Calls to action on public health take center stage at APHA 2019: APHA’s 2019 Annual Meeting and Expo brings together 13,000 health professionals
==================================================================================================================================================

* Kim Krisberg

Key pillars of public health — science, action and health — wove their way through APHA’s 2019 Annual Meeting and Expo in November, where leaders called on colleagues to stand strong in the face of health threats and attacks on science.

“These are perilous times,” said Georges Benjamin, MD, APHA’s executive director, at the meeting’s Nov. 3 opening general session. “We must redouble our efforts, do the research, translate science into practice and expand our grassroots advocacy to engage local leaders, build trust and change both the hearts and the minds in the vast middle...We have to be both ferocious and tenacious.”

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/49/10/1.2/F1)

APHA 2019 meeting-goers take a break from scientific events in Philadelphia and cut loose at the APHA Dance Party.

Photo courtesy EZ Event Photography

The opening session officially kicked off APHA 2019, which welcomed about 13,000 public health practitioners, scientists, advocates, students, educators and supporters to Philadelphia for five days of science, learning, networking and celebration. With a theme of “Creating the Healthiest Nation: For science. For action. For health,” many of the meeting’s hundreds of scientific sessions zeroed in on the three pillars. Presentations reflected the diversity of public health practice, from more traditional topics such as nutrition and maternal health to more contemporary ones such as climate change and health equity.

![Figure2](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F2.medium.gif)

[Figure2](http://www.thenationshealth.org/content/49/10/1.2/F2)

“We need nothing less than a world that generates health,” said Sandro Galea, keynote speaker at the opening session of APHA’s 2019 Annual Meeting and Expo in November.

Photo courtesy EZ Event Photography

Calls to action were especially powerful during the opening session, where Robert Redfield, MD, director of the Centers for Disease Control and Prevention, called on the audience of thousands to be “disruptively innovative.” Redfield also spoke emotionally about the ongoing opioid addiction epidemic, which killed 70,000 Americans in 2017 alone.

![Figure3](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F3.medium.gif)

[Figure3](http://www.thenationshealth.org/content/49/10/1.2/F3)

Panelists share science at a session on women in global health.

Photo courtesy EZ Event Photography

Redfield said he did not fully understand the power of addiction and the stigma that comes with it until one of his own children nearly died of a drug overdose.

“We need to recognize (addiction) for what it is,” he told the opening session audience. “A chronic, relapsing medical condition and not a moral failing.”

Redfield reported on his four major priorities as CDC director: ending epidemics, eliminating disease, investing in global health security and domestic preparedness, and shoring up investments in the core capabilities of public health. For example, he said public health needs “world-class” data and analytics so practitioners can more quickly detect outbreaks and predict future threats.

He also stressed that “social determinants of health matter.” For example, he said the U.S. Department of Health and Human Services’ new plan to end HIV transmission by 2030, released last year, must prioritize the social conditions that exacerbate HIV risk, such as homelessness and addiction.

![Figure4](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F4.medium.gif)

[Figure4](http://www.thenationshealth.org/content/49/10/1.2/F4)

Substance addiction is a “chronic, relapsing medical condition and not a moral failing,” said CDC Director Robert Redfield.

Photo courtesy EZ Event Photography

While challenges facing public health are formidable, Redfield said it is also an exciting time for the field, citing efforts to shift the nation’s health system from one focused on treatment to a system grounded in prevention.

The opening session’s keynote speaker, Sandro Galea, MD, DrPH, MPH, dean of the Boston University School of Public Health, began his address with a message of hope, noting that “our health really has never been better than it is now.” Today, he said, the world has less poverty, fewer people struggle with hunger, more kids are going to school and global life expectancy is on the upswing.

“We are indeed living in a healthier world than ever before, but as you know, that’s not the full story,” said Galea, an APHA member.

While many health indicators are promising, others are not. For example, Galea noted that U.S. life expectancy has dropped for the last three years in a row and the country experiences far more preventable deaths than other high-income nations. Too many people in the U.S. live in unsafe, dilapidated neighborhoods; lack affordable housing and access to parks and healthy foods; and are unable to obtain quality early childhood education.

Another core determinant shaping poor health and inequity is racism — “one of the country’s original sins,” Galea added.

The key, Galea said, to turning around poor U.S. outcomes is taking action on the social and economic conditions that afford better health and longevity.

“We need nothing less than a world that generates health,” Galea said.

The value of public health prevention took center stage during a wide-ranging discussion at the Annual Meeting’s Monday general session on Nov. 4. Brett Giroir, MD, assistant secretary for health at the U.S. Department of Health and Human Services, kicked off the session, reporting that his office has been “driven, perhaps a little obsessed,” with efforts to shift from treatment to prevention.

