Revisit our past State of the Public’s Health Conferences, both virtual and in person, from 2015 to the present.

Highlights from the 2021 10th Annual State of the Public's Health Conference

FThe University of Georgia’s College of Public Health (CPH) hosted its 10th annual State of the Public’s Health Conference virtually on October 14, 2021.

This year’s program featured discussions about mental health, salient health issues affecting rural Georgia, public health law, and COVID-19’s impact on Asian American, Native Hawaiian and Pacific Islanders communities.

For those who could not join us or would like to revisit our presentations, video recordings of the main session and breakout sessions are now available below. A written recap of the conference is also available here.

Main Program

Watch presentations from our keynote speakers and special guests:

  • Benjamin F. Miller, PsyD, President, Well Being Trust. 
    • Dr. Miller is a nationally recognized mental health expert who advocates for the need to make mental health an integral part of health care. As President of Well Being Trust, Dr. Miller oversees the implementation of the foundation’s strategies to have a real-world impact on America’s mental health and addiction crisis. He is also the author of the weekly newsletter – Mental: Fighting the fragmentation of mental health one policy at a time, where hundreds of subscribers gather to read about how everyday happenings are connected to mental health, and what actions they can take to address them.
  • Lemuel “Life the Griot” LaRoche, spoken word artist, author, and executive director of Chess & Community
  • Yvette K. Daniels, JD, Director of University Relations, Georgia Department of Public Health

Breakout Sessions

Minority Health – Asian Americans, Native Hawaiians, and Pacific Islanders on COVID19 and Getting Vaccinated: Results from a National Survey
  • Speakers: Juliet Choi, Executive Director, Asian & Pacific Islander American Health Forum
  • Moderator: Dr. Grace Bagwell Adams, UGA College of Public Health

Rural Health – Facing Three Salient Challenges in Rural Georgia: Aging, Mental Health, and Management of Chronic Conditions
  • Speakers:
    • On aging: Lisa Renzi-Hammond, Associate Professor, and Jenay Beer, Associate Professor, Institute of Gerontology, College of Public Health University of Georgia
    • On Mental Health and Suicide Prevention among Georgia Farmers: Andrea Scarrow, Director, Southwest District Extension, College of Agricultural and Environmental Sciences, University of Georgia
    • On Managing Chronic Conditions: Henry Young , Associate Professor, College of Pharmacy, University of Georgia
  • Moderator: Shellie Bardgett, MPH, UGA College of Public Health

Public Health Law – Public Health Law and the Response to COVID
  • Speakers:
    • Fazal Khan, Associate Professor, School of Law, University of Georgia
    • Greg Sunshine, Public Health Analyst, Public Health Law Program, Centers for Disease Control and Prevention
    • Ani Satz, Professor, School of Law, Emory University
    • Stacie Kershner, Associate Director, Center for Law, Health & Society, School of Law, Georgia State University
  • Moderator: Megan Bramlett, MPH, UGA College of Public Health

Highlights from the 2021 Virtual State of the Public's Health Conference

Due to COVID-19 pandemic, the University of Georgia’s College of Public Health (CPH) hosted its ninth annual State of the Public’s Health Conference virtually on January 12, 2021.

The pandemic highlighted the many barriers to health has also illuminated the path for the future work of public health — to focus on social determinants of health, forge new partnerships advancing public health efforts, and to address racial injustice as a public health problem. We did not want to miss an opportunity to share success stories and continue our dialogue on how we can work together to improve health for all in Georgia.

This year’s program featured discussions about racial equity in public health, the COVID-19 vaccine and vaccine hesitancy, and the collision of COVID-19 and the opioid epidemic in Georgia. Read our conference wrap-up here. For those who missed out, you can find links to video recordings of all keynote and breakout sessions below. Download the agenda for the full program.

Main Program

Watch presentations from our keynote speakers and special guests:

  • Amber Schmidtke, Ph.D., science writer, microbiologist, and public health educator, shares how she is translating data into action through her work making COVID-19 data accessible and understandable to the public;
  • SJ Anderson, MSW/MPH alumnae and spoken word artist;
  • Renée Branch Canady, Ph.D, MPA, Chief Executive Officer of MPH, broadens the discussion on health equity, cultural competence, and social justice, sharing the insights she has gained as a public health advocate, researcher, educator, and facilitator.

Breakout Sessions

Racial Justice and Health Equity
  • Speakers: Nadia Siddiqui, Health Equity Advisor, and Dr. Dennis Andrulis, Health Equity Senior Advisor, Texas Health Institute, presents on the HOPE Initiative and improving health equity in Texas.
  • Moderator: Carmelita Marrow, National Network of Public Health Institutes

COVID-19 Vaccinations and Vaccine Hesitancy
  • Speaker:  Glen Nowak, Director, UGA Center for Health & Risk Communication, presents findings from a new national study.
  • Moderator: Dr. Erin Lipp, UGA College of Public Health

Behavioral Health, and particularly the impact of COVID-19 on the ongoing opioid epidemic in Georgia
  • Speakers: Jim Langford, Substance Abuse Research Alliance (SARA); Neil Campbell, Georgia Council on Substance Abuse; Dr. Aaron Johnson, Institute of Public and Preventive Health at Augusta University; Kaitlin Merchen, Georgia Prevention Project, presents work on the collision of COVID-19 on the Opioid Epidemic.
  • Moderator: Dr. Janani Thapa, UGA College of Public Health

Slide Presentations

Highlights from the 2019 State of the Public’s Health Conference

The 8th annual State of the Public’s Health (SOPH) conference was held Thursday, October 22, 2019 and featured presentations from top national, regional, and state public health leaders.

Featured Keynote Speakers

  • Marcus Plescia, Chief Medical Officer of the ASTHO (Association of State and Territorial Health Officials)​ – “Science and Public Health”
  • Leslie Kantor, Chair of Urban-Global Public Health at Rutgers School of Public Health – “The State of Sexual and Reproductive Health Policy and Rights In the United States: Implications for Public Health”
  • Karen Holbrook, Regional Chancellor, University of South Florida Sarasota-Manatee – “HealthTech: New Age Technology in Public Health and Medicine”

Conference Briefs

Highlights from the 2018 State of the Public’s Health Conference

The 7th annual State of the Public’s Health (SOPH) conference was held Thursday, October 18, 2018 and featured presentations from top national, regional, and state public health leaders. View the conference program here.

Featured Keynote Speakers:

  • William Foege, MD, MPH, epidemiologist, Gates Foundation Global Health Senior Fellow, and former Centers for Disease Control and Prevention Director
  • Umair Shah, MD, MPH, Executive Director, Harris County Public Health in Texas, and NACCHO Past-President
  • Laura Magana Valladares, PhD, President/CEO, Association of Schools & Programs of Public Health (ASPPH), and Academic Dean, National Institute of Public Health in Mexico
  • J. Patrick O’Neal, MD, Commissioner, Georgia Department of Public Health

Conference Briefs

Infant and maternal deaths remain a challenge in Georgia, despite progress

By Emily Webb

While there are various efforts in Georgia aimed at reducing the risk of death and other adverse events among new moms and their babies, there’s still a long way to go, noted speakers at the seventh State of the Public’s Health Conference at the University of Georgia.

During a session at the Oct. 18 event in Athens, experts from The March of Dimes, Healthcare Georgia Foundation and UGA’s College of Public Health painted a grim picture of how well issues like maternal and infant deaths, preterm births and access to prenatal care are addressed statewide.

