New American Public Health Association policy statements address gun suicides, tuberculosis prevention, global food security and more

Summaries of 2018 APHA policy statements adopted by the Governing Council in San Diego

San Diego, Nov. 13, 2018 – The American Public Health Association Governing Council adopted 12 new policy statements at its 2018 Annual Meeting and Expo in San Diego today, covering topics from gun suicides to tuberculosis prevention, global food security and more.

The following are brief descriptions of the 12 policy statements adopted by the Governing Council at the Annual Meeting. One of the new policy statements is a latebreaker, meaning it was not open to the same review as the other 2018 policy statements and will serve as an interim policy statement until reviewed by the Governing Council at its regular 2019 meeting. For more information on any of these policy statements, email

These brief descriptions are not comprehensive and do not include every point, statement or conclusion presented in the policy statements. For the full policy statements, which will be posted in early 2019, visit

20181 Reducing global child mortality rates — Noting that one child younger than 5 worldwide dies of diarrhea every minute and that oral rehydration salts and zinc treatment can prevent many such deaths, calls on federal officials to appoint a U.S. global “Children’s Champion” charged with coordinating U.S. activities to reduce diarrhea-related mortality and serving as a global voice for children’s health. Encourages U.S. global health programs to fund investments to improve the supply of oral rehydration salts and zinc, fund innovations in home-based diarrhea treatment, and train local health providers in treatment guidelines, among other measures. Urges public health professionals and organizations to support efforts to reduce diarrhea-related deaths in young children and work toward increasing public-private partnerships that scale up oral rehydration salts and zinc treatment by at least 30 percent within three years.

20182 Addressing potential health impacts of fracking — Because unconventional oil and gas extraction — often known as fracking — poses a range of known and unknown risks to public health and the environment, including risks to drinking water, air quality and worker health, recommends that unconventional oil and gas development cease and that a strategic phase-out of existing development be encouraged where possible. Calls for policies that explicitly compare the economic and public health trade-offs of fracking, that require environmental impact assessments and that minimize greenhouse gas emissions. Encourages federal, state and local agencies to adopt a precautionary approach to unconventional oil and gas activities, including discouraging the use of chemicals with unknown health risks. Also calls for the elimination of unconventional oil and gas exemptions from federal worker safety rules and encourages federal health officials to establish an industry-wide worker health registry.

20183 Ensuring a healthy energy future — As communities move toward to non-fossil fuel and alternative energy sources, calls on stakeholders across sectors to monitor, evaluate and support effective strategies to transition to healthier, more efficient energy supplies. Regarding coal, calls on the Mine Safety and Health Administration to vigorously enforce worker health and safety standards. Also calls on officials to suspend new coal-fired power plants and cancel plans for future plants. Urges Congress to set fuel economy and emissions standards for vehicles, and urges car manufacturers to begin a complete phase-out of fossil fuel-dependent vehicles. Encourages federal officials to develop effective energy efficiency standards for homes and commercial buildings, and calls on people, families, businesses and governments to expand the adoption of alternative energies, such as wind and solar.

20184 Reducing gun-related suicides — With U.S. suicide rates increasing by nearly one-third over the last 20 years and considering that guns are involved in more than half of U.S. suicide deaths, calls on advocates and professional associations to adopt and promote guidelines for mental health providers on screening for guns in the home and to equip them with information on local offsite gun storage options. Urges state public health agencies to collaborate with public safety and mental health agencies to advocate for increasing the availability of temporary gun storage outside the home. Calls on public health agencies to partner with gun owners and suicide prevention professionals to advocate for increased funding for gun-related suicide research, including research on developing effective marketing campaigns on gun-related suicide prevention.

20185 Understanding, treating violence as a public health issue — With national data showing an increase in violent deaths, such as gun-related homicides and suicides, as well as research finding long-term health effects from childhood exposures to violence, calls on health departments to collect, analyze and report data on violence, including details on how violence impacts historically marginalized communities. Encourages community health programs to start programs that detect and interrupt the transmission of violence using professionally trained workers. Also encourages health providers to screen patients for domestic violence, past exposure to violence and behavioral problems that can lead to violence, all while using a trauma-informed and culturally competent approach. Calls on federal, state and local governments to invest in public health approaches to violence prevention, and recommends that federal agencies help establish an active surveillance system for monitoring violence in communities.

