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					The Nation’s                                                                                            H alth
The Official Newspaper of the American Public Health Association                                                                                         March 2003

 Healthy eating, active living stressed             Medicaid    Global AIDS funding plan announced
 National Public Health Week                        cuts eyed   2004 budget plan has wins,
 centers on overweight, obesity as states                       losses for public health
                                                    tangle with
 H     ealth professionals, community
       advocates and health organizations across
       the country are gearing up to draw attention deficits
 to overweight and obesity during National Public Health
                                                                       resident Bush’s 2004 federal budget
                                                                       proposal, presented to Congress Feb. 3, presents
                                                                       both promises and challenges for the nation’s
                                                                                  s more states         public health programs and agencies.
 Week, which will be held April 7–13.
    The annual event,
 sponsored by APHA, is
 designed to bring attention
                                  of healthy eating and
                                  active living.”
                                     A special toolkit on
                                                                      A           face massive
                                                                                  budget short-
                                                                      falls for the coming year,
                                                                                                            On the upside, the presi-
                                                                                                        dent’s federal health pro-
                                                                                                        posal includes an increased
                                                                                                        commitment to preventing
                                                                                                                                         of the total HHS budget
                                                                                                                                         would go toward Medicaid
                                                                                                                                         and Medicare spending.
                                                                                                                                            “We fully support several
                                  overweight and obesity is
                                                                      questions of how to rein          chronic disease, more fund-      initiatives the president out-
 to public health issues and
 services at the local, state     now available on the                in spending are a top pri-        ing for the global fight         lined in his budget that will
 and national levels. This        APHA Web site at <www.              ority for state legislators,      against HIV/AIDS and pro-        improve the health of the
 year’s event                                                                        grams to protect the food        American people,” said
 focuses on the                                     nphw>. The
                                                                      many of whom are point-           supply from bioterrorism.        APHA Executive Director
 epidemic of                                        toolkit,          ing to Medicaid as a prime        However, the plan also           Georges Benjamin, MD,
 overweight                                        developed to       target for funding cuts.          tightens budgets at the Cen-     FACP. “Sustained support
 and obesity in                                  help commu-                                            ters for Disease Control and     for public health prepared-
 the United                                     nities and pub-          With Medicaid enroll-          Prevention, National Insti-      ness, increases to reduce
 States and car-                                  lic health          ment on the rise, the pres-       tutes of Health and other        chronic diseases, expanded
 ries a tagline                                     personnel         sure on lawmakers to              agencies, level-funding          funding for community
 of “Getting in                                      plan their       curtail the program’s fund-       some programs and slow-          health centers and a new
 Shape for                                            National        ing and restrict eligibility is   ing the growth of others.        U.S. commitment to fight
 the Future:                                          Public          mounting — pressure that              The biggest winners in       global AIDS represent some
 Healthy                                              Health          could seriously affect the        Bush’s $2.23 trillion budget     of the good news. But the
 Eating                                               Week            health of the low-income          proposal were homeland           budget also includes missed
 and                                                  activities,     populations that depend on        defense and the military,        opportunities, and the good
 Active                                      features media           the program.                      which were projected to          news should not come at
 Living.”                         advocacy tips, sample                  Already this fiscal year,      receive significant              the expense of other vital
    “The nation is in the         news releases, talking              13 states have cut their          increases. Of the federal        health programs.”
 throes of an obesity epi-        points and tips on reach-           Medicaid spending, accord-        budget total, about $537            One of the highlights of
 demic,” said Lakitia Mayo,       ing legislators. The toolkit,       ing to a January survey by        billion would go toward the      the president’s budget pro-
 APHA’s director of grass-        which was developed with            the National Conference of        U.S. Department of Health        posal was a significant new
 roots advocacy and Affili-       input from APHA’s Food              State Legislatures. Two-          and Human Services, a 6          commitment to combating
 ate affairs. “National Public    and Nutrition Section, also         thirds of all states plan to      percent increase from the
 Health Week provides an          includes an overview of             reduce their overall budgets      president’s 2003 budget                  See 2004 Budget,
 ideal opportunity for us, as     the overweight and obesity          by $26 billion during the         request. About 82 percent                           Page 12
 health educators, to spread
 the message to our com-                    See NPHW 2003,                        See Medicaid,
 munities of the importance                         Page 10                               Page 10

   The   Nation’s Health                                            PERIODICAL POSTAGE
   March 2003                                                             Paid at Washington, DC
                                                                    and additional mailing offices
   American Public Health Association
   800 I St. N.W.                                                                 USPS 923-140
   Washington, DC 20001-3710

                                                                                                        The president’s plan includes a new commitment to preventing
                       Visit us online at <>.                              chronic disease via healthier lifestyle choices for Americans.
Published by the
                                APHA promotes, takes action
           Public               on key public health issues
           Association          A     PHA took action on
                                      a number of key
                                public health issues in
                                                                 ity leader in support of the
                                                                 issue. The action alert was
                                                                 also sent to leaders of
In this issue of                recent weeks, advocating         APHA’s Affiliates and
The Nation’s Health             action on children’s health      Sections.
                                insurance and prescription
The   Nation                    drug coverage, among             Concerns on advisory
                                other topics.
                                                                 boards discussed
                                                                     APHA continues to be at
                                Prescription drug                the forefront of the public
                                benefit urged                    and scientific debate about
                                   Anticipating the debates      the politicization of federal                                                Photo by Kim Krisberg
                                that will occur in Congress      scientific advisory boards.     APHA member David Michaels, MPH, PhD, right, discusses
                                this year on prescription        The Association’s associate     the role of scientific advisory boards during a January news
                                drug coverage under              executive director of public    briefing. At left is member Lynn Goldman, MD, MPH.
                                Medicare, APHA sent a let-       affairs, Kelly O’Brien, MPA,
                                ter to every member of           represented APHA at a Jan.      confidence in the boards’        Lawrence and Garner. The
Smallpox vaccinations begin     Congress in January outlin-      23 news briefing in Wash-       recommendations and the          two plaintiffs were
as concerns on liability,       ing the Association’s posi-      ington, D.C., about             best scientists will decline     arrested in Lawrence’s
                                tion on the issue.               the issue.                      to serve, said panelist Mar-     Houston home and jailed
compensation linger.                                                 The news briefing, orga-
                                   The Jan. 24 letter,                                           tin Apple, PhD, president        after officers responding
                      Page 7    signed by APHA Executive         nized by Environmental          of the Council of Scientific     to a false report found the
                                Director Georges Ben-            Media Services, was             Society Presidents.              men having consensual
The cost of gun-related         jamin, MD, FACP, urged           designed to educate the                                          sex, stated Lambda Legal.
injuries in the U.S. is high.   that Congress pass legisla-      media and public on how
                                                                                                 APHA comments on                    APHA has policy that
                      Page 7    tion this year that will pro-    federal advisory boards are                                      “deplores all public and
                                vide a comprehensive             supposed to function and        Texas sodomy case                private discrimination
                                prescription drug benefit        how they are currently             APHA signed onto a            against persons with
State & Local                   for all Medicare beneficia-      being influenced. Panelists     friend-of-the-court brief in     homosexual orientation”
                                ries. Specifically, the Asso-    at the briefing raised con-     the case of John Geddes          and “supports the repeal
Maine takes its fight for                                        cerns that the Bush admin-      Lawrence and Tyron Garner        of laws which classify as
                                ciation called for principles
lower drug prices to the        outlined in its policies on      istration is choosing board     vs. State of Texas, which        criminal conduct consen-
U.S. Supreme Court.             the issue, such as cata-         members based on politi-        will go before the U.S.          sual sexual activity of any
                                                                 cal like-mindedness,            Supreme Court in upcom-          form in private.” Other
                      Page 8    strophic protection, guar-
                                                                 instead of scientific and       ing months.
                                anteed access regardless of                                                                       organizations that signed
                                income or health status,         health credentials.                 The case challenges the      onto the court brief
                                protection against out-of-           “Nothing less than the      constitutionality of a Texas     include the National Men-
                                pocket costs and quality of      credibility of public health    law that criminalizes oral       tal Health Association,
                                care standards.                  and the trust of the Ameri-     and anal sex by consent-         National Alliance of State
                                   “APHA supports a pre-         can people in public health     ing gay couples, according       and Territorial AIDS Direc-
                                scription drug plan that         experts to provide accurate     to Lambda Legal, the orga-       tors and Association of
                                offers seniors real protec-      information are at stake,”      nization representing            Nurses in AIDS Care. I
                                tion against rising drug         O’Brien said at the news
                                costs,” Benjamin wrote.          briefing.
                                                                     At APHA’s 130th Annual
Some seafood shoppers                                            Meeting in November, the           News service debuts on APHA Web site
could soon have mercury         Extension advocated              Association’s Governing
warnings on their fish.
                      Page 9
                                for CHIP deadline
                                    APHA members in nine
                                                                 Council unanimously
                                                                 adopted policy to ensure
                                                                                                   A      PHA members looking for the latest
                                                                                                          public health headlines can now find them
                                                                                                   online via the Association’s Web site.
                                states were called on to         the credibility of such advi-        A free public health news service debuted on the
                                take action in December to       sory boards.                      APHA Web site in December. Updated each day, the
The sections                    help support funding for             Panelists pointed to          news service provides the top public health stories
The HIV/AIDS Section            the federal Children’s           numerous examples to jus-         from newspapers and news services around the coun-
surveys its members’ needs.     Health Insurance Program.        tify their concerns, such as      try. In December, for example, the service included
                                    As part of an e-mail         a report from the office of       stories on medical errors, drug use and healthy diets.
                    Page 11     action alert, members in         Rep. Edward Markey, D-               “Every day, new public health news and findings
                                Arizona, Idaho, Indiana,         Mass., that investigated the      are released,” said David Fouse, APHA’s director of
The Affiliates                  Ohio, Oregon, Maine, Mis-        Centers for Disease Control       communications. “This service allows APHA members
                                souri, Texas and Virginia        and Prevention Advisory
Affiliates play role in state                                    Committee on Childhood
                                                                                                   to stay up-to-date through the click of a mouse.”
                                were asked to contact their                                           The service, which is located on the APHA news
bioterrorism readiness.         senators and urge them to        Lead Poisoning Prevention.        page, at <>, also occasionally fea-
                    Page 13     extend the expiration date       The report found that com-        tures stories in which the Association or its leadership
                                of CHIP funding until the        mittee vacancies were             is cited. Each month, APHA is cited in dozens of news
The Globe                       end of 2004. Without such        being filled by individuals       stories in newspapers, Web sites, television programs
                                an extension, almost 1 mil-      with direct ties to the lead      and radio shows around the country and world.
War in Iraq could have dire     lion children are expected       industry, and scientists             The news service is the latest addition to the
health consequences.            to lose health insurance         with long histories of            wealth of public health information available through
                    Page 14     coverage during the next         studying childhood lead           APHA’s Web site. Members can also access a calendar
                                several years.                   poisoning were being              of upcoming public health events, legislative and
Departments                         Residents in the nine        rejected.                         advocacy news and Association news releases.
Vital Signs . . . . . . . 3     states were chosen to take           If the process of choos-         The news feature is provided through LexisNexis,
Journal Watch . . . . . 5       part in the advocacy activ-      ing members for federal
                                                                 scientific boards is based
                                                                                                   a news and information services provider.
                                ity because their senators
Calendar . . . . . . . 21       had recently signed onto a       on politics instead of sci-
                                                                                                      For more information on the news service, e-mail
                                                                                                   <>. I
                                letter to the Senate major-      ence, the public will lose

2         T h e N at i o n ’ s H e a lt h                ❖      March 2003
                                                                 Two-day retreat focuses on board development, training
Vital Signs                                                      Executive Board holds retreat, first 2003 meeting
Perspectives of the president of APHA

Protecting, defending the                                        A          PHA’s Executive
                                                                            Board started off
                                                                            the new year with
                                                                 an invigorated focus,
                                                                 thanks to a two-day January
right to health care coverage                                    retreat in Washington, D.C.
                                                                     The retreat, which

T      he national health
       care debate seems like
tectonic plates inexorably
                                 ance hopes blossomed in
                                 1916, then-APHA President
                                 John F. Andersen wrote that
                                                                 involved both new and
                                                                 returning members of the
                                                                 board, was designed to fur-
grinding against one             “to enact a health insurance    ther development of the
another. Surely, this year       law simply as a relief          Executive Board and Asso-
will be one of continued         measure without adequate        ciation. The session was the
upheaval, exposing the           preven-                         board’s first meeting of the
thrust zones of legislation      tion fea-                       year, and the first with new
and fault lines of rising        tures                           Executive Director Georges
costs, a shallow economy,        would be                        Benjamin, MD, FACP, as an                                                     Photo by Michele Late
budget shortfalls and pro-       a serious                       official member.                Executive board member Brian Saylor, MPH, PhD, discusses a
fessional discontent viewed      mistake,                            “To better position our-    point during the January meeting. Also pictured, from left, are
against the real advances in     but with                        selves as a public health       board members Cheryl Easley, RN, PhD; Camara Jones, MD,
health care that are avail-      a compre-                       leader, we must reengineer      MPH, PhD; and Chris Day, MPH.
able to too few.                 hensive                         ourselves for the future,”
    The estimated numbers        plan for                        Benjamin said. “Developing         “Timing is all in life —      cated to Sections and “make
generated in the perfor-         disease prevention...would      our board leaders is the        especially in the life of an     recommendations for the
mance of our national            prove to be a measure of        first place to start.”          Association — and this is a      future to encourage Section
health care system and           extraordinary value.”               The Jan. 26–27 retreat      watershed time for public        activities and growth.”
industry are staggering — a         N Link health care           was made possible through       health,” he said.“It’s              Under Association proce-
$1.4 trillion annual national    reform to our work to elimi-    a grant from the W.K. Kel-      extremely practical for us to    dures, each Section is pro-
health expenditure in 2001,      nate health disparities and     logg Foundation, which          be mapping our future now.”      vided annual funding based
41 million uninsured and         to the achievement of           recently provided $178,000         In its regular one-day        on its membership num-
an approximately equal           Healthy People 2010. It is      for an APHA leadership          business meeting at APHA         bers. An analysis of 2002
number covered under             crucial to connect issues of    development and training        headquarters Jan. 28, the        Section budgets found that
Medicare. What an ironic         social justice with the         program (see Page 4).           board voted to retain the        81 percent of allotted funds
equation for the world’s         observable, practical, detri-       A meeting facilitator was   Association’s current end-       were spent by Sections dur-
wealthiest nation, and for a     mental effects of unequal       used to guide much of the       of-year accounting proce-        ing fiscal year 2002.
caring nation.                   access to health care on our    retreat, which included dis-    dures for Section budgets.          In its other business, the
    The message is clear:        entire societal economic and    cussions on the role of         The move means that funds        Executive Board also cre-
This is a singular period        social well-being.              board members, the              that remain in Section oper-     ated a Strategic Planning
when APHA must vigor-               N Monitor and synthe-        responsibility of the Execu-    ating budgets at the end of      Committee, headed by
ously protect and defend         size local and state gaps       tive Board and ways to          the fiscal year will not roll    board Vice Chair Edwin
the basic health care cover-     and positive initiatives in     become more efficient and       over to the next year’s bud-     Marshall, OD, MS, MPH, to
age rights that exist as well    health care reform. Our         effective. Members agreed       get. Such rollovers have not     help guide development of
as re-ignite the efforts to      links through APHA mem-         to develop a detailed proce-    been allowed in the past         the Association’s new
promote and extend health        bers and Affiliates can pro-    dure manual for the board       under Association account-       strategic plan and discussed
care entitlement to all.         vide a fact-based position      so that responsibilities can    ing procedures. However,         a recent survey of APHA
    What efforts must the        to advocate for real health     more easily be explained to     the board reviewed the           leadership on ways the
Association undertake            care reform.                    future members, a project       issue at the request of          Association can gain funds.
through our membership              As President Harry S.        that will be spearheaded by     APHA’s Governing Council.           APHA members can
constituencies now?              Truman wrote when he            board member Patricia              Board members opted           access minutes from the
    N Join efforts in connect-   commissioned the report         Mail, MPH, PhD, CHES.           not to make the change in        January meeting and past
ing the public with health       “The Nation’s Health: A 10-         The session also focused    part because of the impact       Executive Board sessions at
care reform. This is pre-        Year Program” on Jan. 30,       on plans for a new APHA         it would have on the Asso-       <
cisely what our founder,         1948: “I have, as you know,     strategic plan. APHA’s most     ciation budget. The door         exboard.htm>.
Stephen Smith, advocated         repeatedly requested Con-       recent strategic plan, devel-   was not closed on the issue         For more information,
in 1872 to “awaken the           gress to enact legislation      oped by the board more          completely, however: Board       e-mail <tiffany.emami@
active and permanent inter-      designed to expand basic        than three years ago, set       members stipulated that> or call (202)
est” and “facilitate the         health services and to bring    goals for the Association       APHA’s executive director        777-2433. I
enlightenment of the pub-        them within reach of all the    through 2002. Goals under       review how funds are allo-                     — Michele Late
lic.” One current example        people. The attainment of       that plan included advanc-
may suffice: The Health          such a goal requires the        ing public health policy,
Care that Works for All          cooperation of state and        strengthening the Associa-       Have a story idea for The Nation’s Health?
Americans Act, introduced        local government, voluntary     tion and stimulating sup-
in Congress in October,
would create a nationwide
                                 organizations (and) the
                                 medical and health profes-
                                                                 port for public health.
                                                                     The new plan, which           T     he Nation’s Health editorial staff is seeking
                                                                                                         reader ideas for stories covered in APHA’s
                                                                                                   monthly public health newspaper.
public debate on improving       sions as well as our citizens   will be completed by the
                                                                 board later this year, is            If there is a health initiative, program, study or topic
the health care system so        working together.”
                                                                 expected to set overarching       you’d like to see covered by a reporter from The
that every American can              It is none too soon to
                                                                 goals for the Association for     Nation’s Health, you can submit your ideas to the news-
have health care coverage.       fulfill President Truman’s
                                                                                                   paper’s editorial staff. The newspaper is especially
    N Emphasize the role of      request of 55 years ago.        the next three years.
                                                                                                   looking for story ideas focusing on the work of APHA’s
public health and health         Our Association must play           The new strategic plan-
                                                                                                   Sections, Special Primary Interest Groups, Caucuses
promotion in health care         an emphatic role. I             ning process comes at a
                                                                                                   and Affiliates.
reform. Public health can-                                       very different time for pub-
                                                                                                      Story ideas, which are accepted year-round, can be
not afford to be the invisi-                                     lic health than three years
                                                                                                   e-mailed to <> or mailed to
ble guest in the health care                                     ago, noted Executive Board
                                                                                                   Editor, The Nation’s Health, c/o APHA, 800 I St., N.W.,
debate and public engage-           Jay Glasser, MS, PhD         member and APHA Presi-            Washington, DC 20001-3710. I
ment. As health care insur-         dent Jay Glasser, MS, PhD.

                                                                       March 2003                  ❖    T h e N at i o n ’ s H e a lt h                          3
    Newest APHA policies now                                                                      Kellogg grants enhance APHA leadership, Journal

                                                                                                                                   health challenges),” wrote       conference in Washington,
    on Association Web site                                                                                    PHA is
                                                                                                               building its        Benjamin in the grant pro-       D.C., will cover a wide
                                                                                                                                   posal. “But to be effective,     range of topics, such as
    A     PHA’s 18 newest
          policies are now
    available in full on the
                                                 APHA Web site.
                                                    “Providing online
                                                 access to APHA policies
                                                                                                               member and
                                                                                                  staff leadership capacity,
                                                                                                                                   it must re-engineer itself for
                                                                                                                                   the future. With the recent
                                                                                                                                                                    HIV, substance abuse,
                                                                                                                                                                    prostate cancer and occu-
    Association’s Web site.                      means that more mem-                                                              hiring of a new executive        pational health, according
                                                                                                  thanks to a recent $178,000      director, the opportunity        to Northridge. The issue
       The policies, passed                      bers can have access to
    by the Association’s Gov-                    them whenever they need                          grant from the W.K. Kellogg      exists to empower the            will also include an editor-
    erning Council at the                        them,” said Natalie                              Foundation.                      Association with the skills      ial from former U.S. Sur-
    130th APHA Annual                            Raynor, APHA’s public                                                             required to effect this          geon General David
    Meeting in Philadelphia                      affairs coordinator.                                 “This grant is a wonder-     change.”                         Satcher, MD, PhD.
    in November 2002,                               APHA’s policies, which                        ful opportunity for the             Already, the grant                The new funding is the
    address issues such as                       cover more than 50 years,                        Association’s Executive          money was used to help           latest benefit of APHA’s
    dietary sodium, safe                         serve as APHA’s official                         Board and staff to enhance       fund a two-day develop-          fruitful relationship with the
    water, tobacco settle-                       stance on health issues                          their leadership skills,” said   ment retreat for APHA’s          Kellogg Foundation. With
    ment funds, syringe                          and guide the Association                        Georges Benjamin, MD,            Executive Board in Wash-         APHA’s help, the Associa-
    prescription and devel-                      in its public health advo-                       FACP, the Association’s          ington, D.C., in January         tion’s Public Health Student
    opment of nuclear                            cacy. The APHA Web site                          executive director. “With        (see story, Page 3).             Caucus received $5,000
    weapons.                                     includes PDFs of the                             public health in the                Among the areas being         from the Kellogg Founda-
       Anyone with Internet                      complete library of poli-                        national spotlight like never    considered for APHA staff        tion to help the Caucus con-
    access can download the                      cies and a searchable                            before, APHA must ensure         training are information         vene the first National
    new policies at <www.                        database of the                                  that it has the skills neces-    technology, teambuilding,        Leadership Conference for                        1991–2002 policies.                              sary to continue to be a         negotiation skills and man-      Students in Health Care,
    policy/index.htm>.                              APHA members with-                            powerful voice for the pub-      agerial and leadership           according to Chris Day,
       Brief summaries of                        out Internet access can                          lic’s interest.”                 training.                        MPH, chair of the Caucus.
    the 2002 policies were                       request copies of the                                The grant, which will           In addition to the leader-    The conference was con-
    published in the Decem-                      2002 policies by calling                         provide support through          ship grant, APHA’s Ameri-        vened at APHA’s 130th
    ber 2002/January 2003                        (202) 777-2511 or e-mail-                        March 2004, will enhance         can Journal of Public Health     Annual Meeting in Philadel-
    issue of The Nation’s                        ing <natalie.raynor@                             leadership development           received a Kellogg grant for     phia in November. The con-
    Health. The March issue            >.                                       via training for the Associa-    $158,000 in July. The Kel-       ference led to the formation
    of the American Journal                         A timeline for the 2003                       tion’s Executive Board;          logg grant will provide full     of the Student Health
    of Public Health is sched-                   policy submission                                development of APHA staff        support for the Journal’s        Alliance, which includes a
    uled to carry an index of                    process is available                             to enhance leadership,           May 2003 issue, which will       dozen organizations repre-
    the 2002 policies, but                       online for APHA mem-                             partnership and manage-          focus on men’s health.           senting more than 180,000
    the full versions will                       bers at <                           ment ability; and creation          “This is our landmark         students. The alliance builds
    only be available on the                     private/ppolicy.htm>. I                          of a “lessons learned” doc-      issue on men’s health —          its work around Healthy
                                                                                                  ument to serve as a tool         we’ve never done it before,”     People 2010, the national
                                                                                                  for future public health         said Mary Northridge, PhD,       plan that sets health objec-
                                                                                                  organizations undergoing         MPH, the Journal’s editor-       tives for the nation.
                                                                                                  transition.                      in-chief.                            For more information on
                              MEMBERSHIP APPLICATION                                                  “APHA has a unique              The May Journal issue,        the Kellogg Foundation,
             A M E R I C A N P U B L I C H E A LT H A S S O C I AT I O N                          opportunity to address           which is scheduled to be         visit <>. I
             800 I St. N.W., Washington, DC 20001-3710 • (202) 777-APHA • Fax: (202) 777-2534     (present and future public       promoted at an April news                     — Kim Krisberg

LAST NAME                       FIRST NAME                      MID. INITIAL        DEGREES

                                                                                                  APHA offering continuing education credits
POSITION/TITLE                                   ORGANIZATION


CITY                                     STATE
                                                                    ❑ HOME      ❑   BUSINESS

