BOSTON. The 123rd Running of the Boston Marathon to Include Expanded Deployment of Everbridge (Business Wire)

The Boston Athletic Association (BAA) has significantly expanded the role of Everbridge’s Critical Event Management (CEM) platform to communicate critical event updates and safety information to all of its volunteers during the 123rd running of the Boston Marathon, taking place Monday, April 15th. This year, the BAA will use Everbridge to provide real-time notifications to its network of nearly 10,000 volunteers preceding the event and during race-day events including start times, route updates or disruptions, and race completion. Additionally, medical tent personnel from local hospitals and the Boston Public Health Commission will be notified of health emergencies via Everbridge-powered text messages. Find out more here.

NATIONAL. Next FDA chief must continue fight against teen vaping, local health officials urge (CNN)

By Shefali Luthra

In an almost uniform response to the impending exit of Food and Drug Administration Commissioner Scott Gottlieb, city and county public health officials are urging the Trump administration to go bigger in its response to adolescents' growing use of e-cigarettes.

The issue, they say, is reaching crisis levels and many worry the FDA's much-touted efforts are falling short.

Read more.

NATIONAL. How a Measles Quarantine Can Lead to Eviction (The Atlantic)

By Olga Khazan

In June 2014, Rex Archer, the director of health in Kansas City, Missouri, quarantined five families during a measles outbreak because several of the families’ members had contracted measles. The residents were told to stay in their home and avoid returning to work for several days.

Quarantine is a necessary, though difficult, measure that public-health officials sometimes take for people who are unvaccinated or at high risk of contracting a very contagious illness. In the case of measles, quarantine can last three weeks. Breaking quarantine can be a crime—one Wisconsin man was recently charged with a misdemeanor for going to the gym when he was supposed to be confined to his home.

Read more.

NATIONAL. Government health officials meet Congress members (Homeland Preparedness News)

By Melina Druga

More than 80 local, state, and territorial health officials met Wednesday with Congress members with the goal of advocating for public health funding. 

The officials told Congress members that investing in public health agencies is critical to protect and promote health. Federal investment in public health has not matched the rate of inflation, the officials said, nor has it matched the health challenges affecting the United States.

Challenges include the opioid epidemic, improving immunization rates, infectious disease outbreaks, the need for more resources and employees at the local level, public health emergencies and extreme weather events.

The officials also are urging Congress to increase funding for the Centers for Disease

Control and Prevention (CDC) by 22 percent by fiscal year 2022.

Annually, $3.5 trillion is spent on health care, according to the Trust for America’s Health, but 3 percent is directed to public health.

The health officials included representatives from the Association of State and Territorial Health Officials, the Big Cities Health Coalition, the National Association of Local Boards of Health, and the National Association of County and City Health Officials (NACCHO).

NACCHO’s board of directors also met with CDC Director Robert Redfield and Robert Kadlec, assistant secretary for preparedness and response.

Read more.

NATIONAL. How a Measles Quarantine Can Lead to Eviction (The Atlantic)

By Olga Khazan

In June 2014, Rex Archer, the director of health in Kansas City, Missouri, quarantined five families during a measles outbreak because several of the families’ members had contracted measles. The residents were told to stay in their home and avoid returning to work for several days.

Quarantine is a necessary, though difficult, measure that public-health officials sometimes take for people who are unvaccinated or at high risk of contracting a very contagious illness. In the case of measles, quarantine can last three weeks. Breaking quarantine can be a crime—one Wisconsin man was recently charged with a misdemeanor for going to the gym when he was supposed to be confined to his home.

For the Kansas City families, it quickly became clear that the quarantine would take its toll. As Archer and his colleague Abby Edsall wrote in the November issue of the journal Health Securitythe families received food donations, but these were a mishmash of ingredients that didn’t form complete meals: peanut butter but no bread; a five-pound bag of dried cranberries; boxes of cereal without enough milk.