“We have a major challenge,” said UGA public health professor José F. Cordero, during a session on promoting healthy starts for mothers and infants. He and others highlighted some of the statistics they find most alarming.

For example, at 7.5 deaths per 1,000 live births, the Peach State ranked among the top ten worst in the country on infant mortality rates— which refers to how frequently a child dies before reaching his or her first birthday. That’s according to 2016 data from the Centers for Disease Control and Prevention. Nationally, the average rate was 5.9 deaths per 1,000 live births.

Georgia also has the highest maternal mortality rate in the U.S., at 46.2 deaths per 100,000 births, according to the 2018 Health of Women and Children Report from America’s Health Rankings, an organization that provides health-related data for policymakers, advocates and individuals.

Likewise, there is concern when a baby is born before 37 weeks of pregnancy, or preterm.  In fact, a report released by the March of Dimes one week after the conference found a slight increase in preterm births over the past year, rising from 11.2 percent to 11.4 percent.

The report reiterated that more work needs to be done. But health care workers continue to face several challenges addressing these problems, and one of the biggest issues is access to care, panelists said.

“High rates of preterm births in areas of the South are related to a separate issue, poor access to prenatal care,” Cordero explained. “These are the same areas [where] there are major limitations in access to obstetricians and midwives,” he said.

Access to proper pre- and postnatal care may also be limited due to lack of health insurance coverage. An estimated 19.4 percent of women in Georgia between the ages of 18 and 44 are uninsured, according to 2018 data from the America’s Health Rankings’ report on the health of women and children.

To turn things around, perhaps the state could benefit from more diverse approaches.

“Public health is not a one size fit all,” said Danielle Brown, director of maternal and child health at the greater Atlanta-area March of Dimes.

As an example, she discussed the March of Dimes’ implementation of a program called the Prematurity Prevention Workgroup, a group of healthcare and medical professionals that join together to offer prenatal care and education, and address disparities in priority areas in the state, among other efforts. The workgroups, originally launched in Savannah, bring pregnant women together in a group with providers to discuss labor, infant care, family planning and postpartum care.

“We wanted to develop a program that was a little more flexible,” Brown said, noting that the program serves a dual purpose. When moms bring their infants for regular checkups, the clinicians will also turn their focus to the issues the mother’s may be facing.

In another example of efforts underway, Andrea Kellum, a senior program officer at Healthcare Georgia Foundation, discussed Taking Care of You. The evidence-based program works to reduce adverse birth outcomes, like preterm births, sleep-related deaths and babies born with low birth weights through targeted community interventions.

Still, panelists agreed more work could be done, a message that was reinforced by the March of Dimes’ president, Stacey Stewart, in an announcement about the new report on preterm pregnancies.

“We must all come together to take concrete, common sense steps to reverse this alarming trend,” Stewart said. “By expanding proven programs and innovative solutions we can shift our healthcare system to improve treatment and preventive care for moms and lower the preterm birth rate. Birth equity is our goal; it can be reached.”

New partnerships, mixed-methods approach to improve community health outcomes

By Mae Eldahshoury

We can collect all the data in the world, but without designing and implementing policies, how useful can that data really be?

New data collection and implementation methods are two integral components pushing us to craft meaningful partnerships within our communities. At least that’s what Grace Bagwell Adams, assistant professor in UGA’s College of Public Health and principal investigator of the Athens Wellbeing Project, suggests is the driving force towards improving community health outcomes.

Adams presented at an afternoon session, “How to Win Partners & Influence Policy,” during the State of the Public Health’s Conference, held Oct. 18 on the UGA campus. Her presentation explored the partnership between the Athens Wellbeing Project and Envision Athens, a community-wide effort strategizing the community and economic development in Athens for the next 20 years.

“Our hope is that we have changes in outputs – changes in service delivery methods, mechanisms and target groups,” said Adams.

The Athens Wellbeing Project (AWP) serves to empower Athens with meaningful data in order to improve decisions and service delivery that impact the quality of life. Its core focuses on collecting information over a variety of domains, or issue areas, such as housing, health, safety and lifelong learning.

Because the Athens Wellbeing Project is not a policy-making organization, its partnership with Envision Athens is crucial to the development of long-lasting policies. “We have to take a mixed-methods approach,” said Adams.

AWP’s approach is three-tiered: representative sampling, collaboration across service areas and transparency in sharing results with the public. It aims to make data a public good and allow communities to understand how it impacts their daily lives.

Prior to her collaboration with Envision Athens, Adams found that many Athens organizations were engaged in needs assessments but were collecting data separately, proving to be inefficient. When these institutions come together, however, data can be collected on issues across the spectrum and allow organizations to work collectively on solutions.

Highlighted in the presentation were case studies on agriculture and behavioral health that proved the success of new partnerships.

The first case study focused on improving food security in Athens. Food swamps, a term coined in the public health sphere, were districts that contained little to no grocery stores with nutritious foods but had an abundance of fast-food restaurants. In response to this data, St. Mary’s Mobile Market changed its route to deliver more fresh foods to these food swamps.

Similarly, the case study on behavioral health found that areas where families could not afford health insurance or did not have access to mental health resources were supported by local hospitals and public safety groups.

These two issues, Adams explained, were only samples of how the utilization of data and partnerships can improve health outcomes.

“We finally have a mechanism to put the data to work. The vehicle is the strategic action plan that’s emerged at the local level,” Adam concludes. “The thing that’s going to make us the most effective is being inclusive of the partners we have at the table to move forward.”

Healthy food initiatives aim to combat the rising obesity epidemic

By Prajakta Dhapte

Lack of access to healthy food, worries about food insecurity and unhealthy diets are major concerns in Georgia, and several non-profit and government organizations are working diligently to address the issues.

Strategies such as community gardens, farm-to-school programs and food-sharing were among the solutions shared by panelists last month during the seventh annual State of the Public’s Health Conference at the University of Georgia.

Speakers from the Georgia Farm to Early Care and Education Coalition, Everybody Eats Fresh Free Fridays Network and Healthier Together outlined local initiatives.

But they also noted the limited scope of the efforts and said there is more work to be done to expand the positive outcomes to more communities across the state and nationwide.

Denise Everson, program development coordinator for Healthier Together, encouraged attendees to turn troubling health statistics into opportunities to deploy new strategies.

“When you get the prize for being a community with a high rate of obesity…it creates a unique opportunity,” she said. “Not only [to address] issues related to the obesity rate, but also chronic disease-related issues.”

That’s what led Healthier Together— a two-year initiative that uses federal funding to introduce community-based interventions— to Taliaferro County, about 90 miles east of Atlanta. There were no fast-food outlets in the county, but there were also no grocery stores.

“You would need to drive out of the county to find one. Which is why they identified access to healthy food as something that they wanted to work on as a community,” said UGA healthy living specialist, Courtney Brown. She was one of the panelists, and part of a university program that collaborates on local efforts.

Healthier Together introduced a community supported agriculture program that included a community garden, and a student-sustained vegetable garden that offers fresh produce at the local elementary school and an area farmer’s market.

A similar mission was outlined by the Georgia Early Care and Education Coalition, with a focus on children ages six and younger. “Starting early is our mantra,” said Roslyn Johnson-McCurry, a board member and trainer for the program.

