SAN ANTONIO: After ‘Tobacco 21,’ Metro Health Director Seeks ‘Culture of Health’ for SA (Rivard Report)

By Roseanna Garza

March 28, 2018 (Rivard Report) -- Photographs and awards line the walls and shelves in Colleen Bridger’s office at the San Antonio Metropolitan Health District, mementos from her last job, in Orange County, North Carolina.

“[Before,] a big day for me would be one press conference and two meetings,” Bridger said of her job in Orange County, which has a population of just 135,000. When she took over as San Antonio’s Metro Health Director just over one year ago, she knew she would have to adjust to a much faster pace.

Bridger moved fast and aimed high during her first big push for change, successfully spearheading San Antonio’s effort to become the first city in Texas to raise the age for purchasing tobacco products from 18 to 21. She introduced the idea to City Council in November 2017, and it was passed just three months later.

She called the legislation, known as Tobacco 21, the “most significant public health policy that I will ever be involved with.”

Counterparts from the Big Cities Health Coalition, which comprises leaders of America’s largest metropolitan health departments, called the policy success “remarkable” given that little progress implementing Tobacco 21 has been made in other Texas cities despite overwhelming evidence of the positive health impact.

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BALTIMORE: COMMENTARY: Baltimore city is suing Trump administration over cuts to teen pregnancy prevention education (The Hill)

Baltimore City joined a lawsuit brought by Healthy Teen Network against President Trump, challenging a decision by the U.S. Department of Health and Human Services (HHS) to cut funding from evidence-based teen pregnancy prevention education.

In June 2015, the Baltimore City Health Department (BCHD) was awarded an $8.6 million grant to implement comprehensive, evidence-based teen pregnancy prevention education in all of the City’s more than 120 middle schools and high schools.

 

In July 2017, BCHD received notice from HHS that the grant period would be terminated two years early. This termination amounts to a reduction in overall grant funding to $5.1 million — a funding cut of $3.5 million. Despite multiple phone and written requests for explanation, Baltimore City has not received a response from HHS as to why our program is being terminated.

 

NATIONAL. Local Officials Urge Congress to Restore Teen Pregnancy Prevention Program Abruptly Cancelled by HHS

The Big Cities Health Coalition (BCHC) held a webinar - you can listen to a recording here - today featuring Patty Hayes, the Director of Public Health – Seattle & King County to discuss how Teen Pregnancy Prevention programs contributed to a dramatic decrease in teen pregnancy rates in her county, why Congress must act to fund them and why her county is suing HHS to protect them. 

Last summer, the U. S. Department of Health and Human Services (HHS) announced it would abruptly end grants totaling $200 million to 81 adolescent health projects across the country, which collectively serve 1.2 million young Americans. These projects are funded through the Teen Pregnancy Prevention Program (TPPP), a federal grant program grounded in evidence-based research, which provides important funding to diverse organizations working to prevent teen pregnancy in the U.S.

Officials in Seattle & King County in Washington State are challenging this decision in court and have filed a lawsuit to block HHS from ending these programs.  The programs are slated to be cancelled at the end of June 2018, rather than the original date, June 2020. Congressional action by March 23 is necessary to preserve the progress that the program has made in improving adolescent health.

NATIONAL. Tough Gun Laws Keep More Hands Off the Trigger: Study (HealthDay News)

By Dennis Thompson

MONDAY, March 5, 2018 (HealthDay News) -- Debate over the value of tough state gun control laws has reached a fever pitch following last month's deadly shooting of 17 people at a Florida high school.

Now, results from a new study indicate that such laws are potentially so effective they can prevent firearm-related murders on a regional basis, with the benefits extending into other nearby states that have more lax laws on the books.

States with strong firearm laws have overall lower rates of gun-related murder and suicide, according to the county-by-county analysis.

But counties in states with weak gun laws also appear to gain some protection from gun violence if they are located next to states with stronger laws, researchers reported.

Read more.