The health department persuaded the restaurants where the families worked to not fire them, but the families nevertheless faced steep consequences from avoiding work, according to Archer and Edsall. One family missed so many paychecks that they were evicted. Several people had their phones shut off after unpaid bills racked up. Ultimately, the health department had a collection among its own employees to raise money to donate to the quarantined families.

Much of this could have been avoided if the United States had a mandatory-paid-sick-leave policy, Archer and Edsall argue. The Family and Medical Leave Act of 1993 protects the jobs of some workers for up to 12 weeks for medical reasons, but it does not guarantee pay, and it doesn’t cover more than 40 percent of all American workers. Ten states and 33 cities have their own sick-leave policies, but still, 28 percent of American workers lack access to any kind of sick leave. The United States and South Korea are the only countries in the Organization for Economic Cooperation and Development that do not mandate paid sick leave.

The problem in the United States is especially pronounced among low-income workers, many of whom work in service jobs. In one survey, 63 percent of restaurant workers admitted that they cooked and served food while sick. Food-service workers are the source of most norovirus outbreaks. “We’re eating at restaurants where folks can have diarrhea and we don’t even know it,” Archer told me by phone. (In a statement, a National Restaurant Association spokesperson told me that the organization “supports companies having the flexibility they need to set HR policies and procedures that work for their individual businesses.”)

The question is one of growing importance as more and more measles outbreaks occur, and as contagious diseases such as Ebola make their way to the United States by air. About 1,500 excess deaths occurred during the 2010 swine-flu outbreak because people did not stay home from work.

“For residents caught in the crosshairs of an outbreak in a state or locality without paid sick-leave legislation,” Archer and Edsall write, “the cost of compliance can be loss of income, loss of job, loss of home, or the inability to care for and feed family members.”

NATIONAL. Big-City Health Officials Talk Opioid, Measles Epidemics (MedPage Today)

March 13, 2019

By Joyce Frieden

WASHINGTON -- The opioid epidemic, the measles epidemic, and the unintended consequences of marijuana legalization were some of the topics on the minds of big-city health commissioners as they convened here this week.

Like many other big cities, Columbus, Ohio has been hit hard by the opioid epidemic, Mysheika Roberts, MD, health commissioner of Columbus, Ohio, said at an event here sponsored by the Big Cities Health Coalition. "In Franklin County [where Columbus is located], we had a 581% increase in opiate overdose deaths from 2003 to 2017," she said, adding that about 450 people die from it every year. "The city has funded a comprehensive harm reduction program, conducted by one of our federally qualified health clinics; we provide naloxone training, HIV and hepatitis C testing, treatment referrals, and wound care."

Two of the city's more unusual efforts include several safe needle disposal boxes located throughout the city, which has reduced the number of needles discarded in parks and other public places, and a "surge notification system," under which the coroner's office, emergency medical services, police departments, and emergency departments alert other agencies via a conference call if they notice an unusually high number of people dying from overdoses or being transported to the hospital for overdose treatment.

"This helps us identify a concentrated area of overdoses," Roberts said. Two years ago, the notification system alerted officials to a high number of overdoses in a particular African-American community in Columbus. "We found a cocaine batch that had [been] contaminated by carfentanyl ... We were able to get on top of that quickly and made sure that people [in that community] had access to Narcan."

But funding such efforts continues to be a challenge, she added. "I know I'm not alone in that. We're going to continue to see more deaths in the community if we don't do something drastic to change things ... One area where we see a lot of [funds] draining is children's services; many children are becoming orphans" because their parents have died from drug overdoses.

The measles epidemic is weighing heavily on the mind of Rachel Banks, MPA, public health director of Multnomah County, Oregon, where Portland is located. "We're really focused on the measles vaccine exemption rate," specifically, the rate of "non-medical" exemptions where people seek exemptions for religious or philosophical reasons, she said, noting that the county is on its fifth recent measles outbreak.