The goal is to link young people to healthy produce, educate them about nutrition and engage them in hands-on activities, like gardening. “Children learn by doing,” said Johnson-McCurry.

The program is beneficial in multiple ways: “We are helping [teachers] develop a curriculum where the children are actively engaged. So they’re doing their own gardening and not just watching their teachers,” she said.

The early care program estimates it may affect the lives of eight million children enrolled in early child-care settings, by introducing them to the healthy behaviors that can have long-lasting effects, like reducing obesity rates. An estimated 22.8 percent of children ages two to five are overweight or obese, according to Johnson-McCurry’s research.

“Obesity places them at risk of what used to be adult onset diseases… or conditions you would normally see in older people like diabetes, high-blood pressure and cholesterol,” Johnson-McCurry said.

Still, while some programs are introducing better food choices into the community, others turned their focus to reducing food waste.

On a field trip to a local food bank, Savannah-area teenagers Ilya Snyder and Jonathan Gibson learned that unused food was thrown away at the end of every week. That inspired the 2012 launch of Everybody Eats Fresh Free Fridays, an effort to increase access to healthy foods for populations that face food insecurity, poverty and those living in food deserts.

Instead of allowing unused food to be tossed, the project collects it from the America’s Second Harvest of Coastal Georgia food bank and redistributes it to those in need. So far, the administrators say, it has distributed nearly 48 tons of produce to families in need, with about 180 individuals being served every Friday each month at all of its sites.

“What’s nice is we are solving two problems at once— connecting people with healthy foods and also preventing waste,” said Cristina Pasa Gibson, chronic disease prevention director of the Coastal Health District in Savannah and one of the founder’s mom.

Panel says Athens’ Oconee River Greenway provides path to improved health

By Mike Terrazas

At least since the development of New York’s Central Park, urban planners have recognized the public value and popularity of city green spaces. Research shows that even limited exposure to green spaces can have significant positive health impacts, and over the past few decades, the North Oconee River Greenway Trail has provided one such option for Athens-Clarke County (ACC) residents.

In a panel discussion that was part of UGA’s State of the Public’s Health conference, five community members offered a case study of the Greenway project and how it navigated the straits of government and public opinion to arrive at its present form as 6.5-mile network of trails. Titled “Greenways to Better Public Health,” the panel was held Oct. 18 in the Georgia Center for Continuing Education.

Public green spaces have been tied to a host of health benefits. Exposure to green spaces—even through windows or in virtual reality environments—has been associated with improved academic performance from students and lower levels of stress markers, such as heart rate and blood pressure, as well as lower levels of the stress hormone cortisol, said Jennifer Gay, associate professor in UGA’s College of Public Health.

Madeline Van Dyck, founding chair of the Oconee River Land Trust, showed a video about the Greenway’s beginnings after it was voted into existence by the ACC unified government in 1992. Van Dyck described the effort as a labor of love, honoring the many individuals who worked on the project both before and after 1992 as “the anatomy and physiology of leadership” who turned a legislative action into actual physical reality.

However the Greenway was not always embraced by ACC leadership, said Melinda Cochran-Davis, assistant director of ACC Leisure Services, who guided the audience through the Greenway’s meandering political path leading to. Nevertheless, she said, despite the ups and downs, its supporters persisted. “Athens is blessed because we have a lot of active, passionate people,” Cochran-Davis said.

Volunteers Jake Maas and Mark Ralston talked both about future plans for the Greenway and related trailways, but also about making creative use of alternate funding options. Maas, director of proposal enhancement in UGA’s Office of Research, serves as the Greenway’s communications and outreach chair and leveraged his grant-writing expertise to help the project land significant funding from the National Fish & Wildlife Service, in addition to the $10 million it secured in 2017 through a successful Athens-Clarke County T-SPLOST vote that will roughly double the current linear mileage of trails.

Ralston talked about the Firefly Trail, a planned multi-use path connecting Athens to Union Point, Ga., along 39 miles of unused railway. Ralston serves as general chair for the effort, which he acknowledged would be expensive—concrete trails, which he said are preferred for their durability, cost about $1.5 million per mile—but also said could literally pay off, citing a Georgia Tech study on the trail’s potential economic impact that determined it would be used by more than a million people and generate some $14.7 million for the local economy each year.

Hidden lead remain a hazard in Georgia’s schools and homes

By Alex Boss

Not enough is being done in Georgia to remove lead from the water systems that run beneath schools and local communities. And a growing mistrust of the water supply could have a negative impact on other public health initiatives, like efforts to tackle the obesity epidemic.

Those were some of the concerns raised by panelists during a session at the Oct. 18 State of the Public’s Health Conference at the University of Georgia. The panel focused on lead, an odorless hazard, that can negatively impact a child’s growth and development.

Journalists recapped an investigative report in which they not only found high amounts of lead in the water pipes of schools and other buildings statewide, but also very little oversight.

“There are a few states that require all schools’ drinking water and fountains to be tested for lead. Georgia is not one of them,” said Andy Miller, the editor and CEO of Georgia Health News.

A 2017 story Miller co-authored with Brenda Goodman, a WebMD senior news writer, said the current system leaves families in the Peach State “uninformed and unprotected.”

Meanwhile, UGA researchers said the poor water quality could also be a leaky valve in the nation’s attempt to address other public health concerns, like high obesity rates.

“The best practice we teach is to serve water indoors and outdoors and make it available as self-serve for our children,” said Caree Cotwright, an assistant professor in the College of Family and Consumer Sciences at UGA. But her team’s survey of childcare workers found fewer than 40 percent were providing water as the top alternative to sugary beverages like sodas.

“Something was going on,” Cotwright said. “Is it water mistrust?” Recent lead findings, she said, should raise alarm bells for many reasons.

For one, there is no safe level of lead in the blood of children, according to the Centers for Disease Control. Exposure to the metal can result in damage to the brain, slowed growth, and behavioral, speech and hearing issues.

Furthermore, it can be difficult to get to the root of the problem, as the symptoms of lead toxicity overlap with other conditions. “Lead poisoning in children can look like features on the autism spectrum,” Goodman explained.

At least four million households have children living in them that are being exposed to high levels of lead, the CDC estimates. According to the Environmental Protection Agency, a high-risk home is a home built before 1986 that has lead pipes. Other examples include homes with lead corrosion, where the metal from paint dissolves and leaks into the water supply.

The panelists are continuing to pursue research into the topic.

Cotwright, is planning to further study the cause for water mistrust among childcare providers. Her team wants to understand the factors that determine the choice of beverages served to children. She also believes that sharing tips on water safety and on how to properly test water for lead could help ease concerns for childcare professionals.

Miller and Goodman submitted the results of their lead investigation to the EPA, and the agency said it would begin conducting inspections and recording results more efficiently.

“We need to follow up on that,” Miller said.

In the meantime, Georgia Health News plans to look further into “hot spots” in the state, where test results have found high rates of children with too much lead in their blood to understand the reasons behind the statewide variations.

Highlights from the 2017 State of the Public’s Health Conference

The 6th annual State of the Public’s Health (SOPH) conference was held Tuesday, October 17, 2017 and featured presentations from top national, regional, and state public health leaders. View the conference program here.