                                                                                                  A         PHA was recently
                                                                                                            awarded four
                                                                                                            more years of
                                                                                                  accreditation status, allow-
                                                                                                  ing the Association to con-
                                                                                                                                   tion activities and providing
                                                                                                                                   an education setting that is
                                                                                                                                   free from commercial bias.
                                                                                                                                      “The Association’s
                                                                                                                                   renewed accreditation will
                                                                                                                                                                    pants who take part in the
                                                                                                                                                                    program earn credit by
                                                                                                                                                                    reading issues of the
                                                                                                                                                                    Journal and completing an
                                                                                                                                                                    exam based on the reading
                                                                                                  tinue to offer continuing        further allow medical and        requirements.
PHONE                                    FAX                           E-MAIL                     medical education credits        health professionals to              The Association also
Check your membership category below. Enclose dues payment with                                   to health professionals.         attain continuing education      offers credits through its
your application and send it to APHA at the address above.
                                                                                                      The Association was          through APHA, one of the         Annual Meeting. Hundreds
❑ Regular — $160/year: Includes all member benefits, including monthly                            awarded accreditation in         nation’s leading authorities     of scientific sessions
issues of The Nation’s Health and the American Journal of Public Health.
                                                                                                  November from the Accred-        on public health,” said          offered during APHA’s
❑ Contributing — $210/year: Includes all member benefits plus individual
alerts to all Section newsletters and other special recognition.
                                                                                                  itation Council for Continu-     Allen Jones, PhD, APHA’s         Annual Meeting are
Special Subsidized Memberships — Includes online access to the
                                                                                                  ing Medical Education,           director of education and        approved for continuing
American Journal of Public Health, monthly mailed issues of The Nation’s                          which identifies, develops       global health resources.         medical education credits.
Health and additional APHA member benefits.                                                       and promotes standards for          Continuing education is       Also during its Annual
❑ Full-time Student— $50/year: Persons enrolled full time (a minimum of                           quality continuing medical       a core function of the Asso-     Meeting, APHA offers Con-
nine credit hours) in a college or university who are actively pursuing a                         education. The accredita-        ciation. The mission of the      tinuing Education Insti-
degree in the health field. (Attach proof of status.)
❑ Retired — $65/year: Persons retired from active public health practice
                                                                                                  tion will allow APHA to          Association’s education pro-     tutes, at which participants
and not deriving significant income from work-related activities.                                 continue to offer category 1     gram is to maintain and          can earn credits.
❑ Special Health Worker — $65/year: Persons employed in community                                 continuing medical educa-        enhance professional                 “APHA offers health pro-
health whose annual salary is less than $30,000 or the equivalent for foreign                     tion credit toward the           knowledge and to help            fessionals an array of health
nationals. Verification from employer is required. (Attach verification.)
                                                                                                  American Medical Associa-        members promote and pro-         fields opportunities to
❑ Consumer — $65/year: Persons who do not derive income from health-
related activities.                                                                               tion’s Physician’s Recogni-      tect the public’s health.        access the latest public
                                                                                                  tion Award. The accredi-            One way APHA offers           health information and
Total amount due: $
                                                                                                  tation, which lasts through      continuing medical educa-        most innovative public
PAYMENT: ❑ Check to APHA ❑ Visa                    ❑ Mastercard ❑ AmExpress                       November 2006, is based          tion credits is through its      health practices,” said
CARD NUMBER                                                            EXP. DATE
                                                                                                  on a number of criteria that     Journal-Based Education          Valerie Okrend, MA, MBA,
                                                                                                  APHA fulfilled, including        Program, which uses              APHA’s manager of continu-
YOUR SIGNATURE                                                                                    consistently using needs-        APHA’s American Journal of       ing professional education.
*Membership dues are not deductible as charitable contributions but may be deductible             assessment data to plan          Public Health to educate             For more information,
as an ordinary and necessary business expense.
                                                                                     TNH 03/03    continuing medical educa-        health professionals. Partici-   call (202) 777-2521. I

4           T h e N at i o n ’ s H e a lt h                                               ❖      March 2003
                                                                 that those who believed         events or exhibits; objects      minorities: Mexican Ameri-
Journal Watch                                                    they could trust their pri-
                                                                 mary care provider and
                                                                                                 and sites of historical, cul-
                                                                                                 tural or educational inter-
                                                                                                                                  cans, Puerto Ricans, Cuban
                                                                                                                                  Americans, blacks, Asian
                                                                 rated that provider as com-     est; and the availability of     Americans, Native Hawai-
Highlights from the January, February issues of                  petent and a good commu-        spectator sports, museums,       ians, American Samoans,
the American Journal of Public Health                            nicator were most likely to     zoos and amusement parks.        American Indians and
                                                                 receive both primary care          Of the 1,160 people sur-      Alaska Natives. The number
                                                                 and referrals to specialty      veyed, the researchers           of women in the minority
                                reduce death rates by up to      care. While minorities and      found “communities that          groups ranged from 24,500
Lack of insurance leads                                          low-income populations tra-     offer arts, entertainment        Alaska Natives to 15.3 mil-
                                60 percent.
to less preventive care            “Our results extend the       ditionally have less access     and recreation are more          lion blacks.
    Lack of health insurance    findings of other studies        to care than the general        likely to have healthier chil-       The results showed that
is a particular problem         showing that periods of          population, such patients       dren.” Such communities          while cancer incidence has
among people who may go         non-coverage increase peo-       with a good patient/            were not necessarily             slowed among minority
only short periods without      ple’s risk of going without      provider relationship were      wealthier neighborhoods,         women, cancer deaths have
coverage because they are       needed care and increase         more likely to receive          the study found.                 not. The researchers said
less likely to seek recom-      the likelihood that they will    essential care. (Page 138)         “While the results of this    more studies are needed to
mended follow-up care,          report problems involving                                        study warrant replication        determine the cultural fac-
care for chronic conditions                                                                      before inferences are            tors that contribute to the
and crucial preventive care,
                                access to care,” the study’s     Kids who have fun               drawn, communities that          continuing disparity.
                                authors wrote. “Additional
according to a study in the     policy initiatives are           are healthier                   have made an investment in           “Understanding cancer-
January issue of the Ameri-     needed to promote stability         Children who live in         the happiness of children        related health disparities in
can Journal of Public Health.   in insurance coverage.”          neighborhoods where art,        may be encouraged to find        women is an important
    In a study sample of        (Page 130)                       entertainment and recre-        that this also may extend to     step toward improving
almost 7,300 people who                                          ation are readily available     children’s health,” the study    health and the quality of
responded to a federal                                           are healthier than children     authors wrote. (Page 288)        life for millions of minority
health insurance survey in
                                Primary care providers           who don’t have access to                                         women,” the researchers
1992, 1994 and 1996,            break down barriers              such activities, according to
                                                                                                 Cancer more deadly               wrote. “Recent trends in
researchers found that             Having an easily accessi-     a study in the February                                          decreased incidence and
intermittent lack of insur-     ble and trustworthy pri-         issue of the American Jour-     for minority women               mortality from most cancers
ance coverage, even across      mary care provider is one        nal of Public Health.               The decline in cancer-       show that preventive strate-
a four-year period, resulted    of the best ways to ensure          Researchers looked at        related deaths among white       gies, early detection meth-
in less access to care. Par-    access to critical health ser-   families living in 20 Ohio      women over the past              ods and successful
ticularly lacking were pap      vices, according to a Janu-      counties and used U.S. Cen-     decade has not been shared       treatments of cancer are
smears and mammograms           ary Journal study.               sus data to determine how       by minority women,               more readily available.
among women and prostate           Researchers looked at         much art, entertainment         according to a February          More research is needed to
cancer screening for men.       more than 18,000 people          and recreation were avail-      Journal study.                   address social, cultural and
   Other studies have           surveyed for the 1996–1997       able in each community.              Researchers studied         biological determinants of
shown that early breast         nationwide Community             Such “fun” activities           cancer incidence and mor-        differential cancer profiles.”
cancer screening can            Tracking Study and found         included live performances,     tality rates among nine          (Page 292) I

  Take the first step to
  April 15-16, 2003 • Baltimore Marriott Waterfront Hotel
  Steps to a HealthierUS: Putting Prevention First Summit will focus
  attention on the urgency of prevention and on promising
  approaches for tackling key challenges. The Summit will
  highlight the priorities and programs for Steps to a HealthierUS,
  the U.S. Department of Health and Human Services’ initiative to
  advance the President’s HealthierUS Initiative. Registration before
  April 1, 2003, is encouraged.

                  Register online at
                               Registration $185

                                                                       March 2003                  ❖    T h e N at i o n ’ s H e a lt h                      5
The        Nation                                                Uninsurance rates back in public spotlight
Health news at the national and federal levels
                                                                 T         he issue of unin-
                                                                           surance entered
                                                                           back into the
                                                                 national spotlight in recent
                                                                 months, with Capitol Hill
                                                                                                    The new legislation
                                                                                                 comes as the nation’s prob-
                                                                                                 lem of uninsurance wors-
                                                                                                 ens: Data released in
                                                                                                 September by the U.S. Cen-
                                                                                                                                  another commodity,” said
                                                                                                                                  Sen. Edward Kennedy, D-
                                                                                                                                  Mass., in his introduction
                                                                                                                                  to the issue. “It is not a gift
                                                                                                                                  to be rationed based on
Obesity, diabetes continue                                       legislators introducing bills   sus Bureau show that 41          the ability to pay.”
                                                                 into Congress in support        million Americans were              Many Americans remain
to be major health threats                                       of a national health plan.      uninsured in 2001, a 1.4         concerned about the rising
                                                                    A group of physicians        million increase from 2000.      cost of health care in the
                                                                 and congressional leaders       A survey released in Janu-       United States and the effect

O          besity and dia-
           betes cases con-
           tinued to climb
during 2001, according to
January findings from the
                                18.5 to 24.9, those with a
                                BMI of 40 or higher had
                                an increased risk of being
                                diagnosed with those
                                health conditions. BMI is
                                                                 came together on Capitol
                                                                 Hill Feb. 4 to introduce the
                                                                 U.S. National Health Insur-
                                                                 ance Act, which would cre-
                                                                                                 ary by the Access Project
                                                                                                 found that uninsured Amer-
                                                                                                 icans have difficulty afford-
                                                                                                 ing care, even at institutions
                                                                                                                                  it will have on their health,
                                                                                                                                  according to a November
                                                                                                                                  poll by the Gallup Organi-
                                                                                                                                  zation. About 75 percent of
Centers for Disease Control     calculated by dividing a         ate a single payer national     designed to assist the poor      survey respondents said
and Prevention.                 person’s weight in kilo-         health program. The legisla-    and uninsured.                   they were dissatisfied with
    Obesity increased from      grams by the square of her       tion, introduced into the          APHA, which supports          the total cost of health care
19.8 percent to 20.9 per-       or his height in meters.         House by Rep. John Cony-        universal health care cover-     in the United States. About
cent of American adults            While obesity and dia-        ers, D-Mich., promises to       age and improving access         25 percent said they or
between 2000 and 2001,          betes are problems that cut      control health costs, pro-      to care for all Americans,       someone in their family
and diagnosed diabetes,         across gender, racial and        vide health coverage to the     has worked closely with          had put off medical treat-
including gestational dia-      ethnic divisions, the study      millions of Americans with-     key congressional members        ment because of cost.
betes, rose from 7.3 per-       found that blacks had the        out health insurance and        in recent months to help            Health advocates will
cent to 7.9 percent during      highest rate of both obesity     create comprehensive pre-       guide legislative work and       work to bring greater atten-
the same one-year period.       (31 percent) and diabetes        scription drug coverage for     debates on the issue.            tion to the issue of uninsur-
The findings were pub-          (11 percent). People with        the nation’s seniors.              The Association helped        ance in America during
lished in the Jan. 1 issue of   less than a high school edu-        The new bill is the latest   keep APHA’s work in the          Cover the Uninsured Week,
the Journal of the American     cation were also more            legislation on the issue of     forefront of Congress’ mind      March 10–16, of which
Medical Association.            likely to be obese and suf-      universal health coverage to    early this year by providing     APHA is a sponsor.
    “Obesity and diabetes       fer from diabetes.               make it before Congress,        every member of Congress            To access the January
are among our top public           The study data were           but won’t be the last this      a copy of the January issue      issue of AJPH, visit
health problems in the          collected through the            congressional session.          of the American Journal of       <>. For the
United States today,” said      Behavioral Risk Factor Sur-      Bipartisan legislation on       Public Health. The issue,        Access Project report, visit
Tommy G. Thompson, sec-         veillance System, a state-       the issue that was intro-       which focuses on health          <>.
retary of the U.S. Depart-      based telephone survey           duced into Congress last        care reform, contains com-       For more on Cover the
ment of Health and Human        that collects information        year by Sens. Ron Wyden,        mentary and insights on          Uninsured Week, visit
Services. “The good news        from adults. For the survey,     D-Ore., and Orrin Hatch, R-     ways to solve the nation’s       <www.covertheuninsured.
is that diabetes and other      participants were asked          Utah, is expected to resur-     health system crisis.            com>. For the Gallup poll,
chronic illnesses can be        about their height and           face this year.                    “Health care is not just      visit <>. I
prevented with modest           weight and whether they
lifestyle changes.”             had been diagnosed with
    More than 44 million        diabetes.
Americans are considered           Two other JAMA stud-            Partners target AIDS among black Americans
obese, reflecting a 74 per-     ies, one published Jan. 8
cent increase in the past
decade. Since 1991, dia-
                                and the other Jan. 22,
                                pointed to more disturb-
                                ing news when it comes
                                                                   H       ealth profes-
                                                                           sionals, educators
                                                                   and a new media
                                                                                                 more than $5.7 million to
                                                                                                 promote HIV/AIDS
                                                                                                                                  Awareness Day. The
                                                                                                                                  event, observed Feb. 7,
                                                                                                                                  encouraged black Ameri-
betes cases increased by
61 percent, according to        to Americans’ expanding            alliance used the oppor-         Through the Drumbeat          cans to become educated
federal health statistics,      waistlines and increased           tunity of Black History       Project, HIV/AIDS public         and get tested for HIV.
with an estimated 17 mil-       health risks. Obesity can          Month in February to          service announcements ran           Also drawing attention
lion Americans suffering        cut a person’s life by 10          draw attention to the         on radio stations and 200        to HIV/AIDS among
from the disease.               years, and for black men,          fight against HIV/AIDS        newspapers featured an           black Americans recently
    “These increases are        the toll is 20 years,              and the toll the disease      eight-part weekly series on      has been Magic Johnson,
disturbing and are likely       according to a Jan. 22             is taking on black            AIDS-related issues.             chair of the Magic John-
even underestimated,” said      study. And in a study of           Americans.                       Statistics show that          son Foundation.
CDC Director Julie L.           national surveys con-                  At the height of cre-     HIV/AIDS has become a               Johnson, a former
Gerberding, MD, MPH.            ducted between 1977 and            ating attention was the       disease that disproportion-      basketball player who
    The JAMA study showed       1998, portion sizes                newly formed Drum-            ately affects black Ameri-       was diagnosed with HIV
that prevalence of both         increased for nearly all           beat Project, a collabo-      cans: Although blacks            more than a decade ago,
diagnosed diabetes and          foods both at home and in          ration of broadcasters,       make up about 12 percent         has teamed up with drug
obesity varied widely           restaurants. For example,          publishers and online         of the U.S. population,          manufacturer Glaxo-
among states. Mississippi       the average soft drink,            media services. Through       they accounted for 38 per-       SmithKline to tour the
had the highest obesity rate    once 13 ounces and 144             the project, developed        cent of the almost 775,000       country and speak to
(26 percent), and Colorado      calories, grew to nearly 20        by the Black AIDS             cases of AIDS that had           communities with high
had the lowest (14 per-         ounces and 193 calories.           Institute and the Black       been reported to the Cen-        incidences of HIV/AIDS.
cent). Alabama had the             CDC recommends 30               Media Task Force,             ters for Disease Control            Barbara Hatcher, RN,
highest diabetes rate (11       minutes of moderate physi-         black-oriented media          and Prevention through           MPH, PhD, APHA’s direc-
percent) and Minnesota the      cal activity most days of the      outlets such as Ameri-        2000.                            tor of scientific and pro-
lowest (5 percent).             week for good health and           can Urban Radio Net-             Also in February, the         fessional affairs, said
    The study found signifi-    60 minutes to achieve sig-         work, Black Enter-            Community Capacity Build-        APHA is exploring ways
cant associations between       nificant weight loss.              tainment Television and       ing Coalition, a coalition of    the Association can work
overweight, obesity, dia-          For more information,           Honey, Vibe and Essence       community-based organiza-        with Johnson’s founda-
betes, high blood pressure,     visit <                magazines agreed to           tions funded by CDC, spon-       tion on mutual projects
high cholesterol, asthma        diabetes> and <www.cdc.            donate airtime and ad         sored the third annual           related to HIV/AIDS
and arthritis. Compared to      gov/nccdphp/dnpa> or call          placement valued at           National Black HIV/AIDS          prevention. I
adults with healthy weight,     (877) 232-3422 or (888)
or a body mass index of         232-4674. I

6        T h e N at i o n ’ s H e a lt h                 ❖      March 2003
Many of those injured lack insurance                            Smallpox vaccinations begin as concerns linger
Cost of gun-related injuries
in the hundreds of millions                                     P         ublic health
                                                                          around the nation
                                                                began administering and
                                                                                                 through the cracks.”
                                                                                                     However, Gerberding
                                                                                                 said that the emphasis in
                                                                                                 the smallpox plan was not
                                                                                                                                 for time off from work or
                                                                                                                                 health care costs.
                                                                                                                                    In a Jan. 24 news
                                                                                                                                 release, APHA Executive

G         un-related
          injuries racked
          up $802 million
in hospital charges in
1997, with almost 30 per-
                               injuries was about eight
                               days, according to the
                                  “(Guns) just continue to
                               be one of the leading
                                                                receiving smallpox vaccina-
                                                                tions in late January, step-
                                                                ping off a vaccination
                                                                campaign that could reach
                                                                                                 on the number of people
                                                                                                 to vaccinate, but rather on
                                                                                                 preparedness capacity.
                                                                                                     On Jan. 17, an Institute
                                                                                                                                 Director Georges Ben-
                                                                                                                                 jamin, MD, FACP, praised
                                                                                                                                 the overall smallpox vac-
                                                                                                                                 cine program for emer-
                                                                as many as 500,000 U.S.          of Medicine committee           gency workers as a
cent of patients lacking       causes of fatal and non-fatal    workers.                         called for more attention to    prudent, “important step to
insurance, according to a      injuries,” Holden said.              The vaccinations, part of    compensation, as well as        further improve our public
new study on gun injuries      “They are particularly prob-     a plan announced by Presi-       education on the risks and      health preparedness
in the United States.          lematic because they are a       dent Bush in December to         benefits for vaccine recipi-    efforts.” However, the
   Ranked as the second        problem among youth.”            protect the public from a        ents. The committee, estab-     Association also drew
leading cause of injury           Most patients admitted        terrorist release of small-      lished to advise CDC on         attention to the need for
deaths after car-related       to hospitals for gun-related     pox, are being provided to       the implementation of its       federal resources for the
deaths, guns caused            injuries came from low-          public health workers, hos-      smallpox vaccination plan,      program, liability protec-
32,400 deaths and more         income areas and were            pital staff, emergency first     recommended that CDC            tions for participants,
than 64,000 non-fatal          admitted to urban teaching       responders and military          evaluate adverse reaction       ongoing surveillance, ade-
injuries requiring treat-      hospitals and academic           personnel. Vaccination           data from initial recipients,   quate vaccine supplies and
ment in the United States      medical centers, the study       numbers in the early weeks       communicate more clearly        education and training.
in 1997, according to a        stated. Also, a quarter of       of the campaign were low,        with the public and clarify        APHA staff organized a
study published in the         patients identified in the       with dozens of hospitals         to workers whether com-         meeting with representa-
January issue of the Amer-     study listed Medicaid as                                          pensation for adverse reac-     tives from some of the
                                                                around the country
ican Journal of Preventive     their primary health insur-      announcing that they             tions is                                         nation’s
Medicine.                      ance, and more than half                                          available.                                       leading
                                                                would not take part in the
     Researchers from          of the total hospital cost of                                         “While                                       health and
                                                                program, in part because of
Allegheny General Hospi-       gun injuries was traced                                           we recog-                                        medical
                                                                safety concerns. However,
tal’s Center for Violence      back to gun injuries result-                                      nize that                                        organiza-
                                                                about 3,000 hospitals have
and Injury Control and the     ing from assault.                                                 CDC has                                          tions at the
                                                                said they will take part in
U.S. Agency for Healthcare        “Firearm-related                                               been asked                                       Associa-
                                                                vaccination programs, the
Research and Quality used      injuries rank highest
                                                                Centers for Disease Control      to initiate                                      tion’s Wash-
the 1997 Nationwide Inpa-      among all conditions in
                                                                and Prevention said in           the immu-                                        ington,
tient Sample, which con-       the number of uninsured
                                                                January.                         nization                                         D.C., head-
sists of patient discharge     hospital stays, and the
                                                                    As of Feb. 6 — about         campaign                                         quarters in
data from more than 1,000      average length of stay (in
                                                                two weeks after CDC began        rapidly, it’s                                    late January
hospitals in 22 states, for    the hospital) is much
                                                                sending vaccine supplies to      important to                                     to discuss
their study. Unfortunately,    longer compared to other
                                                                state and local governments      remember that recipients        concerns that exist around
there is no nationwide         medical conditions,” the
                                                                nationwide — about               of the vaccine are voluntar-    the smallpox program.
surveillance system in         report stated.
                                                                256,000 doses of smallpox        ily assuming its risks for         One of the most press-
place to specifically track       The study’s authors
                                                                vaccine had been requested       the greater public good,”       ing needs for public health
gun-related injuries,          stressed that hospital data
                                                                by 46 states and counties.       said Brian Strom, MD,           professionals and agencies
according to the study.        can provide an important
                                                                    Connecticut became the       MPH, chair of the IoM           involved in vaccinations is
    “Guns are often            framework for policy dia-
                                                                first state to begin vaccina-    Committee on Smallpox           that of funding, said Patrick
severely disabling and         logues concerning gun
                                                                tions on Jan. 24, the date       Vaccination Program             Libbey, executive director
that’s a reason why col-       legislation. Holden agreed
lecting data is so crucial,”                                    federal vaccine liability pro-   Implementation.                 of the National Association
                               and added that data needs
Janet Holden, PhD, chair                                        tections kicked in. While            In a media briefing the     of County and City Health
                               to be collected not only
of APHA’s Injury Control                                        state officials said they        day the IoM report was          Officials at a Jan. 29 Senate
                               on gun-related fatalities,
and Emergency Health                                            were expecting as many as        released, Gerberding said       hearing on the smallpox
                               but on those who survive
Services Section, told The                                      6,000 workers to eventually      CDC was working to              plan. A recent NACCHO
                               gun injuries.
Nation’s Health. “We need                                       be vaccinated, only a hand-      address many of the issues      survey found that one-third
                                  “Those injuries that
that complete information      don’t result in fatalities are   ful took part in the first day   identified by the commit-       of local public health agen-
to realize the real price,     needed to inform the             of vaccinations. On Jan. 29,     tee. For example, CDC has       cies believe that smallpox
both financial and social,     development of our pre-          Los Angeles County became        established a Data Safety       work is negatively affecting
that we are paying for         vention programs,”               the second municipality to       Monitoring Board that will      other public health pro-
these injuries.”               Holden said. “We need to         begin vaccinations, with         monitor the program as it       grams. Accounting for plan-
    Of the 35,800 gun-         know the characteristics         two dozen workers receiv-        progresses and detect any       ning, materials and other
related hospital discharges    of both the victims and          ing the vaccine. Nation-         unexpected problems, she        costs, each smallpox shot is
identified in 1997, more       the perpetrators and the         wide, about 690 workers          said, and has created edu-      costing localities from $142
than 85 percent of those       sites where these injuries       had been vaccinated by           cational materials, training    to $220, Libbey said.
injured were male and          are happening.”                  Feb. 6, CDC said.                Web casts and videos to            A second hearing on the
about 60 percent of all           APHA has a number of              The vaccinations began       inform health care person-      smallpox plan was held
patients were younger          policies on injury reduc-        even as questions on pro-        nel about administering         before a House committee
than 30 years old, the         tion, including those that       tection and compensation         and receiving the vaccine.      on Jan. 30, for which
study stated. The type of      urge schools of public           for workers receiving the        The U.S. Department of          APHA submitted testimony.
gun that caused injury         health to teach about gun-       vaccine lingered.                Health and Human Services          For more information
was not listed in a major-     related violence, call for           In a February news           is also working to address      on smallpox plans, visit
ity of cases, but more than    regulation of the gun            briefing, CDC Director           issues of liability and com-    <>.
30 percent of the cases        industry to reduce injuries      Julie Gerberding, MD,            pensation, she said.            For the IoM committee
were due to handguns.          and advocate increased           MPH, acknowledged that               Some legislators on         report, visit <www.nas.
Also, the average length of    state and local surveillance     compensation concerns            Capitol Hill have said they     edu>. For more on Libbey’s
hospital stays for such        of injury and violence.          “are resulting in people         would introduce legislation     statement, visit <www.
injuries was six days,            For a copy of the report,     being slow to accept the         authorizing federal com-> and for
totaling 111,500 hospital      visit <www.medicinedirect.       vaccine program, particu-        pensations for workers          APHA’s news release and
days for gun assault cases.    com/journal/journal/             larly in situations where        who suffer from adverse         testimony, visit <www.
Length of hospital stays       previous?sdid=6075>. I           they don’t have confi-           effects of the vaccine,>. I
for self-inflicted gun                      — Kim Krisberg      dence that they won’t fall       including compensation                       — Michele Late

