both the commercial and residential sectors to connect these programs more deeply to the communities that need it most.

These are the kind of win-win solutions that have happened by bringing together unlikely partner organizations such as community organizations, the Chamber of Commerce and the Pollution Control Agency and our local utility companies. There is a long list of partners to thank that are involved in this work. Combined public-private-community partnerships make these effective voluntary approaches possible.

The Minneapolis Health Department is also bringing the fight against climate change to an unlikely place, beneath our feet. The Health Department uses tree planting, native planting and other regenerative urban agricultural practices such as biochar to engage the community and help drive change. Biochar is a soil amendment with many useful attributes that increases soil productivity by as much as 30%, reduces pollution runoff, keeps nitrogen in the soil and sequesters carbon for two to three thousand years. We are engaged in partnerships with our Native American community, urban farming groups, Parks and Recreation, public schools, and neighborhood organizations in tree, garden, and pollinator planting projects. This partnership work is increasing soil productivity, improving community nutrition with locally sourced food, and turning our soils into carbon sinks to slow down the effects of climate change. Biochar and regenerative agriculture are among the top 100 strategies in the fight against climate change.

These programs are fairly new but they demonstrate that we can significantly reduce carbon emissions into the air through energy efficiency as we assist our communities in obtaining locally-produced clean solar energy. Our community organizations, non-profits and businesses are already collectively saving over $1.3 million each year through the projects we have done with them, not a bad start.

Minneapolis serves as proof that local governments, guided by an environmental justice lens, can help drive real and significant progress in the fight against climate change. 

Making Public Health Visible

By Narintohn Luangrath, Special Assistant to the  Baltimore City Health Commissioner and
Dr. Leana S. Wen, MD, MSc, FAAEM, Baltimore City Health Commissioner

At a commencement ceremony several years ago, Dr. Linda Rae Murray, then-president of the American Public Health Association, recounted a famous saying: “When public health works, we’re invisible.” She followed that by urging the graduates to “refuse to be invisible, because […] we need to lend our strength and our science to broad social movements whose goal is to make things better.”

When public health is invisible, we only end up talking about it when things go wrong; people tend to think about public health agencies as entities that respond to infectious disease outbreaks or shut down a restaurant due to health code violations. We frequently think about health as healthcare, but what determines how long and how well we live is less about what happens in the doctor’s office and more about where we live, the air we breathe, and the availability of other resources in our communities. At the Baltimore City Health Department (BCHD), we believe that all issues – education, housing, employment, public safety, and beyond – can and should be tied back to health. We are committed to making the progress earned through public health visible, and to make the case for incorporating health-in-all policies across the City.

Wanted: Leaders for a TB-Free United States

By Joseph Iser, MD, DrPH, MSc, Chief Health Officer, Southern Nevada Health District

This blog originally appeared in County Line Magazine

 

Every year on March 24 the health care community commemorates World TB Day to bring attention to a preventable disease that still impacts many people in the United States and around the world. This year’s theme is “Wanted: Leaders for a TB-Free United States. We can make history. End TB.” It is a call for health care partners to work together on a local, national, and international scale to eliminate the disease.

Health care providers are instrumental in this process. For many patients, TB can present as a bad cold or respiratory infection that won’t go away. Physicians should always consider the possibility of TB when examining a patient with an ongoing respiratory infection, especially if it is accompanied by a persistent cough, night sweats, loss of appetite, and fatigue.

Seattle's Food Safety Rating System is One Year Old

In 2017, King County launched our new food safety rating system with the goal of making it the best rating system in the country. With a year under our belt, Public Health – Seattle & King County’s food safety team is proud to say that the new system has achieved measurable success.

  • Over 75 percent of all restaurants in King County now have easy to understand food safety rating signs in their front windows. This has greatly improved the ability for consumers to quickly assess the food safety practices at each restaurant.
  • Anecdotally, our food safety investigators report an increased interest from restaurant owners in improving their food safety practices, which means that the placards are motivating restaurants to do better. The number of perfect scores from all restaurants across King County increased 3 percent in 2017 from 52 percent to 55 percent.
  • The ratings provide a more complete picture of food safety than any other rating system across the country. Ratings reflect the trend of critical food safety practices over time in each restaurant and take inspector differences into account to make sure the playing field is level.
     