In Oregon overall, 5.2% of children are unvaccinated due to a non-medical exemption; in Multnomah County, the rate is 6.1%. Similarly, Oregon has a statement measles vaccine exemption rate of 3.9%, compared with 4.3% for the county, she said, adding that the area's recent measles outbreak has increased vaccine uptake.

"We are concerned with disease spread and the impact on the healthcare system," said Banks. The county health system and the providers have used a joint plan to mitigate community exposures; that model has worked well. For example, "we had one outbreak in July 2018 -- we had three cases with no additional exposures after the first case, and stopped the subsequent spread, but it was very expensive and involved a highly skilled and trained staff."

There are two cost-related issues with the outbreak, Banks continued -- one is the cost of educating families seeking exemptions about the possible consequences, and the other is the cost of the outbreaks themselves. The policy solutions are clear: officials should take a balanced approach by supporting vaccines, while also working with affected families to convince them to take precautions to avoid spreading the disease.

Tomás Aragón, MD, MPH, public health officer for San Francisco, discussed the unintended consequences of marijuana legalization in his state. "In California, you can't consume cannabis in public, so people create consumption places," he explained. However, right now the prevalence of [cigarette] smoking is very low through decreasing demand and also through "de-normalization" -- making smoking not considered the cool thing to do. "So we don't want smoking to now start taking off, because they'll probably go beyond cannabis" and smoke tobacco too.

Clean indoor air and worker safety also could be affected by marijuana legalization, Aragón added, noting that under current state law, "workers are protected from second-hand smoke."

He is also concerned about the high potency of the marijuana being sold, some of which has a 90% level of its main ingredient, tetrahydrocannabinol (THC). "I feel like we're in the Wild West [of marijuana] ... I went to one retail place where the owner himself consumes cannabis 24/7 -- but only at a 25% THC level," said Aragón. Of the cannabis with 100% THC, the owner told Aragón, "I sell this stuff but I would never touch it."

Other health department heads discussed some of their successes. Virginia Caine, MD, director of the Marion County (Indiana) Health Department, where Indianapolis is located, said she recently testified before the Indianapolis City Council in support of a needle exchange program for the city. The day she appeared, Indiana's Attorney General, Curtis Hill, gave a press conference saying that needle exchange programs "enable drug addicts and make this a terrible epidemic for the young generation." Despite Hill's remarks, all 24 council members voted unanimously in favor of the program, Caine said.

HOUSTON. Houston earns praise for efforts to combat human trafficking (AP)

By Juan Lozano

Officials from more than 10 U.S. cities convened Tuesday in Houston to learn about its successes combatting human trafficking, a broad approach in which the city’s health department, restaurant inspectors and cab companies all help identify potential victims.

While human trafficking has typically been viewed as a law enforcement issue, the city in 2015 also began focusing on it through a non-law enforcement lens. That garnered praise from federal officials and interest from other cities wanting to mimic the strategies.

“It is a different way of doing things,” said Minal Patel Davis, special advisor to the mayor on human trafficking in Houston.

Officials with New York City, Atlanta, Dallas and San Francisco are among those attending the two-day meeting this week in Houston, which has long been seen as a hub for human trafficking due to its proximity to the U.S.-Mexico border and its diverse and large population.

A 2016 study by the University of Texas at Austin estimates that there are more than 313,000 victims of human trafficking in Texas. More than 234,000 are victims of labor trafficking, and nearly 79,000 are victims of sex trafficking.

At the time Davis was appointed to her job in 2015, it was the first municipal level position of its kind in the United States. Three cities — Atlanta, Chicago and Minneapolis — have since created similar positions through grant funding.

In Houston, Davis began working with the health department — training its inspectors to watch for signs of labor trafficking at the city’s 13,000 food establishments. Inspectors also handed out outreach cards to workers with the phone number for the National Human Trafficking Resource Center.

The city’s health clinics also included human trafficking awareness as part of its screening processes and a human trafficking case manager was placed at Ben Taub Hospital in Houston.

