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Priority public health issues: asbestos elimination, abortion coverage, worker's comp reform, access to vision care, youth violence prevention (2/17)

February 17, 2010
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The American Public Health Association recently adopted 16 policies at its 137th Annual Meeting in Philadelphia. Following are descriptions of the measures approved by the Association’s Governing Council during the Annual Meeting Nov. 7-11, 2009. For the full 2009 policies, visitwww.apha.org/advocacy/policy.

2009-1 Community health workers — Follow-up to 2001 APHA policy recognizing and supporting community health workers’ role in meeting health care needs. Recognizes a community health worker definition, identifies challenges to community health worker work force development, calls for raising awareness of community health workers, supports strong continuing education and capacity building and calls for reimbursement for community health worker services.

2009-2 Border crossing deaths — Recognizes a doubling in deaths among people crossing the U.S.-Mexico border from 1993 to 2008. Calls for efforts to recognize the deaths as a public health crisis, efforts to reduce such deaths and improve coordination between federal, state and local governments and public health agencies to provide needed social services, support research, conduct surveillance and support other efforts to protect the health and human rights of undocumented migrants.

2009-3 Addressing and preventing food crises — Seeks to ameliorate the effects of the 2008–2009 global food crisis and prevent a recurrence. Encourages the U.S. government to support and finance initiatives to improve food security and develop long-term and sustainable food production, recommends that the United States revise its food and agriculture policies to decrease shipping and processing costs of food aid and to ensure that more funding for food aid benefits local food programs and encourages partnerships with affected countries to strengthen food security and joint policy development and implementation.

2009-4 Millennium Development Goals support — Recommends that the United States commit itself to a comprehensive approach to global health and development oriented toward achieving the current targets of the Millennium Development Goals by 2015 and beyond. Recommends that the United States support comprehensive health system strengthening and work to reduce global child mortality by supporting child health programs with an integrated approach focusing on family health, clean water, nutrition, affordable health care, maternal education, injury prevention and social protection.

2009-5 War and public health — Addresses the role of public health practitioners, academics and advocates in response to war and armed conflict. Provides the scientific basis and justification for an acknowledgment that war has been among the most important public health problems of the last 100 years, and that there is little evidence its importance is waning. Calls for educating public health professionals, policy-makers and the public about the anticipated consequences of war and advocates for alternative resolutions to conflict and for improving the competency of the global health work force to prevent and mitigate the impacts of war. Encourages research and advocacy on the structural causes of conflict, trends in risks to civilians and other factors.

2009-6 Elimination of asbestos — Urges Congress to pass legislation banning the manufacture, sale, export or import of asbestos-containing products and to direct research funding that will identify significant remaining public health hazards due to mining of asbestos, or mining or excavation of other minerals naturally occurring with asbestos. Also urges the U.S. surgeon general to warn and educate people periodically about the public health issues related to asbestos exposure and disseminate widely and periodically its asbestos warning to all relevant federal, state and local health, consumer, labor and environmental protection agencies.

2009-7 Workers’ compensation reform — Supports reforming workers’ compensation into a system that prioritizes prevention of illness and injury and rehabilitation of hurt and ill workers. Advocates for a system that includes a national standard of coverage for all workers; a more comprehensive, no-fault compensation system based on disability, not impairment; and integration with the Social Security disability program. Calls for worker health and safety training, and a national medical and statistical database on worker injuries.

2009-8 Growth hormones in beef and dairy production — Recommends the U.S. Food and Drug Administration ban use of hormone growth promoters in beef and dairy cattle production on the basis of certain exposure and possibility of human health risks; that hospitals, schools and other institutions, especially those serving children, preferentially purchase food products from beef and dairy cattle produced without such hormones; and that public health organizations support increased federal research to better delineate mechanisms of harm from hormone-disrupting chemicals in food and the environment.