The 90 Days of the White House Opioid State of Emergency are up, and communities have little to show for it

By Chrissie Juliano, Director of The Big Cities Health Coalition

Today marks 90 days since the President declared the opioids crisis a public health emergency, and the White House announced last week that it would extend the declaration for another 90 days. To date, little has changed in the federal approach to the epidemic, and unfortunately, the emergency declaration has amounted to little more than administratively nibbling around the edges of a major national public health crisis.  Simply extending the emergency declaration does little to address the epidemic. What is needed is funding and leadership at the federal level.

Measles: An Ongoing Challenge to Prevent and Control Reintroduction Outbreaks

By authors including Jeffrey Gunzenhauser, MD, MPH, Interim Health Officer and Medical Director
and Franklin D. Pratt, MD, MPHTM, Immunization Program, Los Angeles County Department of Public Health

Since measles was eliminated from the United States in 2000, efforts to control reintroduction outbreaks have faced a variety of challenges. An outbreak in California was largely isolated to Los Angeles County and primarily affected a single social group in which anti-vaccination beliefs and behaviors prevailed. The outbreak resulted from a single individual who acquired infection from an unknown source, developed rash on Dec. 2, 2016, and subsequently exposed siblings and other contacts. This produced a clear chain of transmission. In total, 24 cases resulted from this outbreak, with 18 occurring in Los Angeles County and six occurring in nearby jurisdictions.

What a Long Strange Year 2017 has been in Public Health: Historic Storms, “Banned Words,” and Deep Funding Cuts – Just to List a Few

By Chrissie Juliano, Director of the Big Cities Health Coalition

In 2017, governmental public health shined in our country. In the face of historic natural disasters in Texas, Florida, Puerto Rico, and California, public health staff on the front lines dedicated to serving the American people – no matter what – did their work and delivered. Many stayed behind when others fled, or travelled from their safe, dry homes to help those in danger, save lives, or clean up.

Fighting Flu in Big Cities: Lots of Germs in that Big Petri Dish

By Chrissie Juliano, Director of the Big Cities Health Coalition

Fighting seasonal influenza (the flu) is serious business. It may sound rather pedestrian compared to headline-grabbing diseases like Ebola or Zika, but fighting flu, and other such “routine” outbreaks, is what local public health departments do every day to protect lives.

In a moderate to severe year, seasonal flu kills more Americans than car accidents. Over the past 30 years, it’s killed anywhere between 3,000 and 49,000 people in single a flu season. It also costs Americans $87 billion in direct costs and lost productivity. In short, there are many reasons to fight flu.

Beyond Thoughts and Prayers

By Dr. Rex Archer, Director of Health, Kansas City, Missouri Health Department

After the trauma of the events surrounding the Las Vegas mass shooting, stories of horror and heroism unfolded from that horrible act.  My compassion and prayers felt somewhat hollow.  I am in a position to move my compassion to actions that make a difference and to save many lives.  That is why I am in public health. Yet, the enormity of the challenge seems daunting.

Acts of Nature are Public Health Emergencies

By Meredith Li-Vollmer, Public Health - Seattle-King County

The news from Hurricane Harvey has been heart wrenching. Among the memorable images that emerged was one of nursing home residents sitting in wheelchairs, waist-deep in flood water as they waited for help to arrive. As reported by the New York Times, among the thousands of posts to volunteer rescue groups were common pleas such as “East Houston, 9:53 p.m.: Needs evacuation, one elderly person in a wheel chair” and “Northeast Houston5:36 a.m.: He’s on bottled oxygen now, and running out. Nausea from lack of oxygen has already started.” As some of the most vulnerable in the community struggled, news also covered the toll that the hurricane has taken on the world-class hospitals in the Houston area who were well prepared with back-up generators but hampered by the extremity of the weather and flooded roadways to evacuate patients and bring in emergency vehicles, food, and supplies. Hurricanes and floods aren’t just acts of nature. They are also public health emergencies.

“Back to School” Season: Backpacks, school supplies and cancer prevention

By Dr. Julie Morita, Commissioner of Health, Chicago Department of Public Health

Flipping my calendar from July to August, always yields a sense of melancholy as I can see the less structured, long, warm days of summer rapidly disappearing and the busy, regimented, new school year entering into sight. While many people overcome the sorrow of the summer ending with “Back to School” shopping for backpacks, new clothes and school supplies, since becoming a pediatrician almost 25 years ago, I have sought consolation in knowing that “Back to School” means that millions of school-aged children throughout the US will be receiving health examinations and vaccines, which prevent serious diseases including measles, mumps, whooping cough, and polio.

