Health care reform: Public health gets into the mix

Now that the health care reform bill is law, the money is out there and waiting to be spent. The Patient Protection and Affordable Care law, previously H.R. 3590, provided for a $15 billion prevention fund. Nonprofit organizations and public health officials are now looking to allocate those funds, and there is quite a bit of competition for the money.

This article from MSNBC and this one from Kaiser Health News discusses some of the pulls from different organizations. Paul Jarris, Exec Director of ASTHO (Association for State & Territorial Health Officials), is pushing for a big chunk of the fund to go directly to state and local health departments, who are hurting from the economy, having to cut back services and experiencing severe capacity problems. This table from ASTHO shows the various public health funding opportunities in the law.

Take a look - it's a lot of money, and a lot of organizations and agencies deserve some of it. But... a lot don't. It will be interesting to see how it plays out.

Lonely office links

It's 2 days before Christmas. All the CSTE-ers are off celebrating, leaving the lonely Jewish girl here. To work? Nah, to blog! So here are some links for you to peruse while you're getting away from your visiting families:

1. A New York dog is confirmed to have H1N1. The American Veterinary Medicine Association (and surely the National Association for State Public Health Veterinarians as well) wants to ensure the public that while the virus can be passed from human to animal, there is no evidence the virus can be passed from animal to human. No need to stop petting Fido.
2. Associated Content's health news section has come out with the Top 10 health stories of the decade. H1N1 is #1, while health care reform comes in at #9. Hm. Other stories that made the cut include food safety, screening tests, and the HPV vaccine (all stories I've blogged about here!).
3. The Washington Post reports that fewer people are getting tested for H1N1, which "proves" that the second peak has subsided. Has it? Could this just mean that fewer people are being tested because physicians are assuming flu-like symptoms to be H1N1? Fewer tested could just mean that.... fewer are tested, not that the incidence of H1N1 is declining.
4. This op-ed piece discusses One Health, the initiative/idea that animal and human health intersect in increasingly important ways. It is, indeed, a concept that is gaining ground, and so I encourage you to take a look.
5. This editorial in the NY Times discusses the end to abstinence-only funding for sex education programs. It includes an important quote:
   

   Ideology, censorship and bad science have no place in public health policy.

   
   

More links

1. Pneumococcal vaccine: Babies routinely get this vaccine, but older children, adults, and seniors need to keep it in mind too. This vaccine can protect those with underlying health conditions from getting pneumonia, a dangerous complication of influenza.
   

   "But because flu season lasts until May and more outbreaks are likely, some of those officials, including the top ranks at the CDC, have begun talking about the pneumonia vaccine, which they say could save thousands of lives a year and prevent debilitating effects of severe illness in many more."

2. Oh, that unhealthy Santa: Santa, the large jelly-bellied man who "visits" kids at Christmastime, sits around, gets pulled by reindeer, and eats cookies at every house he visits. What an unhealthy image for kids! This article suggests that Santa needs a carrot, not a cookie. And that's not even starting to talk about all the sick, snotty kids who sit on Santa's lap all day, every day this time of year. (Ew.)
   
   
3. Your tap water is legal, but is it healthy? This article discusses the outdated Safe Drinking Water Act, a 35-year-old law that covers a fraction of the thousands of potential chemicals and contaminants. And the effects of these contaminants may not be noticed until years after the exposure, making it difficult to pinpoint the source. The Environmental Protection Agency (E.P.A.) is looking into changing the standards:
   

   ".. Even the E.P.A., which has ultimate responsibility for the Safe Drinking Water Act, has concluded that millions of Americans have been exposed to drinking water that fails to meet a federal health benchmark.."

4. This very interesting blog post examines the latest health care reform proposal in the Senate for public health provisions. Examples include: focus on evidence-based medicine (we'll see how that goes over with the public - see the outcry about mammogram recommendations), emphasis on healthy communities and healthy lifestyles, authorizing the Epidemiology Laboratory Capacity program to increase surveillance capacity (yay!), addressing public health workforce shortages, and an emphasis on prevention.
   
