Houston

HOUSTON. Houston Braces for Another Brush With the Peril of Zika (The New York Times)

HOUSTON — With 4.5 million people in a hot, muggy metropolis built atop a bayou, America’s fourth-largest city, Houston, is a perfect target for the mosquito-borne Zika virus. But it may be better prepared than any other urban center to stop an outbreak...

The $1.1 billion in Zika funding that Congress passed last year runs out in September. The Trump administration seeks to cut the C.D.C. budget by $1.2 billion, to what the agency had 20 years ago.

Many county health departments depend on C.D.C. grants, and they have already been “eviscerated,” said Claude Jacob, president of the health officials’ association. Some 43,000 public health jobs were cut over the last decade.

“We need a contingency fund for epidemics,” said Dr. Paul Jarris, chief medical officer of the March of Dimes, which fights for Zika funding because of the danger to infants. “If we have a hurricane, FEMA doesn’t have to wait for months until Congress responds. Not having a fund just doesn’t make sense.”

Money is not the only obstacle to turning back the virus.

If there is no intense epidemic somewhere in the Western Hemisphere this summer, it will be hard to test any candidate Zika vaccine, said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.

For a valid study, between 2,500 and 5,000 people — ideally in several locations — must get either a vaccine or a placebo.

“If we get a big, big outbreak, we can get an answer about the vaccine’s efficacy by mid-2018,” he said. “If we don’t, it may take till 2020 or 2021.”

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NEW YORK CITY. Trump Victory Underscores the Important Role of Cities (Governing)

By William Fulton

In the middle of the most important urban renaissance in a century, the people of the United States have elected a president who lives in a 58-story mixed-use building in midtown Manhattan. Whatever you think of him, the president-elect is a man who ought to understand cities. He has lived in America’s largest city his entire life. He comes from a family that has developed and managed urban real estate for three generations. The glitziness of major cities -- New York, Chicago, Los Angeles, even Pennsylvania Avenue in Washington, D.C. -- has always had a magnetic appeal for him.

And yet Donald Trump’s election may be the most anti-urban act on the American political stage since the nomination of William Jennings Bryan 120 years ago, when the populist Nebraskan railed against New York bankers in a fiery speech at the Democratic convention. Trump’s political base is anything but urban. It is white, older, exurban and rural, and angry. His supporters are nothing like the Manhattan social elite he has always aspired to be part of. (He lost his home county 82 percent to 9 percent) They are more like the Archie Bunkers he lived among -- admittedly, as a rich kid -- growing up in Queens.

 

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HOUSTON. Battling AIDS in Houston Latin-American communities (The Hill)

This article originally appeared as an op-ed in The Hill newspaper.

by Chrissie Juliano, MPP, Director of the Big Cities Health Coalition

October 15 will mark National Latinx AIDS Day across America, which is an opportunity to take stock of the great strides made towards defeating the virus and eliminating the stigma it can create. (The term Latinx serves as a gender-neutral alternative to Latino/Latina).

Science has come a long way since HIV and AIDS became a part of the national consciousness in the early 1980’s, but as experts have learned, if those advances are not shared with everyday people, and if awareness about the disease and how to prevent it does not grow, then disease rates can continue to climb, despite breakthroughs in the laboratory.

This is where public health expertise makes the difference. According to the American Public Health Association, public health promotes and protects the health of people and the communities where they live, learn, work and play. Several American cities have created innovative strategies to lower AIDS and HIV rates by speaking directly to Hispanic residents – especially youth – about how they can be proactive in protecting themselves and their partners. The theme of the day this year is “Defeat AIDS, con GANAS” ('with our wholehearted efforts,') and perhaps no city embodies that spirit more than Houston. Policy makers all over the country should take notice of their work.

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MIAMI & HOUSTON. New Zika Cases in Florida Show U.S. Cities' Struggle Without Federal Funding (Governing)

After Congress left cities to fend for themselves, four new cases -- possibly the first to be contracted by mosquitoes in the U.S. -- suggest how difficult it is for them to combat the virus on their own.

BY MATTIE QUINN 

Congressional inaction on Zika funds has hampered efforts on the local level to stop the spread of the disease. That was more or less proven Friday when Florida Department of Health officials said it's highly likely that four new cases in Miami were the first to be contracted by infected mosquitoes in the U.S.

To date, there have been 1,658 cases of Zika in the continental United States. But so far, they've all involved someone who had traveled to a foreign country or had sex with someone who had recently been to a Zika-affected country.

President Obama in May proposed $1.9 billion to help combat the spread of the virus. Congress, however, was unable to agree on that number and left for recess without allocating any extra money for state and local governments.

Even if Congress does allocate Zika funding, local officials say they may already have missed an important window for combatting the virus.

“The real tragedy is that now is the time when you need the extra money and resources: July and August is mosquito control time all across the U.S.,” said Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine. “Everything from here on out is just going to be damage control.”

In the absence of federal funding, localities have been left to fend for themselves.

“The Centers for Disease Control is not going to fight this disease. This is going to be a fight almost exclusively at the local level,” said Hotez.

Beyond mosquito control, which is hardest in the summer months, Hotez says local health centers must start being constantly on the lookout for possible cases.