“I am here with you because I can no longer accept a health care system that costs too much and delivers too little,” Giroir said. “For $3.6 trillion — nearly 18% of our (gross national product) — we deserve more than a life expectancy that ranks 28th, infant mortality that ranks 32nd, a suicide rate that ranks 33rd and health disparities that have had near zero improvement in the last 25 years.”

Giroir said HHS is working on multiple projects to transform the U.S. “sick care” system into a “health-promoting” system that provides everyone a fair and realistic opportunity to optimize their health. For example, he cited efforts to update national physical activity guidelines, work to finalize Healthy People 2030, and national plans on vaccines, viral hepatitis and HIV/AIDS. In addition, he said, HHS plans to release the first federal action plan for sexually transmitted infections later this year.

The Monday session also featured a four-person panel — moderated by APHA member Karen DeSalvo, MD, MPH, former U.S. assistant secretary for health under President Barack Obama and now Google’s first chief health officer — that discussed whether prevention remains a “best buy.”

![Figure5](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F5.medium.gif)

[Figure5](http://www.thenationshealth.org/content/49/10/1.2/F5)

Closing session speaker Gail Christopher called for racial healing, including building relationships and bridges of trust.

Photo courtesy EZ Event Photography

Health services investigator Aaron Carroll, MD, a pediatrics professor at Indiana University, challenged the idea that being a “best buy” is necessary for health. There is a notion that prevention must come with cost savings, Carroll noted, yet few expect the same from medical care. The double standard leads the general public and policymakers to believe that effective public health can be done “on the cheap,” he said.

“We have to start recognizing that...prevention is an outcomes good, and that sometimes good things cost money,” said Carroll, an APHA member. “And we have to start making the pitch that there needs to be serious investment into these things, that they can’t just be done easy and quick and cheap.”

APHA member and panelist J. Nadine Gracia, MD, MSCE, executive vice president and chief operating officer at Trust for America’s Health, noted that if public health could help facilitate a broader understanding and recognition of the biases and inequities embedded in the nation’s systems and structures since their inception, it could help “truly transform and create healthy communities.”

Ensuring communities — and the nation — are safe from threats such as substance use is key to protecting health, U.S. Surgeon General Jerome Adams, MD, said during a Wednesday meeting session.

As APHA 2019 was being held, federal and state health workers were investigating a multistate outbreak of illnesses related to e-cigarettes. The illnesses — which CDC researchers linked to vitamin E acetate — had killed 47 people in the U.S. by Thanksgiving and hospitalized over 2,000.

![Figure6](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F6.medium.gif)

[Figure6](http://www.thenationshealth.org/content/49/10/1.2/F6)

HHS’ Brett Giroir addresses a Monday crowd, where he spoke of transforming U.S. care into a “health-promoting” system.

Photo courtesy EZ Event Photography

Risks to U.S. health extend beyond e-cigarettes, however. Adams urged meeting-goers not to downplay the risks that “rapid” legalization and social acceptance of higher potency marijuana may have for the public health.

“What we’re conducting right now, in our country — and among our young people — is a massive and poorly informed public health experiment,” said Adams, who also highlighted marijuana’s risk to pregnant women.

Discussions on timely public health issues continued at the meeting’s closing general session on Nov. 6. Speakers at the packed event highlighted the intersections between racism and health.

“We have to own the problem before we’ll be inclined to try and solve it,” said session speaker and APHA member Gail Christopher, DN, who previously served as senior advisor and vice president at the W.K. Kellogg Foundation, where she helped lead the Truth, Racial Healing and Transformation initiative to address the historic and contemporary effects of racism.

![Figure7](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F7.medium.gif)

[Figure7](http://www.thenationshealth.org/content/49/10/1.2/F7)

Naloxone is an important tool for preventing overdose deaths, Jerome Adams said as he demonstrated a dispensing device.

Photo by Aaron Warnick

Christopher spoke on a “prescription” for racial healing, defining the process as individually and collectively ridding people of the ideology that underpins structural racism — that some people are more valuable than others. A key ingredient in that difficult process, she said, will be bringing a majority of people on board to build relationships and bridges of trust.

![Figure8](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F8.medium.gif)

[Figure8](http://www.thenationshealth.org/content/49/10/1.2/F8)

Karen DeSalvo, Google’s chief health officer, moderates an Annual Meeting session.

Photo courtesy EZ Event Photography

Fellow closing speaker Thomas LaVeist, PhD, dean of the Tulane University School of Public Health and Tropical Medicine in New Orleans, noted that while the country has made progress on issues of equity, that progress is less of a steady march and more like a pendulum that moves forward only to keep falling back.

