More than 12,000 attend APHA Annual Meeting in Philadelphia: Meeting spotlights water, health reform
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Public health professionals have the power to transform the nation’s health and influence everything from health reform and health funding to chemical safety and water supplies, according to speakers at APHA’s 137th Annual Meeting.

More than 12,000 public health workers came together in Philadelphia Nov. 7–11 for APHA’s Annual Meeting, which focused on the latest issues in public health. The meeting celebrated recent accomplishments in the field and laid out challenges for public health workers to take action on. The idea that public health workers can lead the way and be the voice for change resonated throughout the meeting, including comments by U.S. Surgeon General Regina Benjamin, MD, who spoke at the meeting’s opening session.

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APHA Executive Director Georges Benjamin, left, with Surgeon General Regina Benjamin at the Annual Meeting opening session.

Photo courtesy EZ Event Photography

In her first major public speech since her confirmation in October as surgeon general, Benjamin reflected on her work as a doctor in rural Alabama, noting that she learned “one person can make a difference” as she worked to improve the health of her patients and community.

“I also learned there are things that I couldn’t take care of with a prescription pad,” Benjamin told the crowd of about 6,000 people. “Clean water, clean air — these are things that are just as important as prescriptions.”

Benjamin said that as surgeon general she will work to promote prevention as well as raise awareness of public health and what public health workers do, noting that “people really need to know what you are doing every day.”

Public health workers can — and do — play an important role in shaping the nation’s environmental health work, said Lisa Jackson, administrator of the Environmental Protection Agency, who also spoke at the meeting’s opening session. Jackson highlighted public health issues that are of importance to EPA, such as children’s health, telling audience members “I need you desperately on the front lines.”

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Audience members show their enthusiasm for presenters at the APHA Annual Meeting closing session on Nov. 11.

Photo courtesy EZ Event Photography

Jackson called on public health workers to stand by EPA on work the agency is undertaking to update the nation’s chemical safety law, which has fallen behind the times and is a “woefully inadequate tool for protection.” (See related story, Page 1.)

“We know far too little about chemicals that are coming into the marketplace and are on the marketplace already,” Jackson said.

## Water theme on tap during discussions

From the effects of climate change on the world’s oceans to pollutants in backyard wells, the Annual Meeting’s official theme of “Water and Public Health: The 21st Century Challenge” flowed throughout the five-day event.

Mirta Roses Periago, MD, director of the Pan American Health Organization, called on the world’s public health leaders during the opening session to reduce the prevalence of water-borne diseases and to increase access to water and sanitation, which half the planet’s population lacks. For example, Latin America is the continent that has the most water per capita, or 11 times that of Europe, but because of population growth and the use of water in agriculture, the amount of water available per person in Latin America decreased 50 percent from 1950 to 1980, she said.

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Mirta Roses Periago at the meeting opening session

Photo courtesy EZ Event Photography

“Sixty percent of the population of Latin America lives in 20 percent of the land area and has access to only 5 percent of the water resources of the region,” she said, noting that universal access to water is a critical component of human security and mandatory to securing a peaceful world.

Additionally, maintaining bacteriological water quality and the fight against transmissible diseases of water origin are a “constant worry” to health authorities, Periago said, adding that surveillance and control of drinking water causes important problems worldwide.

“Globally, improving water, sanitation and hygiene has the potential to prevent at least 9.1 percent of the disease burden,” Periago said. “No public health intervention has greater impact on the health of a nation…than water, sanitation and hygiene combined.”

The relationship between water, the environment and human health is evident throughout the world, according to filmmaker and ocean advocate Céline Cousteau, who also spoke at the opening session. Cousteau discussed her work to bring attention to the health needs of people in the Amazon as well as her experiences advocating on behalf of the world’s oceans. During her work with orca whales, Cousteau said she was surprised to learn that the animals contained high levels of PCBs because of chemicals in the water, noting that “all of our actions have a reaction somewhere.”

“Ocean health and environmental health is undeniably connected,” Cousteau said. “Everything that happens in our environment happens to us, even if we don’t know it yet.”

During a scientific session later in the Annual Meeting, Gregory Bossart, VMD, PhD, senior vice president and chief veterinary officer at the Georgia Aquarium in Atlanta, called marine mammals “good sentinels” for ocean and human health. New diseases affecting marine mammals, such as the emergence of oral papillomaviruses in free-ranging dolphins, should make humans pay more attention to ocean health issues, he said.

Water quality and access to safe drinking water also dominated meeting discussions. Speaking about her organization’s Take Back the Tap campaign at another session, Wenonah Hauter, MS, executive director of Food and Water Watch, called on Congress to increase funding to improve the nation’s water pipes and sewers.