“City departments touch nearly all aspects of life. They are a great set of eyes and ears,” Davis said.

The city has also reached out to the local business and corporate community to raise awareness about human trafficking.

The parent company of Yellow Cab and Taxi Fiesta agreed to notify its drivers by email and text about possible signs of human trafficking with its customers as traffickers often rely on taxis for transportation.

In 2017, Houston passed a city ordinance that implemented a zero-tolerance policy for human trafficking in city service contracts and purchasing. The ordinance requires contractors that work with the city ensure that their supply chains as well as those of their subcontractors adhere with labor laws.

At Tuesday’s meeting, Mayor Sylvester Turner said the success of these various programs in Houston shows the city’s approach is working.

“The reality is, if we are not working to eradicate human trafficking in all cities, in all states and globally, you don’t win,” Turner said.

In October, Secretary of State Mike Pompeo recognized Houston as a national model for building anti-trafficking infrastructure at the municipal level during a meeting in Washington, D.C. of the President’s Interagency Task Force to Monitor and Combat Trafficking in Persons.

“The city now boasts one of the most comprehensive and forward-leaning anti-trafficking programs anywhere in the United States,” Pompeo said.

Ouleye N. Warnock, a senior human trafficking fellow with the city of Atlanta who attended Tuesday’s meeting, said her office is working to develop partnerships with the private sector to offer job opportunities for trafficking victims.

Warnock said she has also had to work to educate the public that human trafficking is not only about sex trafficking about also about forced labor.

Expanding funding to combat human trafficking is something that is being debated during the current Texas legislative session. Lawmakers are discussing providing an additional $60.8 million to establish an anti-gang and an anti-human trafficking task force, providing the Texas Alcoholic Beverage Commission $5.6 million to help spot human trafficking at bars and clubs and $500,000 to the Texas Department of Licensing and Regulation to help identify trafficking at salons and spas.

NATIONAL. Lawmakers urged to prepare for pandemics (Precision Vaccinations)

By Don Ward Hackett

A coalition of national organizations representing public health, healthcare providers, biotechnology companies, and researchers urged congressional leaders on December 6, 2018, to swiftly approve the Pandemic and All-Hazards Preparedness and Advancing Innovation (PAHPAI) Act of 2018. 

The PAHPAI clarifies the role of the U.S. Centers for Disease Control and Prevention (CDC) in preparing public health departments for disasters. 

And, this legislation delivers the tools to the CDC to improve biosurveillance capabilities to better detect new threats to Americans. 

And, taking lessons learned from Ebola cases, the bill helps develop specialized hospitals that are capable of responding to extraordinary outbreaks.

“This bill is a great step forward, but I hope we don’t restrict this legislation to perceived pandemic threats,” said Peter Jay Hotez, M.D., Ph.D., Dean for the National School of Tropical Medicine, Baylor College of Medicine.   

“Any new bill should include efforts to address and help the 12 million Americans I estimate living in poverty with neglected tropical diseases,” Dr. Hotez said, the author of Blue Marble Health: An Innovative Plan to Fight Diseases of the Poor amid Wealth. 

The bipartisan reauthorization bill, H.R. 6378/S. 2852, would strengthen America’s defense, preparedness and response to chemical, biological, radiological or nuclear (CBRN) attacks, natural disasters, and emerging infectious diseases. 

The groups added that “it would be a setback for our national health security to delay reauthorization until 2019.” 