To help address continuing injustices, public heath professionals need to be fully engaged in their communities, said LaVeist, an APHA member. That could range from working to elect supportive leaders to volunteering with a local Girl Scouts troop to help young people develop a sense of agency and increase the likelihood they grow up to be “fully actualized” adults.

“The public health professional needs to be at the table,” LaVeist said. “Be a full participant in the community.”

Public health professionals can watch the opening, Monday and closing general sessions online now via APHA Live. The program provides access to video recordings of 14 APHA 2019 sessions. Continuing education credits are also available to people who purchase and watch APHA Live.

## Science, action on APHA 2019 agenda

Beyond the meeting’s general sessions, Annual Meeting attendees took in hundreds of scientific sessions, browsed exhibits at the Public Health Expo, celebrated public health achievements and even took to the streets: Attendees organized a march to a local Immigration and Customs Enforcement office to demand an end to family separations and the poor treatment of migrants.

The Annual Meeting also came with opportunities to accrue continuing education credits. More than 330 people took part in APHA’s Learning Institutes, half-, full- and two-day sessions held Nov. 2 and 3. In all, more than 1,300 APHA 2019 attendees registered to earn continuing education credits, with the opportuity to earn more than 31 credits over the course of the five-day meeting.

Beyond the science, meeting attendees also took time out to celebrate and spread the public health messages on social media. For example, this year’s APHA Dance Party invited attendees to hit the dance floor after a long day of learning and networking, while the second Annual Meeting Sunset Tweetup on Nov. 5 welcomed guests for a virtual public health chat.

Throughout the Annual Meeting, APHA was busy bringing the latest news from Philadelphia to those not able to attend the meeting in person via APHA’s social media. Overall, Annual Meeting attendees generated more than 27,000 tweets using the hashtag #APHA2019.

The APHA Annual Meeting Blog — at [www.publichealthnewswire.org](http://www.publichealthnewswire.org) — published more than 50 posts from Philadelphia, while APHA TV broadcast daily news updates and original interviews with public health leaders. The episodes can be viewed on APHA’s YouTube channel.

Attendees looking to improve their social media skills received one-on-one coaching at the APHA Social Media Lab, offered in partnership with John Snow Inc. Over its two days, the lab welcomed hundreds of visitors.

For health practitioners not able to attend APHA 2019 or for those who could not fit in all the sessions they wanted to, the RAMP: Recorded Annual Meeting Presentations program is available. RAMP allows users to listen to audio and view slides from hundreds of the meeting’s scientific sessions. For information, visit [www.apha.org/ramp](http://www.apha.org/ramp).

Planning has already begun for APHA’s 2020 Annual Meeting and Expo, which will be held Oct. 24-28 in San Francisco under a theme of “Creating the Healthiest Nation: Preventing Violence.” Abstract submission for APHA 2020 is now open online.

For more information, visit [www.apha.org/annualmeeting](http://www.apha.org/annualmeeting).

*Melanie Padgett Powers and Aaron Warnick contributed to this story, portions of which were published on the APHA Annual Meeting Blog.*

## Annual Meeting festival offers access to screenings, filmmaker discussions

![Figure9](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F9.medium.gif)

[Figure9](http://www.thenationshealth.org/content/49/10/1.2/F9)

Panelists address the audience at the opening event of the APHA Public Health Film Festival in Philadelphia.

Photo by Aaron Warnick

For more than a decade, APHA’s Public Health Education and Health Promotion Section has invited attendees of APHA’s Annual Meeting and Expo to engage with public health issues in a different way. Through visual storytelling, the APHA Public Health Film Festival, held Nov. 3-6, highlighted a range of public issues, from climate change to sexual violence.

Film festival events included screenings, panel discussions and Q&As with filmmakers. Festival-goers were treated to screenings of numerous documentaries and short films. Feature films included “8 Billion Angels” and “Is Your Story Making You Sick?”

## See anyone you know? Photos from 2019 Annual Meeting online now

![Figure10](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/10/1.2/F10.medium.gif)

[Figure10](http://www.thenationshealth.org/content/49/10/1.2/F10)

Meeting-goers take a break in APHA 2019’s Mix and Mingle Lounge. Photos from the meeting are now online.

Photo courtesy EZ Event Photography

With hundreds of sessions and events, APHA 2019 was a whirlwind of public health science and inspiration in Phildelphia.

Photographers were on hand throughout the five days of APHA’s 2019 Annual Meeting and Expo to capture the excitement. Photos from the event can be browsed and purchased online now.

Photos taken by EZ Event Photography are available to view at [bit.ly/APHA2019photos](http://bit.ly/APHA2019photos). To order photos from EZ Event Photography, email jezell{at}usa.net or call 562-277-6292.

For even more photos of the meeting, visit APHA’s Flickr page at [www.flickr.com/aphapublichealth](http://www.flickr.com/aphapublichealth).

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