                                                                      March 2003                   ❖    T h e N at i o n ’ s H e a lt h                    7
State & Local                                                                  Nine states sue to block EPA air pollution plan
Issues at the state and community levels                                       N         ine states are
                                                                                         legally challenging
                                                                                         the Environmental
                                                                               Protection Agency’s plan to
                                                                               relax air pollution controls
                                                                                                               modern air pollution con-
                                                                                                               trols when facilities are
                                                                                                               upgraded or modified.
                                                                                                               However, the new regula-
                                                                                                               tions exempt thousands of
                                                                                                                                                sions testing requirement, a
                                                                                                                                                revised approach for calcu-
                                                                                                                                                lating baseline emissions
                                                                                                                                                and looser caps on emis-
                                                                                                                                                sion levels, all of which
Maine takes fight for lower                                                    at power plants and other
                                                                               industrial facilities.
                                                                                                               industrial sources, such as
                                                                                                               coal-fired power plants,
                                                                                                                                                could lead to increased air
                                                                                                                                                pollution, the attorneys
drug prices to Supreme Court                                                      The states — Connecti-
                                                                               cut, New York, Maine,
                                                                                                               from New Source Review.
                                                                                                                  The attorneys general
                                                                                                                                                general said.
                                                                                                                                                    The EPA rule change
                                                                               Maryland, Massachusetts,        from the nine states said        was denounced by many

T        he U.S. Supreme
         Court heard argu-
         ments on Jan. 22 in
a case that could change
the debate on the high cost
                                       “We are here today not
                                    just for Maine, but for the
                                    nation,” said John Carr,
                                    president of the Maine
                                    Council of Senior Citizens,
                                                                               New Hampshire, New Jer-
                                                                               sey, Rhode Island and Ver-
                                                                               mont — filed a joint lawsuit
                                                                               against EPA in December in
                                                                                                               they were filing the lawsuit
                                                                                                               because their states are
                                                                                                               hard-hit by the damaging
                                                                                                               effects of smog and acid
                                                                                                                                                environmental and health
                                                                                                                                                advocates as well as some
                                                                                                                                                legislators on Capitol Hill.
                                                                                                                                                In January, members of the
of prescription drugs.              at a Washington, D.C., news                the U.S. Circuit Court for      rain, both of which are          U.S. Senate voted in favor
   The case, Pharmaceutical         conference a day before the                the District of Columbia.       linked to nitrogen oxide         of a study that will evaluate
Research and Manufacturers          Supreme Court hearing.                     The suit alleges that the       and sulfur dioxide emis-         the effects of power plant
of America vs. Concannon,              Also present at the news                new EPA regulations, which      sions from industrial            emissions on human
concerns a state-                   conference were two older                  took effect Dec. 31, will       sources. Even without the        health. However, the sena-
sponsored program in                Maine residents who take                   lead to increased air pollu-    new exemptions, pollution        tors rejected an amendment
Maine called Maine Rx,              part in Maine Rx Express, a                tion and violate the U.S.       sources such as power            sponsored by Sen. John
which uses the market               program sponsored by the                   Clean Air Act.                  plants release about 11 tons     Edwards, D-N.C., that
power of the state’s Medic-         Maine Citizen Leadership                      “The Bush administra-        of sulfur dioxide and 5 mil-     would have delayed the
aid program to negotiate            Fund that buses people to                  tion has taken an action        lion tons of nitrogen oxides     New Source Review roll-
lower prescription drug             Canada to purchase afford-                 that will bring more acid       each year, according to the      backs for six months, until
prices for all Maine resi-          able prescription drugs.                   rain, more smog, more           advocacy group Environ-          such a study was complete.
dents. According to the pro-           “I have to leave my own                 asthma and more respira-        mental Defense.                      Also in January, Sens.
gram, if a pharmaceutical           country to get medicine,”                  tory disease to millions of        “I find it incredible that    Joseph Lieberman, D-
manufacturer does not               said Rx Express participant                Americans,” said New York       we would have to resort to       Conn., and John MCain, R-
agree to give discounts to          Paulette Beaudoin at the                   Attorney General Eliot          a lawsuit to prevent the         Ariz., introduced legislation
the state, its products will        news conference. “That’s                   Spitzer.                        Bush administration from         that would require power
be put on a list of drugs           pretty sad.”                                  The new EPA regulations      gutting the Clean Air Act,”      plants to set mandatory tar-
that require prior authoriza-          Beaudoin said on her                    affect the New Source           said Maine Attorney Gen-         gets for reducing their
tion in Maine’s Medicaid            last trip to Canada, she                   Review Program, which is        eral G. Steven Rowe.             greenhouse gas emissions.
program. The Maine Rx               saved $5,000 on prescrip-                  part of the federal Clean Air      The multi-state lawsuit           For more information on
program, which has not yet          tion medicines. Fellow Rx                  Act. New Source Review          challenges key provisions        the New Source Review,
started, would be open to           Express rider Carleen Simp-                requires that power plants      of the new EPA regulations,      visit <>. I
any state resident, but only        son said she saved $2,000                  and industrial facilities add   such as a weakened emis-                      — Michele Late
individuals who pay out-of-         on a trip to Canada, and
pocket for prescriptions            noted that without the Rx
would receive discounts.            Express, she would have to                 States fall short on allocation of tobacco dollars
   Maine Rx was enacted             choose between the medi-
by Maine’s Legislature in           cines her doctor prescribes
2000 and soon after faced
opposition from the phar-
maceutical industry, which
sued the state. In 2001, the
                                    her and food and heat.
                                       U.S. Rep. Michael
                                    Michaud, D-Maine, who co-
                                    sponsored the Maine Rx
                                                                               B         illions of dollars
                                                                                         in tobacco settle-
                                                                                         ment money are
                                                                               being used to supplement
                                                                               state budgets rather than
                                                                                                               chief executive officer John
                                                                                                               L. Kirkwood.
                                                                                                                   The report was released
                                                                                                               four years after the 1998
                                                                                                               multi-state tobacco settle-
                                                                                                                                                ria developed by a National
                                                                                                                                                Cancer Institute advisory
                                                                                                                                                committee. Grading for
                                                                                                                                                tobacco program funding
                                                                                                                                                came from the Centers for
U.S. Court of Appeals for           legislation when he was a                  prevent tobacco use, and        ment, which stipulated that      Disease Control and Pre-
the First Circuit ruled that        state senator, announced at                states overall are doing a      the tobacco industry pay 46      vention’s “Best Practices for
Maine Rx does not violate           the news conference that                   bad job when it comes to        states approximately $206        Comprehensive Tobacco
the constitutional clauses on       he has begun drafting con-                 anti-smoking efforts,           billion over 25 years to         Control Programs.”
commerce and supremacy.             gressional legislation to cre-             according to the American       help defray the states’             According to the Ameri-
Nevertheless, the pharma-           ate America Rx, a national                 Lung Association.               tobacco-related health care      can Lung Association, the
ceutical organization               program based on Maine’s                      In a January report, the     costs. Four states settled       ideal state tobacco control
appealed the decision to the        original concept.                                                          their tobacco lawsuits sepa-     approach would include a
                                                                               association graded states on
Supreme Court. Maine’s                 For more information on                                                 rately for a total of $40 bil-   fully-funded, comprehen-
                                                                               their smoke-free air laws,
program cannot begin oper-          the Maine plan, visit <www.                                                lion over 25 years.              sive tobacco control pro-
                                                                               allocation of money toward
ating until the Supreme   >. I                                                                The American Lung            gram that reflects CDC’s
                                                                               comprehensive smoking
Court releases its ruling.                            — Kim Krisberg                                           Association also pointed to      minimum guidelines; a high
                                                                               prevention and cessation
                                                                               programs, cigarette taxes       cigarette taxes as an effec-     cigarette excise tax; smoke-
                                                                               and efforts to curb the sale    tive smoking deterrent and       free air in all public places;
                                                                               of cigarettes to youth.         funding source. Fourteen         and youth access laws that
                                                                               While 18 states received an     states and the District of       punish merchants who sell
                                                                               “A” in at least one category,   Columbia now have a ciga-        cigarettes to children.
                                                                               the majority of states          rette tax of at least $1 a          APHA policy adopted
                                                                               received at least one or        pack, according to the           during the 130th Annual
                                                                               more “F” grades for failing     report. But the average          Meeting in November urges
                                                                               to adequately address the       state cigarette tax was 62       states to use tobacco settle-
                                                                               cause of more than 440,000      cents in 2002, and 17 states     ment money for “tobacco
                                                                               yearly American deaths.         received an “F” grade in the     control and public health
                                                                                  “This report should be a     report for taxes that were       activities.”
                                                                               wake-up call to state legis-    far below the average.              More information is
                                                                               lators and governors about          The grades each state        available at <www.
                                                                               how far they need to go to      received in the American>. APHA poli-
                      Photo courtesy World Health Organization, by P. Virot    address the tobacco epi-        Lung Association report for      cies are available at <www.
The price of prescription drugs is at the center of a Supreme                  demic,” said American Lung      smoke-free laws and youth
Court case concerning an innovative drug program in Maine.                     Association president and       access were based on crite-      index.htm>. I

8        T h e N at i o n ’ s H e a lt h                              ❖       March 2003
                                                                             Connecticut targets racial, ethnic disparities

                                                                             C         onnecticut
                                                                                       state health offi-
                                                                                       cials are working
                                                                             to eliminate racial and eth-
                                                                             nic heath disparities in the
                                                                                                              community residents to a
                                                                                                              local health fair, at which
                                                                                                              they can participate in a
                                                                                                              host of activities.
                                                                                                                  “The local health depart-
                                                                                                                                                new edition of the report is
                                                                                                                                                expected this year.
                                                                                                                                                    For five years, the state
                                                                                                                                                health department has con-
                                                                                                                                                tained an Office of Multicul-
                                                                             state, tackling the issue        ment plays an important           tural Health, which is
                                                                             community by community.          role in reaching out to spe-      tasked with improving
                                                                                 Under a program led by       cific communities,” Beras-        health by eliminating racial
                                                                             the Connecticut Depart-          tain said.                        and ethnic health dispari-
                                                                             ment of Public Health, com-          The state health depart-      ties. More recently, the
                                                                             munities across the state        ment’s efforts come as the        health department hosted
                                                                             are hosting local health         racial and ethnic make-up         the state’s first Multicultural
                                                                             forums on the issue of           of Connecticut’s population       Health Summit, bringing
                                                                             racial and ethnic health dis-    becomes more diversified.         together 250 health officials
             Photo courtesy U.S. Department of Agriculture, by Ken Hammond   parities. Working through        According to the 1990 U.S.        in August.
Shoppers select seafood at their local supermarket. California’s             local health departments,        Census, 10 percent of resi-           The array of work being
attorney general wants to put mercury warnings on some fish.                 Connecticut residents are        dents identified themselves       done by the state and local
                                                                             invited through fliers, radio    as black, almost 8 percent        health departments testifies
California stores sued for                                                   announcements and adver-
                                                                             tisements in culturally rele-
                                                                                                              as Hispanic and 2 percent
                                                                                                              as Asian.
                                                                                                                                                to the high priority that
                                                                                                                                                eliminating racial and eth-
                                                                             vant newspapers to meet              The community outreach        nic disparities in health has
lack of mercury warnings                                                     with their local health com-     programs are just one facet       in the state, said Michael
                                                                             missioner and discuss            of health officials’ efforts to   Purcaro, spokesman for the

I    n an attempt to
     protect consumers
     from eating fish conta-
minated by mercury, Cali-
fornia’s attorney general is
                                      stores from selling the fish
                                      until they post mercury
                                      warnings. It also seeks civil
                                      penalties for violations of
                                      Proposition 65 and the
                                                                             health issues. Health offi-
                                                                             cials are using feedback
                                                                             from the forums to develop
                                                                             interventions and programs
                                                                             that are tailored to the
                                                                                                              make inroads on the issue
                                                                                                              of disparities in health. State
                                                                                                              health workers regularly
                                                                                                              collect data on diseases and
                                                                                                                                                Connecticut Department of
                                                                                                                                                Public Health.
                                                                                                                                                    “The issue of multicul-
                                                                                                                                                tural health is not just in
                                                                                                              conditions known to dispro-       one program,” Purcaro said.
suing five grocery stores for         state’s Unfair Competition             needs of their residents.        portionately affect minority      “It transcends all bureaus
not providing warnings on             Act. Under both laws, each                 So far, the program has      populations.                      and divisions. I think that’s
their fish packaging.                 defendant is liable for civil          been directed mainly at the          Armed with such find-         the key to the success of
   The fish in question —             penalties of up to $2,500              state’s eight main urban         ings, the state produced its      our efforts.”
tuna, swordfish and shark             per day for each violation.            cities, which contain some       first Multicultural Health            For more information on
— have routinely been                 Lockyer said the stores                of the state’s most diverse      Report in 1999, detailing         Connecticut’s activities, visit
found to contain high levels          have been failing to com-              populations. But plans call      the health status of minor-       <>. I
of mercury, a known car-              ply with Proposition 65                for the forum program to         ity groups in the state. A                      — Michele Late
cinogen. APHA policy sup-             since 1988.                            be expanded to less popu-
ports more efforts aimed at              Representatives from the            lous and rural sites in
both reducing mercury con-            stores did not respond to              upcoming months.
tamination in fish and                inquiries from The Nation’s                While the state health
warning the public about              Health on the lawsuit.                 department plays an impor-
possible exposure.                       Some facts about mer-               tant role in shepherding the      BoneScreen’s
   California Attorney Gen-           cury and fish:                         community health forum
eral Bill Lockyer said the            N The U.S. Environmental               program, it is the local          Osteoporosis
suit was not intended to                 Protection Agency has               health workers that connect
discourage people from                   advised pregnant                    with residents, said Edna         Screening with
eating fish, but rather to               women and women of                  Berastain, executive assis-       Omnisense 7000
ensure they make informed                childbearing age to eat             tant to the state’s health
decisions about their food               no more than 12 ounces              commissioner, who over-           Ultrasound
choices.                                 of fish weekly. The Food            sees the health depart-
   “Generally, fish are an               and Drug Administration             ment’s Office of
important source of protein              has advised pregnant                Multicultural Health.
and play a prominent role
in many Californians’ diets,”
Lockyer said. “But con-
                                         women not to eat sword-
                                         fish and shark because
                                         of high mercury levels.
                                                                                 “It has really given us a
                                                                             good idea of what is in the
                                                                             minds of different commu-
                                                                                                                 O     ver 200 attendees of the APHA 130th annual meeting
                                                                                                                       in Philadelphia were screened for osteoporosis risk
                                                                                                                 with the Omnisense 7000 ultrasound diagnostic instru-
sumers deserve to know                N In a one-year survey of              nities in Connecticut in            ment. These screens have the advantage of being radia-
when they are being                      internal medicine                   regard to health,” Berastain        tion-free, precise, fast and inexpensive.
exposed to chemicals that                patients in San Fran-               said.                                    BoneScreen President Robert Jusino, DC, MPH, with
can cause cancer, birth                  cisco, a significant num-               Also at the local level,        the assistance of manufacturer Sunlight Medical, provided
defects and reproductive                 ber of patients had diets           state health officials are
harm.”                                                                                                           osteoporosis education and screenings at their booth.
                                         high in fish. A large per-          reaching out to communi-
   In a complaint filed in                                                                                           “We are excited to provide such a valuable public
                                         centage of those                    ties on racial and ethnic
January in San Francisco                 patients, including                 health issues by teaming up         health service to so many academic and government offi-
Superior Court, Lockyer                  women and children,                 with churches, businesses           cials,” Jusino said. “Hopefully they can help to update
alleged that fives stores —              had blood mercury lev-              and community groups. In            the present, x-ray dominated, osteoporosis guidelines to
Safeway, Kroger’s, Albert-               els exceeding federally             one particularly successful         reflect the technological advances and advantages of
son’s, Trader Joe’s and                  recommended standards.              partnership, local health           diagnostic ultrasound.”
Whole Foods — violated                N Fish such as lake trout,             officials have joined with              “It is too late for preventive nutritional and exercise
the state’s Proposition 65.              salmon and bass are less            volunteer faith-based orga-         measures after age 65. The general population must be
The ballot initiative enacted            likely to contain high              nizations to distribute infor-      educated and screened with ultrasound diagnostics at a
by voters in 1998 requires               mercury levels if they              mational health packets             much earlier age for effective osteoporosis prevention.”
businesses to provide “clear             are small and young.                door-to-door. The packets
                                                                                                                     BoneScreen will exhibit their instruments at booth 969
and reasonable” warnings                 For more information,               contain health information
before exposing people to             visit <           that is determined to be rel-       in the upcoming APHA annual meeting in San Francisco.
known carcinogens and                 us>. APHA policies are                 evant to each community,            For more information contact Dr. Jusino at (847) 331-4208,
reproductive toxins.                  posted at <www.apha.                   noted Berastain.                    e-mail or visit our Web site at
   The lawsuit asks the               org/legislative/policy/                    The volunteers use the
court to prohibit the five            index.htm>. I                          face-to-face contact to invite

                                                                                   March 2003                   ❖    T h e N at i o n ’ s H e a lt h                        9
NPHW 2003,                      Public Health Association.      and planner to thousands
Continued from Page 1              The new toolkit is a         of health departments
                                supplement to APHA’s            nationwide. Copies will
problem, state-by-state data    annual National Public          also be provided to each
and information on minori-      Health Week Planner’s           of APHA’s 53 state and
ties and children.              Guide, which has been           local Affiliates.
    With almost two-thirds      updated for 2003. The               About 20 national
of U.S. adults now over-        planner’s guide, which is       health organizations had
weight and millions of          also available online,          signed on as National Pub-
children at risk, National      includes ideas for National     lic Health Week partners as
Public Health Week’s focus      Public Health Week events,      of early February, with
on overweight and obesity       strategies for coordination     more expected. Co-sponsor-
comes at an important           and planning, tips on           ing organizations include
time, according to Patricia     developing a marketing          the Association of American
Markham Risica, DrPH, a         plan and advice on how to       Medical Colleges, American
Food and Nutrition Section      reach the community.            Dietetic Association, Ameri-
member who is serving as           Visitors to the National     can Dietetic Association
a liaison for the event.        Public Health Week Web          Foundation and Research        Emad Al-Badawi, of Tufts University Dental School, teaches
    Risica encouraged           page can download a copy        America.                       teethbrushing techniques to students at a preschool in Brook-
APHA’s Sections and Affili-     of the 2003 logo to use on          “Many people nation-       line, Mass., during last year’s National Public Health Week.
ates to use National Public     their materials or Web          wide are excited about
Health Week as an opportu-      pages. They can also sub-       being involved in National     lights from National Public      Health, c/o APHA, 800 I
nity to plan events around      mit details of the upcoming     Public Health Week this        Health Week celebrations         St., N.W., Washington DC
overweight and obesity or       events and plans for the        year,” Mayo said. “We are      across the country in an         20001-3710, fax (202) 777-
to educate their colleagues     celebration.                    expecting to see greater       upcoming issue. Partici-         2532 or e-mail <nations.
and communities.                   Along with the new           involvement than ever          pants should send a sum->.
    “One of the best parts      focus on overweight and         before.”                       mary of what they did to             To download National
of the APHA initiative is       obesity, APHA is undertak-          Communities, organiza-     observe the event, who           Public Health Week mate-
that it provides a lot of       ing greater outreach to         tions and health advocates     was involved and what the        rials, including the toolkit,
information and resources,      promote National Public         who take part in National      goals were. Photos and art-      planner’s guide and logo,
but also allows users to        Health Week this year. The      Public Health Week events      work are also welcome.           visit <
decide what are the best        Association is teaming          this year will have an             The deadline for mater-      nphw>. For more informa-
tactics to reach their own      with the National Associa-      opportunity to have their      ial submission to The            tion, call Mayo at (202)
audiences,” said Risica,        tion of County and City         work publicized in The         Nation’s Health is Monday,       777-2515 or e-mail <lakitia.
who is also the president-      Health Officials to distrib-    Nation’s Health. The news-     May 5. Send your informa->. I
elect of the Rhode Island       ute copies of the toolkit       paper will showcase high-      tion to Editor, The Nation’s                   — Michele Late

Medicaid,                       a Washington, D.C., news        pant David Parella, direc-     Medicaid eligibility in fis-     ated almost $280 billion in
Continued from Page 1           conference announcing           tor of Connecticut’s Med-      cal year 2003, according to      increased output of goods
                                the report.                     ical Care Administration.      the survey.                      and services from
next four months, according        The rise in Medicaid         Parella said three things         “Medicaid is caught in a      increased business activ-
to the survey. Of the 37        spending was driven by          are needed to keep Med-        crossfire between the            ity. The report found that
states that said their spend-   an 8.5 percent rise in the      icaid functioning: more        rapid deterioration of state     nearly $6 billion in
ing is exceeding budgeted       program’s enrollment,           flexibility within the pro-    revenues, on the one             increased business activity
levels, 32 reported excessive   according to the govern-        gram, more federal assis-      hand, and increased              per state was generated
Medicaid or health costs.       ment report. Program            tance with prescription        health care spending, on         due to Medicaid spending.
   According to the latest      expansions to cover the         drugs and reexamination        the other,” the survey           Also in fiscal year 2001,
figures from the federal        uninsured and looser eli-       of state and federal roles     stated.                          Medicaid spending created
government’s annual report      gibility standards were         in relation to Medicaid.          Ironically, cutting Med-      almost 3 million jobs and
on national health care         cited as reasons for the           “It’s time for the fed-     icaid funds could actually       increased wages.
spending, Medicaid’s total      enrollment spike. In com-       eral government to pay its     do more damage than                  “As state budget
budget had grown to             parison, spending on            fair share,” Parella said.     good to state economies,         options are weighed and
$224.3 billion in 2001, a       Medicare, the government           But because Medicaid,       according to the January         balanced, the equation
growth of 10.8 percent —        health program serving          which covers more than         report “Medicaid: Good           should include recognition
the fastest growth since        seniors, grew to $242 bil-      42 million low-income          Medicine for State               of the economic benefit of
1993.                           lion in 2001, a growth that     people, is the second          Economies” by Families           using state spending on
   Overall, the nation’s        was 2.8 percentage points       largest program of most        USA, an advocacy organi-         Medicaid to pull in new
health care spending            faster than in 2000.            states’ budgets, it has        zation for health care con-      federal dollars,” the report
reached $1.4 trillion in           The report warned that       become prime territory for     sumers.                          stated. “These new federal
2001. The 8.7 percent rise      as the nation’s economic        budget cuts, according to         The report argued that        dollars are a powerful
in health care spending is      recession continues, a ris-     a 50-state and District of     “every dollar a state spends     stimulus to state
the “fastest growth in a        ing number of uninsured         Columbia survey con-           on Medicaid pulls new fed-       economies.”
decade and is another           people are going to             ducted by the Kaiser Com-      eral dollars into the state          Under a latebreaking
sign of the waning influ-       depend on state and fed-        mission on Medicaid and        — dollars that would not         policy adopted by APHA’s
ence of managed care,”          eral governments for            the Uninsured that was         otherwise flow into the          Governing Council at the
according to “Trends in         health care. To keep Med-       released in January.           state.” About 43 percent of      Association’s 2002 Annual
U.S. Health Care Spend-         icaid programs afloat, the         According to the sur-       total federal grant dollars      Meeting, APHA called on
ing, 2001,” which was           federal government will         vey, since the beginning of    given to states is because       Congress to enact legisla-
published in the                need to pitch in more           the fiscal year, 49 states     of Medicaid, according to a      tion that would help states
January/February 2003           money, said Alan Weil,          have created plans or          2002 study cited in the          limit the severity of Medic-
issue of Health Affairs.        director of the Assessing       already acted to lower         Families USA report.             aid cuts.
   “Clearly, our society has    New Federalism Project at       Medicaid spending. Also, a        Using an economic                 For more information
a desire to purchase            the Urban Institute, dur-       number of states reported      model created by the U.S.        on Medicaid and health
health care over other          ing the news conference.        plans for new caps on          Department of Com-               spending, visit <www.
goods,” said one of the            “Medicaid is the core of     pharmacy costs, restric-       merce’s Bureau of Eco- >, <www.
report’s authors, Katharine     the nation’s health care        tions on eligibility, reduc-   nomic Analysis, Families> or <www.familiesusa.
Levit, director of the          safety net,” he said.           tions in benefits and          USA found that in fiscal         org>. For APHA’s policies
National Health Statistics         Medicaid has always          increases in co-payments.      year 2001, the more than         visit <
Group at the Centers for        been underfunded, said          Twenty-seven states            $97 billion that 50 states       legislative/policy>. I
Medicare and Medicaid, at       news conference partici-        reported plans to restrict     spent on Medicaid gener-                      — Kim Krisberg