“We believe that time is of the essence in reauthorizing these important authorities,” wrote members of AABB (formerly known as American Association of Blood Banks); AFSCME; the Alliance for Biosecurity; the American Academy of Pediatrics; the American Association on Health and Disability; the American Hospital Association; American Public Health Association; American Society for Microbiology; America’s Blood Centers; the Association of American Medical Colleges; the Association of Maternal and Child Health Programs; the Association of Public Health Laboratories; the Association of State and Territorial Health Officials; Big Cities Health Coalition (BCHC); the Biotechnology Innovation Organization (BIO); California Life Sciences Association; the Chicago Department of Public Health; the Council of State and Territorial Epidemiologists; Healthcare Ready; Health Industry Distributors Association; Infectious Diseases Society of America; the International Safety Equipment Association; Johns Hopkins Center for Health Security; Los Angeles County Department of Public Health; March of Dimes; the National Association of County and City Health Officials; the New York City Department of Health and Mental Hygiene; the TB Alliance; and Trust for America’s Health. 

H.R. 6378 and S. 2852 are under consideration in the U.S. Senate Health, Education, Labor, and Pensions Committee.

NATIONAL. A coalition of national organizations...this week urged congressional leaders to swiftly approve the PAHPAI Act of 2018 (Homeland Preparedness News)

By Kim Riley

A coalition of national organizations representing public health, healthcare providers, biotechnology companies, and researchers this week urged congressional leaders to swiftly approve the Pandemic and All-Hazards Preparedness and Advancing Innovation (PAHPAI) Act of 2018 before Congress adjourns for the year.

The bipartisan reauthorization bill, H.R. 6378/S. 2852, would strengthen America’s defense, preparedness and response to chemical, biological, radiological or nuclear (CBRN) attacks, natural disasters and emerging infectious diseases. The U.S. House on Sept. 25 passed H.R. 6378 and sent it to the U.S. Senate, which has been reconciling the bill with its version, the same-named S. 2852.

NATIONAL: FDA proposals target electronic, traditional cigarettes (Business Insurance)

By Gloria Gonzalez

The U.S. Food and Drug Administration has proposed new steps to limit access to flavored e-cigarettes by those under the age of 18 and ban menthol in cigarettes and cigars.

Technologies such as electronic nicotine delivery systems were developed as an alternative to cigarettes for adults, but new research from the U.S. Centers for Disease Control and Prevention show that e-cigarette use among youngsters is significantly increasing, FDA Commissioner Scott Gottlieb said in a statement on Thursday. From 2017 to 2018, there was a 78% increase in current e-cigarette use among high school students and a 48% increase among middle school students, with the total number of middle and high school students currently using e-cigarettes rising to 3.6 million, meaning 1.5 million more students are using these products than in the previous year, according to the new CDC research.

In response, the FDA’s Center for Tobacco Products will revisit its compliance policy as it applies to electronic nicotine delivery systems, including all flavors other than tobacco, mint and menthol, with a proposal to have these products sold in age-restricted, in-person locations and, if sold online, under heightened practices for age verification, according to the FDA’s statement.

“FDA Commissioner Scott Gottlieb got it right when he called e-cigarette use among youth an ‘epidemic’,” Chrissie Juliano, director of the Big Cities Health Coalition in Washington, D.C., said in a statement on Thursday. “And their action today is a step in the right direction. Most drug stores and gas station retailers will no longer be allowed to sell flavored e-cigarettes and additional restrictions regarding online sales should also help to stem the tide. This is a good start, but opportunities remain. These flavors are still available for sale on the internet to those over the age of 18, and brick-and-mortar specialty retailers will continue to sell highly addictive, traditionally flavored e-cigarettes to those ‘of age.’ Further, menthol and mint vaping products will also still be available.”

The agency will also put forth a notice of proposed rule making that would seek to ban menthol in combustible tobacco products, including cigarettes and cigars, according to the FDA’s statement.

“This closes a major regulatory loophole in the Tobacco Control Act and is long overdue,” Ms. Juliano said in the statement.

However, Gregory Conley, president of the American Vaping Association in Washington, said in a statement on Thursday: “No youth should vape and there is room for more rigorous enforcement to ensure youth are not accessing these products. However, this move by Commissioner Gottlieb will only serve to make it harder for adult smokers to switch to a far less harmful alternative.”