Keynote Speakers

  • Laura Hanen, MPP, NACCHO Interim Executive Director and Chief of Government Affairs,
  • Claude-Alix Jacob, MPH, Chief Public Health Officer for the Cambridge Public Health Department and NACCHO Immediate-Past President
  • J. Patrick O’Neal, MD,  Commissioner, Georgia Department of Public Health

Conference Briefs

As rural hospitals, healthcare become scarce, telehealth still shows promise

By Emily Webb

Rural Georgia has a healthcare problem. Though one in five people in Georgia live in rural areas, only one in ten physicians practice in these areas. Hospital closures have become commonplace. All the while, rural counties consistently have higher rates of chronic disease, obesity, and infant mortality, compared to urban districts.

“We need to find other ways to get specialty care and get providers out to these rural communities,” said Mason Reid, a legal consultant with Boling & Company.

As an attorney serving the healthcare industry, Reid and his partner William Boling are witness to the changing landscape of healthcare. In their view, telehealth — technology used to deliver medical and health services to consumers — is the future of providing care to rural populations.

Their presentation at the State of the Public’s Health Conference in Athens, Georgia, on October 17 served to update the crowd of public health professionals and researchers of the current state of affairs of telehealth.

“Telehealth is such a critical tool in the toolbox right now,” Boling said, though rural communities have been slow to adopt it due to a lack of resources or infrastructure.

Telemedicine offers an option for care close to home. Now, many patients rely on hospitals to access basic health services like diabetes care. A wider adoption of telemedicine could help keep hospitals open, said Reid.

Since fall 2016, Jenkins County and Baldwin County hospitals have been sold in distress. Jefferson County and Monroe County appealed to their communities, which agreed to extra taxes to keep their hospitals alive.

Due to Georgia’s decision to reject Medicaid expansion, Disproportionate Share Hospital payments (DSH) and Indigent Care Trust Fund payments (ICTF), both of which provide crucial financial support for hospitals that take on a majority of underinsured or uninsured patients, continue to peter out.

“For hospitals, especially, but for all rural providers, [it’s] a difficult environment that we’re in,” said Boling.

Boling and Reid are hopeful about the growth of telemedicine. In a recent study conducted by Kaufman Hall & Associates, 21 percent of respondents said they would choose to have video visits for middle-of-the-night care.

“Consumers are developing more of an appetite for this,” Reid said. “Maybe some of the stigma around telemedicine as being unsafe or unreliable is going away.”

Boling and Reid describes three models for telehealth, all of which have pros and cons for implementing in rural communities. The main hurdle, said Boling, for taking on any model for telehealth is the novelty of it.  Healthcare providers and patients, he said, must be open to it.

Still, Boling and Reid remain optimistic. The proposed CHRONIC Care Act, which is currently making its way through Senate committees, would expand telehealth with federal funding.

“High-end specialists and subspecialists can grow a business model around this [bill], and the local community hospitals and the local community patients all benefit. It’s a win-win-win-win,” said Boling.

CDC program improves prenatal testing for HIV

By Prajakta Dhapte

Prenatal testing for Human Immunodeficiency Virus (HIV) is a crucial method for preventing the transmission from mother to baby.

“CDC stats show that, the sooner a pregnant woman gets linked to care or intervention, her chances of delivering a HIV infected baby is reduced to a mere 1 percent,” said Marcie McClellan at the State of the Public’s Health Conference in Athens, Georgia, on October 17th.

Although there has been a significant drop in the number of perinatal HIV infections since the 1990s, it still remains the most common route of infection in children according to CDC reports. In Georgia, the mother to child HIV is higher than the national rate, according to the Enhanced Perinatal HIV Surveillance.

Early intervention in the form of routine HIV testing, anti-retroviral (ARV) drug therapy, caesarean delivery, education and support on avoidance of breast feedings are some of the crucial steps that may help prevent transmission.

In 2007, the CDC launched the One Test, Two Lives (OTTL) campaign, a nation-wide campaign which  provided obstetric providers with resources to promote universal voluntary prenatal testing for HIV for all pregnant women.

“According to a recent study, providers exposed to OTTL materials are more likely to include HIV testing as a regular screening test with pregnant patients,” McClellan said, who worked on developing content for the campaign with JBS International.

The CDC recommends an “opt-out” approach in which pregnant women are informed about the inclusion of the HIV test along with other standard prenatal tests and has the opportunity to decline the test. The opt-out approach has helped increase testing rates among pregnant women, said McClellan.

Although there are several interventions available in the market, there are still barriers preventing women from getting tested for HIV infections. One of the primary issues is the stigma associated with HIV testing. McClellan recommends that healthcare providers normalize the conversation about HIV testing.

“Make the talk about HIV testing a routine practice by incorporating it within the standard group of tests,” said McClellan. “Be transparent and provide all the necessary prevention and treatment information to the patient.”

Newer tools have been introduced by the CDC in order to make HIV testing more accessible and more conceivable for both OB/GYNs and pregnant women.

The Due Date Calculator, for example, predicts the estimated date of delivery and more importantly this tool highlights the ideal time to test a pregnant woman for HIV and provides reminders that it is never too late to test for HIV.

Other materials like fact sheets and posters that highlight the benefits of prenatal testing and explain the HIV test results to the patients and clinicians have also been made available by the CDC. Interventions like these and more will potentially help reduce the burden of perinatal HIV transmission and ensure a healthy future for newborn babies.

Georgia Dept. of Health aims to reduce word gap with new program

By Alex Boss

The more words babies hear during their first 18 months of its life, the better they can read by the third grade. However, some babies hear fewer words from their parents and fall behind in their reading skills.

Kimberly Ross is trying to fix this word gap by educating parents during visits to Woman, Infant and Children (WIC) clinics.

“The idea is to get the message to parents through work forces such as WIC clinics,” said Ross, who manages the Early Brain Development & Language Acquisition Program Manager at the Georgia Department of Public Health.

This initiative is part of the Talk With Me Baby project, which is led by six leadership organizations with the goal of bridging the word gap in babies. Ross presented an overview of the project and its goals at the 2017 State of the Public’s Health Conference in Athens, Georgia on October 17th.

The program presented educational information in two phases. Phase one focused on informing parents through video material.

“We played a video in the waiting room of the WIC clinics,” said Ross, “It was a passive approach.” The downside was that many parents did not remember the material.

In phase two, WIC nutritionists had direct tools they could use with their patients, including a flip chart, stickers and a fridge magnet. The flip chart featured graphics on one side and coaching language skills on the other for parents to use with their children. The stickers included fun facts or pictures, and the fridge magnet had description for language that tied into food.

Out of all the tools used with patients the fridge magnet was the most informative and influential.

“They learned the most from it,” said Ross, “Staff like the magnet because participants could pick a goal.” The flip chart also received positive reviews. “The flipchart was engaging and staff liked how visual it was,” said Ross.

A limitation of the study is the low response rate, says Ross, which was 23 percent. However, looking towards the future Ross spoke about other initiatives in motion outside of the WIC clinics.

“There’s a pilot going on for early care teachers and in the Grady hospital system,” said Ross. “They are becoming a Talk With Me Baby hospital, so we’re looking at them as a pilot, for building this ecosystem where everybody who works in a mother baby unit is trained. We are trying to see what is really going to support this language rich environment.”

Birmingham’s Greg Townsend offers model to improve health equity in divided communities

By Sydney Shadrix

“All I wanted was a box of Cracker Jacks.”