10       T h e N at i o n ’ s H e a lt h                ❖      March 2003
                                                               of The Nation’s Health.                well-connected to Section                       respond to their needs,”
The       Sections                                             “The newspaper is always
                                                               looking for ways to high-
                                                                                                      leadership, other Section
                                                                                                      members and the Section
                                                                                                                                                      Taylor said.
                                                                                                                                                         Because many new Sec-
                                                               light innovative Section               as a whole.                                     tion members and stu-
                                                               activities.”                                The survey also                            dents responded that they
News about the Association’s Sections,                            Taylor said the HIV/                addressed issues such as                        felt “disenfranchised” at
Special Primary Interest Groups & Caucuses                     AIDS Section survey                    what needs members                              the Section’s socials dur-
                                                               elicited a 23 percent                  would like the HIV/AIDS                         ing the APHA 130th
                                                               response rate from Section             Section to address.                             Annual Meeting in
                                                               members, and its results               Respondents suggested                           Philadelphia in November,
Member outreach shapes future activities                       will be used to shape Sec-             expanding network and                           Taylor said the Section is
                                                               tion activities and improve            information-sharing                             developing a mechanism
HIV/AIDS Section uses survey                                   communication among                    opportunities via e-mail,                       to make everyone feel
                                                               Section members.                       identifying other mem-                          included and welcomed.
to gauge members’ needs                                           “People had a lot of
                                                               good ideas for how they
                                                                                                      bers’ areas of expertise
                                                                                                      and opportunities to
                                                                                                                                                      Also, the Section is begin-
                                                                                                                                                      ning a mentoring program
                                                               wanted to get more                     access that expertise and                       for students and new

W                 ith inspiration from a fellow
                   Section, APHA’s HIV/AIDS Section recently
                  released results from a survey designed to
assess the needs of its quickly growing membership.
                                                               involved in the Section,”
                                                               Taylor told The Nation’s
                                                                  The survey touched on
                                                               a variety of issues, such as
                                                               reasons for joining the
                                                                                                      more opportunities for
                                                                                                          Other survey questions
                                                                                                      tried to gauge interest in
                                                                                                      the Section’s e-mail
                                                                                                      newsletter, listserve and
                                                                                                                                                      researchers, which will
                                                                                                                                                      match students with
                                                                                                                                                      HIV/AIDS Section mem-
                                                                                                                                                      bers, Taylor reported.
                                                                                                                                                         “The survey gives us
                                                                                                                                                      very useful ideas on what
   After reading in The         vey via e-mail to Section      Section, how connected to              Web site. Section leaders                       people want from the Sec-
Nation’s Health about the       members and mailed sur-        the Section members felt               also wanted to know how                         tion, and the insight we
success of a similar survey     veys to those who had not      and what services mem-                 many members were inter-                        need to serve our mem-
conducted by the Oral           provided APHA with an e-       bers would like the Sec-               ested in receiving continu-                     bers better,” said
Health Section, the Sec-        mail address. The Section      tion to offer.                         ing education credits and                       HIV/AIDS Section Chair
tion’s leadership decided a     even offered a $100 gift          Taylor noted that she               in what area education                          Richard Conviser, PhD.
survey would be a great         certificate raffle prize to    was surprised at the num-              was desired. Respondents                           The winter 2003
way to evaluate the needs       members who chose to           ber of survey respondents              were also asked their                           HIV/AIDS Section
of its own members.             provide their name with        who did not feel con-                  areas of expertise in the                       newsletter can be
Stephanie Taylor, PhD,          their survey responses.        nected to the Section.                 HIV/AIDS field and the                          accessed with a member
MPH, the Section’s mem-            The survey was based        According to the survey                populations with which                          password through
bership chair, said that the    on a rough draft of the        results, which were pub-               they work or study.                             <>
HIV/AIDS Section, which         Oral Health Section’s sur-     lished in the Section’s                    “(Section leadership)                       or through the APHA Web
attained Section status in      vey, which had helped the      winter 2003 newsletter,                now feels in touch with                         site at <
2000, is growing so             Oral Health Section priori-    large numbers of Section               members and we can plan                         sections>. I
quickly that Section lead-      tize its goals and projects,   respondents did not feel               some specific activities to                                           — Kim Krisberg
ership didn’t have a han-       according to an article on
dle on who was joining or       the project published in
what they wanted.               the November 2001 issue
                                of The Nation’s Health.
   The Section decided to
conduct the survey last
summer and began the
                                   “It’s great to know that
                                APHA’s official newspaper
                                                                    Earn credit for reading
process in November. With
APHA’s help, the Section
                                is helping to inspire new
                                ideas within Sections,”
                                                                         the Journal!
sent the 41-question sur-       said Michele Late, editor                    Journal-Based Education Program
                                                                                    Fall 2003 Program:
  Public Health Nursing Section calls                                         AJPH issues January-June 2003
  for nominees for three awards                                                                                         health education; communicate health and health

                                                                     ublic health professionals who read the
                                                                                                                        education needs, concerns, and resources.
 A      PHA’s Public Health Nursing Section is
        calling for nominations for awards that it will
 be presenting at APHA’s 131st Annual Meeting in
                                                                     American Journal of Public Health can earn
                                                                     continuing education hours for their efforts.
                                                                         Registration Deadline: July 25, 2003
                                                                                                                        How the Program Works
                                                                                                                        Through self-directed learning, participants read 6
 San Francisco in November.                                     This CE / CME program is currently available to         AJPH issues. An exam of no more than 50 questions
    Nominations are requested for the following                 CHES and physicians for credit. However non-physi-      derived from the reading is sent to participants for
                                                                cians may participate in CME and obtain a certificate
 honors:                                                                                                                completion. Exam answers and program evaluations
                                                                of participation.
 N the Ruth B. Freeman Award, which will recognize                                                                      are returned to APHA for tabulation. For a score of
    a person who has had a distinguished career in                                                                      75% or better, CHES earn 25 Category I continuing
    public health, in service or in education;                                                                          education contact hours (CECH), physicians earn 25
                                                                Purpose/Objective: To expose physicians involved
 N the Public Health Nurse Creative Achievement                                                                         hours of Category 1 credit toward the AMA PRA.
                                                                in public health to the latest research, information
                                                                and trends presented in the scientific peer-reviewed    (Note: certificates of participation are provided to
    Award, which will recognize an individual’s cre-
                                                                American Journal of Public Health, and enable them      non-physician CME participants.) Certificates of
    ative contribution to public health nursing prac-                                                                   award are sent thereafter.
                                                                to maintain, develop, or increase their knowledge,
    tice, research, education or administration; and
                                                                skills, and professional performance in the domain
 N the Lillian Wald Service Award, which will recog-            of public health.                                       JBE Fall 2003 Program—Information
    nize individuals, agencies or media depicting                                                                       AJPH issues referenced: . . . . . . .January-June 2003
    exemplary public health nursing practice to the             Certified Health Education Specialists                  Registration deadline: . . . . . . . . . . . .July 25, 2003
    public, especially in political, legislative, profes-       (CHES)                                                  Materials/exam mailed: . . . . . . . . . .August 8, 2003
    sional or interdisciplinary activism.                       Objective: To expose CHES to the latest research,       Answer sheets/evaluation due: . . .October 3, 2003
    The deadline for submission of nomination materi-           information and trends presented in the peer-           Certificates mailed: . . . . . . . . . .November 7, 2003
 als is May 1, 2003. For questions or to request nomi-          reviewed American Journal of Public Health, in
                                                                order to provide an educational experience that
                                                                                                                        For more information: Call (202) 777-2522,
 nation materials, contact the chair of the PHN Section                                                                 e-mail or go to
                                                                helps CHES maintain their core competencies,
 Awards Committee, Derryl Block, PhD, MPH, RN, at                                                                       education
                                                                which are to: assess individual and community
 the University of Wisconsin Green Bay, 2420 Nicolet            needs for health education; plan effective health
                                                                                                                        Accreditation Statement: APHA is accredited by the Accreditation
                                                                                                                        Council for Continuing Medical Education to provide continuing medical
 Drive, A312 Mary Ann Cofrin Hall, Green Bay, Wis-              education programs; implement, evaluate the effec-      education for physicians. Designation Statement: APHA designates this
                                                                                                                        educational activity for a maximum of 25 hours in category 1 credit
 consin 54311-7001; fax (920) 465-2854; call (920) 465-         tiveness of, and coordinate the provision of health     toward the AMA Physician’s Recognition Award. Each physician should
 2976; or e-mail <>. I                           education programs; act as a resource person in         claim only those hours of credit that he/she actually spent in the activity.

                                                                     March 2003                         ❖     T h e N at i o n ’ s H e a lt h                                                    11
                                                                                  2004 Budget,                         “Last year, we made the      that focus on health pro-
 New commitment to chronic                                                        Continued from Page 1            largest one-time commit-
                                                                                                                   ment to the nation’s public
                                                                                                                                                    fessions training, child-
                                                                                                                                                    hood vaccinations, worker
 disease prevention proposed                                                      global HIV/AIDS. In his          health infrastructure ever,”
                                                                                                                   said HHS Secretary Tommy
                                                                                                                                                    safety and health pro-
                                                                                                                                                    grams, and family plan-
                                                                                  Jan. 28 State of the Union

 P     resident Bush’s federal budget proposal for
       fiscal year 2004 includes a new initiative aimed at
 combating the nation’s chronic disease epidemic.
                                                                                  Address, Bush announced
                                                                                  plans for the Emergency
                                                                                  Plan for AIDS Relief, which
                                                                                                                   Thompson. “In this budget,
                                                                                                                   we are redoubling and
                                                                                                                   building on our commit-
                                                                                                                                                    ning programs for
                                                                                                                                                    low-income women.
                                                                                                                                                        At NIH, the president’s
     The Steps to a Healthier U.S. initiative, unveiled by                        would provide $15 billion        ments to make America            budget would bring to a
 the U.S. Department of Health and Human Services                                 during the next five years       better prepared to respond       close a run of significant
 Jan. 22, would use community-based programs to                                   to African and Caribbean         to any kind of attack or dis-    funding growth at the
 tackle asthma, diabetes and obesity. Bush’s budget                               countries.                       ease outbreak.”                  agency, raising concerns
 plan proposes $125 million for the plan, which would                                 The plan, which Bush             The president’s budget       from medical care and
 fall under the authority of the Centers for Disease                              introduced as “a work of         also included a new com-         research advocates. The
 Control and Prevention.                                                          mercy beyond all current         mitment to combating             president’s plan recom-
     “To truly stem the epidemic of preventable diseases                          international efforts,” would    chronic disease. The Steps       mended only a 2 percent
 that threaten too many Americans, we need to move                                reportedly triple the U.S.       to a Healthier U.S. initiative   increase to the agency’s
 from a health care system that treats disease to one                             commitment to AIDS,              would provide $125 million       budget, vs. the 14 percent
 that avoids disease through wiser personal choices,”                             beginning with $2 billion in     to prevent diabetes, obesity     to 15 percent annual
 said HHS Secretary Tommy Thompson. “This new                                     fiscal year 2004. The presi-     and asthma through com-          increases provided during
 initiative will support community programs aimed at                              dent’s proposal would use a      munity initiatives (see side-    the past five years.
 getting results and helping those at risk to avoid these                         network of clinics, sites and    bar, left).                          “Unless there is sus-
 diseases through proven prevention methods.”                                     programs established                 The Indian Health Ser-       tained federal support, the
     According to HHS, the Steps to a Healthier U.S. ini-                         through HHS, the U.S.            vice is proposed to receive      recent momentum we have
 tiative would include state programs that would sup-                             Agency for International         $114 million for sanitation      gained in research could be
 port positive health choices, such as healthy eating                             Development, organizations       construction projects under      lost completely in just a few
 and exercise; community-based programs, especially                               and host governments.            the budget. The $20 million      years,” said Jordan J.
 those aimed at younger and older Americans; and                                      The president’s              increase would help sup-         Cohen, MD, president of
 health care and insurance systems that place a priority                          announcement was wel-            port safe water and waste        the American Association of
 on prevention.                                                                   comed by many AIDS and           disposal to about 22,000         Medical Colleges.
     The initiative has specific goals of preventing                              international health advo-       homes. The agency’s bud-             Air, water, land and
 asthma-related hospitalizations for at least 50,000                              cates, including the joint       get would also provide           enforcement activities at
 Americans, preventing obesity for at least 100,000                               United Nations Programme         $150 million for diabetes        the Environmental Protec-
 Americans and preventing diabetes for at least 75,000                            on HIV/AIDS, which called        prevention grants — a $50        tion Agency were slated to
 Americans during fiscal year 2004.                                               the measure “an encourag-        million increase — to 300        receive a 7 percent
     The new HHS initiative builds on the White House’s                           ing sign.”                       tribes and organizations.        increase under the presi-
 Healthier U.S. program, launched in June 2002.                                       “This initiative should          In regard to Medicare,       dent’s plan. About $7.7
     For more information on the proposed initiative,                             spur other wealthy coun-         the president’s plan pro-        million of the agency’s
 see the Jan. 22 news release at <>. I                                 tries to increase their sup-     poses $400 billion over 10       $7.63 billion budget was
                                                                                  port for global AIDS             years to revamp the pro-         proposed for the EPA’s
                                                                                  efforts,” said Peter Piot, MD,   gram, including a subsi-         Clear Skies initiative,
JUST PUBLISHED! ORDER YOUR COPY TODAY!                                            PhD, executive director of       dized prescription drug          which has been touted by
                                                                                  UNAIDS. “AIDS is rapidly         benefit, preventive benefits     the Bush administration as
                           New book about bioterrorism                            wiping out decades of            and insurance protection,        a way to reduce power
                           and other public health disasters                      development and contribut-       according to HHS. The bud-       plant emissions. An addi-
                                                                                  ing to regional instability.     get also proposes a 12 per-      tional $3 million — for a
                                                                                  The case for increasing          cent increase for Medicaid,      total of $23.9 million —
                           Public Health                                          action against the epidemic      which Thompson said              was earmarked for EPA’s
                                                                                  has never been stronger or       would “give states more          efforts on children’s
                           Management of                                          more urgent.”                    flexibility to tailor coverage   asthma, including its suc-
                                                                                                                   to the needs of recipients.”     cessful school program.
                           Disasters:                                                 However, some advo-
                                                                                  cates were disappointed              Prior to the release of          Some critics took issue
                           The Practice Guide                                     that the president’s budget      the president’s proposal,        with increases touted in the
                                                                                  did not include additional       APHA and more than a             president’s 2004 proposal
 By Linda Young Landesman, DrPH, MSW                                              funding for the Global           dozen other health and           because of the way they
                                                                                  Fund to Fight AIDS, Tuber-       medical groups released a        were derived. Usually, fund-

 T    he tragic events of Sept. 11, 2001, raised the stakes for public health.
      This timely book is both desk and field manual for health, public
 health and public safety practitioners who need rapid information about
                                                                                  culosis and Malaria, which
                                                                                  is facing a funding crisis.
                                                                                                                   news release outlining the
                                                                                                                   nation’s most pressing
                                                                                                                                                    ing projections are mea-
                                                                                                                                                    sured against spending for
 disaster preparedness, response and recovery.                                    APHA was part of a letter        health problems. The             the previous fiscal year to
                                                                                  sent to Bush in January          release, issued Jan. 27,         determine whether totals
 Public Health Management of Disasters is the first comprehensive text
 for public health practitioners in this relatively new practice area as pub-     calling for more funding for     called for more funding          have increased. However,
 lic health leaders begin the comprehensive nationwide integration of             the program (see Page 24).       across the public health         Congress had not passed a
 health departments into the emergency response of communities. It iden-              Other highlights in the      continuum to improve the         fiscal year 2003 budget
 tifies the public health role in each aspect of disaster activity, something     president’s HHS plan             nation’s poor state of           plan by the time the presi-
 that no other book has done, and organizes morbidity and mortality con-
 cerns by disaster so that these negative outcomes can be referred to             included $3.6 billion for        health. The release noted        dent’s 2004 proposal was
 quickly.                                                                         preventing and combating         that the United States is        released. Therefore, the
 An epilogue contains newly added information about the Sept. 11, 2001,           bioterrorism. The total          ranked 25th among the            new projections were com-
 events.                                                                          includes $117 million for        nations of the world in life     pared to Bush’s 2003
                                                                                  the Food and Drug Admin-         expectancy, yet spends           request, which may or may
              2001 ❚ 250 pages ❚ Softcover                                                                         more on health care than         not match actual spending.
                                                                                  istration to protect the
       $28.95 APHA Members ❚ $37.95 Nonmembers
                       plus shipping and handling                                 nation’s food supply from        any other country.                   For more on the presi-
                                                                                  intentional contamination,           The Association also         dent’s overall budget, visit
                         ISBN 0-87553-025-7                                       $5 million of which would        issued a news release after      <>.
                                                                                  be used to improve labora-       the budget was unveiled,         For more on the HHS por-
 American Public Health Association                                               tory preparedness, $5 mil-       detailing the positive and       tion, see <>.
          Publication Sales
          Web:, a secure ordering site                               lion to improve monitoring       negative aspects of the          For EPA’s budget, see
          E-mail:                                                 of food and $10 million to       budget. Among the under-         <>. To read
          Tel.: (301) 893-1894 or Fax: (301) 843-0159                             begin a domestic and for-        funded programs in the           APHA’s response to the
          Mail: P.O. Box 753, Waldorf, MD 20604-0753                              eign food registration sys-      president’s budget, accord-      plans, see <www.apha.
                                                                                  tem, according to HHS.           ing to APHA, are those           org/news>. I

12      T h e N at i o n ’ s H e a lt h                                      ❖   March 2003
                                                                 are connected to the               paredness funding request         possible bioterror attack.
The Affiliates                                                   response to bioterrorism,
                                                                 who have a clear under-
                                                                                                    to the Centers for Disease
                                                                                                    Control and Prevention
                                                                                                                                      The state Affiliate is using
                                                                                                                                      the grant to develop and
                                                                 standing of all of the issues      and the Health Resources          create a Web site that will
State and regional public health associations                    that have to be considered         and Services Administra-          provide the public health
                                                                 and all of the tasks that          tion. The state also agreed       work force with consoli-
                                                                 have to be performed,”             to give 60 percent of             dated information on
                                                                 Bruning said.                      bioterrorism preparedness         bioterrorism preparedness
APHA Affiliates are players                                          In Massachusetts, the          funds directly and indi-          training and education
                                                                 state APHA Affiliate con-          rectly to local public            opportunities, according to
in state preparedness efforts                                    vened an advisory commit-          health, according to              NYSPHA President-elect
                                                                 tee of local public health         Wilkinson.                        Carol Young, PhD.

A          PHA state Affili-
           ates are taking an
           active role in
helping their states
strengthen their bioterror-
                                  New Hampshire to repre-
                                  sent a broad group of pub-
                                  lic health professionals and
                                  to form alliances with a
                                  broad group of public
                                                                 officials and representa-
                                                                 tives from public health
                                                                 organizations, who met
                                                                 with commissioners from
                                                                 the state’s Department of
                                                                                                       In addition to conven-
                                                                                                    ing the advisory commit-
                                                                                                    tee, MPHA is participating
                                                                                                    in an education and train-
                                                                                                    ing work group formed by
                                                                                                                                         “We’re the one organiza-
                                                                                                                                      tion that represents all the
                                                                                                                                      players in public health,”
                                                                                                                                      she said.
                                                                                                                                         The site, which is slated
ism preparedness capabili-        health professionals,” she     Public Health, according to        the state to provide advice       for debut in March at
ties, from helping to             told The Nation’s Health.      Geoffrey Wilkinson, MSW,           on preparedness issues,           <www.nysphatrainingnet.
publicize leadership train-       “We believed we were the       executive director of the          Wilkinson said. The Massa-        org>, will also provide
ing opportunities to mak-         right ones to take on some     Massachusetts Public               chusetts Affiliate is also        links to consumer informa-
ing sure that local public        of the major issues that       Health Association. Wilkin-        collaborating on a pro-           tion on public health and
health voices are being           needed to be done to meet      son said the state’s local         posal that will be submit-        bioterrorism preparedness,
heard.                            our preparedness goals.”       public health officials were       ted to the state by a             according to NYSPHA
   In December, the New               According to Bruning,      worried that bioterrorism          consortium of universities,       grant coordinator Damon
Hampshire Public Health           NHPHA will work hand-          funds would flow in a              public health providers           Vasilakis, MSHSA.
Association received a con-       in-hand with the state         “top-down” fashion and             and advocates to conduct             “Across the country,
tract from the Office of          public health agency to        local regions would be left        risk communication train-         APHA state Affiliates are
Community and Public              assess leadership needs,       with inadequate funding.           ing for health workers            helping to shape the
Health, a division of the         create leadership develop-         “We are at the heart of        involved in preparedness.         course of preparedness by
state’s Department of             ment plans and implement       an advocacy process that is           “The ability of the            being a voice for local
Health and Human Ser-             the actual training. There     keeping local public health        United States to respond          public health workers,”
vices, to work on leader-         will also be targeted train-   providers working directly         to future terrorist attacks       said Lakitia Mayo, APHA’s
ship development in               ings for the many different    with the state officials to        depends on the ability of         director of grassroots advo-
relation to bioterrorism          professional groups            make this whole process            local communities to              cacy and Affiliate affairs.
preparedness. The con-            involved in preparedness       work to improve local pub-         respond,” Wilkinson said.         “APHA Affiliates are an
tract, which is for more          training, such as emer-        lic health infrastructure,”        “And in Massachusetts,            invaluable resource as our
than $200,000, will allow         gency responders.              Wilkinson told The Nation’s        that means building a             nation moves forward with
the Affiliate to hire staff           Bruning said Affiliate     Health.                            stronger public health            preparedness efforts.”
members to develop a              members will also serve an         Many of the recommen-          infrastructure.”                     For more information,
leadership program,               important role by dissemi-     dations that the advisory             With a state grant for         visit <>,
according to Alice Bruning,       nating information and         committee provided to              about $50,000, the New            <> or
MPH, president of NHPHA.          providing advice.              state commissioners ended          York State Public Health          <
   “(NHPHA) is uniquely               “We want to build a net-   up being included in the           Association is also pitching      communities/nyspha>. I
positioned in the state of        work of individuals who        state’s bioterrorism pre-          in to help prepare for a                        — Kim Krisberg

                                                                   Affiliate annual meeting dates announced
                                                                   Alabama         April 24–25   Mobile             Mississippi      Sept. 3–5     Biloxi
                                                                   Alaska          Dec. 2–3      Anchorage          Missouri         Oct. 26–28    Lake Ozarks
                                                                   Arizona         Sept. 25–27   Phoenix            Montana          Sept. 16–18   Kalispell
                                                                   Arkansas        May 7–9       Hot Springs        Nebraska         Oct. 9–10     Grand Island
                                                                   California N.   Jan. 30–31    Oakland            New Hampshire    April         TBA
                                                                   California S.   May 9         TBA                New Jersey       Fall          TBA
                                                                   Colorado        Sept. 22–23   Steamboat          New Mexico       April 7–9     Albuquerque
                                                                   Connecticut     October       TBA                North Carolina   Sept. 17–19   Winston-Salem
                                                                   Metro D.C.      April 9–10    TBA                North Dakota     Feb. 18       Bismarck
                                                                   Florida         Aug. 4–8      Palm Beach         Ohio             May 12–14     Columbus
                                                                   Georgia         Sept. 2–5     Augusta            Oregon           October       TBA
                                                                   Hawaii          June 4–6      Honolulu           Pennsylvania     Oct. 15–17    Harrisburg
                                                                   Idaho           Oct. 22–24    Pocatello          Rhode Island     May 12        Warwick
                                          Photo courtesy MWPHA     Illinois        April 6–9     Springfield        South Carolina   May 21–23     Myrtle Beach
  Metropolitan Washington, D.C., Public Health Associa-            Indiana         May 12–13     Bloomington        South Dakota     June 25–27    TBA
  tion members, above, protest against possible war in Iraq.       Iowa            March 26      TBA                Tennessee        Sept. 17–19   Franklin
                                                                   Kansas          Sept. 23–25   Overland Park      Texas            April 6–8     San Antonio
  Affiliate members call for peace                                 Kentucky        April 1–3     Louisville         Utah             May 1–2       Orem
                                                                   Louisiana       April 9–11    New Orleans        Vermont          April 8       Montpelier
  M       embers of the Metropolitan Washington,
          D.C., Public Health Association joined the anti-
  war demonstrations that descended upon the nation’s
                                                                                   May 30
                                                                                                                    West Virginia
                                                                                                                                     Oct. 13–15
                                                                                                                                     Sept. 16–19
  capital on Jan. 18. According to Karyn Pomerantz,                Michigan        March 14      Ann Arbor          Wisconsin        May 20–21     Milwaukee
  MLS, MPH, a member of the D.C. Affiliate, about 15               Minnesota       May 23        TBA                Wyoming          Sept. 23–26   Cheyenne
  people joined the MWPHA contingent. Demonstrators
  held signs calling for health care for all and protesting        Affiliates that are not listed did not have a meeting date or location available at press time
  against a possible U.S. invasion of Iraq. I                      or have already held their meetings. Visit <> for updates.