   
5. Trust for America's Health has released a new report "which finds that the H1N1 flu outbreak has exposed serious underlying gaps in the nation's ability to respond to public health emergencies and that the economic crisis is straining an already fragile public health system." Surprise! The report scores states on their preparedness levels.
   
   
6. And finally, CSTE has released its 2009 Epidemiology Capacity Assessment report, which assesses states' capacity to perform essential public health services related to epidemiology and surveillance. Check it out!
   
   

Some headlines ... briefly

See below for more details, but this blog will be light this week due to our Annual Conference. But here are a few headlines to peruse:

Tom Frieden to take over CDC Monday
State public health laboratories in the spotlight
This article highlights how much states and counties are hurting.
A general public health opinion/human interest piece.
Is FDA regulation of tobacco a good idea or a bad idea? Hard to say, there are lots of arguments (which I cannot get into now with my current time contraints) but this article has quite an opinion!
I told you - H1N1 has not gone away. Click here.

"When public health is successful, nothing happens."

This is a great article about the "invisible hand" of public health.

"When public health is successful, nothing happens, and therefore there is no news to report. You will never see a headline citing how many people dined in a clean restaurant, avoided an injury or did not contract a sexually transmitted disease. However, when an outbreak such as listeriosis or the H1N1 flu virus occurs, there is panic."

So true! Public health officials deal all the time with the question of how to communicate this message. And it matters for funding, too. How does one communicate that ample funds are needed to prevent something from happening... to make sure that there is no news? In the example of H1N1, this article underscores that the country is prepared. Now, they're talking about Canada, but the same goes for the U.S. Pandemic plans are in place.

The author notes, "in fact, they will continue to promote the best science on how to enhance the health of Canadians, whether with respect to infectious diseases, chronic diseases, injury prevention or environmental health (topics that are not as sexy as pandemics)." Excellent point, Vivek Goel! There are many aspects of public health that are not nearly as exciting as infectious disease and pandemics, but they are hugely important public health issues.

Links for the week

The Kaiser Family Foundation reports results from a survey that show Americans find the HIV epidemic less urgent, even after the latest incidence estimate showed that more people than previously thought are contracting the virus each year. Interesting results - one would think public pressure to do something about the HIV epidemic would be even higher, but it's not.

Generally, public health is important! If you're reading this, the concept is nothing new - I'm preaching to the proverbial choir. This article brings home the point once again. Epidemiology and surveillance, clean water, disease treatment and prevention, food safety, and more. The author, Valerie Bassett, puts this very eloquently: "Who needs public health? We all do. Every resident of the Commonwealth - whether aware of it or not - relies on a strong, functioning public health system - a system that is greatly endangered. Without public health, there is no way for the Commonwealth to succeed in education, economic growth, environmental innovation, or civic engagement."

Take a look at this article about doctor shortages. While not directly public health, it certainly has an impact on public health.

In case you haven't heard, red meat isn't good for you.

See my next post for updates on swine flu!

Can foreclosures cause public health problems?

What a cool article!
The gist of it: foreclosures = abandoned homes = neglected swimming pools = standing water = mosquitoes = increased incidence of West Nile Virus. What a connection to make.

Other possible public health problems that might result from foreclosures:
- Environmental toxin exposures as homes sit and are neglected.
- Mental health concerns stemming from homeowner stress. (A fact sheet about mental health & public health, another fact sheet, and an article.)
- Injuries from neighborhood kids playing around the foreclosed house.

Any other ideas?

Cool video - Healthiest Nation in 1 Generation

This is a neat video.. check it out!

Health surveillance & the internet

This article discusses detecting disease outbreaks through the internet. Wow.. whoever thought! Shoe leather epidemiology goes high tech. There are several sites that do this already, and they are growing in popularity and are quite intriguing. (Click here. Or here.) But it does indeed seem to hold up, at least to some extent - tracking disease through internet searches does seem to correlate with disease trends. The article uses a Canadian listeriosis outbreak as an example and has a nifty graph.
Screen shot of Google Flu (the Georgia trends, of course!)

This is Public Health Video

Check out this organization: http://www.thisispublichealth.org/
They emphasize that public health is EVERYWHERE - and it's true! They also give information about public health careers, schools of public health, and more. Very catchy marketing!