Then an eight-year-old boy, Greg Townsend remembers taking his 25 cents to the neighborhood corner store, which sat on the dividing line of the black community and the white community in Birmingham, Alabama.  Like many stores in the 1960s segregated South, one side of the store was designated for white customers; the other for colored customers. On this day, the division presented a problem for Townsend — only the white side had Cracker Jacks.

Townsend, who now serves as the health services administrator for the Jefferson County Department of Health in Birmingham, Alabama, was determined to get his treat.

“Being the man that I am—the young boy that I was—I walked over to the white side of the store to get my box of Cracker Jacks,” Townsend said.  “They told me as I was leaving, ‘You people — your people — shop on the other side of the store. You don’t come on this side.’ But, I still got my box of Cracker Jacks.”

Stores may no longer be overtly segregated, but for many in Jefferson County today, the impact of racial and ethnic divisions are reflected in access to quality health services.

“There are still people — still communities — searching for their box of Cracker Jacks,” Townsend told attendees at the State of the Public’s Health Conference in Athens, Georgia on October 17.

Health equity means that everyone has a fair opportunity to live a long and healthy life.  Unfortunately, Townsend explained, that is not the case in Jefferson County.

Single-parent households make up almost of a quarter of all households, and 26.3 percent of children are living in poverty. For every unemployed white person, two African Americans are unemployed. The infant mortality rate for African Americans is nearly three times higher compared to whites in Jefferson County.

Statistics like these illustrate how social determinants matter, Townsend said. “There is a 10-year difference in quality of life because of poverty and all of the other issues that we have,” Townsend said. “Ten years.”

To take on health disparities, communities must work together to address the divide. Better health can be achieved by promoting physical activity, creating a built environment, optimizing healthcare access, and improving mental health.

Yet, these goals cannot be accomplished by one person or by one health department.

Townsend suggested six principles for advancing health equity, which emphasize the importance of bringing community voices — those who have been negatively impacted by health disparities — to the table to develop, implement and evaluate new programs. in the development, implementation, and evaluation of new programs.

‘The time is now,” Townsend said. “We work in healthcare. We take care of people- from the wealthiest to the least, from the 99 percent to the one percent. The time is now for us in healthcare to take the leap if we’re going to create a health equity movement.”

Improving health literacy can play key role to prevent opioid misuse

By Chris Herbert and Dannie Parker

According to the CDC, approximately 140 people die in the U.S. from opioid overdoses every day. Georgia’s overdose rate is increasing faster than any other state, and having doubled since 2009.

Henry N. Young, the Kroger Associate Professor of Pharmacy at UGA’s School of Pharmacy, led a panel discussion on using health literacy as a tool to combat the state’s rising opioid addiction rates at the State of the Public’s Health Conference in Athens, Georgia on October 17.

Typically, a person’s initial exposure to opioids when they are prescribed by a doctor in a legitimate medical situation. However, not understanding doctors’ jargon or medical literature is directly affecting improper use of opioids statewide.

“At least 14 percent of adults have less than basic health literacy … and 9 out of 10 lack the skills necessary to manage their healthcare properly,” said Aimee Dyal, assistant professor of health promotion at Kennesaw State University

Thirty-two percent of patients receive no communication about their medications from providers and pharmacists, said Michael Crooks, pharmacist and care coordination and interventions technical lead with Alliant Quality. “In healthcare, we do a pretty poor job in discussing these medicines,” Crooks said.

The panel emphasized several techniques for providers to better convey messages to patients without high levels of health literacy. Use of plain language, focused message, visual cues, colors, symbols and “teach back” – requiring the patient or caregiver to explain in their own words back to the provider – have proven to be effective methods. Encouraging patients to be active and asking questions during the visits is vital.

Young stressed the importance of teaching patients about the dangers of incorrectly using the drugs and also about the unintentional harm drug sharing can do to the people they love.

Young was quick to quash the myth of the opioid epidemic being supplied by the illegal drug trade. “Drug sharing is not criminal like we think,” said Young. “Most un-prescribed opioids are given to someone from a family member or friend with the intention of helping that person.”

A muddled medication list also adds to the potential for opioid abuse. Patients with multiple providers are frequently overprescribed opiates, said Crooks. To avoid receiving double doses of opiates, patients and caregivers are encouraged to physically bring current medications to each medical appointment.

“You are the source of truth. Your medicines are the most accurate source that truth. I do best when I get to look at your actual medicines versus looking at a list,” Crooks said.

Young believes professional development education for local physicians and pharmacists will improve patients’ health literacy and help reduce opioid abuse. Working with the UGA Archway Partnership, Young is developing the program for the surrounding Athens area.

And there is more to come. Young is dedicated to combating substance abuse. “One of the things I really get jazzed up about- my overarching goal- is to help patients use medication safely and appropriately.”

Policy plans in the works to reduce opioid abuse in Georgia

By John Slights and Brittany Jefferson

Ohio, West Virginia, and Utah. When we talk about the opioid epidemic, it’s usually about these states, which have been the hardest hit by heroin and prescription drug abuse and overdoses. Thus far, the state of Georgia has not been a part of the conversation, but it may be soon.

“Georgia is number 11 in the country for heroin deaths per capita,” said Amanda Abraham, an assistant professor of public administration and policy at the University of Georgia. “We are what’s known as a second-tier state – we aren’t the worst of the worst when it comes to this epidemic, but we’re quickly rising and we’re not far removed from it at all. There is reason to be alarmed.”

Abraham was one of three panelists who spoke to Georgia’s growing opioid crisis at the State of the Public’s Health Conference in Athens, Georgia, on October 17th. The panel, which included Substance Abuse Research Alliance (SARA) director Jim Langford and Lawrence Bryant with the Georgia Department of Public Health, outlined the latest data on opioid abuse as reported in SARA’s recent white paper.

“In the United States, you can get heroin in almost 10 to 15 minutes upon arriving in any town,” said Langford.  “What makes this drug so dangerous is how easy it is to obtain.”

In 2016, there were 50,018 heroin-related deaths in the United States, but “the CDC estimates that number could be 40 percent higher, since a lot of heroin deaths remain unreported or are the result of a health condition related to the drug’s abuse,” Langford said.

Abraham added that 68.8 percent of all drug-related deaths in the state of Georgia for 2017 are estimated to be related to opioids or heroin.

“The main issue is that a lot of these deaths are taking place in rural areas,” Abraham said.  “People lack access to the proper resources for treatment and don’t have access to proper medical care, which is why we are seeing so many heroin-related deaths in these parts of the state.”

The white paper outlined eight strategies state legislators should consider in developing drug abuse prevention policy.

“We have to work together and collaborate,” Bryant said, who also offered an update on DPH’s simultaneous efforts to tackle the epidemic. “It’s going to take a team effort from public health officials and the public.”

Bryant advocated for increasing funding for treatment for heroin addicts in the state, as well as increasing access to treatment, largely for those addicted living in rural areas.

“We need to work together to change the culture for addicts, from one of shaming addicts to having compassion for addicts.  We must change the rhetoric.”

Bryant knows first-hand about the dark side of drug addiction and the salvation of rehabilitation. He was once addict himself before receiving treatment for substance abuse and turning his life around.

“Often times when we’re doing our work, we don’t always hear the stories of the people that were impacted,” he said. “On August 26, I celebrated 26 years of continuous sobriety. Once the work that we are doing can be implemented, people’s lives can be changed.”