                                                                       March 2003                     ❖    T h e N at i o n ’ s H e a lt h                         13
The                                                             War in Iraq would have dire health results
Public health news from around the world                        A          U.S.-led military
                                                                           campaign in Iraq
                                                                           could put 10 mil-
                                                                lion Iraqi civilians at risk of
                                                                hunger and disease and in
                                                                                                  tional status of some 3.03
                                                                                                  million persons country-
                                                                                                  wide will be dire and they
                                                                                                  will require therapeutic
                                                                                                  feeding.” More than 2 mil-
                                                                                                                                 even though the two
                                                                                                                                 countries have roughly the
                                                                                                                                 same number of residents.
                                                                                                                                 While Afghanistan’s popu-
                                                                                                                                 lation is largely rural, the
Lee nominated to head                                           need of immediate assis-
                                                                tance, according to the
                                                                                                  lion of those affected
                                                                                                  would be children younger
                                                                                                                                 majority of Iraqis live in
                                                                                                                                 cities. And 60 percent or
                                                                United Nations and human-         than age 5, and an addi-       more of the country’s pop-
WHO, PAHO welcomes Roses                                        itarian rights groups.            tional 1 million will be       ulation depends on the
                                                                    In a confidential report      pregnant or lactating          government for services

A          South Korean
           doctor who has
           led the global
fight against tuberculosis
is in line to become the
                                Harlem Brundtland, MD,
                                MPH, who opted not to
                                seek another term.
                                   Other leading candi-
                                dates for the director-gen-
                                                                released in January, U.N.
                                                                officials estimated a war in
                                                                Iraq would lead to such
                                                                consequences as wide-
                                                                spread outbreaks of
                                                                                                     The document also pre-
                                                                                                  dicted that as many as
                                                                                                  500,000 people would
                                                                                                  require medical treatment,
                                                                                                                                 such as food and health
                                                                                                                                     As a military campaign
                                                                                                                                 seemed likely at press
                                                                                                                                 time, more than 500 con-
next director-general of        eral position had included      cholera and dysentery as          based on a WHO estimate        cerned health workers
the World Health Organi-        Peter Piot, MD, PhD, of         well as mass starvation.          of 100,000 direct casual-      signed a letter published
zation.                         Belgium, who heads the          The country’s residents           ties and 400,000 people        in the Jan. 25 issue of The
    WHO’s executive board       UNAIDS program.                 have become increasingly          affected by secondhand         Lancet that urged British
nominated Jong Wook                                             dependent on government           effects such as disease. An    Prime Minister Tony Blair
Lee, MD, MPH, to the                                            help for food and basic           estimated 900,000              to work toward a peaceful
director-general position
                                Roses assumes helm              services since sanctions          refugees would flee the        resolution to the conflict.
in January. Lee, a 19-year      at PAHO in January              were imposed in 1991.             country and require some       The letter cited the U.N.
WHO veteran, has served            Also gaining new leader-         The United Nations            sort of assistance, includ-    report as well as a WHO
                     as         ship in January was the Pan     routinely prepares “worse-        ing medical aid, food and      2002 Report on Violence
                     director   American Health Organiza-       case scenario” documents          shelter. Damage to electri-    and Health and a study
                     of         tion, WHO’s regional office     in areas of global unrest,        cal power supplies would       released by a Britain-
                     WHO’s      of the Americas.                but officials usually will        reduce “water and sanita-      based group of health
                     Stop TB       Mirta Roses Periago,         not comment on these              tion as well as health.” In    workers concerned about
                     pro-       MD, was sworn in to a           reports. The Iraq report,         the short term, an esti-       the effects of war. The
                     gram       five-year term as PAHO’s        dated Dec. 10 and marked          mated 39 percent of the        WHO report estimated
                     since      new director Jan. 31 in         “strictly confidential,” was      country’s 26 million peo-      that 72 million people
                     2000.      Washington, D.C. Roses,         first reported in The Times       ple would have to be pro-      have died during the 20th
                        A       who replaced former             of London and then posted         vided with potable water.      century due to military
                     native                         PAHO        in January on the Web site           The report suggested        conflict.
                     of the                         Director    of the Campaign Against           cholera and dysentery will         The U.N. report is avail-
Republic of Korea, Lee is                           George      Sanctions on Iraq, a stu-         be specific concerns           able from <
renowned for his work on                            Alleyne,    dent group based at Cam-          because of unsanitary> and
infectious and vaccine-pre-                         MD,         bridge University.                conditions.                    “Collateral Damage: The
ventable diseases. As head                          FACP, is        According to the docu-           The document pointed        Health and Environmental
of WHO’s Global Program                             an 18-      ment, which is based in           out that the situation in      Costs of War on Iraq” is
for Vaccines and Immu-                              year        part on estimates from the        Iraq is not comparable         available from <www.
nizations and executive                             PAHO        World Health Organization         with last year’s military>. I
secretary of the Children’s                         veteran,    and UNICEF, the “nutri-           campaign in Afghanistan,                  — Donya C. Arias
Vaccine Initiative, Lee                             most
oversaw critical develop-                           recently
ments in childhood vacci-                           serving
nations, including the          as the organization’s assis-    Global road safety concerns include drug use
global polio eradication        tant director. A native of
    A graduate of Seoul
National University Med-
ical School of Medicine
and the University of
                                Argentina, Roses gradu-
                                ated from the National
                                University of Córdoba
                                with a specialization in
                                infectious disease.
                                                                R         ecent declines
                                                                          in road fatalities
                                                                          around the world
                                                                may be leveling off, and
                                                                drug-related auto crashes
                                                                                                  under the influence of
                                                                                                  drugs is an increasing road
                                                                                                  safety problem. For exam-
                                                                                                  ple, 18 percent of those
                                                                                                  who died in traffic crashes
                                                                                                                                 to increase in countries
                                                                                                                                 with relatively good safety
                                                                                                                                 records. More than 90 per-
                                                                                                                                 cent of vehicle occupants in
                                                                                                                                 Germany, Australia and
Hawaii, Lee’s career has           “The focus of my atten-      and deaths among middle-          in the United Kingdom had      New Zealand wore seat
also included work on           tion will be working in         aged motorcyclists have           one or more illicit drugs in   belts. But in a number of
leprosy, HIV, malaria and       and with the countries,”        risen notably in many             their system.                  countries, including the
chronic diseases.               Roses said. “Faithful to my     countries, according to a            The United Kingdom,         United States, Austria and
    In a manifesto posted       profession as an epidemi-       recent study.                     United States and France       Hungary, average seat belt
on the Stop TB Web site in      ologist, I will seek contact       The Organization for           have experienced a rapid       use was 75 percent or
January, Lee pledged that       with the communities and        Economic Co-operation             rise in deaths among           lower.
he would work toward            observe the projects in the     and Development, which            motorcycle riders ages 25         Despite overall road
reducing poverty and            field.”                         is made up of 31 member           to 64. In the United States,   safety improvements since
inequality, increasing             Roses pledged to             countries including the           the most affected group has    1990, performance varies
investment in health care       restore PAHO as the main        United States, conducted a        been men older than age        widely from country to
systems and services to         forum for health in the         multi-nation study of road        40 who ride large, powerful    country. Fatality rates in the
strengthen infrastructure       Americas, renew the com-        safety that looked at             motorcycles.                   United Kingdom and the
and continue WHO’s com-         mitment of health work-         trends such as the per-              During the first six        Netherlands were half of
mitment to public/private       ers, build consensus and        centage of crash victims          months of 2002, there was      those in France and Bel-
partnerships.                   forge alliances and con-        who were under the influ-         no improvement in the          gium, for example.
    The 56th World Health       vert PAHO into a preemi-        ence of illegal drugs and         number of road fatalities         The World Health Orga-
Assembly will vote on           nent health information         the number of drivers who         in preliminary data            nization has dedicated
Lee’s nomination during         resource center.                regularly wear seat belts.        reported by 12 countries       World Health Day 2004 to
its annual meeting in              For more on Lee, visit          Among the study’s find-        in the study, with deaths      road traffic injury preven-
Geneva in May. Once con-        the WHO Web site at             ings was that although            nearly stable compared         tion with a theme of “Safe
firmed, Lee will assume         <>. For more         speeding and alcohol              with the same period in        Roads.”
the director-general posi-      on Roses, visit <www.           remain the primary causes         2001.                             For more information,
tion vacated by Gro   >. I                    of deadly crashes, driving           Seat belt use continued     visit <>. I

14       T h e N at i o n ’ s H e a lt h                ❖      March 2003
A finite resource, water poses complex problems for public health                                   of APHA’s
Privatizing water systems draws mixed reviews                                                       Health Sec-
                                                                                                    tion, agreed
                                                                                                    that societies

I    n a landmark deci-
     sion last year, a United
     Nations committee
agreed that access to safe
and affordable water
                                  project of the Center for
                                  Public Integrity, transna-
                                  tional water companies
                                  often work closely with the
                                  World Bank, lobbying for
                                                                  increased access to safe
                                                                  water, WHO stated.
                                                                     But just how to deliver
                                                                  safe water is under intense
                                                                  scrutiny from advocates
                                                                                                    must find
                                                                                                    methods to
                                                                                                    offer safe
                                                                                                    water to all
                                                                                                    people, but
should be a human right.          policy changes that would       who assert that privatiza-
                                                                                                    did not
Public health advocates,          force the privatization of      tion of public water sys-
                                                                                                    exclude pri-
such as the World Health          public water systems. The       tems puts undue burden on
                                                                                                    vatization as
Organization, hailed the          lobbying effort is a prof-      the poor and does little to
                                                                                                    one of those
move as an important step         itable one for water compa-     ease the effects of poverty.
toward realizing a U.N. mil-      nies, whose yearly revenues        “When private compa-
                                                                                                    Martin’s com-
lennium development goal          are in the billions, accord-    nies come in, bad situations
                                                                                                    ments reveal
of reducing the number of         ing to the investigation.       are exacerbated,” Sara
                                                                                                    the wide
people without safe water.           “It’s shocking to imagine    Grusky, PhD, policy analyst
                                                                                                    breadth of
    But the road to 2015, the     the reality of people in        for the Water for All Cam-
                                                                                                    opinions on
year development goals are        developing countries being      paign at Public Citizen, told
                                                                                                    water privati-
targeted to be achieved, is       asked to contribute to          The Nation’s Health.
                                                                                                    zation, even
paved with widely differing       transnational corporations         Grusky prepared the
                                                                                                    among pub-
strategies on how to deliver      to have access to safe water    September 2002 Public Citi-
                                                                                                    lic health
safe water to the world’s         and sanitation,” Shaffer, an    zen report “Profit Streams:
population. On one side of        APHA Network on Global-         The World Bank and
the debate is the call for pri-   ization and Public Health       Greedy Global Water Com-
vatization, in which private      member, told The Nation’s       panies,” which examined                                                     Photo courtesy WHO, by P. Virot
                                                                                                    essential that
companies purchase public         Health. “If governments are     how the economic policies                           Privatizing public water systems could have a
                                                                                                    a society,
water systems, in both            not capable of running their    of the World Bank impose                            devastating health effect on people in the
                                                                                                    including its
developed and developing          own water systems, they are     water privatization on                              developing world, according to advocates.
nations, with promises to         even less capable of over-      developing nations. Accord-
                                                                                                    find ways to
resurrect dilapidated and         sight in regard to huge         ing to the report, the World
                                                                                                    provide at least basic water        some public systems simply
inefficient water delivery        multi-national companies.”      Bank and International
                                                                                                    and sanitation to all of its        cannot provide services and
systems. On another side of          According to Shaffer and     Monetary Fund often attach
                                                                                                    citizens,” Martin told The          so all options should be
the debate are advocates for      Switlick, privatizing water     conditions to loans and
                                                                                                    Nation’s Health. “But the           examined, including privati-
public health and the poor,       systems and charging user       debt relief that require
                                                                                                    challenge in poor countries         zation.
who worry that treating           fees, especially in develop-    needy governments to pri-
                                                                                                    of financing that objective is          “I would not say that pri-
water like a commodity will       ing nations, will force those   vatize their water systems.
                                                                                                    extraordinarily complex and         vatization is entirely bad,
put disadvantaged people at       who can’t afford safe water     Many loans also require
                                                                                                    must be studied on a case-          but there needs to be safe-
heightened risk of disease.       to find alternative, and usu-   governments to replace
                                                                                                    by-case basis. One can not          guards for protecting the
    “Water is one of the          ally unsafe, water sources.     public funding with full-
                                                                                                    automatically assume that           poor, and that’s where we
issues that has the greatest      Shaffer added that in devel-    cost recovery, which means
                                                                                                    privatization of water sys-         get into trouble,” he said.
impact on the health of all       oping nations, lack of safe     collecting user fees from
                                                                                                    tems and charging user fees             Kleinau pointed out that
people in the world,” said        water access only adds to       the consumer for the full
                                                                                                    is necessarily a bad idea.”         education is a major prob-
public health student Kim-        other health problems, such     cost of operating and main-
                                                                                                        Martin said that assert-        lem during water privatiza-
berly Switlick, author of         as HIV/AIDS and maternal        taining the water service.
                                                                                                    ing that water and sanita-          tion and another area in
APHA’s new policy on              and child health.               Full-cost recovery puts
                                                                                                    tion are basic human rights         which public health exper-
“Access to Safe Water, Sani-         “In the developing           major burdens on a coun-
                                                                                                    is not very helpful in the          tise is needed. Even if safe
tation and Hygiene Promo-         world, it’s a much more         try’s poor, such as in India,
                                                                                                    absence of feasible options         water is accessible, without
tion in Developing                severe problem,” she said.      where some poor house-
                                  “(Unsafe water) is one of       holds can pay as much as          for financing, managing             educating citizens on how
Countries,” which was
adopted by APHA’s Govern-         the most serious underlying     25 percent of their income        and maintaining public              to safely store water to fend
ing Council during the            causes of ill health in the     for water, according to the       works systems. But, he              off contamination, health
130th Annual Meeting.             developing world.”              Public Citizen report.            added that public health            risks still exist, he said.
    The APHA policy states           According to a 2000             “Private sector compa-         needs to be a factor during             Water will be an espe-
that privatized water sys-        report from WHO on global       nies are organized to make        such financial discussions.         cially hot topic on March
tems and imposed user fees        water supply and sanita-        profit, not to fulfill socially       “There is a tendency for        22, which is World Water
make water unaffordable to        tion, the percentage of peo-    responsible objectives such       these decisions to be made          Day. The U.N. Environment
the poor and further adds         ple served with some form       as achieving universal            by public works ministers           Programme is the lead
to economic inequality. The       of improved water supply        access to water,” the report      and financiers, and (public         agency for the day, which
APHA policy opposes               rose to 82 percent in 2000,     noted.                            health advocates) should            encourages global under-
strategies that approach          a 3 percent increase from          Grusky said that to            very strongly insist that           standing of the need for
water as a commodity ruled        1990 figures. Still, as of      reverse the privatization         agencies like the World             responsible water use and
by market forces. Ellen           2002, about 1.1 billion peo-    trend, governments must           Bank insist that health min-        conservation.
Shaffer, PhD, MPH, an             ple had no access to safe       have a commitment to              isters be a part of these dis-          “(Water is) one of these
APHA member who trav-             water, WHO stated.              access to clean and afford-       cussions,” he said.                 sustainable issues — it’s
eled to Ghana last year to           Each year, about 4 bil-      able water, but added that            Fellow International            something we take for
examine water privatization       lion cases of diarrhea result   20 years of the World Bank        Health Section member               granted — but water will
proposals, said many water        in 2.2 million deaths,          pushing privatization has         Eckhard Kleinau, DrPH,              continue to be an issue
privatization plans in devel-     mainly among children,          cash-starved some nations’        who does environmental              because it’s a finite
oping countries are               about 10 percent of devel-      public sectors.                   health work in relation to          resource and will not go on
attached as conditions to         oping world populations            She said alternatives to       water supply and hygiene,           forever,” Switlick said.
loans from institutions such      are infected with intestinal    privatization include creat-      said in his experience,                 For more information on
as the World Bank and the         worms and about 6 million       ing citizen accountability        water user fees discriminate        water and public health,
International Monetary            people are blinded from         structures that have over-        against the poorest people,         visit <>,
Fund.                             trachoma, a disease of the      sight over public utilities       who often pay a much                <>, <www.
    According to a year-long      eye, according to WHO.          and having more decen-            larger proportion of their> or
investigation by the Inter-       These health problems,          tralized, local control over      income for services. He             <
national Consortium of            along with many others,         water.                            said that although water            legislative/policy>. I
Investigative Journalists, a      could be alleviated with           Ray Martin, MPH, chair         should be a basic right,                             — Kim Krisberg

                                                                        March 2003                    ❖     T h e N at i o n ’ s H e a lt h                             15
Classifieds                                                                                              Job Openings
        Conference                                H.E.L.P. 2003                                                                                  use) and/or health disparities.
                                                                                                                  California                     Interested applicants should pos-
2nd International Conference on
Urban Health in NYC. October 15-18,              Health Emergencies                                      Assistant Professor
                                                                                                                                                 sess a doctoral degree in public
                                                                                                                                                 health, psychology, sociology, sur-
                                                in Large Populations
2003. Program, registration informa-                                                                     (Public Health and Community            vey methodology, social work, or
tion and call for abstracts at http://                                                                   Dentistry) The University of Cali-      any other related social, behav- Phone contact: P.                                                                          fornia at Los Angeles School of         ioral, or health science discipline.
Hempstead (212) 987-0435.                A three week course in meeting health needs of                  Dentistry, Division of Public Health    Fellows will be expected to work
                                                                                                         and Community Dentistry, invites        collaboratively with Center staff on
                                         refugees, internally displaced persons, and those
                                                                                                         applications for a full-time, tenure-   ongoing funded projects and in the
                                         affected by disasters and conflict covering—                    track position at the Assistant Pro-    development of grant proposals.
                                         G planning, assessment, and evaluation                          fessor level. Experience in             Annual stipends are competitive
      APHA                               G measuring nutritional needs and organizing food               case-based teaching of Prevention,      (between $32,000 and $50,000)
                                                                                                         Cardiology, Health Policy, Culture
     members:                                distribution
                                                                                                         and Health, Ethics, or Behavioral
                                                                                                                                                 depending on the number of years
                                                                                                                                                 of postdoctoral experience. The
                                         G meeting needs for water, sanitation, shelter and fuel         Sciences is highly desirable. Board
     Have you                            G establishing curative and preventive care                     certification or eligibility highly
                                                                                                                                                 position will include fringe benefits
                                                                                                                                                 and a travel allowance. Start date is
   changed your                          G control of communicable diseases                              considered. Expertise in one or         negotiable. Review of applications
                                                                                                         more of the following areas: epi-
                                         G protection of women and other vulnerable groups                                                       will begin in March 2003 and con-
     address?                            G collection, analysis, and use of data
                                                                                                         demiology, community dentistry,
                                                                                                         public health, and/or biostatistics
                                                                                                                                                 tinue until the positions are filled.
                                                                                                                                                 Send vitae, (p) reprints, a cover let-
                                         G ethical concerns in response to conflicts                     is required. An interest in clinical
       Association                       G human security                                                teaching is desirable. Preference
                                                                                                                                                 ter describing interests, and three
                                                                                                                                                 letters of reference to: Dr. Robert
      members can                        G protection of vulnerable women                                will be given to applicants with an     Belli, Postdoctoral Fellowships,
                                                                                                         established record of epidemiology,     UNL Gallup Research Center, 200
      update their                       G applying International Humanitarian Law to protect            health services or clinical research    North 11th Street, P.O. Box 880241,
      APHA records                           populations at risk.                                        and the potential for continued         Lincoln, NE 68588-0241. It is the
                                                                                                         generation of extramural research       policy of the University of Nebraska
       online with                                          July 7-25, 2003                              support. Candidates must possess a      not to discriminate based on gen-
                                                     The Johns Hopkins University                        DDS/DMD and/or a PhD/DrPH
     their member                             Bloomberg School of Public Health, Baltimore               degree. Opportunity with intra-
                                                                                                                                                 der, age, disability, race, color, reli-
                                                                                                                                                 gion, marital status, veteran’s
     passwords. See                                 Katrina Alston (410) 955 3928                        mural practice and consulting is        status, national or ethnic origin, or
                                                                                                         available. The University of Califor-   sexual orientation.                                                           nia is an equal opportunity/
                                                              Co-sponsors                                affirmative action employer. All
   intro_private.cfm                                                                                     qualified applicants are encour-                  Maryland
                                          International Committee of the Red Cross—Geneva,               aged to apply, including women
    for instructions.                     American Red Cross,World Health Organization/PAHO              and minorities. Position is avail-      International
                                                       World Medical Association                         able July 1, 2003. Applicants should    Training
                                                                                                         submit a letter of interest defining    Health and Child Survival Fellows
                                                                                                         research and career goals, a cur-       Program prepares junior and mid-
                                                                                                         riculum vitae and names and             career health professionals for
                                                                                                         addresses of three references by        international careers through two-
                              University of Minnesota                                                    May 1, 2003 to: Dr. Kathryn A.
                                                                                                         Atchison, Chair of Search Commit-
                                                                                                                                                 year, practice-oriented assignments
                                                                                                                                                 with the U.S. Agency for Interna-
         Conducting Health Outcomes Research I August 2-9, 2003                                          tee, UCLA School of Dentistry, 53-      tional Development (USAID) or
                                                                                                         038 CHS, Box 951668, Los Angeles,       other similar agencies. USAID
    The University of Minnesota Clinical Outcomes Research Center (CORC) is sponsoring an eight-day      CA 90095-1668.                          assignments can be in overseas
    Outcomes Research Institute designed for persons who want to learn how to conduct outcomes                                                   field missions or in the United
    research or wish to sharpen their research and methodological skills. The program will include                                               States. All other assignments are
    didactic sessions and extensive small group work in which each participant will design the ele-
                                                                                                                   Nebraska                      overseas. The focus of assignments
    ments of a study to be implemented on his/her return home. Institute faculty will continue to sup-                                           are varied and include infectious
                                                                                                         Postdoctoral                            diseases, maternal and child
    port students after they return to their bases of practice.                                          Fellowships                             health, nutrition, HIV/AIDS, and
    Students will learn to:                                                                              Fellowship on Survey Data Collec-       health systems. Candidates for spe-
      • identify the elements of good study design                                                       tion in the Health Sciences. The        cific positions are drawn from a
      • develop a conceptual model for a research question                                               University of Nebraska-Lincoln          pool of applicants and must have
      • delineate a clear set of research questions                                                      Gallup Research Center is offering      these qualifications: at least a mas-
      • translate those questions into meaningful measures                                               up to two postdoctoral fellowships      ter’s degree in a health-related
      • select from the literature appropriate measures that fit the context of the study                to focus on verbal report data col-     field, a commitment to a career in
      • develop an appropriate study sample                                                              lection and measurement methods         international health, and U.S. citi-
      • collect data carefully and at clinically relevant times                                          in the health sciences. Fellowships     zenship. To obtain an application
                                                                                                         will be offered for two years, and      package, contact: National Secre-
      • analyze the data appropriately
                                                                                                         continuing appointments within          tariat, the Health and Child Sur-
      • present the findings in ways that are meaningful to the target audience
                                                                                                         the Center are possible, dependent      vival Fellows Program, Johns
    Credit Options:                                                                                      on funding. We are seeking candi-       Hopkins Bloomberg School of
     L Arrangements can be made to take the course for three (3) University of Minnesota graduate        dates who have experience and           Public Health, 103 East Mount
          credits (PubH 5864—requires additional U of M tuition).                                        interests in pursuing survey            Royal Avenue, Suite #2B,
     L The U of M is accredited by the Accreditation Council for Continuing Medical Education            research to explore issues on           Baltimore, MD 21202. Tele-
          (ACCME) to provide continuing medical education for physicians. The U of M designates this     health risks (e.g., cancer, substance   phone (410) 659-4108. E-mail
          educational activity for a maximum of 45 hours in category 1 credit towards the AMA Physi-
          cian’s Recognition Award. Each physician should claim only those hours of credit actually
          spent in the educational activity.
     L It has also been designed to meet Minnesota Board of Nursing Continuing Education require-                             April is the 17th annual
          ments. However, nurses are responsible for determining whether this activity meets require-
          ments for acceptable continuing education.
                                                                                                                     Alcohol Awareness Month
                   Cost:            $2,000 (must be received by July 7)                                                     sponsored by the
                   Reduced rate: $1,500 (for registrations received by May 30)                                       National Council on Alcoholism
    For additional information and registration forms, contact:
      Clinical Outcomes Research Center                         Phone: (612) 624-1185                                  and Drug Dependence Inc.
      University of Minnesota School of Public Health           Fax:      (612) 624-8448                             For planning materials, visit
      420 Delaware Street SE (MMC 197)                          E-mail:
      Minneapolis, MN 55455                                     Web site:           
               The University of Minnesota is an equal opportunity educator and employer