20186 Regulating electronic nicotine delivery products — With the use of electronic nicotine delivery systems increasing among all U.S. demographic groups and little known about their long-term safety or efficacy in helping people quit cigarettes, calls on the Consumer Product Safety Commission to add nicotine to its list of substances covered by regulations and to require special packaging and warning labels for such products. Also calls on Congress to amend the Prevent All Cigarette Trafficking Act to include electronic nicotine delivery systems. Encourages federal agencies and health organizations to fund research on the short- and long-term health effects of such products on both users and those subject to secondhand exposures. Calls on state and local officials to enact laws prohibiting the use of electronic nicotine delivery systems in enclosed public spaces and places of employment.

20187 Preventing tuberculosis among health workers — With tuberculosis causing nearly 2 million deaths worldwide in 2016 and with health care workers at higher risk of infection than the general population, urges national and state governments to develop and implement policies that strengthen workplace health and safety programs that focus on prevention and education. Calls for workers’ compensation programs that provide adequate tuberculosis treatment and counseling, paid leave and death benefits. Recommends workplace programs that have rigorous respiratory protection components, improve exposure control efforts inside hospitals, promote new diagnostic strategies, and provide counseling to help workers cope with the side effects of tuberculosis treatment. Calls on the Centers for Disease Control and Prevention to increase funding for tuberculosis research, including more support for research efforts focused on developing a vaccine for the disease.

20188 Advancing the health of refugees — With global instability contributing to historic levels of displaced people and knowing that refugees face significant health challenges, calls on the U.S. government to fully invest in and cooperate with the international community in efforts to prevent conflict and to reaffirm the New York Declaration for Refugees and Migrants and its goal of coordinating a multi-sector response to the refugee crisis. Encourages U.S. officials to work with state and local partners to coordinate housing, educational and health needs among refugees. Urges health care systems and providers to tailor their services to meet the needs of refugees, including the use of trauma-informed, culturally competent care. Calls on the U.S. government to work cooperatively to ensure safe passage for refugees, and urges the international community to adopt legal protections for displaced people.

20189 Achieving health equity in the U.S. — With research documenting clear disparities in morbidity and mortality, particularly among racial and ethnic minority groups, calls on federal officials and members of Congress to fully fund the Affordable Care Act, the National Prevention Strategy and Implementation Plan, and the National Partnership for Action to End Health Disparities. Calls on federal public health agencies, as well as public health organizations, to develop and implement evidence-based toolkits that communities can use to reach vulnerable populations. Calls on state and local officials to support social policies to improve education, income, housing, jobs and transportation, and urges state and local government to work with urban planners and health professionals to integrate health considerations into planning, policy and decision-making. Encourages people and communities to advocate for the enforcement of civil rights and disability laws.

201810 Supporting global food security — With hunger still a daily challenge for more than 815 million people worldwide, calls on U.S. leaders to ensure adequate funding for U.S. Agency for International Development programs that improve food security and encourages leaders to fund efforts focused on preventing and mitigating the effects of climate change on world food production. Encourages U.S. leaders to sign or ratify relevant United Nations conventions that support food security, such as the Convention on the Rights of the Child, the UN Resolution to Support Breastfeeding, and the Convention on the Elimination of All Forms of Discrimination Against Women. Urges the U.S. government, foundations and other donors to mobilize funding and resources to increase the scale, scope and impact of food security efforts. Calls on U.S. officials to support the creation of a system to collect and interpret global dietary data.

201811 Addressing police violence as a public health issue — With law enforcement violence — including death, injury, trauma and stress — often disproportionately affecting marginalized populations, calls on federal agencies, localities and states to add death and injury by legal intervention to their list of reportable conditions. Calls on Congress to fund the National Institute of Justice and the Centers for Disease Control and Prevention to conduct research on the health consequences of law enforcement violence, with a particular focus on disproportionate burdens among people of color, people with disabilities or mental illness, people living in poverty, people experiencing homelessness, immigrant populations, and lesbian, gay, bisexual and transgender populations. Urges governments and law enforcement agencies to review policies that can lead to disproportionate violence against specific populations. Calls on governments to allocate funding from law enforcement agencies to community-based programs that address violence and harm without criminalizing communities, including restorative justice programs.

LB-18-12 Opposing family-child separations at the U.S. border — With the separation of immigrant children and families at the U.S.-Mexico border a public health crisis with the potential for long-lasting negative health impacts, calls on federal officials to permanently halt such separations unless there is an imminent, ongoing threat to the child’s safety in a respective parent’s care. Urges the federal government to collect relevant data to ensure that children and parents can be located if separated. Calls on federal officials and agencies, as well as contractual partners, to offer culturally competent resources and support to reunite separated families. Urges public and private funding agencies to support additional research to understand the mental, physical, spiritual and cultural consequences of separating families, including the separation of lactating mothers and their babies. Recommends that such research examines the roles and history of racism, xenophobia and inequality in the creation of family separation policies.

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