MIAMI. Guns kill about 90 people a day. Is that a public health threat? (Miami Herald)

BY DANIEL CHANG

dchang@miamiherald.com

February 23, 2018 05:55 PM

On the same day that a troubled former student walked onto the campus of Marjory Stoneman Douglas High School in Parkland and murdered 17 people with an assault-style rifle, at least 28 more people died from gunshots elsewhere in the United States.

Some of those gun deaths were matters of self defense or public safety. Some were suicides, which account for nearly two-thirds of all firearm deaths in America, according to the Centers for Disease Control and Prevention.

But even though doctors and public health officials have long considered gun deaths a public health threat — firearms kill as many Americans each year as die in car accidents — the CDC and state agencies responsible for reducing preventable deaths can do little when it comes to guns.

Read more. 

SANTA CLARA COUNTY. Federal budget cuts put Californians’ health at risk

By the Mercury News & East Bay Times Editorial Boards

Congress does have a doctor in the House. Fifteen of them, to be exact. And another physician in the Senate. So there’s no excuse for the appalling attack on health care in the budget deal passed by Congress on Friday and signed by President Trump.

Congress did fund the Children’s Health Insurance Program for 10 years. That’s the good news for 200,000 kids in the Bay Area who rely on it to meet their basic health care needs. But Congress came up with the funding for CHIP by grabbing $1.35 billion from the Centers for Disease Control’s Prevention and Public Health Fund.

“Pitting prevention against care and treatment is really a false choice,” said Dr. Sara Cody, Santa Clara County’s public health officer. “Nobody knows for sure how much the CDC will cut from California and Bay Area county budgets. But once again the importance of prevention is being short-changed.”

Public health keeps people, not surprisingly, healthier and out of the hospital. It’s as simple as that. Controlling outbreaks before they become widespread is an essential component of basic health care strategy. The CDC’s prevention budget supports vaccine coverage, enables states and counties to respond to infectious outbreaks, such as Ebola or Zika, and fights chronic problems, including diabetes, cancer, stroke and heart disease.

This winter’s flu outbreak demonstrates the importance of  public health funding. About 40 percent of Californians fail to get flu shots every year, and more than 160 under the age of 65 have died during the current flu season.

The value of the CDC funding became obvious in January 2016, after Santa Clara University student Bradley Sheffield contracted meningitis from an unknown source. The outbreak put the entire campus at risk.

The university’s quick action and the support of local public health officials stopped the disease in its tracks by providing thousands of students with emergency vaccinations. Sheffield recovered and was able to return to classes in the spring.

“The only reason we were able to be so nimble in response was because of the federally funded vaccines allowing the state to keep an emergency supply on hand,” said Cody. “It was 48 hours from the time we heard about the outbreak to the first shot in the arm.”

It’s an open question with the reduction in funding whether the state will be able to maintain a supply of emergency vaccinations for various outbreaks.

The CDC prevention and public health funding also provides crucial support in the East Bay. In 2016, Alameda County received a $500,000 grant to fight chronic disease, another $204,000 for smoking prevention programs and $65,000 to support its immunization program.

Benjamin Franklin was actually talking about fire safety when he said an ounce of prevention is worth a pound of cure. It shouldn’t be too much to ask Congress to be smart enough to know how foolish it is to stop protecting Americans from devastating outbreaks and diseases.

NATIONAL. 4 Health Programs (Other Than CHIP) That Congress Has Left in Limbo. (Governing)

By Mattie Quinn

It’s been more than 100 days since Congress missed its deadline to pass a long-term spending bill for the federal government. That has left the fate of many federally-funded, state-administered programs up in the air.

Most of the uproar around Capitol Hill gridlock is aimed at the Children’s Health Insurance Program (CHIP). It has historically had bipartisan support and covers 9 million children and pregnant women who don’t have employer-based insurance but make too much money to qualify for Medicaid.

In the meantime, the federal government has repeatedly released unspent funds to help states keep CHIP running. The most recent money is supposed to keep the programs afloat through March, but federal health officials warned last week that some states could run out this month.

Read more.