16          T h e N at i o n ’ s H e a lt h                     ❖    March 2003 URL: http:// The program offers
two MPH scholarships at Johns                                                                                                          2003 Classified
Hopkins University to candidates        Assistant/Associate Professor Tenure-Track Position                                              Advertising
who will add to the program’s
diversity. The HCSFP is a USAID-                      Department of Preventive Medicine                                                     Closing Dates
funded program. JHU is an equal
opportunity employer.
                                                    University of Tennessee Health Science Center                                     Issue . . . . . . . . .Deadline
                                                                                                                                      February . . . . . . . . . Dec. 16
          Michigan                      T   he Department of Preventive Medicine is seeking two faculty members
                                            for fully-funded, state-supported positions at the Assistant or Associate
                                        Professor level. Candidates should have a strong foundation in behavioral
                                                                                                                                      March . . . . . . . . . . . Jan. 20
                                                                                                                                      April . . . . . . . . . . . . Feb. 21
                                                                                                                                      *May . . . . . . . . . . March 24
Assistant or Associate                  epidemiology, behavioral medicine, or health promotion with demonstrated                      *June/July . . . . . . . . . May 1
Professor                               experience in applying these methods in health behavior research. We are                      *August . . . . . . . . . .June 20
The Section on Health Services Re-                                                                                                    *September . . . . . . . July 18
search in the Department of Medi-       particularly interested in candidates with applied research in the areas of
                                        physical activity and nutrition.                                                              *October . . . . . . . . . Aug. 20
cine at Michigan State University                                                                                                     November . . . . . . . . Sept. 24
invites applications for a tenure-          The University of Tennessee Health Science Center is a major medical
                                                                                                                                      December/January . . Nov. 10
track faculty position in health        and research center located in Memphis, Tennessee. The Department’s areas
                                                                                                                                       * Bonus Issues
economics at the Assistant or Asso-     of current emphasis include cardiovascular disease epidemiology, women’s
ciate Professor level. We are seek-     health, geriatrics/gerontology, genetic epidemiology, behavioral epidemiol-                  Mailing Date —
ing applicants with research            ogy, community health promotion, disease prevention, nutritional epidemi-                    Approximately the first
interests in the study of health care   ology, and bone health. The University also houses collaborative research                    week of issue month
delivery and utilization, health        centers in health services, women’s health, and health disparities offering the
insurance and reimbursement,
                                        opportunity for affiliative appointments.
                                                                                                                                     Circulation — 29,300
labor economics, cost analysis,
and other topics related to health          Requirements for the position include a doctorate in epidemiology or a                   Acceptance of advertising
economics. Applicants should have       related discipline with demonstrated training in epidemiology. The primary                   does not imply endorse-
a PhD in a relevant field such as       requirements of the position include teaching epidemiology and health                        ment by APHA.
economics or health services            behavior courses in the Master’s of Epidemiology program and scholarly
research or public policy with an       activity in a field of epidemiology or public health. Collaboration with local               APHA policy requires all
emphasis in health economics.           community partners and university research centers will be encouraged.                       employers advertising to
Experience        in    collaborative       Applicants should submit a curriculum vitae, a cover letter describing                   affirm that they follow non-
research in a multidisciplinary set-    research interests and teaching experience, and the names and addresses of                   discriminatory practices
ting, excellent written and oral        three references to: Lisa M. Klesges, PhD; Chair, Health Behavior Search                     with regard to race, sex,
communication skills, and strong                                                                                                     creed, age and sexual ori-
                                        Committee; Department of Preventive Medicine; 66 N. Pauline, Suite 633;
quantitative skills are required.                                                                                                    entation.
The position is primarily for           University of Tennessee Health Science Center; Memphis, TN 38163.
research and thus, the successful                    The University of Tennessee Health Science Center is an
candidate will be expected to seek                                                                                                              Line Rates
                                                         equal opportunity/affirmative action employer.
extramural funding to support                                                                                                            Job Opportunity ads:
research endeavors. The Health                                                                                                              $3.20 per word
Services Research Section within
the Department of Medicine has                                                                                                               Display Rates
close collaborations with several                                                                                                        ( Job Opportunities Only)
other academic departments                                                                                                           Full Page $1,640 9 1⁄8 x 12 1⁄4
including the Department of Eco-                                                                                                                950-word limit
nomics, Department of Epidemiol-                                                                                                     Mini Page      $1,340 5 3/8 x 12 1⁄4
ogy and Biostatistics, and                                                                                                                      800-word limit
Department of Family Practice.
                                        Associate/Full Professor Tenure-Track Position                                               Half Page      $1,215 9 1/8 x 6
                                                                                                                                                600-word limit
Current studies in the Health Ser-                                                                                                   2⁄5 Page       $1,130 3 1⁄2 x 12 1⁄4
vices Research Section focus on a
                                                     Department of Preventive Medicine
                                                                                                                                                350-word limit
broad range of topics, including                   University of Tennessee Health Science Center                                     3⁄10 Page       $800      5 3/8 x 6
health disparities, labor market                                                                                                                250-word limit
outcomes of chronic diseases,
Medicaid and Medicare service uti-
lization, ethical, legal, and social
                                        T   he Department of Preventive Medicine is seeking to fill a mid-
                                            career to senior-level position to develop a program of research in
                                        cancer prevention and control within the department. This is a fully-
                                                                                                                                     1⁄5 Page        $650
                                                                                                                                                150-word limit
                                                                                                                                                               3 1⁄2 x 6

implications of genetics, doctor-
                                                                                                                                                 Logo scan
                                        funded tenure-track position. Candidates may integrate their research                                       $25
patient relationship, medical deci-     with ongoing departmental activities in women’s health, geriatrics/
sion-making, quality of life, health                                                                                                          Typesetting
                                        gerontology, genetic epidemiology, behavioral epidemiology, com-
services research, cost-effectiveness                                                                                                       Full page, $155;
analysis, women’s health, cardio-       munity health promotion, disease prevention, nutritional epidemiol-
                                        ogy, and health outcomes research or develop new areas of research                                 Mini page, $145;
vascular disease, and cancer.                                                                                                          1/2 page, $130; 2/5 page,
Opportunities for collaboration         as part of a recently formed university cancer center. Collaborative
exist across departments and col-       research opportunities with St. Jude Children’s Research Hospital as                            $120; 3/10 page, $110;
leges at MSU and with the College       well as centers in genomics, vascular biology, health services research,                          and 1/5 page, $100
of Human Medicine’s system of           women’s health, and health disparities are available.
community campuses. Candidates
                                                                                                                                     For line and display
                                            Requirements for the position include a doctorate in epidemiol-                          classified ad rates, please
should send a current CV and a let-     ogy or an MD with a significant track record of epidemiological
ter indicating areas of expertise                                                                                                    go to <> and
                                        research; evidence of excellent scholarly productivity in cancer pre-                        click on the advertisement
and interest and a list of possible
                                        vention and control; evidence of collaborations with other disciplines;                      information at the bottom
references to: Cathy J. Bradley,
PhD, Health Services Research Sec-      and a record of obtaining extramural funding in cancer prevention                            of the page.
tion, Department of Medicine,           and control. The successful candidate will participate in our Master’s
B212 Clinical Center, Michigan          of Science in Epidemiology training program.                                                 Prepayment (by check, Visa,
State University, East Lansing, MI          Interested applicants should submit a curriculum vitae, a cover                          MasterCard or American
48824. Applications will be accepted    letter describing research interests and experience, and the names and                       Express) or purchase
until March 30, 2003, or until the      addresses of three references to: Lisa M. Klesges, PhD; Chair, Cancer                        order/insertion order must
position is filled. Michigan State      Prevention and Control Search Committee; Department of Preven-                               accompany all classified ads.
University is an Affirmative Action/    tive Medicine; 66 N. Pauline, Suite 633; University of Tennessee
Equal Opportunity Employer with a                                                                                                        Send your ad to:
                                        Health Science Center; Memphis, TN 38163.
strong commitment to diversity.                                                                                                
If you need additional information,                 The University of Tennessee Health Science Center                                       Ashell Alston
contact       Dr.     Bradley      at              is an equal opportunity/affirmative action employer.                                 Phone (202) 777-2470         For                                                                                                    Fax (202) 777-2531
more information about the Division                                                                                                  E-mail <>
of Health Services Research, visit                                                                                                       TDD (202) 777-2500

                                                                           March 2003                          ❖   T h e N at i o n ’ s H e a lt h                         17
     Faculty Search

       Johns Hopkins School of
            Public Health                                                  Professor and Founding Chair
     The Women’s and Children’s Health Policy                              New Department of Behavior and Health
     Center, in the Department of Population and
     Family Health Sciences at Johns Hopkins
     Bloomberg School of Public Health, is seeking
                                                                  A     pplications and nominations are sought for the founding chair of a new academic depart-
                                                                        ment of behavior and health whose mission is to develop and apply theory and methods
                                                                  to better understand and intervene upon those behaviors that contribute substantially to the
     a non tenure-track faculty position as a Re-                 global burden of disease. The new department has a mandate to develop an outstanding PhD
     search Associate to serve as a Senior Research               program with a focus on theory and methods for the study of behavior and health.
     Projects Manager. This individual will oversee               The Bloomberg School of Public Health has a unique niche for the new department. There are
     a set of program evaluation and research activ-              more than 50 faculty in the behavioral and social sciences. They have a multi-level, multi-dis-
     ities related to parenting practices and early               ciplinary perspective and an intervention orientation. The School is also a leader in interna-
                                                                  tional health and in the biological and quantitative sciences that can support innovations in
     child development. The person will be                        behavioral research. This new department will be one of ten in the largest and most academi-
     involved with a related set of studies focused on            cally acclaimed school of public health and will also be closely linked to leading departments
     a cohort of 5,565 children whose families re-                in the Johns Hopkins Schools of Medicine, Arts and Sciences, Nursing and to the Johns Hop-
     ceived enhanced pediatric care in their chil-                kins Health system.
     dren’s first three years of life as part of the              We seek a new chair with strong leadership and intellectual skills and the drive to build a
     Healthy Steps for Young Children Program.                    unique department. Nominations, applications and inquiries should be received by April 1,
                                                                  2003. Minority and women candidates are particularly encouraged to apply. The Johns Hop-
     The Projects Manager will work with the Prin-
                                                                  kins University is an affirmative action/equal opportunity employer.
     cipal Investigators to oversee current projects
                                                                                                   Scott L. Zeger, PhD
     as well as plan new studies and solicit funds for                             Chair, Behavior and Health Chair Search Committee
     further related activities. Responsibilities for                                             c/o Ms Barbara Diehl
     this non tenure-track faculty position include:                                Johns Hopkins Bloomberg School of Public Health
     managing current program evaluation activi-                                            615 N. Wolfe Street, Room W1041
     ties including supervising staff; communicating                                           Baltimore, MD 21205-2179
     with researchers, national organizations, and
     other stakeholders; facilitating ongoing collab-
     orative activities with colleagues at other insti-
     tutions; and planning analyses in collaboration              The University of Arkansas for Medical Sciences
     with the interdisciplinary research team. Per-                                         College of Public Health
     son will contribute to additional scholarly                           Chair, Department of Health Policy and Management
     activities related to product development and
                                                                       Requirements: Preference will be given candidates who possess a doctoral
     dissemination efforts including manuscript                        degree in a health policy/public policy discipline, or a doctoral degree with con-
     preparation and presentations. Requires: Mas-                     siderable experience in state or national health policy and have strong academic
     ter’s degree in related field and three to fivew                  records of achievement. Other desirable attributes: strong interpersonal skills, a
     years experience or doctorate; excellent oral                     participatory management style, in-depth knowledge of the American health care
     and written communication skills; computer                        system, health administration, and fiscal expertise — including skills in strategic
     skills including basic database management.                       planning and policy development, an understanding of the core principles of grad-
                                                                       uate-level teaching, an appreciation for the values of research in building an acad-
     Experience with project management and/or
                                                                       emic enterprise, and the ability to develop and nurture collaborative relationships
     program evaluation required.                                      with potential campus, professional, and community partners.

     Send letter of interest, curriculum vitae, and                    Background of the UAMS College of Public Health. Funds to start the
     the names of three references to:                                 College and its new campus building were appropriated by the state legislature in
                                                                       April 2001, using proceeds from the state’s tobacco settlement. MPH and post-
       Cynthia Minkovitz, MD, MPP                                      baccalaureate certificate programs were approved in April 2001. Courses were
       Department of Population and Family                             launched for 92 students during the initial year, and 185 faculty members were
         Health Sciences                                               appointed, most of them joint appointments with other academic programs. By
       Johns Hopkins Bloomberg School of                               September 2002, Dr. James M. Raczynski was on board as the permanent dean,
         Public Health                                                 and appointments of the full-time faculty and permanent staff are now under way.
       624 N. Broadway
       Baltimore, MD 21205                                             Applications/nominations of women and minorities are encouraged. The Univer-
       (410) 614-5106 (tel)                                            sity of Arkansas is an EEO/AA employer.
       (410) 614-0799 (fax)                                            Please send letter with curriculum vitae and names of three references to: Joseph                                              H. Bates, MD and Thomas A. Bruce, MD Co-Chairs, Health Policy and
                                                                       Management Search Committee, University of Arkansas for Medical
        The University is an Equal Opportunity/Affirmative
                                                                       Sciences Slot #820, 4301 W. Markham St., Little Rock, AR 72205.
           Action Employer; we encourage women and
              under-represented minorities to apply.

18       T h e N at i o n ’ s H e a lt h                     ❖   March 2003
Chair, Dept of Health Policy                                                                       Chair, Dept of
The George Washington University School of Public Health and Health Services
                                                                                                  Health Services
is undertaking a national search for the position of Chair of the Department of
Health Policy ( The Department of Health Policy, as
part of the only public health school in the nation’s capital, offers extraordinary
opportunities for faculty and students to interact with national health policy makers.

The Department of Health Policy was established in July 2002; it offers the MPH,
                                                                                                 and Leadership
MS, and DrPH degrees; it also offers a certificate in health policy and provides the              The George Washington University Medical Center
policy component for the School’s Master of Health Services Administration degree.                is seeking a Chair for its Department of Health
The Department works collaboratively with other degree programs in the University                 Services Management and Leadership (HSML)
(e.g., public policy, public administration, and business) to offer the health policy             within The School of Public Health and Health
content courses as well as law and health policy courses. The Department has 20                   Services at The George Washington University. It
full-time regular and research faculty, with approximately 50 majors (projected to                offers a Master of Health Services Administration
grow to 100) in the newly established department. The Department is also                          (MHSA) to prepare students for the challenges of
responsible for the core health policy course taken by all students in the MPH                    delivering quality health services, dealing with the
program.                                                                                          trends in service delivery, managing financial
                                                                                                  resources, and practicing quality management, all
The Department is closely linked to the Center for Health Services Research and                   while ensuring quality delivery of health care to
Policy, which currently manages approximately $12 million in sponsored research.                  individuals and communities.
The Center holds three basic ordering agreements with the federal government.
The Department also oversees the Hirsh Health Law and Policy program, which                       Within the School and across the University, the
offers joint study programs for JD and LLM students at the GW Law School, law-                    Chair will be encouraged to develop partnerships to
based health policy courses for all health policy students, and professional studies              enhance the educational experiences of its students
programs in collaboration with the D.C. Bar Association and others. The                           (e.g., developing an MBA in Health Services
Department also includes the School’s Minority Health Policy program, designed                    Administration in cooperation with the School of
to provide fellowship opportunities for professional graduates, and the Forum for                 Business and Public Management). The Chair will
Collaborative HIV Research, a public-private partnership whose objective is to                    serve as the administrative officer and manager of
catalyze research into critical questions related to the medical management of HIV.               the Departmental faculty and will oversee and
                                                                                                  participate in the Department’s academic, research
The successful candidate for department chair must:                                               and service activities. The Chair will lead the
                                                                                                  department’s faculty recruitment activities consistent
    I    Possess a PhD, DrPH, JD, or MD;                                                          with the School’s goal of attracting and promoting
    I    Be nationally recognized as a scholar and expert in a wide range of                      well-qualified women and underrepresented minority
         health services and public health policy matters;                                        candidates.
    I    Have a strong track record in teaching and student mentoring at the
         graduate level, including masters, doctoral, JD, and LLM candidates;                     Applicants must hold a doctoral degree in a field of
    I    Have the ability to lead a multi-disciplinary approach to teaching and                   public health, health science, health administration,
         research, with special emphasis on health law;                                           public administration, law, or medicine and must have
    I    Have the ability to mentor and develop researchers and faculty;                          an established record of successful leadership in the
    I    Have a strong track record of attracting and leading extramural                          health care system. Preference will be given to those
         research, including funding from government agencies and private                         with prior success in obtaining and managing
         foundations;                                                                             sponsored research . Rank and contractual status
    I    Possess overall management skills necessary to oversee a complex                         commensurate with experience. The successful
         academic program and to work collegially with faculty members and                        candidate should possess a strong business
         the leadership of the School;                                                            background and experience, both in the real world
    I    Have a strong record in fundraising to support academic programs,                        and as an educator in health services administration.
         including experience in gift and endowment-related activities;                           Additionally, the Chair is expected to have experience
    I    Have the leadership qualities necessary to build and sustain a new                       with and embrace a student body that is multi-cultural
         department and market a new program to prospective students;                             and interdisciplinary.
    I    Have practical policymaking experience.
                                                                                                  Interested applicants are invited to submit a
Interested applicants are invited to submit a curriculum vitae and letter of                      curriculum vitae and letter of interest including a
interest to:                                                                                      statement of qualifications to:

                             Richard Windsor, Ph.D.                                              John H. Grossman III, M.D., Ph.D., M.P.H.
                  Chair, Health Policy Chair Search Committee                                      Chair, HSML Chair Search Committee
                                C/O Janan Sarkis                                                              C/O Janan Sarkis
                   School of Public Health and Health Services
                           2300 I Street, NW Suite 106
                                                                                                  School of Public Health and Health Services
                              Washington, DC 20037                                                       2300 I Street, NW Suite 106
                                                                                                            Washington, DC 20037
Faculty rank and contractual status commensurate with experience. Review of
                                                                                                 Review of applications will begin on February 9, 2003,
applications will begin on February 9, 2003, and continue until position is filled.
                                                                                                         and continue until position is filled.
     The George Washington University is an equal opportunity/affirmative action employer.                  The George Washington University is an
                                                                                                         equal opportunity/affirmative action employer.

                                                                             March 2003      ❖      T h e N at i o n ’ s H e a lt h                        19
                                                                         School of Public Health
                                                                     Florida International University

 Florida International University (FIU) seeks a Founding Director for a                     - Demonstrate national leadership in public health education and
 new School of Public Health within the College of Health and Urban                            research
 Affairs. The School is being created through an endowed gift.                              - Encourage faculty development
                                                                                            - Raise funds to support the mission of the School
 The Founding Director will provide vision and leadership to establish an                   - Promote linkages among the university, professional and community-
 accredited School that can assume a significant national and interna-                         based organizations
 tional role in public health research and education. The new School of                     - Manage the School’s resources
 Public Health will be one of five schools in the interdisciplinary College                 - Be tenured as a full professor in the School
 of Health and Urban Affairs.
                                                                                            A letter of interest that describes your experience in the areas detailed
 Florida International University (FIU) is a Carnegie Doctoral/Research                     above, a current vitae, and the names of three professional references
 Extensive University with 200 graduate and undergraduate degree pro-                       will constitute an application. Review of applications will begin March
 grams and over 34,000 students. FIU ranks in the top one percent of all                    10, 2003, and continue until a successful candidate is identified. Send
 US universities in campus diversity. The College, with $15 million in                      inquiries and applications to:
 sponsored research — mostly in health related areas, is among the most
 research productive units in the university, and it is the third largest pro-                                          William W. Darrow, PhD
 ducer of FTEs in the university.                                                                                 Chair, Search and Screen Committee
                                                                                                                     Florida International University
 Currently, the Department of Public Health is a CEPH-accredited pro-                                                 Department of Public Health
 gram initiated in 1986. The department has an extremely diverse stu-                                              University Park Campus, VH 216
 dent body, including students from more than 20 nations. Currently we                                                   11200 S.W. 8th Street
 graduate about 60 MPH students annually.                                                                                    Miami, FL 33199
                                                                                                                         (305) 348-4903 office
 The successful candidate will:
                                                                                                                           (305) 348-4901 fax
 - Provide direction and leadership in the development of the new
                                                                                                                   e-mail address:
 - Facilitate interdisciplinary collaboration                                                    Florida International University is a member of the State University
 - Develop and manage sponsored research                                                             System of Florida and an Equal Opportunity/Equal Access/
                                                                                                                     Affirmative Action Employer.

                    Kanawha-Charleston Health Department
                                                                                                     position is classified as an “Exempt Position.” The Director serves at

                            he Kanawha-Charleston Board of Health is seeking a Physician
 Medical Director

                            Director for the Kanawha-Charleston, City-County Health                  the will and pleasure of the Board.
                            Department located in Charleston, West Virginia. The Depart-                The Director is responsible for all aspects of the day to day opera-
                    ment serves a population of 200,000 people, and covers 900 square                tion of the Department. This includes preparation of the annual bud-
                    miles. The position requires an individual with at least five (5) years of       get and it’s submission to the Board for approval. Upon approval, the
                    public health experience, and at a minimum, an MPH degree. Prefer-               budget is forwarded to the City of Charleston, the Kanawha County
                    ence is given to specialists certified by the American Board of Preven-          Commission, and the State Bureau for Public Health.
                    tive Medicine. The Department employs a staff of 50, and has an                     The Director is responsible for the hiring of personnel, and the
                    annual budget of $3.5 to $4 million. Salary is commensurate with                 management of all Department Programs. He/she oversees the opera-
                    experience. The range is $105,612-$189,096. Outstanding medical,                 tions of all programs conducted by the Department and is medically
                    dental, vision, and long term disability insurance plans, as well as an          responsible to insure that all clinical services meet or exceed the com-
                    excellent retirement program.                                                    munity norms, as well as State of West Virginia, and National Stan-
                        Being the Capitol City, Charleston enjoys a wide variety of cultural         dards or Guidelines.
                    and recreational activities. The state park system and resorts in West              The Director serves as the Kanawha County Health Officer upon
                    Virginia offer outstanding outdoor activities to include skiing, hiking,         recommendation of the Kanawha County Commission, and approval
                    white water rafting, hunting, fishing and golf. Charleston is home to            by the State Health Commissioner, Bureau for Public Health. His/her
                    the West Virginia Symphony, as well as a variety of live “legitimate the-        responsibilities in these matters are contained in Chapter 16, of the
                    ater” productions. Construction for a new $90 million Center for the             WV Code.
                    Performing Arts is in progress.                                                     The Director is actively engaged in community outreach. Partici-
                        Applications and Resumes will be accepted until the position is              pates in a wide variety of activities involving community organiza-
                    filled. For further information, please send your e-mail to: kchdad@             tions whose goal it is to address health, environmental, social and
           or write to: P Box 927, Charleston, West Virginia 25323.
                                             .O.                                                     emergency response needs and issues. He serves as the medical advi-
                    You may also call (304) 348-8069/8067.                                           sor to the community, with respect to public health matters.
                               The Department is an Equal Opportunity Employer.                         The Director assesses community health needs, facilitates access
                                                                                                     to medical care, assures the quality of preventive health care services,
                                                                                                     and proposes policies for the improvement of community health ser-
                    Position Description                                                             vices, to the Board. The Director serves as the recording secretary for
                        The position of Medical Director, Kanawha-Charleston Health                  the Board.
                    Department is filled by appointment, after consideration by the                     The Director represents the Board and the Department in matters
                    Kanawha-Charleston Board of Health. The Department is a member                   of public health interest at the national, state, and local Levels. He/she
                    of the State of West Virginia Personnel System; however, the Director            performs all other duties as assigned.