NATIONAL. Big cities need more epidemiologists, health officials say (Becker's Hospital Review)

Written by Mackenzie Bean

October 23, 2018 

Many major cities in the U.S. staff fewer epidemiologists than recommended by state staffing ratios, according to a survey from the Big Cities Health Coalition and the Council of State and Territorial Epidemiologists.

BCHC comprises leaders from the country's largest metropolitan health departments who share strategies to promote the health and safety of more than 55 million people, or 17 percent of the U.S. population.

The survey includes responses from 27 of the group's 30 participating health department leaders recorded from October to December 2017.

Here are four survey findings to know:

 1. About 18 percent of health departments do not have a dedicated leader to oversee epidemiology activities. A majority (78 percent) employ generalist epidemiologists who support a few or all public health program areas.

2. Every health department had an infectious disease and emergency preparedness program, but only 33 percent had a mental health program and 19 percent had an occupational health program. Lead epidemiologists were most likely to oversee infectious disease programs (85 percent), followed by maternal and child health programs (74 percent), and vital statistics programs (67 percent).

3. The 27 participating health departments employ a total 1,091 full-time epidemiologists. Overall, the departments would need to increase epidemiology staff by 40 percent to reach full capacity.

4. When asked to rate their department's capacity to conduct essential public health services related to epidemiology, leaders said they were most capable of monitoring health status (93 percent) and identifying and investigating community health hazards (78 percent). However, only 33 percent of leaders said their departments were capable of researching innovative solutions to health problems, and 41 percent said their departments could thoroughly evaluate population-based health services.

"Some cities are woefully under-resourced," the authors wrote. "Even in well-staffed departments, there is a perceived need for a significant increase in capacity."

NATIONAL. Daily on Healthcare: Republicans embrace key tenets of Obamacare (The National Examiner)

by Philip KleinKimberly Leonard, & Robert King

October 22, 2018

Local officials raise alarm about shortage of epidemiologists. Local health departments will need to grow their epidemiology staffs by 40 percent to meet public health emergencies, according to a report published Friday by the Big Cities Health Coalition and Council of State and Territorial Epidemiologists. A shortage of “disease detectives” would be particularly concerning amid the opioid crisis and the latest spread of paralysis-inducing acute flaccid myelitis.

Read more.

SEATTLE. ‘Heartless, punitive’: Health officials, immigrant advocates decry Trump proposal to limit access to green cards if using public benefits (The Seattle Times)

By 

Seattle Times staff and  Los Angeles Times

Health officials and advocacy groups are strongly condemning the Trump administration’s proposal to limit legal immigrants’ access to green cards if they use an array of public benefits, including Medicaid, food stamps and federal housing subsidies.

“This is not only bad for the health and well-being of the people most directly affected, it is bad for all of us,” said Dr. Georges Benjamin, head of the American Public Health Association, one of scores of health-care groups to criticize the administration’s proposal.

“We hope that this heartless, punitive public policy will be reversed,” Benjamin said.Among the major groups nationally calling on the Trump administration to withdraw the so-called public charge proposal – posted Wednesday in the Federal Register – are the American Medical Association, the March of Dimes and the American Hospital Association.

Read more.

NATIONAL. FDA hunts for more details on e-cig marketing (STAT)

By Megan Thielking

The FDA is expanding its investigation into how e-cigarette businesses might be illegally marketing their products. The FDA fired off letters to 21 e-cigarette companies — both manufacturers and importers — seeking information about about whether their products were on sale before August 8, 2016. That's the date when the FDA started requiring new or modified products to receive clearance before hitting the market. Meanwhile, leaders of more than two dozen urban health departments — from Austin to Boston — just sent a letter to FDA Commissioner Scott Gottlieb urging him to ban flavors in e-cigs and vapes.