“We started Take Back the Tap because if people’s commitment is to bottled water, they are less willing to see their tax dollars spent on infrastructure,” Hauter said. “We are having a major infrastructure crisis and we don’t want to have to be a nation where people have to buy bottled water or don’t have potable water to drink.”

In the United States, water-borne diseases are not just linked to drinking water, but also to food and recreational water sources, said Michael Beach, PhD, associate director for healthy water at the Centers for Disease Control and Prevention’s National Center for Zoonotic, Vector-Borne and Enteric Diseases, during another session.

“We need to transition ourselves in the United States to think about the full plethora of water-borne disease prevention,” Beach said.

With health reform high on the political agenda this fall, the issue was another common theme that resonated throughout the meeting. As health workers gathered in Philadelphia, advocates both at the meeting and around the nation were applauding the public health provisions of a health reform bill passed by the House of Representatives on the first day of the meeting, Nov. 7. (See Page 2.)

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Some of APHA’s past presidents come together for a social gathering at APHA’s 137th Annual Meeting in Philadelphia.

Photo by Michele Late

Thanks to the vote, “we are one step closer to the president’s commitment to quality and affordable health care,” EPA’s Jackson said at the opening session.

“We’re closer than we’ve ever been to meeting APHA’s goal of being the healthiest nation in one generation,” she said.

The focus on reform carried on throughout scientific sessions and other events and on to the closing session on Wednesday, Nov. 11. Federal public health leaders at the final meeting event called on audience members to bring the voice of public health to the health reform discussion.

Howard Koh, MD, assistant secretary for health at the U.S. Department of Health and Human Services, said that as a physician, he often witnessed how factors outside the doctor’s office — more commonly known as the social determinants of health — impacted the well-being of his patients. It was a realization, he said, that propelled him into the field of public health — a field he described as built on “inspiration and compassion.” Such characteristics make it incumbent that public health workers bring their experiences and knowledge into the health reform debate, Koh said.

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Howard Koh of HHS at the meeting closing session

Photo courtesy EZ Event Photography

“Public health is the voice of conscience in the rat race of health care,” Koh said.

APHA member Yvette Roubideaux, MD, MPH, the first woman director of the Indian Health Service, reminded the closing session audience that the communities she serves also have a stake in health reform (see an exclusive Q&A with Roubideaux, Page 15). Skyrocketing health care costs have a critical impact on IHS, especially as the agency works to stretch a limited budget, Roubideaux said. However, she said, more funding is not the only pathway to better health — empowering communities is also key.

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EPA Administrator Lisa Jackson speaks at the Annual Meeting opening session before an audience of about 6,000 people.

Photo courtesy EZ Event Photography

“IHS is a great example of what you can do with little resources,” Roubi- deaux said. “The only way that we are going to improve the health of communities is to work in partnership with them.”

Mary Wakefield, PhD, RN, administrator of the U.S. Health Resources and Services Administration, echoed Roubideaux’s call for stronger partnerships, calling on audience members to use their expertise to help HRSA accomplish its mission of eliminating health disparities.

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Mary Wakefield, left, administrator of HRSA, and Yvette Roubideaux, IHS director, at the meeting closing session

Photo courtesy EZ Event Photography

“You at APHA are critical to achieving that end — you’re critical to achieving the mission of HRSA,” Wakefield said at the closing session.

## Annual Meeting news, social media online

Even if they weren’t able to attend the APHA Annual Meeting this year, public health professionals can still become involved, thanks to online offerings from APHA. For the third year in a row, APHA’s Annual Meeting blog posted updates throughout the meeting, covering a range of activities and events (see Page 10). The more than 50 blog entries can be read online now at [http://aphaannualmeeting.blogspot.com](http://aphaannualmeeting.blogspot.com) and comments are welcome.

Overall, social media at the November meeting was an success. Twitter users made more than 1,300 posts with the meeting hashtag — a type of code used to track topics on Twitter — sharing tips and reporting information from sessions. Photo fans shared their pictures online via Flickr. Also, for the first time, APHA posted clips from the meeting’s opening session on its YouTube page, [www.youtube.com/aphadc](http://www.youtube.com/aphadc), including speeches from the keynote speakers.

Additionally during the meeting, attendees raised $7,000 through APHA’s annual Help Us Help Them campaign. The donation was presented to Philadelphia’s People’s Emergency Center, which aids homeless families through housing, counseling, employment, parenting and children’s programs.

The 2010 APHA Annual Meeting, which will have a theme of “Social Justice: A Public Health Imperative,” will be held Nov. 6–10 in Denver. Abstract submissions are now being accepted for the meeting (see Page 4).

For more on APHA’s past and future Annual Meetings, visit [www.apha.org/meetings](http://www.apha.org/meetings), call 202-777-2742 or e-mail comments{at}apha.org.

*   Copyright The Nation’s Health, American Public Health Association