20       T h e N at i o n ’ s H e a lt h                         ❖     March 2003
                                                                                                                                        overweight and obesity. A
                                                                                                        Calendar                        free planner’s guide and
                  BIOSTATISTICS                                                                         March
                                                                                                                                        other materials are online
                                                                                                                                        at <>.
            Assistant / Associate Professor                                                             Uninsured Americans             For more information, call
                                                                                                                                        (202) 777-2515.
  The University of Texas School of Public Health at Houston                                               Cover the Uninsured
                                                                                                        Week will be observed
 The University of Texas School of Public Health at Houston invites applications from                   March 10–16 in communi-         STDs, HIV/AIDS
 doctoral graduates in biostatistics or related fields to fill four tenure-track faculty positions at   ties across the United             The Second Forum on
 the Assistant or early Associate Professor level. The successful applicants will join a growing        States. A national kick-off     HIV, AIDS and Sexually
 multidisciplinary SPH faculty located on the Houston Campus in the Texas Medical Center.               event will be held in Wash-     Transmitted Infections in
 Responsibilities will include teaching, conducting research and performing community                   ington, D.C. The event          Latin America and
 service. Teaching includes courses for students in the Master of Public Health, Doctor of              focuses attention on the        Caribbean — also known
 Public Health, Master of Science, and Doctor of Philosophy degree programs. This includes              plight of the millions of       as FORO2003 — will be
 advanced biostatistics courses and service courses for students in related degree programs.            Americans who lack health       held April 7–12 in Havana,
 Classes will be small and extensive computing and video facilities will enhance teaching.              insurance. For more             Cuba. For information, visit
 The positions also include extensive opportunities for collaboration and at least one position         information, visit <http://     <
 is affiliated with the faculty in the Coordinating Center for Clinical Trials.               >.         ingles/index.html>.
 Qualifications include: (1) strong interest in teaching and advising graduate students,
 (2) evidence of both independent and collaborative research potential, (3) interest in                                                 Correctional health
 developing innovative instruction in biostatistics, and (4) excellent written and oral
                                                                                                        Health behavior
                                                                                                           The Third Scientific            The Clinical Updates in
 communication skills.
                                                                                                        Meeting of the American         Correctional Health Care
 Review of applications will begin immediately and continue until the positions are                     Academy of Health Behav-        Conference will be held
 filled. Academic rank will be determined by the qualifications of the candidates.                                                      April 12–15 in Anaheim,
                                                                                                        ior will be held March
 Applicants should submit electronically a letter of interest, C.V., and contact                                                        Calif. The four-day confer-
 information for three professional references to: Robert J. Hardy, Ph.D., Professor of                 16–19 in St. Augustine, Fla.
 Biometry, Chairman, Biometry Search Committee, The University of Texas Health                          The conference will             ence is sponsored by the
 Science Center at Houston, School of Public Health, 1200 Herman Pressler, Suite                        include sessions on pre-        National Commission on
 E-833, Houston, TX 77030: Email:                                            vention science, environ-       Correctional Health Care.
                                                                                                        mental and health               For more information, call
                                                                                                        behavior. For more infor-       (773) 880-1460 or visit
                     THE UNIVERSITY of TEXAS                                                            mation, visit <www.aahb.        <>.
                     H E A LT H S C I E N C E C E N T E R              AT    HOUSTON
                                                                                                                                        Suicide prevention
                                                                                                        April                              Competent Communi-
       The University of Texas is an Equal Opportunity, Affirmative Action Employer. Minorities                                         ties: Suicide Prevention
      and women are strongly encouraged to apply. This is a security-sensitive position and thereby
                               subject to Texas Education code §51.215.
                                                                                                        Public health                   through Support, Research
                                                                                                           National Public Health       and Practice, sponsored by
                                                                                                        Week 2003, sponsored by         the American Association
                                                                                                        APHA, will be observed          of Suicidology, will be held
                                                                                                        across the nation April         April 21–26 in Santa Fe,
                                                                                                        7–13. The eighth annual         N.M. For more information,
                                                                                                        celebration will focus on       call (800) 442-4673. I
Senior Research Professor
  Center for Urban Health
    College of Nursing and Health Professions                                                              Kick Butts Day, Mental Health
      Drexel University (formerly MCP Hahnemann University)                                                Month to be observed nationwide
        Philadelphia, PA
                                                                                                           A      PHA is helping to promote two upcoming
                                                                                                                  public health observances aimed at raising
                                                                                                           awareness of mental health issues and fighting
T   he Center for Urban Health at Drexel University is a new initiative representing a
    unique collaboration between the College of Nursing and Health Professions
(CNHP) and the School of Public Health. The Center encompasses research, education
                                                                                                           youth tobacco use.
                                                                                                               The Association is a supporter of the eighth annual
                                                                                                           Kick Butts Day, sponsored by the Campaign for
and health care focused on health disparities in an urban setting. Center activities are
                                                                                                           Tobacco-Free Kids. The event, which
based in an inner city community where the CNHP has established a six-year relation-                       will be observed nationwide on
ship with the residents resulting from health education and care delivered through a                       April 2, will engage youth in
nurse-managed health service. To strengthen the research arm of the Center for Urban                       activities against tobacco
Health, the CNHP is seeking a senior research professor to conduct research, mentor                        use. In 2002, more than
junior researchers and teach occasional interdisciplinary research seminars. Salary and                    1,500 events were held
benefits will be commensurate with academic achievement and experience.                                    nationwide, including ral-
                                                                                                           lies, mock trials, educa-
Required Qualifications: earned doctorate in an area appropriate for urban health/                         tional campaigns, sporting
health disparities research (including but not limited to epidemiology, health policy, med-                events and essay contests. This
ical sociology, nursing, urban planning); record of funded research; experience working                    year’s event has a theme of “Turn
collaboratively with other researchers and communities in an interdisciplinary setting.                    the Tide: Drown Out Big Tobacco.”
To Apply: send letter of application addressing the required qualifications, current cur-                      More information and a free Kick Butts Day guide
                                                                                                           with planning activities is available online at
riculum vitae, and names and addresses of three references to:
         Dean Gloria Donnelly                                                                                  In May, the National Mental Health Association is
         College of Nursing and Health Professions                                                         sponsoring its annual Mental Health Month obser-
         Drexel University                                                                                 vance. The event, which carries a theme of “Mental
         Mail Stop 501, 1501 Race Street                                                                   Health Matters — Every Day” will help raise aware-
         Philadelphia, PA 19102                                                                            ness of the issue nationwide.
                                                                                                               A public education planning guide — including
  Drexel University is an equal opportunity, affirmative action employer and actively                      sample news releases, letters to the editor and procla-
    seeks to enhance the diversity of the faculty. Female and minority researchers                         mations — will be available on the National Mental
              with a history of funded research are encouraged to apply.                                   Health Association’s Web site. For more information,
                                                                                                           visit <>. I

                                                                                   March 2003             ❖    T h e N at i o n ’ s H e a lt h                   21
     Assistant, Associate or Full Professors
        Infectious Disease Epidemiologists
                   University of Minnesota

                     T         he Division of Epidemiology, School of Public Health, University of Minnesota seeks two more full-
                               time faculty positions for teaching and research in a growing program in infectious disease epidemiol-
                               ogy — one tenure-track Assistant Professor; and one tenure-track Assistant or Associate Professor, or
                     tenured Full Professor, These appointments provide outstanding opportunities for transdisciplinary collabora-
                     tion within a broad range of sub-disciplines, including zoonoses, emerging infections, HIV/AIDS, foodborne
                     disease, tuberculosis, and malaria, as well as traditional chronic disease epidemiology and prevention/
                     intervention studies.
                     The Division of Epidemiology ( provides a rich and collaborative environment for the
                     investigation of the etiology and prevention of chronic and infectious diseases. It has 45 primary faculty who
                     bring in over $26 million annually in sponsored research grants, and an additional 65 adjunct faculty. It cur-
                     rently enrolls 34 students in the PhD epidemiology program, and 215 students in its MPH and MS programs
                     (Epidemiology, Community Health Education, Maternal/Child Health, Public Health Nutrition, and
                     Clinical Research).

                     Numerous opportunities for collaboration exist locally with the Minnesota Department of Health; other
                     schools in the Academic Health Center (Medical School, College of Veterinary Medicine, Dental School); the
                     University’s Center for Infectious Disease Research and Policy (CIDRAP — under the
                     Direction of Dr. Michael Osterholm, Center for Animal Health and Food Safety (CAHFS —
            under the direction of Dr. Will Hueston, Center for Global Health under the direction of
                     Dr. Ian Greaves, and Carlson School of Management; the U.S. Department of Agriculture; and community-
                     based agencies in the metropolitan area.
                     International collaborative opportunities exist with the International Training Research and Exchange Pro-
                     gram in Infectious Disease Epidemiology (INTREPIDE) between the University’s School of Public Health and
                     the French Institute of Tropical Medicine and Epidemiology (IMEA) at the University of Paris. Additional
                     international opportunities and collaborations exist with members of the new, interdisciplinary University of
                     Minnesota Center for Global Health.
                     Requirements include: 1) PhD, DrPH, ScD; or 2) MD, DVM, or DDS with MPH or MS in epidemiology or
                     related field; or 3) MD, DVM, or DDS with evidence of at least one year of post-graduate training in Epidemi-
                     ology; and 4) background in epidemiologic methods and research design; 5) relevant publications in peer-
                     reviewed journals; 6) experience in research sponsored by NIH, CDC, USDA or other public/private agencies;
                     and 7) experience in infectious disease epidemiology. Requires some graduate-level teaching experience. Pri-
                     mary criteria for evaluation are relevant research experience, publication in peer-reviewed journals, and evi-
                     dence of graduate level teaching. Rank of appointment will depend on level of accomplishment in these areas.
                     Responsibilities include: 1) teaching and research to enhance the program in infectious disease epidemiology;
                     2) collaboration with AHC faculty and others in research; 3) collaboration as Principal or Co-Investigator on
                     research studies; 4) authoring manuscripts for publication; and 5) teaching and advising master’s, doctoral, and
                     post-doctoral students.
                     Applications are currently being reviewed and will continue until suitable candidates are identified and the
                     position is filled. Applicants should submit statement of scientific interests, CV, publications list, and list of at
                     least three references to Dr. Donna Arnett c/o Kathy Ramel, Div. of Epidemiology, School of Public
                     Health, University of Minnesota, 1300 So. 2nd St., #300, Minneapolis, MN 55454-1015. Please refer-
                     ence job #SPH 471. For additional information or a complete job description, please e-mail Kathy Ramel

                                                       The University of Minnesota is an equal opportunity educator and employer.

22   T h e N at i o n ’ s H e a lt h          ❖    March 2003
         The University of Tennessee
                                                                                   fication as a Health Education Specialist (CHES). Desired: MPH

        pplications are invited for one administrative and three faculty
        positions with the Department of Health and Exercise Science,              degree; research focus in behavioral and community interventions
        which has a nationally accredited MPH Program. The nine-                   for adolescent and young adult populations.
month tenure track appointments are effective August 1, 2003.                    Assistant Professor of Safety
Required qualifications for each position follow. In addition, appli-              Earned doctorate in safety, human factors engineering, or related
cants for all positions should reflect interest in teaching and advising;          health discipline. Desired: Research focus on injury prevention and
evidence of scholarly productivity; and commitment to obtaining                    assessment with regard to health protection of special populations
extramural support for research. More detailed position announce-                  (special needs groups, adolescents, high-risk workers, athletes); and
ments may be obtained by contacting the Department.                                interest in intervention-oriented measurement studies associated
Department Head and Professor                                                      with injury prevention and/or biomedical engineering.
  Earned doctorate in exercise science, health education, or public                 Designated a Carnegie I research university, The University of Ten-
  health; strong record of scholarship including research and publica-           nessee is the oldest, largest and most comprehensive institution of
  tions; demonstrated success in obtaining extramural support for                higher education in Tennessee. Academic programs on the Knoxville
  research; administrative experience in academia; and demonstrated              campus enroll approximately 20,000 undergraduate students and
  commitment to equal employment opportunity and affirmative                     nearly 5,500 graduate students. The University of Tennessee Web site:
  action. Responsibilities include academic programs; budgetary and    
  promotion decisions; leadership and advocacy for development of                   Application review will begin March 24, 2003, and continue until
  research, teaching and public service; promotion of collaborative              positions are filled.
  interactions with internal and external constituencies; instruction of            Applicants send letter of interest addressing qualifications, curricu-
  graduate level courses and direction of theses and dissertations; and          lum vitae, and names, addresses, and telephone numbers of three ref-
  pursuit of external funding.                                                   erences to: Search Committee
Assistant/Associate Professor (Epidemiology/Community Health)                                  Department of Health and Exercise Science
  Earned doctorate; focus in epidemiology or other closely related                             The University of Tennessee
  field; research interests in infectious or chronic disease (e.g., physical                   1914 Andy Holt Avenue
                                                                                               Knoxville, TN 37996-2710
  activity, obesity) epidemiology; and university teaching experience.
                                                                                               (865) 974-5041 (office)
  Desired: MPH or MSPH degree; experience with secondary data                                  (865) 974-6439 (fax)
                                                                                     The University of Tennessee is an EEO/AA/Title VI/Title IX/Section
Assistant Professor of Community Health Education                                     504/ADA/ADEA institution in the provision of its education and
  Earned doctorate in health education or health promotion; and certi-                               employment programs and services.

                                      Deputy Health Officer
                                             hasta County Public Health in Northern Cali-            A Master’s of Public Health (MPH) degree is
                                             fornia (near Mt. Shasta) is recruiting for physi-   desirable and may be substituted for one year of
                                             cian Deputy Health Officer for a progressive        experience as a licensed physician. Board-certifica-
                                      local health department with a leadership that has         tion in General Preventive Medicine/Public Health is
                                      decades of Public Health experience and is active          strongly desired and may substitute for two years of
                                      and visionary. The communities comprise about              experience as a licensed physician.
                                      170,000 population, are semi-rural, and offer many             Must possess an unrestricted physician and sur-
                                      attractions.                                               geon license to practice medicine in the state of
                                          The salary range is $116,338-$148,491.                 California from the Medical Board of California or
                                          The ideal physician will demonstrate strong            be eligible for same if from out of state.
                                      interest and experience in communicable disease                How To Apply: Applications will be accepted in
                                      (CD) control (eg, STD, IZ, TB, HCV, HIV, PH Lab,           the County Human Resources Office until 5:00 p.m.,
                                      Bioterrorism); have understanding and enthusiasm           March 31, 2003. A cover letter and/or resume will
                                      for population-based prevention strategies, particu-       be accepted in addition to the application form but
                                      larly in the areas of CD, injury and violence preven-      will not serves as a substitute for a completed appli-
                                      tion, Disaster Preparedness and/or MCAH (eg, CCS,          cation. Closing date postmarks or faxes will NOT be
                                      foster care, CHDP); significant prior local or state       accepted.
                                      health Dept public health experience; and skill in         Shasta County Is an Equal Opportunity Employer
                                      both the science and art of medicine and public                 Shasta County Human Resources
                                      health practice.                                                1600 Court Street
                                          These employment standards are typically                    Redding, CA 96001
                                      attained with five years of experience as a licensed            (530) 225-5515
                                      physician and two years of experience administer-
                                      ing/overseeing public health programs AND pos-             Applicants are encouraged to apply online at:
                                      session of an MD or DO Degree from an accredited  For more information about
                                      school of medicine AND board specialization in             Shasta County please see www.reddingchamber.
                                      Public Health/Preventive Medicine or a primary care        com or
                                      specialty as defined by California law (Family Prac-
                                      tice, Pediatrics, Obstetrics/Gynecology or General            Great Opportunity, Apply Quickly!
                                      Internal Medicine).                                                    Closes March 31, 2003.

                                                                 March 2003                ❖     T h e N at i o n ’ s H e a lt h                             23
Advocates seek more funding
for global HIV/AIDS battle                                               Assistant/Associate/Full Professor
                                                                                                School of Public Health
T     he United States
      must significantly
increase its U.S. funding
                                100 health and medical
                                professionals, including
                                APHA Executive Director          Florida International University is creating a new School of Public Health, building upon the
for international AIDS pro-     Georges Benjamin, MD,            CEPH accredited program in the current Department of Public Health within the College of
grams, including the            FACP, who signed on behalf       Health and Urban Affairs. We seek to fill two positions; rank is open for both. At least one
Global Fund to Fight AIDS,      of the Association.              of these positions will be filled by an epidemiologist with a strong background in environ-
Tuberculosis and Malaria, a         “Even as we orient our       mental health, biostatistics, health promotion, international health or epidemiology will be
group of physicians, health     nation towards fighting ter-     considered for the other position.
professionals, nurses and       rorism and weapons of
scientists urged President      mass destruction, we urge        The positions require a doctoral degree in a health-related field. Successful candidates will
Bush in a January letter.       you to commit your admin-        demonstrate potential for effective teaching, scholarly activity, and ability to communicate
   The letter, sent to Bush     istration to reversing the       effectively with ethnically and culturally diverse communities. Responsibilities will include
in advance of the February      terrible tide of HIV/AIDS        teaching and student advisement, research, and serving the university, professional and
release of his 2004 budget      and aiding those who are         neighboring communities. Salary is commensurate with qualifications and experience.
proposal, called for a series   suffering and dying of this
of steps to reduce the toll     treatable disease,” said the     A letter of interest, vitae, and the names of three professional references who can comment
of HIV/AIDS on the world’s      letter. “As HIV/AIDS con-        on teaching and research experience or potential will constitute an application. Review of
population. Among the           sumes entire communities         applications will begin March 10, 2003, and continue until successful candidates are iden-
measures advocated was          the world over and threat-
                                                                 tified. Send inquiries and application to:
scaling up public health        ens our own national secu-
infrastructure in AIDS-bur-     rity, we look forward to the                                    William W. Darrow, PhD
dened countries, expanding      prospect of a major new                                         Chair, Search and Screen Committee
AIDS treatment programs,        presidential initiative on                                      Department of Public Health
enhancing assistance for        HIV/AIDS. The fate of mil-
                                                                                                Florida International University
AIDS orphans and increas-       lions of people rests in
                                                                                                University Park Campus, VH 216
ing prevention programs.        your hands.”
                                                                                                11200 S.W. 8th Street
   The letter, coordinated          The letter is at <www.
by Physicians for Human                                      Miami, FL 33199
Rights, was signed by about     release012303.html>. I                                          (305) 348-4903 office
                                                                                                (305) 348-4901 fax
                                                                                                E-mail address:
 Dental, oral health data now online
                                                                     Florida International University is a member of the State University System of Florida

 P     ublic health professionals looking for the latest
       dental and oral health statistics can find them
 through a new federal Web site.
                                                                            and an Equal Opportunity/Equal Access/Affirmative Action Employee.

    The site, launched in January by the Dental, Oral and
 Craniofacial Data Resource Center, includes statistical
 information on the oral health status of the U.S. popula-
 tion and a searchable database of surveys and archives of
 oral health procedures, with more than 200 surveys and
 data sets.
                                                                 HIV Prevention
    The Dental, Oral and Craniofacial Data Resource Cen-
 ter is funded by the National Institutes of Health and          Senior Technical Advisor
 Centers for Disease Control and Prevention. The site is
 online at <>. I

APHA Annual Meeting raises
                                                                                                 he DoD HIV/AIDS Prevention Program (DHAPP) in
                                                                                                 African militaries, based in San Diego at the Naval
                                                                                               Health Research Center, is seeking applicants for a
                                                                 Senior Technical Advisor to manage the program’s technical support office.
money for maternal, child health                                 Candidates must have a health related doctorate degree with experience in project

A      ttendees at the
       130th APHA Annual
Meeting in November raised
                                utive Director JoAnne Fis-
                                cher in a December letter
                                to APHA. “Thank you
                                                                 management and expertise in infectious diseases, particularly sexually transmitted
                                                                 infections and HIV. The successful applicant will report to the senior management staff
                                                                 and will provide assistance with related requests for DHAPP on an as-needed basis. This
more than $4,000 to help        again for helping us to
improve maternal and child      strengthen families, one         individual will assist in the review, development, and implementation of the program’s
health in Philadelphia.         baby at a time.”                 technical assistance guidelines relevant to African uniformed services in the following
    Participants at the             The contribution drive       HIV/STI areas: surveillance, laboratory support, prevention and education, behavioral
Annual Meeting had an           was part of APHA’s annual        change communications, clinical management, and public health.
option on their Meeting reg-    Help Us Help Them cam-
istration form to donate $3     paign, which works to give       This person will coordinate, plan, develop, and evaluate technical support activities of
to the Maternity Care Coali-    back to the communities          DHAPP, in conjunction with service program representatives, CDC, USAID, and other
tion, a Philadelphia organi-    where the Association’s          federal, non-federal, and multilateral agencies active in the field. This individual will
zation that works to            Annual Meeting is held. Par-     recommend alternative short- and long-term planning objectives to address program
improve maternal and child      ticipants in this year’s         goals, identify and develop program technical support priorities, provide scientific guid-
health and well-being.          Annual Meeting, to be held
                                                                 ance to staff, and monitor progress of approved projects and initiatives. This person will
About 1,300 registrants         Nov. 15–19 in San Fran-
opted to contribute to the      cisco, will be given the         review grant/project proposals, procurement contracts, and inter-agency documents for
coalition, whose activities     opportunity to contribute to     scientific and/or technical merit. U.S. citizenship required.
include home visits to preg-    a public health organization
                                in that community.               To be considered qualified candidates must state salary requirements and forward
nant women, new parents,
infants and their families.         For more information         resume/CV in Word format to
    “Your generosity makes      on the Maternity Care
a difference and touches        Coalition, visit <www.                                             EOE, AA, MFHV
lives,” wrote coalition Exec->. I

24       T h e N at i o n ’ s H e a lt h                ❖      March 2003
TITLE:              Research Associate Professor