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HOUSTON. Troisi, Williams: Public health approach can stem gun violence Accidental shootings prompt experts to apply familiar safety measures (Houston Chronicle)

By Catherine Troisi and Stephen Williams

We have heard the statistics: Every year in the U.S., an estimated 30,000 persons die from injuries involving guns, including heartbreakingly, 1,500 children. Here in Harris County, gun accidents are now the second cause of accidental death among children. Regardless of where you stand on the role of guns in society, we would all agree that we need to decrease these numbers. We believe that taking a public health approach, similar to that successfully used to decrease deaths from automobiles, is the method we need to use to do this. According to a review of major achievements of public health done by the U.S. Centers for Disease Control and Prevention, six times as many people drove in 2000 as in 1925, and the number of cars increased by eleven­fold with the number of miles driven 10 times higher. One might therefore anticipate that more people are dying in motor­ vehicle­ related crashes ­ and yet the data show otherwise. The annual death rate (calculated per vehicle miles traveled) has declined by an incredible 90 percent. What improvements led to remarkable achievement? This decrease in motor­ vehicle fatalities is due in large part to the work of a physician, Dr. William Haddon, who applied standard public health methods to this problem. Public health workers/leaders/advocates took a three­pronged approach to increasing road safety targeting cars, roads and drivers through both technological advances and policies.

The 1966 Highway Safety Act set standards for both safer motor vehicles and highways. Car design was improved to afford better protection to occupants in case of a crash. New car safety features such as safety belts, shatter­ resistant windshields, head rests, etc., increased the likelihood that persons involved in a crash would survive and would suffer fewer or less severe injuries. Roads were redesigned ­ road reflectors, center stripes, breakaway sign and utility poles, improved lighting and guard rails were added to advance safety. While these changes led to rapid decreases in motor ­vehicle deaths, these were not the only improvements. Driver and passenger behavior changed due to a combination of laws, policy, and education, as well as changes in social acceptability of certain behaviors.

There was greater enforcement of laws against driving while intoxicated, underage drinking, open containers and requirements for safety­ belt and child­ safety seats. Graduated licensing laws aimed at beginning drivers enacted policies that make the process of learning to drive safer. Groups such as Mothers Against Drunk Driving helped change the social acceptability of DWI while other groups focused on the importance of using child safety seats. Other policies that have contributed to motor vehicle safety include car safety inspections, speed limit changes and traffic regulations. Preventing motor ­vehicle related injuries took the application of a public health approach using technology, policies and behavior change and the collaboration of specialists in these areas. According to Dr. Georges Benjamin, executive director of the American Public Health Association, "Time and again, a public health approach to solving health threats is a proven, evidence­ based approach to improving health and preventing injury.

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HOUSTON. Commentary: We can stem gun deaths the same way we lowered auto deaths (Austin-American Statesman)

By Cathy Troisi and Stephen Williams - Special to the American-Statesman

The news from Orlando has broken our hearts yet again. This was the largest mass murder in US history, but every year in the U.S., an estimated 30,000 persons die from injuries involving guns, including unbearably, 1,500 children. Regardless of where you stand on the role of guns in society, we would all agree that we need to decrease these numbers. We believe that taking a public health approach, similar to that successfully used to decrease deaths from automobiles is the method we need to use to do this.

Six times as many people drove in 2000 as in 1925 and the number of cars increased by eleven-fold with the number of miles driven 10 times higher. One might therefore anticipate that more people are dying in motor-vehicle-related crashes — and yet the data show otherwise. The annual death rate, calculated per vehicle miles traveled, has declined by an incredible 90 percent. What improvements led to remarkable achievement?

This decrease in motor-vehicle fatalities is due in large part to the work of a public health physician, William Haddon, who applied standard public health methods to this problem. Public health workers, leaders and advocates took a three-pronged approach to increase road safety targeting cars, roads, and drivers through both technological advances and policies.

The 1966 Highway Safety Act and the National Traffic and Motor Vehicle Safety Act set standards for both safer motor vehicles and highways. Car design was improved to afford better protection to occupants in case of a crash. New car safety features such as safety belts, shatter-resistant windshields, heads rests, etc., increased the likelihood that persons involved in a crash would survive and would suffer fewer or less severe injuries. Roads were redesigned – road reflectors, center stripes, breakaway sign and utility poles, improved lighting, guard rails were added to advance safety.

While these changes led to rapid decreases in motor-vehicle deaths, these were not the only improvements. Driver behavior changed due to a combination of laws and education as well as changes in social acceptability of certain behaviors. There was greater enforcement of laws against driving while intoxicated, underage drinking, open containers and requirements for safety-belt and child-safety seats. Graduated licensing laws aimed at beginning drivers made the process of learning to drive safer. Groups such as Mothers Against Drunk Driving changed the social acceptability of DWI while other groups educated about the importance of using child safety seats. Other policies that have contributed to motor-vehicle safety include car safety inspections, speed limit changes, and traffic regulations.

Preventing motor-vehicle related injuries required a public health approach using technology, policies, and behavior change. We need to use these tools to stem the tide of gun-related injuries. We need data about what works and doesn’t work which requires lifting the ban on research dollars to study this. We need to work with the gun industry to design safer “smart” guns just as we have safer cars. We need an understanding of which policies work, and which don’t, to protect people from injuries caused by guns. We need research into understanding and addressing violent behaviors including suicide prevention.

According to a statement by Dr. Georges Benjamin, executive director of the American Public Health Association, “health epidemics don’t end unless we intervene taking the best science about what does and does not work and using it. The epidemic of intentional gun violence can be reversed with a science-based approach. It happened with Ebola, it worked for automobile crashes and it can absolutely reduce gun violence.” To accomplish this, it’s time to reduce the rhetoric and have open conversations about this epidemic, agree on a common goal, and work together to reduce these preventable injuries and deaths. No more Orlandos.

Catherine Troisi is an epidemiologist and chair-designate of the American Public Health Action Board. Stephen Williams is director of the Houston Health Department.