Keon Gilbert, DrPH, MPA, MA, is an associate professor in behavioral science and health education at Saint Louis University’s College for Public Health and Justice, and co-editor of “Racism: Science & Tools for the Public Health Professional,” published by APHA Press. The death of George Floyd at the hands of Minneapolis police officers in May sparked a wave of protests around the nation as well as calls for police reform and interventions to root out systemic racism. Gilbert talks about social change and racism in America.
Where does systemic racism cut the deepest in America?
It’s really hard to say. And the reason why I say that is because it’s embedded in so many systems that work together to produce systemic racism.
I am reminded of a quote from the writer Audre Lorde: “There is no such thing as a single-issue struggle, because we do not live single-issue lives.”
We can do an analysis, an antiracist analysis, for example, within institutions, but it’s very difficult to do that unless you start to look at the overlap or the interconnectedness between one institution and another.
You have to be able to look across systems. And that’s the difficulty of unpacking systemic racism.
Read the full Q&A with Gilbert in The Nation's Health. And tune in to Reborn Not Reformed: Re-Imagining Policing for the Public's Health, the third in APHA's Advancing Racial Equity webinar series.
Rear Admiral Michael Weahkee was confirmed April 21 by the U.S. Senate as director of the Indian Health Service, an agency within the U.S. Department of Health and Human Services. He has served in various roles at IHS since 1998, and was appointed principal deputy director in 2017. IHS provides health care services to 2.6 million American Indians and Alaska Natives in hospitals, clinics and other settings. The coronavirus pandemic has created new challenges within American Indian and Alaska Native populations, but health successes point to a hopeful future.
With physical distancing enacted due to the pandemic, how is IHS health care adjusting?
Our challenges with COVID include how we ensure that patients with chronic health conditions continue to get the treatment and the medications they need.
We’ve expanded prescription fills from 30 days to 90 days to help alleviate the need for them to see their physician and spread out the physical in-person meetings as best we can.
We’ve also worked hard to expand telehealth so that patients can connect with their care teams without the requirement to come into the hospital or the health center.
Read the full Q&A with Weahkee in The Nation's Health.
As COVID-19 spread throughout across the U.S. this spring, it highlighted worsening health disparities faced by minority populations in the U.S., including Hispanics. In April, half of U.S. Hispanics said they or someone in their household had taken a pay cut, lost their job or both because of the coronavirus outbreak. Preliminary data has also shown that Hispanics make up an unequal proportion of coronavirus cases in some states. In a recent podcast, The Nation’s Health spoke with Amelie Ramirez, who is the director of Salud America.
How does COVID-19 impact Hispanics in the U.S. differently?
One of the reasons we think (we’re seeing a disproportionate impact) is our population, our Latino community, really has a lot of different co-morbidities that are making it more difficult perhaps to get the treatment that they need.
For example, we have higher rates of diabetes, obesity, cardiovascular disease, asthma in our community, so that if they are impacted by COVID-19, their cases are probably more complicated because of that.
Read more or listen to the full podcast.
APHA member Sandro Galea, MD, DrPH, MPH, dean and professor at the Boston University School of Public Health, was the keynote speaker at the Nov. 3 opening session of APHA’s 2019 Annual Meeting and Expo in Philadelphia. In addition to his academic leadership, Galea is a gun violence researcher, an outspoken advocate on social determinants of health and author of a new book, “Well: What We Need To Talk About When We Talk About Health.”
What do you think we get wrong — as a country — when we discuss health?
Right now, the way we understand health rests on a conflation of health and health care. And that conflation has real implications, because it means that we understand health as being the product of clinical intervention, when in fact, clinical intervention in health care is about healing people once they’re sick.
Health should be about keeping people healthy, and that means we need to invest in the forces that keep people healthy.
That means having opportunities for employment; having good education, primary education and secondary education; having stable, affordable housing; and having economic opportunities that lift people from poverty. Those are the forces that we ultimately should couple with our health.
It is the job of public health to create an understanding of the conditions that generate health, and we should take that job seriously
Read the full Q&A with Galea in The Nation's Health.
The Nation's Health talked with the assistant secretary for health at HHS about ending America's HIV epidemic.
What has happened since "Ending the HIV Epidemic: A Plan for America" was announced in February?
...Our latest total (as of mid August) shows we have interacted with 29 different jurisdictions, including 13 site visits and 42 listening sessions, because we really want to listen and learn and interact with the community.
This is not us coming to Jackson, Mississippi, and saying, “This is the way to do it.” We’re here to listen and learn.
This is really very important, because what we want is the communities to come together to understand what’s right in their communities — that they have the resources to do those planned grants so that when the money becomes available, hopefully with the new budget, that they’re ready to spend it and to actually start implementing in their community plan.
In addition to that, we’ve awarded $6 million to four jurisdictions for pilot sites. That’s DeKalb County in Georgia; Baltimore; East Baton Rouge, Louisiana; and the Cherokee Nation of Oklahoma.
These places met predefined criteria, and have made progress in this regard and have certain standards. We want to jump-start their effort, not only to get those communities started — but that they can serve as exemplars that all of the communities can learn from and we can learn from, as well.