DUTIES:             Duties are to include: 1) develop                   Injury Research
                    research grants to secure external
                    funding; 2) conduct original health                 Faculty Positions Available
                    services research with special em-                                                   Center for Injury Research and Policy
                    phasis on cost and utilization studies
                    focusing on vulnerable populations                                                Columbus Children’s Research Institute
                    (i.e.,persons living with HIV,the men-
                    tally ill, rural and/or poor, the unin-                                               Children’s Hospital, Columbus, Ohio
                    sured, and racial disparities); 3)
                    prepare reports for funding agen-                      The Center for Injury Research and Policy located at Children’s Hospital in Columbus,
                    cies; 5) publish research results in                   Ohio, is seeking applicants for two tenure-track faculty positions. The Center is expanding
                    peer-reviewed journals; 6) mentor                      its research in the areas of traumatic brain injury, family violence, impact biomechanics,
                    doctoral students; 7) teach courses                    motor vehicle occupant injury, and injury surveillance and epidemiology. Faculty members
                                                                           will have an appointment in the Department of Pediatrics, Ohio State University College of
                    in the use of statistical packages and
                                                                           Medicine and Public Health. Joint appointments with other departments and colleges
                    data management as applied to                          within the university are possible. Applicants should have a doctoral degree in the medical,
                    health services research and public                    public health, or related field, and a track record in research productivity. Individuals with
                    health; and 8) maintain the major                      an interest in health services and health economics research are encouraged to apply.
                    Federal data sets that are key to pub-                 Applicants will be considered at the Assistant, Associate, or Full Professor levels. Applica-
                    lic health and health services re-                     tions from mid-career researchers are encouraged. Salary and benefits are very competitive
                                                                           and are based on experience and academic rank. An attractive five-year start-up package
                    search for the Department.
                                                                           will be tailored to the faculty member’s needs. The startup package includes sufficient fund-
                                                                           ing to purchase equipment and support research staff, postdoctoral fellows, and/or graduate
HOURS:              37.5 hours per week (M-F, 8:30 AM –                    students. Candidates should apply by sending a letter of application, CV, and list of three ref-
                    5:00 PM or equivalent)                                 erences to: Gary A. Smith, MD, DrPH, Director, Center for Injury Research and Policy,
                                                                           Children’s Hospital, 700 Children’s Drive, Columbus, Ohio 43205; telephone (614) 722-
REQUIREMENTS: 1) A DrPH from an accredited School                          2400; Fax (614) 722-2448; e-mail:
              of Public Health in Health Adminis-                                          Children’s Hospital, Inc. and The Ohio State University are
              tration or Public Health Administra-                               Affirmative Action/Equal Opportunity Employers. Women, minorities, veterans,
              tion; 2) a demonstrated record of                                             and individuals with disabilities are encouraged to apply.
              research published in peer-reviewed
              professional journasl; 3) a demon-
              strated expertise in SAS and SPSS
              statistical packages and the ability to
              program in SAS; 4) evidence of
              research design capabilities, hypoth-
              esis testing, and descriptive statisti-
              cal methods as applied to health
              services research in public health; 5)
              knowledge of how to manage and                              You’ll Find
              maintain the major Federal health-
              related data bases (health status,                                    More Than Your Next Job
              consumer and provider attitudes                                                                    at APHA’s CareerMart
              and behaviors, cost and utilization
              data) for the Department; 6) good                           Employers: APHA’s CareerMart brings the best and brightest right to your
              interpersonal skills.                                       desktop. Browse through our public health talent bank or create your own
                                                                          applicant database. CareerMart offers unbeatable exposure for your job
APPLICATION         Deadline for applications is                          openings at the right price. Check out our new savings packages for multi-job
DEADLINE:           March 30, 2003.                                       postings. Register today and transform the way you find new employees!
                     Contact or send resume to: Sonja                     Job Seekers: Post your resume today to receive attention from public
                     Snowdon, Health Administra-                          health employers across the country.
                     tion, Arnold School of Public                        CareerMart at the APHA 131st Annual Meeting
                     Health, University of South Car-                     Want to be a part of CareerMart at APHA’s Annual Meeting in San Francisco
                     olina, 800 Sumter Street, Colum-                     in November 2003?
                     bia, SC, 29208                                       Go to or e-mail for information.
              Phone: (803) 777-3400                                       APHA’s CareerMart is the only resource for both employers and job seek-
              Fax:    (803) 777-1836                                      ers in the public health arena.Take a look at our exciting new features and
              E-mail:                                     more. We’re only a click away!
  The University of South Carolina provides affirmative action
      and equal opportunity in education and employment
  for all qualified persons regardless of race, color, religion, sex,
          national origin, age, disability, or veteran status.                                                                               Working for a Healthier World

                                                                          March 2003                      ❖     T h e N at i o n ’ s H e a lt h                          25
     MATERNAL AND CHILD HEALTH                                   Assistant Professor
        Applications are invited for the                         Health Behavior/Health Services Research
        position of Chair of the Depart-
        ment of Maternal and Child
        Health, School of Public Health,                          T   he Department of Health Behavior and Administration at the University
                                                                      of North Carolina Charlotte invites applications for a tenure-track posi-
                                                                  tion at the Assistant Professor level to begin August 2003. Applicants must
        University of North Carolina at
                                                                  have a PhD (by August 2003) in health behavior, health services research,
        Chapel Hill.                                              public health, or a related field. The successful candidate will join a newly
           The chair will be appointed to a                       established research intensive unit in the transformed College of Health and
                                                                  Human Services; and the candidate will contribute to expanding initiatives
        tenure-track faculty position at the
                                                                  in health services research, community health behavior, and health adminis-
        full professor level and lead a                           tration. Preference will be given to candidates with a focused research
        department that has 20 full-time                          agenda, current research funding or strong evidence of potential for estab-
                                                                  lishing a successful program of funded research, and teaching experience at
        faculty, 90 graduate students in
                                                                  undergraduate and graduate levels. Candidates with research programs
        master’s and doctoral programs,                           incorporating one or more of the following topics are preferred: health out-
        and $7 million in research funding.                       comes research methods, assessment, and evaluation; community health;
                                                                  health disparities; cost-effectiveness. Applications including a vita, a descrip-
        The department builds on the
                                                                  tion of a research agenda, a statement of teaching philosophy, a copy of all
        MCH tradition by relying on a                             graduate transcripts, and three letters of recommendation, should be sent
        range of academic disciplines com-                        to Chair, Search Committee, Department of Health Behavior and Adminis-
                                                                  tration, UNC Charlotte, 9201 University City Blvd., Charlotte, NC 28223. The
        mitted to improving the health of                         review of candidates will began February 15, 2003, and will continue until
        women, children, and families,                            the position is filled. UNC Charlotte is an Equal Opportunity/Affirmative
        both domestically and internation-                        Action employer. An AA/EOE employer, minority applicants and individuals
                                                                  with a disability are encouraged to apply.
        ally. The chair, who reports to the
        dean of the School of Public
        Health, is expected to build upon
        the department’s success as an
        independent academic unit
                                                              Saint Louis University
        engaged in research, teaching,                        School of Public Health
        and practice, and to enhance                          Faculty Position in Epidemiology
        excellent relationships with
        research programs on campus and
        in the surrounding area. Candi-
                                                       S    aint Louis University, a Catholic, Jesuit institution dedicated to education,
                                                            research and health care, invites applications for a tenure-track faculty position, at
                                                        the assistant or associate professor level, in the School of Public Health. The success-
        dates should have a distinguished               ful candidate will be appointed in the Department of Community Health on a 12-
        record of research, teaching, pro-              month contract. The Saint Louis University School of Public Health is nationally
                                                        recognized for its community-based disease prevention research.
        fessional and public service, and
                                                            For full consideration, applicants must have a doctoral degree with advanced
        administration. Review of applica-              training in epidemiology and behavioral sciences. S/he should have a consistent and
        tions will begin immediately and                productive record of research publication and demonstrated ability or clear potential
        continue until the position is filled.          to secure external research funding. Primary responsibilities for the position include
           For more information, see                    teaching up to three graduate courses per year, conducting independent and collabo-
                                                        rative research, advising masters and doctoral students, and working with post-doc- The Uni-
                                                        toral fellows.
        versity of North Carolina at Chapel                 Successful candidates will find opportunities for collaboration in a productive
        Hill is an Equal Opportunity, ADA               school portfolio of projects based in community settings aiming at prevention through
        Employer. Members of minority                   designated research projects related to obesity, physical activity, cardiovascular health,
        groups and women are strongly                   AIDS, and health communication. Research opportunities in the School will include
                                                        contributing expertise to the measurement of social determinants to research projects
        encouraged to apply.
                                                        and by conceptualizing how social determinants can be integrated into intervention
           Please submit applications to                activities.
        Diane Rogers, Department of                         Applications should include a curriculum vitae and three letters of reference to:
        Maternal and Child Health, School               Dr. William R. True, Search Committee Chair and Professor, Saint Louis University
        of Public Health, University of                 School of Public Health, 3545 Lafayette Ave., St. Louis, MO 63104. The application
                                                        review process will begin in early April, but the search will remain open until the posi-
        North Carolina at Chapel Hill,
                                                        tion is filled. E-mail inquiries to: mcdanieb@SLU.EDU.
        CB# 7445, Rosenau Hall, Chapel
                                                                                 Saint Louis University is an Equal Opportunity/Affirmative
        Hill, NC 27599-7445.                                                   Action Employer. Minorities and women are encouraged to apply.

26    T h e N at i o n ’ s H e a lt h            ❖   March 2003
 The Nation’s                                                                                             Promise made,
                                         Letters                                                          promise kept
                                                                                                             As a longtime advocate
                                                                                                                                                 In memoriam
                                                                                                                                                 Arbona, public
                                                                                                          for holistic health and phys-
         ISSN: 0028-0496                 Personal perspectives on public health                           ical activity, I have
                                                                                                                                                 health leader
       Vol. XXXIII, No. 2                                                                                 observed the critical role
                                                                                                                                                    Guillermo Arbona,
          March 2003                                                                                                                             MD, MPH, Puerto Rico’s
                                                                                                          that lifestyle factors play in
                                         Morning-after pill               January 2003 issue of The
                                                                                                          regard to health and
                                                                                                                                                 former secretary of
 The Official Newspaper of the                                            Nation’s Health. The article,                                          health and a 66-year
American Public Health Association       differs from RU-486              “Government boards              chronic disease. During my
                                                                                                                                                 APHA member, died
          800 I St. N.W.                     I applaud APHA for call-     threatened by politics,”        term as APHA president in
                                                                                                                                                 Dec. 27 in San Juan. He
   Washington, DC 20001-3710             ing for more credible            stated that RU-486 is com-      2001, I worked to promote
                                                                                                                                                 was 92.
     Phone: (202) 777-APHA               appointees to the federal        monly known as the              a balance between health,
                                                                                                                                                    A longtime medical
       Fax: (202) 777-2534               science-based advisory           morning-after pill. In fact,    well-being and the physical
                                                                                                                                                 educator and health
     Web site:              committees that influence        these terms refer to differ-    and social environment.
                                                                                                                                                 administrator, Arbona
   For Change of                         public health policy (Dec-       ent drugs.                      Regular readers of The
                                                                                                                                                 served as Puerto Rico’s
 Address or Problems                     ember 2002/January 2003,            As public health profes-     Nation’s Health may recall a
                                                                                                                                                 secretary of health in
  with subscription:                     The Nation’s Health).            sionals, it is important for    pledge I made in my March
                                                                                                                                                 1957. He was known for
    Contact Membership Services              However, I was disap-        us to be well-versed with       2001 president’s column to
     by phone (202) 777-2400;                                                                                                                    his work in the 1950s to
                                         pointed to see that the arti-    the reproductive health         run a marathon.
   TDD (202) 777-2500; or e-mail                                                                                                                 reorganize Puerto Rico’s
                                         cle inaccurately describes       options available today.           Although I was unable                                                                                                                     health system into a net-
                                         RU-486 as the “morning-          Greater awareness of these      to fulfill that pledge during
                                                                                                                                                 work of primary care
                                         after pill.” It is not. RU-486   options on our part will        my presidency, I am proud
  Executive Director/                                                                                                                            centers and hospitals.
                                         is a pill or series of pills     result in greater knowledge     to report that I recently
    Executive Editor                                                                                                                                Arbona was affiliated
                                         taken within seven weeks         and less ignorance, fear        realized my goal: My suc-
   Georges Benjamin, MD, FACP                                                                                                                    with the University of
                                         of a woman’s last men-           and confusion on the part       cessful December run in
           Editor                                                                                                                                Puerto Rico for most of
                                         strual period, which             of the public.                  the Honolulu Marathon,
          Michele Late                                                                                                                           his life, heading the
                                         induces medical abortion.           Sandi Pruitt, MPH            which benefitted the San
     Assistant Editor                                                                                                                            Department of Public
                                             In contrast, the morn-          Houston, Texas               Francisco AIDS Foundation,
          Kim Krisberg                                                                                                                           Health in the School of
                                         ing-after pill is a high dose                                    was dedicated to the health
                                                                                                                                                 Tropical Medicine from
  Contributing writer                    of birth control pills that      Editor’s note: A correc-        workers of the world. The
       Donya C. Arias                                                                                                                            1942 to 1947. In 1965,
                                         prevents pregnancy when          tion was published in the       enormous spirit they carry
                                                                                                                                                 he received APHA’s
Communications Intern                    taken within 72 hours of         February 2003 issue of The      within themselves and use
                                                                                                                                                 Bronfman Award.
     Divya Mutyala                       unprotected sex, and is          Nation’s Health.                to transform the health of
                                                                                                                                                    Arbona received his
                                         known as emergency con-                                          those around them served
     Phone: (202) 777-2742                                                                                                                       master’s of public health
                                         traception.                                                      as my inspiration.
       Fax: (202) 777-2534                                                National health                                                        from the Johns Hopkins
 E-mail:             To ensure that women                                           Michael E. Bird,
                                                                                                                                                 School of Hygiene and
    Web site:              in New York state have           insurance a must                   MSW, MPH
                                                                                                                                                 Public Health in 1937. I
         thenationshealth                greater access to emer-             The general public is          Oakland, Calif. I
                                         gency contraception —            sharing the pain of the
   Editorial Advisory                    currently available by pre-
                                                                          nation’s retirees as health
                                         scription only — I am            insurance premiums con-
       Elsie Eyer, MS, chair             sponsoring the Unintended
     David Corbin, MED, PhD
                                         Pregnancy Prevention Act,
                                                                          tinue to rise, causing many
                                                                          to join the growing number
    Kay Kinsey, PhD, RN, FAAN
        Paul Locke, DrPH                 also known as A00888,            of uninsured. Prescription                                   Public Health
                                         which will allow women to        drug coverage is no more
 Advertising Director
                                         obtain emergency contra-         than a buzzword.
       Ashell Alston                     ception directly from their
                                         pharmacists. It is my hope
                                                                             National health insur-                                    Effectively:
                                                                          ance is a must, with 41 mil-
Advertising Typesetting                  that the Food and Drug           lion uninsured who may
                                                                                                                                       A Guide for Practitioners
      Susan Westrate
                                         Administration will heed         avoid or be denied neces-                                   Edited by David E. Nelson, MD,
        Advertisers:                     the recommendations of           sary health care. Providers,                                MPH; Ross C. Brownson, PhD;
       Send advertising orders           health organizations that        faced with the potential for
 and correspondence to Ashell Alston,                                                                                                 Patrick L. Remington, MD, MPH;
                                         have called for emergency        unfunded demands, have
        APHA, 800 I St. N.W.,            contraception to be made                                                                     and Claudia Parvanta, PhD
     Washington, DC 20001-3710;                                           not come out in force to
                                         available over-the-counter.
       phone (202) 777-2470;
   e-mail         Until that time, I am com-
                                         mitted to ensuring that
                                                                          call for national health
                                                                             The Medicare program
                                                                                                             A     s the first of its kind, this book provides a com-
                                                                                                                   prehensive approach to help public health
                                                                                                             practitioners in both the public and private sector to
           Printing                      women in New York have
  Citizen Press, Beaver Dam, Wis.
                                                                          has been a godsend for             improve their ability to communicate with different
                                         access to the safest, most       providers, who would have
     Periodical postage paid at          effective pregnancy preven-                                         audiences. Covering all the various modes of com-
  Washington, D.C., and additional                                        been unable to meet the
                                         tion options possible.                                              munication, each chapter provides practical, real-
   mailing offices USPS 923-140                                           needs of the elderly with-
                                           Amy R. Paulin                  out federal funding. Unfor-        world recommendations and examples of how to
                                           New York Assemblywoman         tunately, hospitals and            communicate public health information to nonscien-
  The Nation’s Health
       is published monthly                Scarsdale, N.Y.                physicians continue to fight       tific audiences more effectively. The knowledge and
    (bimonthly in June/July and                                           national health insurance,         skills gleaned from this book will assist with plan-
        December/January)                Greater awareness                just as they did years ago         ning and executing simple and complex communi-
         10 times each year
 for APHA members. Non-members           needed on RU-486                 when Social Security was           cation activities commonly done by public health
may subscribe for $45 per year in the       I was disheartened to         enacted.                           practitioners.
    United States and Canada or          find a common misnomer             A.Z. Hamburg
           $58 elsewhere.                                                                                                       ISBN 0-87553-027-3
                                         in the December 2002/              Philadelphia                                    240 pages ❚ softcover ❚ 2002
        Postmaster:                                                                                                 $25.95 APHA Members ❚ $33.95 Non-members
        Send address changes to          Letters policy: The Nation’s Health accepts letters                                 plus shipping and handling
  The Nation’s Health, APHA, 800
                                         to the editor. Letters accepted for publication do not neces-
I St. N.W., Washington, DC 20001-3710.
                                         sarily represent APHA positions. Letters may not exceed 200         ORDER TODAY!
           Reprints:                                                                                         American Public Health Association
                                         words and may be edited for length and clarity; may not                       Publication Sales
     Articles may be photocopied
    or reprinted. Please credit The      duplicate material published or submitted elsewhere; must                     Web:, a secure ordering site
        Nation’s Health and              be signed by a single author; and must include a daytime                      E-mail:
         indicate date of issue.         telephone number and city of residence.                                       Tel: (301) 893-1894 or Fax: (301) 843-0159
                                                                                                                       Mail: P.O. Box 753, Waldorf, MD 20604-0753

                                                                                March 2003                  ❖    T h e N at i o n ’ s H e a lt h                       27
FDA recommends warning                                         Teens fight tobacco marketing in Asian-American communities
labels for nonoxynol 9                                         Anti-tobacco project promotes health messages

T        he U.S. Food and
         Drug Administra-
         tion proposed in
January that new warning
labels be placed on vaginal
contraceptives containing
                                conducted by the World
                                Health Organization and
                                presented at the Interna-
                                tional AIDS Conference in
                                Durban, South Africa, in
                                2000. The study evaluated
                                                               A            group of
                                                                            teens who set
                                                                            out last year
                                                               to protect their peers from
                                                               the influence of tobacco
the spermicide nonoxynol        the effectiveness of
9. The proposal comes after     nonoxynol 9 among a            company marketing found
studies showed that the gel     high-risk population of        that the industry has
could actually increase the     female sex workers in          established a heavy pres-
chance of HIV infection.        Africa and Thailand.
    According to FDA, the          The study’s findings        ence in their Asian-
new warning labels would        showed that women who          American communities.
state that vaginal contracep-   used nonoxynol 9 had a
tives containing nonoxynol      higher incidence of HIV           As part of Tobacco Not
9 do not protect against        infection than those that      Tolerated: The Korean
HIV or other sexually trans-    used a placebo gel, accord-    Teen Tobacco Education
mitted diseases and that the    ing to FDA.                    Program, 10 New York                                             Photo courtesy Tobacco Not Tolerated

use of the contraceptive           More recently in 2002,      City high school students     Grace Chung takes part in Tobacco Not Tolerated: The Korean
could increase vaginal irri-    WHO issued a warning that      visited about 160 retailers   Teen Tobacco Education Program in New York City. As part of
tation, which in turn           nonoxynol 9 will not pro-      in 10 Queens neighbor-        the project, teens documented tobacco ads in local neighborhoods.
heightens risk of infection.    tect women against HIV,        hoods. The teens docu-
                                                               mented tobacco                   “Given that 75 percent         tion. Only about 30 per-
    Since nonoxynol 9 had       gonorrhea or chlamydia.
                                                               advertising and marketing     of teens shop at these            cent of the store owners
been shown to kill HIV and      The warning also stated
                                                               in the stores, located in     type of convenience stores        chose to make the poster
other sexually transmitted      that nonoxynol 9 poses
                                                               predominantly Asian-          at least once a week, our         exchanges, however.
disease pathogens in previ-     those same health risks for
                                                               American neighborhoods,       youth are being exposed              “We didn’t think many
ous studies, it had been        people who engage in anal
                                                               and asked store owners to     to high levels of tobacco         people selling cigarettes
recommended to reduce           intercourse.
                                                               replace tobacco advertis-     ads,” said APHA member            would want to put up an
the risks of infections. But       FDA is soliciting public
                                                               ing posters with materials    Simona C. Kwon, MPH,              anti-tobacco poster in
with the backing of several     comment on the proposed
                                                               that carried health           project director of the           place of a cigarette ad in
studies, FDA in January         warning labels through
                                                               messages.                     Asian American Network            their stores, but we were
proposed the new warning        April 16. To submit com-
                                                                  “The project was time      for Cancer Awareness              surprised to learn that
labels to “provide a clear,     ments online, visit
                                                               consuming — we often          Research and Training.            many could not,” said
consistent message” that        <
                                                               walked two hours at a            Created in 2000, the           Grace Chung, one of the
the contraceptive will not      ecomments>. For a copy of
                                                               time, sweating heavily,”      Tobacco Not Tolerated             teens who took part in the
prevent infection.              the proposed rule, visit
                                                               wrote teen participant        project is a partnership of       project. “Many of the store
    The proposed labeling       <
                                                               Sunny Park in a recent        the Korean Community              owners we asked to trade
requirement was based, in       dockets/98fr/03-902.
                                                               report on the findings.       Services of Metropolitan          posters with told us that
part, on a four-year study      htm>. I
                                                               “We were proud of our-        New York Inc. and Asian           they were actually being
                                                               selves, however, and we       American Network for              paid by the cigarette com-
                                                               were proud every time we      Cancer Awareness                  panies to put up many of
                                                               were able to exchange a       Research and Training, a          the ads.”
  Smoking continues despite illness                            poster.”                      research project based at            At the conclusion of the
                                                                  Not surprisingly, the      Columbia University’s             project, the teens who
  A      substantial
         percentage of peo-
  ple diagnosed with
                                12 months, their doctor
                                had encouraged them to
                                                               teens found that the stores
                                                               — which included small
                                                                                             Mailman School of Public
                                                                                                                               took part in Tobacco Not
                                                                                                                               Tolerated headed a news
                                                                                                                               conference in New York
                                                               markets, gas stations,           While Tobacco Not Tol-
  chronic conditions con-          The questionnaire                                         erated originally began as        City to publicize their
                                                               pharmacies and conve-
  tinue to smoke ciga-          was given to a pool of                                       a peer education program,         findings and to destroy
                                                               nience stores — carried a
  rettes even though their      15,660 adults 18 years                                       the project expanded to           the tobacco materials
                                                               high amount of tobacco
  doctors had urged them        of age and older.                                            include the store survey          they’d collected.
                                                               advertising. Almost 80 per-
  to quit, according to            Other findings of the                                     and poster exchange after            A 1999 study of Califor-
                                                               cent of the stores had
  new findings from the         questionnaire included:                                      the teens showed interest         nia teens found that about
                                                               tobacco advertising or
  Agency for Healthcare         N 23 percent of the            promotional materials that    in playing a greater role.        16 percent of Asian-Ameri-
  Research and Quality.            adult U.S. civilian,                                      With oversight from the           can teens smoked, though
                                                               were visible from the
     Based on data from a          non-institutionalized                                     New York City Coalition           the rates varied by ethnic
                                                               streets, and 87 percent
  self-administered ques-          population currently                                      for a Smoke-Free City, the        group. Previous research
                                                               had tobacco advertising
  tionnaire that was added         smoked;                                                   teens conducted the out-          in California also found
                                                               on the interior of the
  to the agency’s Medical       N almost 25 percent of         store.                        reach from February 2002          that tobacco displays and
  Expenditure Panel Sur-           blacks, whites and             The teens also found       to May 2002.                      billboards are more preva-
  vey in late 2000, the            others smoked, com-         that exterior and interior       During the course of           lent in Asian-American
  findings showed that             pared to only 17 per-       tobacco ads were more         their work, the teens             neighborhoods.
  about 38 percent of peo-         cent of Hispanics; and      prevalent in the Asian-       found that some store                A report on the teens’
  ple with emphysema, 25        N people with less than        American neighborhoods        owners were unwilling to          work and results, “Find-
  percent of people with           a high school educa-        they visited than docu-       replace their tobacco             ings from the Tobacco Not
  asthma, 20 percent of            tion were substan-          mented in an earlier          advertising. The teens            Tolerated Point of Pur-
  people with hyperten-            tially more likely to       nationwide survey. Addi-      approached store owners,          chase Tobacco Advertise-
  sion or cardiovascular           smoke than those            tionally, they found that     offering to exchange              ment Survey and
  problems and 19 percent          with more than 12           the cigarette brands most     tobacco posters with their        Intervention Project,” is
  of people with diabetes          years of education.         heavily advertised — such     choice of a health-themed         now available. For more
  continued to smoke.              For more informa-           as Marlboro, Kool and         poster, including those           information, call (212)
  Also, three out of five       tion, visit <www.meps.         Newport — were those          that had health messages          305-9079 or send an
  people who smoked              that are most commonly        about cancer prevention,          e-mail to <sck32@
  reported that in the past     stat07.htm>. I                 smoked by Asian-Ameri-        physical activity and fruit>. I
                                                               can teens.                    and vegetable consump-                            — Michele Late

28       T h e N at i o n ’ s H e a lt h                ❖     March 2003