DETROIT. Detroit targets hepatitis A outreach: "What we're trying to do is reach people where they are". (MichiganRadio)

By Sarah Cweik

etroit is trying to fight a hepatitis A outbreak in the face of limited resources and low national vaccine supplies.

Detroit health department director Dr. Joneigh Khaldun talked about the city’s efforts to fight an outbreak of the viral liver disease on a conference call with other local and national health leaders Tuesday.

Michigan is one of a handful of states experiencing hepatitis A outbreaks right now. Michigan’s is one of the largest, with 610 cases and 20 deaths reported since August 2016.

Some of the highest-risk populations, including drug users and people experiencing homelessness, are also some of the hardest to reach. Khaldun says that’s especially true in Detroit, where the homeless population often means people living in transient housing spread out across the city.

So to fight the outbreak, “What we’re doing is trying to reach people where they are,” Khaldun said. That includes working with shelters, health clinics and other partners to screen and vaccinate people. In recent weeks, the health department has also brought on emergency rooms at the city’s four major hospitals to do that work.

The city is also following up with people in close contact with known hepatitis A cases. They can be protected if they receive a vaccine or immunoglobulin within two weeks of exposure.

“For every case that comes through and is associated with a city of Detroit resident, my team immediately responds to identify who those contacts can be, so that we can quickly get that person that post-exposure prophylaxis,” Khaldun sasid.

But that kind of follow-up is a challenge for a department with just three epidemiologists and limited resources. Another challenge: limited national vaccine supplies.

Khaldun says the city is relying on other health agencies to help supplement its efforts. The department is also purchasing more doses from private vendors, but can only get so much at a time. “So we’ve literally been every day purchasing 400 [doses], our max,” she said.

Read more.

NATIONAL. Local Health Officials: GOP Tax Reform Jeopardizes Our Response to Infectious Disease Outbreaks. (Route50)

By Quinn Libson

Local health officials are sounding the alarm about the ways in which the GOP tax reform plan, which was passed by the U.S. House on Tuesday, might jeopardize our country’s response to outbreaks of infectious disease—like the hepatitis A outbreaks happening at this very moment around the country.

The National Association of County and City Health Officials, which represents nearly 3,000 local governmental health departments, warned during a call on Tuesday with reporters that proposed tax cuts have the potential to result in the near elimination of the Prevention and Public Health Fund—a source of money that was created by the Affordable Care Act—due to automatic spending reductions triggered by the Statutory Pay-As-You-Go Act of 2010. Aside from making up 12 percent of the U.S. Centers for Disease Control and Prevention’s total funding, the PPHF makes local infectious disease response possible in several crucial ways.  

Read more.

LAS VEGAS. COMMENTARY: A prescription for reducing gun deaths (Las Vegas Review Journal)

By Joseph P. Iser Special to the Review-Journal

Over the past several months, our nation has endured multiple incidents of gun violence and mass shootings that hit especially close to home in Southern Nevada. Deaths and injuries related to firearms continue to be a leading public health crisis in the United States.

For the second year in a row, this number has risen, making it 12 deaths per 100,000 people, according to the Centers for Disease Control and Prevention. As a community that has experienced the all-too-real consequences of this alarming trend, we can no longer let this problem be put on the back burner as our politicians seek to appease the gun lobby.

In 2016, Nevada voters passed Question 1, approving background checks on private gun sales. Shortly after the election, Attorney General Adam Laxalt told Nevadans that the initiative was not enforceable, even though the question passed. As trusted members of a profession dedicated to protecting and preserving life, we present a united and authoritative voice to an issue that we feel needs to be addressed. We need to enforce the law.

Additionally, numerous professional health care organizations have issued position statements supporting stricter controls on assault weapons, firearm purchases and improved access to mental health and other resources. By using a harm-reduction approach to this issue, we can vastly improve the safety and security of our communities.

These measures can include:

■ Universal background checks on all firearm purchases. As of now, background checks are required for all firearm purchases at gun stores. In an effort to take precautionary measures, we must extend these laws to include all sales at gun shows, by gun dealers and private sales by individuals.

Read more. 