So we’re not just sitting on our hands. We’re not waiting for new money. This is a serious initiative. We have all been on the road. Me, others and particularly Dr. (Robert) Redfield (head of the Centers for Disease Control and Prevention) have been out there working in communities.
Read the full Q&A with Giroir in The Nation's Health.
Dara Richardson-Heron, MD, is the chief engagement officer for the All of Us Research Program, a long-term federal study dedicated to building one of the largest biomedical datasets in the world. Heron leads efforts to engage 1 million people, including groups typically underrepresented in health science studies. The National Institutes of Health program launched in May 2018, and one year later, 80% of the 142,000 people who have signed up are from underrepresented groups, including over half who are racial and ethnic minorities.
How do you build the trust of underrepresented individuals so they are comfortable taking part in a federal health study? After all, the U.S. has a history of unethical research on minorities.
We are intentionally not shying away from these issues. Instead, we are partnering directly with key stakeholders who are our trusted community and provider organizations and participant partners.
And we are acknowledging and addressing these realities head-on and sharing the progress that has been made to prevent these historic transgressions and breaches of trust that have happened in the past, such as human subjects protection, education and training, institutional review boards, and other laws and policies that protect human research participants.
But simultaneously, we must share the great news that research has the potential to be a powerful change agent — one with the potential to begin chipping away at the really unacceptable health disparities that we see in many communities.
And certainly at the All of Us Research Program, we are doing our level best, with both our words and our deeds, to make it abundantly clear that we are committed to helping those who have concerns understand that the only way we can learn more about, and hopefully one day eliminate, health disparities, is to have much more robust and diverse participation in research and clinical trials. You really can’t have precision medicine for all if all of us aren’t reflected in the research.
Read the full Q&A with Richardson-Heron in The Nation's Health.
Centers for Disease Control and Prevention Director Robert Redfield, MD, recently spoke with APHA's Public Health Newswire about the state of public health and the agency’s plans for 2019.
We’ve seen a flood of headlines lately on falling vaccination rates and new cases of previously eliminated infectious diseases, such as measles. What’s the CDC’s approach to turning the tide on vaccination?
Immunizations are our strongest and most powerful public health tool. Vaccines have been so successful, many people have forgotten how serious vaccine-preventable diseases can be. The recent spate of measles cases is a wake-up call for Americans. CDC is redoubling efforts to reach out to vaccine-hesitant parents and public health leaders to remind them of the solid science behind recommended immunizations. The key is for individuals to embrace vaccination for themselves, their families, their communities, their schools, and their churches. Science that sits on the shelf has no value.
Read the full Q&A with Redfield in Public Health Newswire.
Under a new challenge released in September, CDC is calling on governments, businesses and other organizations around the world to commit to taking action against antibiotic resistance, which is one of the world’s most urgent threats to health. APHA has signed the challenge, committing to raise awareness of antibiotic resistance and advocate for funding for research and development of new drugs and vaccines. The Nation’s Health spoke with Rima Khabbaz, MD, director of the National Center for Emerging and Zoonotic Infectious Diseases, about the challenge.
Why is it so important to bring young people into conversations about improving health outcomes in their communities?
Public health...has really come to the forefront of addressing the problem of antibiotic resistance.
We have an antibiotic lab response network where we have seven regions that have now the ability to improve diagnostics to be able to detect emerging infections.
Resistance is not just a problem of individual health care facilities. Resistance spreads from facilities to other facilities and to the community, so (public health) has stepped in to address it and be part of the solution to detect emerging infections quickly.
If you quickly and aggressively are able to detect new and emerging resistance…(you can) go full speed to contain it.
We also, I think, need public health workers to be involved in the fight by being able to talk about this, about the risk and best practices as far as antibiotic prescribing both in the professional work and in their personal role as champions of public health.
Read the full Q&A with Khabbaz in The Nation's Health. For more on antibiotic resistance and to commit to the challenge, visit www.cdc.gov/drugresistance.
The California Endowment's 10-year, $1 billion initiative, Building Healthy Communities, has already made significant progress toward its 2020 goals: The campaign has supported work to insure 4.5 million Californians, slash school suspensions and expulsions and help nearly 1 million people reclassify their former low-level felonies as misdemeanors, opening doors to housing and employment opportunities. The Nation’s Health spoke with California Endowment Vice President Tony Iton, MD, JD, MPH, an APHA member, about creating a people-powered movement in the name of public health.
Why is it so important to bring young people into conversations about improving health outcomes in their communities?
We recognized fairly early on in our work that youth were the rocket fuel of change…You look around and look at the Parkland youth, you look at Black Lives Matter, you look at marriage equality movements — these are driven by young people. And what we recognized is that our role is really to organize them and kind of stay out of the way, and also that the kinds of changes we were looking for to promote health in California required a social movement, that they weren’t just technical policy issues, they are political issues.
We realized that we needed to essentially help catalyze a social movement, that these issues were fundamental to politics, and if you want to change politics you’ve got to bring power to the table, and that meant we needed to organize people. And when you study the history of movements, you recognize that it means you have to organize the youth.
Read the full Q&A with Iton in The Nation's Health.