SARA’s finalized white paper, which will provide a framework for legislators to enact the appropriate changes to decrease overdoses and improve access to treatment, will be available at the end of the year. The Georgia Department of Public Health’s fully-developed proposal to combat the heroin epidemic will be unveiled in early February of next year.

Two Georgias Initiative launches, seeks to reduce health disparities in rural counties

By Talia Levine

Four years ago, a series of hospital closings in rural Georgia highlighted a disturbing trend in the state’s healthcare landscape. As county health rankings continued to seat mostly rural counties in the bottom 10 slots, the disparities in access to and quality of health between urban and rural communities have become too obvious to ignore.

“This notion of ZIP code determines how long you live and how well you live in terms of health and health status is truly alive and well as it describes rural Georgia,” said Dr. Gary D. Nelson, president of the Healthcare Georgia Foundation, to a crowded auditorium at the State of the Public’s Health Conference in Athens, Georgia on October 17th. “ZIP code is becoming more of a factor than genetic code in describing the problems and the fate of rural Georgians,” he said.

It has been said that there are two Georgias in terms of economic vitality. Although originally offered in an economic context, the Healthcare Georgia Foundation recognized the applicability of this description to the health disparities between rural and urban residents of Georgia.

The foundation is dedicated to advancing the health of all Georgians and to expanding access to affordable, quality healthcare with an emphasis on underserved individuals and communities. The Two Georgias Initiative responded to the increasingly place-based inequities they noticed in health access and services.

“By that we mean the pursuit of creating conditions in which everyone has the opportunity to achieve their full potential through the elimination of disparities,” Nelson said.

The Two Georgias Initiative hopes to improve the lives of rural Georgians through partnerships with communities in need of support. The foundation awarded its first 11 Community Partnerships in June of this year. Among other criteria for selection, Nelson mentioned readiness and inclusion as two important qualities initiative-ready communities demonstrated.

Partner communities had to be willing to abandon traditional healthcare models and to explore new methods of delivering healthcare in their communities. These communities also understood the need for those most adversely affected residents to have a voice in an effective solution.

In the first year, grantees will focus on building partnerships in their communities, and creating a Community Health Improvement Plan (CHIP) and an Evaluation Plan. The second year will be devoted to implementation activities. Lisa Medellin, Senior Program Officer of Healthcare Georgia Foundation, noted that communities bring their own strengths to the program that will serve them well in this process.

“They are resilient communities. They have dedicated residents and engaged local leadership,” Medellin said. “Some of them have challenges—limited resources and fragile non-profit infrastructures—but they still do have a lot of assets.”

Grantees will also benefit from Healthcare Georgia Foundation’s partnerships with other organizations working towards bridging gaps in inequities. The Emory Prevention Research Center will provide capacity building to partnerships and assist with evaluation plans. Georgia Tech Health Analytics Group will translate data into formats more useable for important health decision-making.

Although the foundation has set up a scaffold for partner communities over the next two years, Nelson recognizes that health is an increasingly broad term, and that successful initiatives will recognize the myriad of factors that impact the health of a community’s residents.

“As the largest health foundation in the state, I don’t think anybody wants this foundation to stray from its health mission,” Nelson said. “Yet at the same time, we know we have to go upstream to truly move the needle on health outcomes, and to do so means we are going to have to figure out a way to address transportation, housing, poverty, jobs, you name it.”

The foundation knows that each community’s challenges will be different, and a technical assistance team is in place to assist them in identifying priorities. Central to the initiative is the tenet that each community must determine its own way forward. Although Nelson would love to see the program succeed and expand, he said the first step is for communities to decide what success means for them. Part of equity is returning control to the community.

“This is a movement moment as I like to describe it,” said Nelson. “This is about accelerating impact, it’s about delivering impact, it’s about measuring impact, and it’s about sustaining impact in rural Georgia, and we’re putting the control, the ownership, the flexibility and choice in the hands of rural Georgians to figure out how best to do that.”

UGA partners with, empowers rural communities to reduce obesity

By Lauren Baggett

Obesity is a serious and costly problem in Georgia, and the burden is greater in low-income, rural, and minority communities. Calhoun and Taliaferro are two rural counties in Georgia that, like most rural counties, experience high rates of poverty, chronic disease and obesity. In fact, around half of the people living in Calhoun and Taliaferro counties are obese.

But time and research have shown that reducing obesity requires more than encouraging communities to eat more vegetables and exercise more often.

“You can’t tell someone to walk more when there’s nowhere to walk. That’s a lost message,” said Courtney Still, program coordinator for Healthier Together Still presented an overview of the project, which just wrapped up its first year, at the State of the Public’s Health conference in Athens, Georgia, on October 17th.

Created through a partnership between University of Georgia Cooperative Extension, the College of Family and Consumer Science and the College of Public Health, the Healthier Together project tackles obesity from an environmental approach. The environment of a place — access to fresh food, access to safe places to exercise, social networks — dramatically impacts the health of its residents.

Extension staff in both counties gathered interested community members to form coalitions to create strategies to reduce and prevent obesity in their communities through education, promotion, and policy and environmental changes within the community. In the Healthier Together model, collaboration is key.

Coalitions include members representing diverse groups and organizations, including Family Connection, school systems, law enforcement, local businesses, and city and county government.

The coalitions had a hand in developing action plans for their communities, which included projects that would not only increase healthy eating and physical activity in the short term, but would also include environmental and policy changes that support health in the long term.

When the Healthier Together project began, the only place to buy food in Calhoun county was a convenience store. In July, the county installed its first community garden. Taliaferro held its first Bike Rodeo event, and the local school now has raised beds. In November, the coalitions met with a representative from Fresh Stop Markets, a CSA-type program designed to connect local farmers with communities lacking access to fresh produce.

Future projects will include a visit from an expert on building pedestrian-friendly infrastructures and a lesson on smart lunchrooms from Still herself. All of these individual steps, she says, will hopefully lay the path to behavior change.

“We’re trying to make the healthy choice, the easy choice,” said Still.

Highlights from the 2016 State of the Public’s Health Conference

The 5th annual State of the Public’s Health (SOPH) conference was held Tuesday, October 18, 2016 and featured presentations from top national, regional, and state public health leaders. View the conference agenda here.

Keynote Speakers

  • Alonzo L. Plough, PhD, MPH, Vice President of Research-Evaluation-Learning and Chief Science Officer at the Robert Wood Johnson Foundation
  • John Auerbach, MBA, Associate Director for Policy at the Centers for Disease Control and Prevention (CDC) and the Acting Director of the Office for State, Tribal, Local and Territorial Support (OSTLTS)
  • Mary Guinan, MD, PhD, Founding Dean, School of Community Health Sciences, University of Nevada, Las Vegas, and Author of Adventures of a Female Medical Detective
  • Brenda Fitzgerald, MD, Commissioner, Georgia Department of Public Health and State Health Officer
Highlights from the 2015 State of the Public’s Health Conference

The 4th annual State of the Public’s Health (SOPH) conference was held Tuesday, October 6, 2015 and featured presentations from top national, regional, and state public health leaders. View the conference program here.