NATIONAL. Healthcare.done: ACA open enrollment comes to an end in 39 states (Politico Pulse)

By DAN DIAMOND (ddiamond@politico.com@ddiamond)

12/15/2017 10:00 AM EST

State, local public health officials sound alarms over House spending bill. The bill would slash the ACA's Prevention and Public Health Fund, which represents about 12 percent of the CDC's budget, by $6.35 billon over eight years.

That's sparked a furious response from the nation's largest public health groups — the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO) and the Big Cities Health Coalition — who warn that immunization programs, anti-smoking campaigns and other key public efforts will be sacrificed.

“You are just trading off one part of the health safety net for another and it will cost you more in the end by disinvesting in programs that prevent people from getting sick in the first place,” NACCHO Interim Executive Director Laura Hanen said in a statement.

Read more.

CHICAGO. Efforts in Chicago help narrow disparity gap in breast cancer deaths of black, white women (The Chicago Tribune)

 

Every June, without fail, Diane Walker got a mammogram. Cancer ran in her family, she said. Even her mother had it. Determined not to be next, she went year after year. She tested negative, year after year.

But in 2003, freshly retired, Walker and her husband went on a traveling spree. Walker went to the Bahamas, Bowling Green, Ky., back to her hometown of Waycross, Ga. So caught up relishing her retirement, she said, she went everywhere, except to her doctor’s office....

In the early 1980s, black and white women with breast cancer in Chicago died at roughly the same rate. Thanks to improvements in detection and treatment in the 1990s, the mortality rate for white women fell sharply — but it stayed about the same for black women. Between 2005 and 2007, the death rate for black Chicago women with breast cancer was 62 percent higher on average than for white women, according to a report by the Sinai Urban Health Institute in Chicago. From 1999 to 2005 in Chicago, an average of 90 more black women died of breast cancer than white women annually, according to a local task force.

Experts attributed the troubling trend — the widest breast cancer mortality gap of any major city in the nation — to a number of causes, key among them a lack of access to quality mammography and less access to quality treatment once diagnosed.

But in the past 10 years, partnerships between the city and groups like the Metropolitan Chicago Breast Cancer Task Force, founded in 2007, were created to reduce these disparities. Chicago now leads the nation in reducing the disparity in deaths among black women, said Anne Marie Murphy, the task force’s executive director — down from that high of 62 percent to 39 percent between 2011 and 2013, the most current period for which data are available.

“When we started, Chicago had disparity in breast cancer mortality that was higher than (the national) average,” said Murphy, who holds a doctorate in molecular genetics. “And though women biologically haven’t changed in that nine years, the system has.”

Now, Murphy said, Chicago is addressing the disparity with increased funding for quality mammograms, enhanced education and outreach programs, and other supportive services. This year, the city Department of Public Health invested $700,000 to increase breast health services for populations that have faced difficulties accessing quality care.

Read more.

BALTIMORE. Public Officials of the Year: Leana Wen, Health Commissioner, Baltimore

By Mattie Quinn

Leana Wen never had her sights set on public office. She was happy working as an emergency room doctor and lecturer in medicine in Washington, D.C. And when the position of Baltimore health commissioner came open, in 2014, she was only 31 years old. But a widely respected former commissioner urged her to apply for his old job, and she decided to go for it. 

There was no way Wen could have imagined what she was about to get into. Just a couple of months after she moved into her new post in Baltimore, riots erupted in the city following the death of Freddie Gray, an unarmed black man, in police custody. Wen leveraged the unrest to start a conversation about police brutality and poverty as public health issues. “If we care about our children and their education,” she said, “we should also care about lead poisoning in their homes. If we care about public safety, we should also address mental health and substance addiction and the huge unmet need there.”

Born in Shanghai to a family of Chinese dissidents, Wen emigrated to the U.S. when she was eight and grew up in Compton, south of downtown Los Angeles. She graduated college at 18 -- summa cum laude from California State University -- and then went on to become a Rhodes Scholar at Oxford, held a clinical fellowship at Harvard, and wrote a book called When Doctors Don’t Listen.