How the Senate's Obamacare repeal bill would wallop the urban poor, and especially those who rely on Medicaid and public hospitals

By Dr. Mary T. Bassett and Stanley Brezenoff

If there was any hope that Senate Republicans could bring some sanity into the national discussion around the future of our health care system, such hope completely vanished on Thursday. Like the House's health care bill, the Senate's proposal is nothing less than an all-out attack on public health and our public hospital system, and its consequences will be devastating for New York City and the country.

Showing up for LGBTQ communities

By Jesse Chipps, HIV Planning Council Administrator, Public Health - Seattle & King County

June is National Lesbian, Gay, Bisexual and Transgender (LGBT) Pride Month, and each year at this time hundreds of King County employees, department directors and public officials march together in Seattle’s Pride Parade. Rainbow tinsel laden vehicles, bubble machines, and matching t-shirts pull the group together as One King County.

The Zika Fight of 2017

By Chrissie Juliano, Director of the Big Cities Health Coalition

Last year’s high profile infectious disease outbreak of the Zika virus is still fresh in our minds. While official announcements last week told Americans that the outbreak is waning in the U.S., all of the same conditions that created a Zika emergency last year are still present today. And just like then, the consequences of inaction are very real for those at risk, especially pregnant women and their babies. Unlike last year, we are also dealing with an Administration proposing an absurdly large –$1.2 billion – cut to the U.S. Centers for Disease Control and Prevention’s (CDC) budget in a way that would severely hamper its ability to fight, not to mention prevent, disease.

Combining Disciplines, Reducing Stigma: How Long Beach Incorporates Mental Health into Public Health

By Kelly Colopy, MPP, Director, Long Beach Health Department

May is Mental Health Awareness Month, which brings a heightened awareness and opportunity to support the mental and emotional health of those in our communities experiencing a mental illness.  As individuals and families, as well as communities and organizations, we are learning that we all know someone, often close to us, who has experienced some level of mental illness in their lifetime.  Nearly 1 in 5 adults (43 million) in the United States experiences a mental illness each year.  The impacts of mental illness diagnosis vary widely; some have serious impacts on the ability to perform major life activities.  Access to treatment has improved with the passage of the Mental Health Parity and Addiction Equity Act of 2008 and under the Affordable Care Act in 2010, yet more capacity for treatment is needed.  The conversations are increasing at the systems level as we work to grow healthy supportive environments and increase access to mental health resources in our community.  Yet, at an individual and community level, the conversations continue to be difficult.  The stigma, while lessened, still remains.

Four Ways We Are Measuring Affordable Care Act Proposals

By Patty Hayes, Director, Public Health—Seattle & King County

This blog originally appeared in Public Health Insider

Any reform or replacement for the Affordable Care Act should help people lead healthier lives. We believe that’s the underlying purpose for health care reform (while acknowledging that there are economic and other reasons to reform, as well). We’re tracking four key areas that help us measure each proposal.

Health Equity and Minority Health in Bexar County and the City of San Antonio

By Vincent R. Nathan, PhD, MPH, San Antonio Metropolitan Health District

Bridging Health Equity Across Communities" is the theme of this April’s U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) National Minority Health Month. Over the past month,  HHS OMH, with their partners, worked to raise awareness about efforts across health, education, justice, housing, transportation and employment sectors to address the factors known as the social determinants of health – environmental, social and economic conditions that impact health.  San Antonio, Texas joins DHHS in celebrating, and more importantly, recognizing the disparities in health among different groups.

Earth Day – A Celebration of Environmentalism and Environmental Justice for All

By Cynthia Harding, MPH, Robert Gilchick, MD, MPH and Angelo J. Bellomo, REHS, QEP, Los Angeles County Department of Public Health

Earth Day, celebrated each year on April 22, commemorates the birth of the modern environmental protection movement.  Started in 1970 during an era when pollution was rampant in our country, Earth Day is credited with bringing the concept of environmental protection into the national political agenda.  The first Earth Day was marked by massive rallies and demonstrations advocating for a healthy and sustainable environment.  In 2017, Earth Day will be marked by a national call to action around science, with a march in Washington DC and other communities throughout the nation.

The Chief Health Strategist Role in Tarrant County, Texas: Building Walkable Streets and Greener Food Carts

By Vinny Taneja, MBBS, MPH, Director of Tarrant County Public Health

Fort Worth and Arlington are both located in Tarrant County, a fast growing community of approximately 2 million individuals living within 902 square miles. Like many large urban communities, neighborhoods vary significantly by culture, race/ethnic background, income, education, green space, housing, crime and many of other social determinants of health.