2009-9 Better transportation and land use — Calls for federal transportation policy that prioritizes health, equity and safety for all travelers and that emphasizes cleaner energy sources and reducing harmful emissions, including greenhouse gases. Calls for community development and redevelopment activities that preserve historic, environmental, agricultural and aesthetic resources. Urges state transportation departments and local agencies to partner with community groups to conduct health impact assessments for major transportation and land use projects.

2009-10 Improving access to vision care — Recommends that the Health Resources and Services Administration increase resources to improve access to on-site primary eye and vision examinations for patients who receive care at community health centers and address work force issues by creating recruitment and retention strategies for optometrists, including eligibility for the National Health Service Corps, to provide comprehensive vision care services at such centers. Calls for community health center staff to educate patients in a culturally competent manner about the importance of comprehensive eye exams throughout all stages of life.

2009-11 Public health role in health reform — Urges Congress and the U.S. Department of Health and Human Services to adopt APHA’s 2009 Agenda for Health Reform to support population-based services that improve health, and to reform health care coverage and delivery. Calls for universal coverage that is affordable and provides access to quality care. Urges the president and Congress to defend and support publicly funded and publicly administered health care plans and public health programs, and to address the chronic under-funding of the nation’s public health system.

2009-12 Eliminating highly enriched uranium from pharmaceuticals — Citing nuclear weapons proliferation hazards, calls for radiopharmaceutical suppliers to expedite universal conversion of isotope production targets using highly enriched uranium to low-enriched uranium as soon as possible, and to refrain from developing new isotope production facilities that use highly enriched uranium. Encourages further research and development of non-reactor generation of isotopes currently produced in reactors and calls for the development of a global code of conduct against the civilian production, trade and use of highly enriched uranium.

2009-13 Building codes, injury prevention and usability — Stresses the problem of home stairway falls and home fire sprinkler-related injury prevention. Calls for local and state governments to carefully review building codes to ensure public health is adequately served and, if not, to amend the codes to better address public health problems. Calls for code enforcement officials to work closely with public health professionals to develop policies, procedures, technical content and enforcement practices for model codes and standards, and for the International Code Council to modify its policies and procedures to better support public health and safety.

2009-14 Youth violence prevention — Urges Congress and states to fund comprehensive culturally competent programs based on scientific evidence and using guidance from the surgeon general’s 2001 report on youth violence. Urges training for state and local public health departments about the role of public health in preventing violence and in effective, evidence-based programs for youth violence prevention. Calls for the support of additional research to understand the community and societal factors that can contribute to or prevent youth violence and how such factors can be modified to reduce risk or enhance protection.

2009-15 Integrating public health into undergraduate curricula — Recommends universities and colleges incorporate undergraduate public health education into a general liberal arts curricula to include core introductory public health courses such as public health, epidemiology and global health. Calls on schools of public health and applied public health training programs to provide outreach to respective undergraduate student bodies. Recommends partnering with public health and arts and sciences educational associations to educate their members on the role of undergraduate public health education in creating an educated individual and providing scientific evidence to support the integration of public health education in undergraduate curricula.

The following policy was passed as a latebreaker and will serve as interim policy until confirmed by the Governing Council at its 2010 meeting.

LB-09-01 Protecting abortion coverage in health reform — Calls on U.S. Senate and House leadership and President Barack Obama to ensure that any final health reform legislation passed by Congress and signed into law refrains from further eroding already-restricted access to abortion services. States that decisions about which services should be included in health coverage should be made based on medical standards of care and sound public health principles, not politics or ideology. Says that Congress should maintain the status quo on abortion coverage. Calls for health reform legislation that ensures that all women, regardless of their income status or source of health coverage, have access to comprehensive women’s health care services, including abortion.

Founded in 1872, the APHA is the oldest, largest and most diverse organization of public health professionals in the world. The association aims to protect all Americans and their communities from preventable, serious health threats and strives to assure community-based health promotion and disease prevention activities and preventive health services are universally accessible in the United States. APHA represents a broad array of health providers, educators, environmentalists, policy-makers and health officials at all levels working both within and outside governmental organizations and educational instituti

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