NATIONAL. Big Tobacco is marketing vapes to our kids, so our city took them on and won — it’s the FDA’s turn now (The Hill)


By Tomas Aragon and Derek Smith

The FDA recently announced that it considers a new surge in teen e-cigarette use to be an epidemic, and will give e-cigarette manufacturers 60 days to prove that they are not marketing to kids. This is a very welcome move for those of us who have been pushing to prevent teen tobacco use. Our city recently took on the makers of e-cigarettes and won. The FDA should take San Francisco's lead and do everything it can to protect kids from Big Tobacco. Read the full article

NATIONAL: San Francisco Voters Uphold Ban on Flavored Vaping Products (The New York Times)

By Jan Hoffman

Despite a $12 million ad blizzard by a giant tobacco company, voters in San Francisco resoundingly supported a new ban on the selling of flavored tobacco products, including vaping liquids packaged as candies and juice boxes, and menthol cigarettes.

The measure, known as Proposition E, is said to be the most restrictive in the country, and health groups predicted it could serve as a model for other communities.

The vote had been expected to be close, but the final tally was 68 percent to 32 percent in support of the ban. Those results reflected a big miscalculation by R. J. Reynolds Tobacco Company, which had saturated the city with multimedia ads in four languages, likening the ban to Prohibition and invoking a black market crime wave.

Read More

SEATTLE. King County Wins Sex Ed Funding Case

By Katie Rusch

High fives were common in Seattle & King County Public Health’s Family Planning division this week. On Tuesday, a federal judge ruled the Department of Health and Human Services (HHS) illegally terminated a sex education grant King County was using to study the effectiveness of its FLASH curriculum.

Developed by Seattle & King County Public Health, FLASH has been the primary sex education program used by public schools in King County since it was developed here in the 1980s. Beyond all school districts in King County, the science-based program is used in 44 other states. While, anecdotally, King County program officials have had significant positive public feedback on the curriculum, the organization never had the opportunity to gather data to support their theories that FLASH reduces teen pregnancy and STD rates.


In 2015 that changed. As part of the Teen Pregnancy Prevention Program (TPP), Seattle & King County Public Health was awarded a five-year $5 million grant to study FLASH’s effectiveness. But in 2017, HHS decided to cut King County’s funding two years early, along with the funding to 80 others who received TPP Program grants. Their funding was set to end on June 30.

In February, 10 of those organizations (including King County) filed four seperate lawsuits against the federal government claiming the early termination was illegal.

“We’ve invested three years of taxpayer dollars and resources,” said Heather Maisen, of the Seattle King County Family Planning program. “It would have been three years wasted and promises broken.”

The FLASH curriculum is currently being studied in 20 schools in Minnesota and Georgia. That data could then be used by school boards across the country to help members decide whether or not to use FLASH.

Tuesday’s ruling delivered the fourth and final victory for the organizations suing HHS. Favorable rulings for the other plaintiffs came down in April.

In his ruling issued Tuesday, Judge John Coughenour referenced the three other previous decisions noting that HHS has “attempted to convince multiple courts of their position with no success” while ruling in favor of King County.

“This ruling is such a relief,” said Patty Hayes, the director of Public Health for Seattle & King County. “Our goal with FLASH is to improve the quality of what happens in classrooms across the nation and to protect our most vulnerable youth.”

Judge Coughenour added in his ruling that “HHS failed to articulate a satisfactory explanation for its decision to shorten King County’s project period. In fact, HHS never gave King County an explanation.”

In an August news release, HHS suggested “73 percent [of TPP grantees] either had no impact or had a negative impact on teen behavior,” but provided no proof. HHS has yet to not respond to Seattle Weekly’s repeated requests for comment on the issue.

While Tuesday’s court ruling doesn’t force the federal government to hand over the remainder of King County’s grant, it makes it more difficult for HHS to withhold the money. To end the funding, HHS would have to show King County violated the terms of the grant agreement.

Maisen said she sees no reason the funding won’t come this year calling the victory a “huge hurdle,” but not the “final hurdle.”

