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Health & Medicine at APHA

Health & Medicine Policy Research Group (HMPRG)
December 9, 2014
In November, members of the Health & Medicine staff and board joined health professionals from across the nation for the American Public Health Association’s (APHA) Annual Meeting & Exposition. This year’s conference was held in New Orleans and centered on the theme Healthography: How where you live affects your health and well-being. The conference was an invaluable opportunity for our staff and other public health professionals convene, learn, network and engage with peers.

Each year, after the conference, the Health & Medicine community comes together to reflect on what they’ve learned. We’d like to share some of those reflections from our staff and board so you can see some of the thoughts and ideas we found to be most memorable.

The Health & Medicine team at APHA: (from left to right) Bonnie Ewald, Erica Martinez, Wesley Epplin, Margie Schaps, and intern Renee Dubois.

Margie Schaps, Executive Director
For me, the most powerful session I attended at the 2014 APHA convention was titled Counting to Make People Count for Health Equity.  The session began with a discussion of the 2020 US census and conversations around the country about how to make the census and other population surveys reflect the reality of the US population. 

Counting all people can have profound implications for political representation and resource allocation.  These data affect our understanding of population distributions of health, disease, and well-being in ways that can promote health equity or worsen inequity.  A couple of interesting areas explored included the huge numbers of unauthorized Latino immigrants who came to the gulf coast after Hurricane Katrina to help rebuild and how difficult it is to count these people because of their mobility and their desire to remain unobserved.  These people are especially vulnerable to wage theft (in which their employers deny them earned wages) and crime victimization, especially street robbery, on-the-job injuries and lack of access to health care. Finally Becky Pettit from the University of Washington gave a powerful talk about the fact that most national surveys do not account for prison inmates, resulting in a misrepresentation of US political, economic and social conditions in general and black progress in particular.

Joseph Zanoni, PhD, Health & Medicine Board Secretary
The Occupational Health and Safety Section celebrated our 100 anniversary with looking back to the past and taking action for the future. We created a resolution on addressing the needs of temporary workers that was approved by APHA. Historian David Rosner offered a moving talk on efforts to address recognized hazards such as silica and lead and stated that we need to be able to define and express the collective narrative about workers and their health.  Linda Rae Murray, a fellow Health & Medicine Board member and former president of APHA, provided a moving response calling us to action given the high stakes for our families' health and that of the planet.

Bonnie Ewald, Program Coordinator
This was my first time attending APHA, and it was a very inspiring experience. It was great to be surrounded by folks with a belief in the systemic approach to improving health, and to hear about the wide range of academic work and program development that is happening around the country and the world.

In much of my work at Health & Medicine, I work on “transitional care”, by which we mean intensive support and care coordination, typically for older adults who are leaving the hospital and transitioning back into the community. There was one session at the conference focusing on care transitions, which I happily attended and saw some familiar faces at. Two of the speakers at the session were focused on transitional care as I described before. However, I was pleasantly surprised that the other two speakers were talking about care transitions in a completely different sense. One spoke of the transition that occurs when a young adult moves from seeing a pediatrician to seeing a family practice or internist as his/her primary care provider, and the other focused on the transition that occurs when a woman becomes pregnant and transfers from her primary care provider to her midwife or OB/GYN for prenatal care and labor and delivery care, and then back to her primary care provider after her post-partum follow-up is done.

In each of these cases, the speakers stressed the importance of collaboration and open communication among patient and providers in order to ensure vital information was not lost, and they each showed evidence that long gaps in the time it takes for a patient to connect with the new provider after a transition can be problematic and dangerous. Attending the session was very helpful in broadening my understanding of why transitions in general are a challenging time that the health system should be focused on.

Wesley Epplin, Policy Analyst
During a breakfast one morning during APHA, a student at the University of Illinois at Chicago School of Public Health shared her thought that every session ought to include a community activist, organizer, or other community partner.  Her conviction was strong on this point and it made me reimagine a conference at which, by design, most every session directly included the voices from communities who are impacted by public health problems and intervention, and those who are seeking to address health inequities within their own communities. 

Many APHA conference sessions already have such community partners included, and a great many researchers and practitioners engage in community-based or community-engaged participatory research.  Still, for me, I cannot help but imagine the potential positive ripple effects—of APHA making it a goal to consistently increase the number of sessions that directly include community voices—on learning, research, and practice.  This change could significantly influence the field to be even more deliberate about forming more equitable, long-standing, and authentic partnerships with communities our field seeks to help, which may help build more trust and power equity, both necessary for health equity. 

A couple of questions come to mind regarding prioritizing this type of change for future conferences: 1) Does/Should the process of reviewing abstracts provide scoring for whether or not community partners are involved (and thus encourage such partnerships)? 2) Do we allow enough spaces for free or reduced conference fees, and travel/lodging awards to make it affordable for community partners to attend?

Erica Martinez, Policy Analyst
The “Public Health Care – Post-Katrina” tour (organized by Spirit of 1848/Praxis Project APHA radical history) was the most impactful experience for me during this year’s APHA conference. On the tour we learned more about the closing of Charity Hospital, the city’s public hospital, and what that meant for the most vulnerable in New Orleans.  After Hurricane Katrina, Charity Hospital did not re-open. This meant the Safety Net Hospital for the city was stripped away—it wasn’t simply that health care access was inadequate, it actually didn’t exist anymore. Those who needed care had nowhere to go, the place many people knew as their medical home was closed. Standing outside the massive, empty art deco building that had over 500 beds, provided me with a greater appreciation for the Cook County Health and  Hospital System which continues to be the safety net hospital for many underserved communities .