Keynote Speakers:

  • Jeff Levi, Executive Director of Trust for America’s Health, will explore opportunities and challenges of advancing public health in a reforming health care system;
  • José Carlos León Vargas, International Cooperation and Development Director of Solidaridad Internacional Kanda, will share insights about creating inclusive communities that address health disparities;
  • Kaye Bender, President and CEO of Public Health Accreditation Board, will discuss the benefits and barriers to public health accreditation;
  • Brenda Fitzgerald, Commissioner of the Georgia Department of Public Health, will give an update on the state’s current public health initiatives

Conference Briefs and Commentary

The following video playlist features commentary from keynote speakers, organizers, and participants. All content, including the session briefs below, were produced by graduate students in the Health & Medical Journalism Program at UGA’s Grady College of Journalism and Mass Communication.

Introduction

By Sandra L. McGill

More than 300 health professionals attended the University of Georgia’s fourth annual State of Public Health Conference on Tuesday, October 6. It featured keynote addresses from Dr. Jeff Levi, Executive Director of the Trust for America’s Health, and José Carlos León Vargas, Director of the Solidaridad Internacional Kanda in Mexico.

Funding for the conference came in part from the Healthcare Georgia Foundation.
Also speaking at the conference were Dr. Kaye Bender, President and CEO of the Public Health Accreditation Board, and Dr. Brenda Fitzgerald, Commissioner of the Georgia Department of Public Health and State Health Officer.

Much of the day was devoted to workshops, where participants address critical topics including tobacco cessation and prevention, building a public health workforce, public health accreditation, ACA implementation and health literacy as a key to public health.
Scholars from throughout the state presented research findings in a poster session featuring more than 40 recent studies.

Looking back to the 2014 conference, “It’s a little humbling to think of all that’s happened in just one year,” said Dr. Marsha Davis, Associate Dean for Outreach and Engagement in the College of Public Health. In her welcome address, Davis cited milestones such as the Supreme Court’s upholding of the Affordable Care Act, the banning of smoking on Georgia campuses, the Ebola crisis, the Disneyland measles outbreak, and other incidents affecting the state, nation and world.

Davis also emphasized work that needs to be done. Although more Georgians have health insurance than ever before, the percentage of uninsured residents remains one of the country’s highest. Rural hospitals are closing, too many Georgians die of preventable diseases, and too many children live in poverty.

But Davis ended on an upbeat note. “Everyone has a role in public health,” Davis said. “We’re not alone—we’re all in this together.”

Audio Story about the College of Public Health’s annual SOPH conference
Video Commentary from Dean Phillip Williams, Dean of the College of Public Health
Video Commentary from Dr. Marsha Davis, CPH Associate Dean of Outreach and Engagement

Morning Keynote: Dr. Jeff Levi, Executive Director of the Trust for America’s Health

By Meera Naqvi

Keynote speaker Dr. Jeff Levi called public health “a broad and daunting landscape,” but he emphasized that the health of Americans be improved if public health professionals, medical providers, and social service agencies combine forces and work together.

The United States ranks at the bottom of a list of 17 industrialized countries on most health indicators, said Levi, Executive Director of the Trust for America’s Health. The conventional wisdom is that this happens even though “the U.S. way outspends other countries on healthcare,” he said.

But appearances can be misleading. If you add up what other rich nations spend on both healthcare and social services, their costs are very close to per capita spending in the United States. Health outcomes in the U.S. may be worse, however, because we lag the rest of the industrialized world when it comes to investment in services such as housing and education. Now that the Affordable Care Act is in place, the Centers for Medicare and Medicaid Services emphasizes that a national prevention strategy will mean better coordination of medical and social services. This makes sense, Levi said, because much of what affects health happens outside the four walls of the clinic, he emphasized.

“Investment in social services has a health return,” Levi said. The two most important social determinants of health are housing and education, and “the biggest predictor of longevity is income and or education status.”

Children who do well in school will be healthier for their entire lives, and an early start is key. Pre-school programs for children as young as three make a big long-term difference in health outcomes. “Early development is vital,” he said.

Stable, safe housing is also key; people with housing insecurity experience are more likely to become ill.

Levi points to Hennepin County, Minnesota, as a place where medical and social service agencies have partnered to successfully. Their integrative approach has improved the outcomes for residents while also cutting spending, Levi said.

Among their initiatives are a unified data system and an outpatient center that helps people recover from alcohol or substance abuse. The partnership takes a holistic approach, so that if a homeless person seeks medical care they will also receive housing assistance. Costs of care fall for someone who is safely housed.

“Yes, we’re doing God’s work in public health, but we also have to show return on investment,” Levi said.

Audio Story about about moving from treatment to prevention
Video Commentary from Dr. Jeff Levi

Lunch Keynote: Dr. Brenda Fitzgerald, Commissioner of the Georgia Department of Public Health and State Health Officer

By Erin Geoffroy

“Sometimes, we are tested,” said Brenda Fitzgerald, looking across a room filled with public health officials, scholars and students from throughout Georgia. Fitzgerald, the commissioner of the Georgia Department of Public Health and state health officer, was referring to the Ebola panic that shook the country last fall.

Between March 2014 and September 2015, more than 28,000 people were diagnosed with the potentially deadly Ebola virus, nearly all of them in three West African Counties. International travel restrictions snapped into place and Hartsfield-Jackson in Atlanta became one of only five United States airports where flights from  Africa were allowed to land.

Although two Ebola patients arrived at Emory University Hospital in Atlanta on August 2, public panic did not break out until October. That was when a Liberian man died in a Dallas hospital and two nurses who cared of him were infected.

Georgia’s leaders knew they needed a plan  Governor Nathan Deal quickly established an Ebola response team that included Fitzgerald, top law enforcement officials, the state medical examiner, funeral directors, and other key groups. The Department of Public Health sent letters to 40,000 physicians, providing guidelines for handling suspected Ebola patients.

Having a single information source for everyone was crucial. “Right from the beginning, we had a single number: 866-PUB-HEALTH,” said Fitzgerald.

Worried consumers could call for information. Hospitals called to report any suspected cases and to report how many beds they had available in case of an outbreak.

State leaders created several tools that would be useful if the spread of Ebola becomes a real threat in Georgia.  Fever is an indication of infection, and one of these was a smartphone app that medical personnel could use to send twice daily temperature readings to the department of health.

Fitzgerald is proud of the state’s efforts during the crisis. A legacy of the effort is a regional plan for coordinating outbreak response and transportation, which she said is now a model for other states.

Fitzgerald beamed when she said, “I believe that everyone was tested and found formidable.”

Audio Story about Georgia’s plan for ebola response
Video Commentary from Dr. Brenda Fitzgerald

Afternoon Keynote: José Carlos León Vargas, International Cooperation and Development Director, SiKanda (Solidaridad Internacional Kanda)

By Elizabeth Best

José Carlos León Vargas believes in the power of community. In 2009, Vargas had a revelation about changing the meager lives of the poorest of the poor in Brazil and Southern Mexico. He realized that people living in slums, and or subsisting on the edge of giant trash dumps, could transform their own lives if they learned to grow their own food and construct houses and schools from scavenged material.

Today he is the director of SiKanda, a nonprofit group he co-founded in 2009 with his wife. The name means “transformation,” or “change” in Mixtec, and that is what the organization strives to do in one impoverished community after another in the province of Oaxaca, Mexico.

In his keynote address, Vargas, encouraged a “bottom up” approach to helping others and working with charitable organizations. He emphasized how crucial it is to engage those who need help and educate them about using existing resources in totally new ways.