Read More.

NATIONAL. President Trump’s Says He Wants to Stop the Opioid Crisis. His Actions Don’t Match (TIME)

By Dr. Mary T. Bassett, Dr. Julie Morita and Dr. Barbara Ferrer 

Dr. Mary T. Bassett is the Commissioner of Health for New York City, a position she assumed in February 2014. With more than 30 years of experience in public health, Dr. Bassett has dedicated her career to advancing health equity.

Dr. Julie Morita was appointed as commissioner of the Chicago Department of Public Health (CDPH) in early 2015; under Dr. Morita’s leadership, CDPH developed and launched Healthy Chicago 2.0, a four-year plan to assure health equity by addressing the social determinants of health.

Dr. Barbara Ferrer leads the Los Angeles County Department of Public Health which protects and promotes health and prevents disease among L.A. County’s more than 10 million residents. Dr. Ferrer has over three decades of experience as a philanthropic strategist, public health director, researcher, and community advocate.

President Trump’s declaration of opioids as a public health emergency left jurisdictions across the country – including New York City, Los Angeles and Chicago, the cities and county we serve as health commissioners and director – scrambling to understand the actual impact that this legal action will have on our response to an alarming increase in drug overdose deaths. In our cities, 2,650 people died last year of a drug overdose, the largest number on record.

Given the public health emergency designation, answers to three basic questions will determine the significance of this action: How much funding for public health responses will states and cities actually be able to access to support a long-term response to this deadly epidemic; how those dollars can be used; and for how long new funds will be available.

Read more.

SAN FRANCISCO. The Intersection of Black Lives Matter and Public Health

Watch a new video created by the San Francisco Department of Public Health about how health connects to the Black Lives Matter movement.

Public health professionals have seen disparities in health outcomes along racial and ethnic lines for decades. Data point to disparities in life expectancy, rates of new HIV diagnoses, rates of viral suppression for those who are HIV positive, rates of emergency room visits due to asthma or heart disease, among others. With the Black Lives Matter movement elevating the discussion on disparities to a national dialogue, we asked public health professionals how they can use that momentum to inform their work. Take a listen to public health and social justice professionals from the Bay Area talk about how different sectors such as the economy, transportation, housing, and food can work together and use the national conversation on disparities to address health outcomes. Featuring: -Jessica Brown, San Francisco Department of Public Health -Dr. Muntu Davis, Alameda County Health Department -Dr. Joy DeGruy, author of Post Traumatic Slave Syndrome -Melissa Jones, Bay Area Regional Health Inequities Initiative -Krystal Robinson Justice, Bay Area Regional Health Inequities Initiative -Zachary Norris, Ella Baker Center for Human Rights -Veronica Shepard, San Francisco Department of Public Health

MARICOPA COUNTY. Feds cutting Tucson teen-pregnancy prevention funds. (The Arizona Daily Star)

By Stephanie Innes

Two programs to prevent teen pregnancy in Southern Arizona are in peril due to funding cuts by the Trump administration.

The U.S. Department of Health and Human Services will pull grant funding for its Teen Pregnancy Prevention Program, created by the Obama administration in 2010. The funding affects 81 sites, including sites in Tucson and Phoenix.

Officials with Child & Family Resources, a nonprofit Tucson social-service agency, are trying to figure out how to move forward after the recent and unexpected news that, come June, the organization will lose the final two years of a $7 million, five-year federal grant to prevent teenage pregnancy.

The lost money amounts to $2.8 million for evidence-based programs that have been reaching 3,000 Southern Arizona youths per year. Evidence-based refers to programs shown to improve measurable outcomes.

HHS emailed a statement to the Star that the Teen Pregnancy Prevention Program has shown “very weak evidence of a positive impact” and is proving to be a “poor use of more than $800 million in taxpayer dollars” nationwide.

Federal officials also cited a recent report that sexually transmitted diseases are at record highs as further evidence that the program was ineffective.