This case was just one of the Trump administration’s attempts to remove money from evidence-based sex education programs. Since 2015, funding for sex-education programs that promote abstinence-only or “sexual-risk avoidance” curriculums has increased by $45 million. If HHS succeeds in moving $110 million Teen Pregnancy Prevention Program dollars to these programs—something they alluded to in April—that would more than double the increase.

Maisen knows there is a “long road forward,” but she says this latest legal victory proves King County is on the right path to help the people that FLASH is really all about—the kids. “Our youth in this country are now going to be given access to information that is critical to the outcome of their health and their future goals.”

NATIONAL: Chicago health commissioner: Big Tobacco is targeting our youth and we must stop them (The Hill)

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

The U.S. Food and Drug Administration recently announced a crackdown on e-cigarette sales to minors, but before then, the city of Chicago had already taken matters into its own hands. The City Council passed an ordinance to require tobacco dealers to post warning signs at their doors about the health risks of e-cigarettes and other tobacco products. These signs, once designed and distributed, will also contain quit-line numbers to help our residents beat a nicotine addiction. 

The ordinance, introduced by Mayor Rahm Emanuel, reflects the nation’s growing understanding that e-cigarettes, also known as vaping products, are the latest effort by Big Tobacco to get our kids hooked on a risky and potentially deadly habit.

To be sure, our country has made strides fighting tobacco use, with declining rates of smoking and lung cancer deaths. In Chicago, we have reduced cigarette smoking rates by high school students from 13.6 percent in 2011 to 6.0 percent today, a record low. 

Yet, according to the Centers for Disease Control and Prevention Youth Risk Behaviors Survey the rate of cigar smoking (7.2 percent) and e-cigarette use (6.6 percent) is now higher than cigarettes among Chicago high school students. Even more concerning, 14.5 percent of students report tobacco use of any kind. Tobacco remains the leading cause of preventable disease, disability and death in the United States.

E-cigarettes hit the market in 2004 and since then we’ve seen their use rise dramatically. Nearly all e-cigarettes use flavored liquids that attract young people with names like Gummy Bear, Cherry Crush and Crème Brulee. Most e-cigarettes contain nicotine and harmful toxins, making them addictive and dangerous to youth, whose developing brains are more susceptible to addiction. Other tobacco products such as cigarillos and dip, which are known to cause cancer, also come in flavors that entice youth. 

Big Tobacco knows that marketing that focuses on flavors is effective at getting youth to start using. Such marketing, as well as tactics like cheap prices, coupons and a barrage of misleading messages, have led the public, especially young people, to vastly underestimate the health and addiction risks of these products. 

This misconception must be taken seriously, as tobacco use almost always begins in adolescence and young adulthood. The problem is worsened by the fact that some of today’s most popular vaping products, like JUUL, are designed to look like USB flash drives, making them easy for youth to conceal.

Unfortunately, the research is now clear that the use of e-cigarettes by youth is associated with an increased likelihood of progressing to cigarettes. For young people, tobacco use begets more tobacco use. 

In Chicago, knowing that prevention will save lives for generations, we have confronted Big Tobacco’s ever-evolving tactics through a robust suite of policies. Prior to our recent warning sign ordinance, we raised the purchasing age from 18 to 21, made cigarette prices among the highest in the nation, banned tobacco discounts and required that clerks ringing up tobacco sales be at least 21. 

We have targeted vaping by banning the use of e-cigarettes in public facilities, prohibiting the sale of flavored tobacco (including menthol) within 500 feet of high schools and becoming the first big city to impose our own e-cigarette tax.

Cities and states across the country should follow suit. And, the FDA should act immediately to ban youth-attracting flavors in all tobacco products, prohibit e-cigarette marketing to youth and reverse its 2017 decision to delay vaping regulation and allow risky products to remain on the market without undergoing agency review.

The fight against Big Tobacco isn’t over, despite our nation’s gains. Every level of government must enact bold, transformative solutions to meet the emerging threats to public health and equip young people to reject tobacco, once and for all.