He also encouraged public health workers to focus one community at a time to have the biggest impact. His organization has helped more than 7,000 people in 12 locations in Oaxaca – but not all at once.

As a case study for his talk, Vargas focused on a group of people living on the edge of a landfill. Sixty-five percent of the adults are women, because most of the men have migrated north to find work. They lived in flimsy lean-tos and earned $2 to $3 per day. He described teaching the people how to use earthworms to turn garbage into compost, which they sold for money and used to grow their own vegetables.

earning to produce their own food helped the community members have a more economically sustainable lifestyle and to eat healthier diets. Sikanda makes healthy eating a priority in their programs because 10 percent of Mexico’s population suffers from diabetes.

SiKanda raised $400 from donors and set out help local people build small, sturdy houses for their families. Working from a plan developed for the project, Vargas bought some materials and helped fabricate construction materials from recycled materials found in the landfill. These houses protected families from potential illness and poor weather conditions.

People in the community want education for their children, and SiKanda recently
built a one-room school building and stocked it with books and furniture.

Vargas is now trying to raise social awareness about communities such as the one by the landfill. Privileged Oaxaca residents know Paris or London better than the outskirts of their own city, he said. So he is bringing them to look at some of SiKanda’s projects, hoping to build support.

New Directions in Tobacco Prevention and Cessation in Georgia

By Anshool Deshmukh

Three teams from the Georgia Department of Public Health shared the stage during the workshop on tobacco prevention and control. Oluwayomi Fabayo and his colleagues used small, mobile monitors to measure the indoor air quality establishments that are exempt from Georgia’s ban on smoking in public places. Sampling in five cities found that particles and chemicals remain in the air long after smokers extinguish their cigarettes, putting anyone who enters the environment at risk for adverse health effects, Fabayo reported. Although smoking has been prohibited in shops, restaurants and most workplaces since 2005, the Georgia Smoke-free Air Act exempts bars and 18-and-older establishments as well as designated smoking areas. These findings indicate that legislators should eliminate these loopholes if the goal is to guard Georgians against health dangers associated with secondhand smoke, said Fabayo, program and policy, advisor for the Georgia DPH.

Turning to help for smokers, Kayla Lloyd reported that promoting the Georgia Tobacco Quit Line to physicians pays off in terms of tobacco cessation. Doctors who participate in the Georgia cAARds Program makes pacts with doctors who agree to ask every patient whether they smoke, advise them about the benefits of stopping, and refer them to the Georgia Tobacco Quit Line for follow up. This phone service provides support seven days a week for smokers looking to quit the deadly habit, said Lloyd, the state’s tobacco cessation coordinator. It has a 33 percent quit rate and is meant to help smokers who can’t make it to face-to-face support groups because they live in rural areas or lack transportation.

The final key to making smoking a thing of the past is to influence children and young people before they light up, said Anne Marie Coleman, also a DPH advisor. Raising the prices of tobacco products, developing anti-tobacco media campaigns and involving communities in restricting minors’ access to such products are key in curbing youth smoking rates. The rise of e-cigarettes presents another problem, as they are viewed as a “safe” alternative, an incorrect and dangerous assumption, Coleman said.

The presenters emphasized that any tobacco use is dangerous, a message they are working to get out to the public.

Audio Story about Georgia’s tobacco problem
Video Commentary from Anne-Marie Coleman, Georgia Department of Public Health
Misconceptions surrounding e-Cigarettes and tobacco cessation

Building a Public Health Workforce for a Healthier Georgia

By Shelby Jarret

Internship programs, partnerships with academic institutions and on-the-job training can all help relieve some of the pressures felt by public health providers whose programs are perennially short on resources.

Field placement programs advised by the Region IV Public Health Training Center are a win-win situation for students and for the health departments that supervise them, Laura M. Lloyd and Melissa Alpern of the center said. Internship programs at the Rollins School of Public Health, East Tennessee State University, and Florida A&M University are good examples, the presenters said.

Workshop participants agreed that having interns benefits a public health program, but they had suggestions for increasing the yield for both parties. The best field placements assign interns to work on clearly defined, discrete projects with measurable outcomes.

Partnerships with academic departments are another way that local public health programs amplify their impact. Dr. Jimmie Smith is a public health physician who serves as a liaison between Mercer University’s public health school and the North Central Health District. Both are headquartered in Macon, and they have a formal agreement that turns the health district into what Smith called an “academic health department.” As a teaching health department, this program addresses concerns regarding the separation of education and public health practice.

One of the innovations of this program is Operation T.R.I.M. (Taking Responsibility by Informing Men). Students distribute free condoms in Macon barbershops as a way to increase personal protection against HIV and other sexually transmitted infections. The program was created by students and mostly managed by them, and illustrates the types of novel interventions possible in an academic health department.

Another way to expand the impact of the existing public health workforce is to make sure that their training is targeted to genuine needs and kept up to date. Professionals throughout Region IV say they need reinforcement in cultural competencies, financial planning, leadership and environmental health. In response, Laura Lloyd said that the Region IV Public Health Training Center offers free online courses, lectures, practice academy trainings and webinars on these topics.

Audio story about Academic Health Departments
Video Commentary by Dr. Jimmie Smith

Leveraging Implementation of the Affordable Care Act to Advance Community Health in Georgia

By Elizabeth Fite

Individuals who need health coverage are not the only ones affected by implementation of the Affordable Care Act (ACA). In addition to the 541,080 Georgians who signed up for insurance during the latest open enrollment period, health care providers, hospitals and communities are also feeling its effects.

Nonprofit hospitals are now required to conduct a Community Health Needs Assessment (CHNA) every three years. Ideally, the results will enable communities to judge whether these hospitals — which are exempt from taxes — are delivering enough health benefits to the community they serve.

“There weren’t a lot of people thrilled about the Affordable Care Act to begin with, and then there’s also the case that it has placed an additional requirement on our hospitals,” said Fenwick Broyard, executive director of Community Connection of Northeast Georgia. His organization contracted with the two hospitals in Athens to study health needs in the 17 counties they serve.

“Hospitals have a choice as to whether or not to view this as an obligation or an opportunity,” Broyard said.

Beth Stephens of Georgia Watch reviewed CHNAs from 38 hospitals across Georgia, and she saw substantial variation in the quality of the assessments. Although some were thorough and well executed, others had shortcomings, such as failing to gather information from vulnerable populations, said Stephens, health access program director for the public interest watchdog group.

The Athens hospitals made a special effort to gather input from people whose voices often go unheard in policy debates, Broyard said. The two institutions worked well together despite being in competition with each other, he said, and saw the needs assessment as an opportunity to better serve the community.

Future CHNAs could be improved by greater collaboration between hospitals and health departments, which are valuable sources of public health expertise, said Reinetta Waldrop, an assistant professor in community health and preventive medicine at Morehouse School of Medicine.

“Hospitals are required to collaborate with public health and community-based groups to address these community health needs,” Stephens said. “Right now is a great time to reach out and get engaged with your hospital in that next CHNA process and also volunteer to be an active participant in that assessment process and share your insight.”

Audio Story – Why public health professionals participate in the SOPH each year…
Video Commentary from Dr. Jean O’Connor, Chronic Disease Prevention Director, Georgia Department of Public Health
Video Commentary from Dr. Margaret Holt, retired UGA Professor of Adult Education, who is currently working at the National Network of Public Health Institutes