HHS says future decisions regarding the program will be guided by science and a “firm commitment to giving all youth the information and skills they need to improve their prospects for optimal health outcomes.”

But grant administrators in Tucson and around the country say the programs have proven effective in continuing a national trend of reduced teen pregnancies.

 

Read more.

CHICAGO. From the Notebook: City Official Appears on D.C. Panel. (Chicago Tribune)

By Katherine Skiba,

Dr. Julie Morita, commissioner of the Chicago Department of Public Health, will appear Tuesday on a panel on Capitol Hill to talk about funding for public health programs.

Morita on Monday said more federal money is needed to detect and respond to outbreaks of illnesses such as influenza, mumps, measles, whooping cough, meningitis and the Zika virus.

She worries that if insurance coverage for so-called essential health benefits is eliminated, fewer people will obtain vaccines and be screened for diseases such as breast and colon cancer. Such steps prevent disease or allow for early detection, Morita said.

A flyer for the panel discussion says just as with the nation’s roads and bridges, its public health infrastructure “remains antiquated and in need of modernization.”

Count her among opponents of a GOP effort in the Senate to dismantle Obamacare, which she said led to about 300,000 more Chicagoans obtaining health insurance. A recent study showed just over 9 percent of city residents are not insured, which she called a record low. 

The event is sponsored by the Congressional Public Health Caucus, a bipartisan group of House lawmakers including U.S. Rep. Jan Schakowsky, an Evanston Democrat.

Read more.

NATIONAL. Republicans Are Remarkably Good At Uniting Opposition Against Themselves (The New York Times)

By VIKAS BAJAJ and STUART A. THOMPSON SEPT. 25, 2017

Despite the likely demise of the latest Republican health care bill, it achieved one stunning feat: it united patient advocacy groups and most of the health care industry in opposition to it.

Four Republican senators have declared their opposition to the bill, one more than is needed to defeat it. Some of them were no doubt swayed by the size and diversity of groups that quickly stood up to oppose the legislation. Hospitals joined ranks with insurance companies, while insurers banded together with patient groups like the AARP. The legislation sponsored by senators Lindsay Graham, Bill Cassidy, Dean Heller and Ron Johnson was so objectionable that these disparate groups found common cause in opposing the bill.

Below, we list those we’ve been able to identify as for and against the bill. Conservative religious and anti-abortion groups favored the bill because it prevented people on Medicaid from using their insurance at Planned Parenthood clinics and prevented health care plans sold on the federal health care marketplace from covering abortion beyond existing limitations. This list is not complete, and we invite organizations that would like to be listed to contact us here.

ORGANIZATIONS

4SUPPORT

Christian Coalition of America

Family Research Council

National Right to Life

Susan B. Anthony List

Have we missed any? Let us know

110OPPOSE

Asthma and Allergy Foundation of America

AARP

Adult Congenital Heart Association

ALS Association

Alzheimer's Association

Alzheimer's Impact Movement

Academy of Nurtition and Dietetics

America's Essential Hospitals

America’s Health Insurance Plans

American Academy of Family Physicians

American Academy of Pediatrics

American Cancer Society Cancer Action Network

American College of Emergency Physicians

American Psychological Association

American College of Physicians

American College of Preventive Medicine

American College of Rheumatology

American Congress of Obstetricians and Gynecologists

American College of Surgeons

American Diabetes Association

American Foundation for the Blind

American Health Care Association

American Heart Association

American Hospital Association

American Liver Foundation

American Lung Association

American Medical Association

American Nurses Association

American Occupational Therapy Association

Academy on Violence and Abuse

American Osteopathic Association

American Psychiatric Association

American Public Health Association

American Society for Addiction Medicine

American Society for Radiation Oncology

American Society of Clinical Oncology

American Speech-Language-Hearing Association

Amputee Coalition

Arthritis Foundation

Association for Community Affiliated Plans

Association of American Medical Colleges

Association of Oncology Social Work

Association of Public Health Associations

Association of University Centers on Disabilities

Autism Society

Autism Speaks

Autistic Self Advocacy Network

Big Cities Health Coalition

Read more.