APHA’s National Public Health Week: A Review of Events

APHA’s National Public Health Week was chock-full of fun and educational public health events! If you weren’t able to tune in or attend these events in person, don’t fret! Many were recorded for future visits. Check out this outline of some of the week’s big events below:

  • Monday April 1st: Theme – Healthy Communities
    • Keynote address from reproductive justice expert Joia Crear-Perry who spoke of the importance of grassroots organizing to improve the health of communities. Panelists with other areas of expertise aligned with the different daily themes of the week were also included. Check out the recorded forum here.
  • Tuesday April 2nd: Theme – Violence Prevention
    • APHA pushed out a message regarding supporting universal background checks on gun sales. You can sign the action alert for your state here.
    • APHA’s Mighty Fine discussed violence prevention for #NPHW in a new #HealthiestCities podcast: https://bit.ly/2FMSQtW
  • Wednesday April 3rd: Theme – Rural Health
    • Global #NPHW Twitter chat: Look for #NPHWChat on twitter to see what was discussed! Details about the chat here.
    • There was a Q&A with CDC Director Robert Redfield on public health in 2019. Read the full interview here.
    • There was also a blog from  All of Us Research that discusses how precision medicine can help with health disparities in rural communities: https://bit.ly/2FZKu3l
  • Thursday April 4th: Theme – Technology and Public Health
    • APHA hosted a @GetReady Photo contest for animal lovers. See details here: http://bit.ly/GerReady2019Contest
    • National Public Health Week Student Day: early and mid level career public health professionals talked about how they transitioned from student life to public health workers. See the panelists here (this year’s talk has not been posted yet, but check back soon!)
  • Friday April 5th: Theme – Climate Change
    • APHA pushed out a message about climate change and posted a link where you can #SpeakForHealth and alert members of Congress in your state about your interest and passion to protect the public’s health from climate change. See link here: http://bit.ly/2HwUQty
    • APHA’s Surili Patel discusses the important work of APHA and others to address the health threats of climate change. https://bit.ly/2VqVjkj #NPHW#ClimateChangesHealth
  • Saturday & Sunday April 6th and 7th: Theme – Global Health

These were just a few highlights from the busy week! So much more occurred throughout the seven days. What did you do to celebrate this year’s National Public Health Week? Let us know what you did to celebrate this year’s National Public Health Week for a chance to be featured in our blog or quarterly newsletter. Send us an email at ihsection.communications@gmail.com.

If you didn’t join in on the festivities this year, be sure to tune in next year! If you’re interested in hosting an event for next year, check out this timeline to help with the planning process here.

2019 World Cancer Day – “I Am and I Will”

Every year on February 4th, World Cancer Day is celebrated by bringing awareness and providing education about the disease. Many of the efforts focus on making the reduction of preventable cancer a global health priority.

In 2018, it was estimated that there were 26,000 deaths that occurred due to cancer across the globe every single day. This rate is only predicted to increase with time due to a variety of factors. To name a few: the age of the world population is increasing, there is a general lack of education about ways to prevent cancer in developing countries, and early detection methods and treatment are scarce in these same developing countries. By 2030, the rate of cancer deaths per year is expected to hit 21.6 million – this is 8.4 million more than the 2010 rate. To put this into perspective with infectious diseases, in 2015 alone, the deaths per year due to malaria was 72,000 while cancer rates met 8.9 million – with the majority of the deaths coming from developing countries.

The largest gaps in rates of cancer survival can be noticed in cancers that are more responsive to early screening and treatment (for example: breast and colorectal cancers). These rates vary greatly between developing and developed nations as well as in different racial groups in the same country.  In the United States and Australia, the 5 year survival rate for breast cancer (2010-2014) was up to 90% compared to only 65% in Malaysia for the same time frame. In the U.S. between 2004 and 2009, there was a difference in the 5 year survival for cervical cancer between whites and blacks, 64% and 56% respectively. These differences in rates can be attributed to differences in prevention and treatment programs. For example, in many developing countries, cancer patients do not have access to radiotherapy facilities near their homes. There are 60 countries across the globe with cancer patients that do not have one radiotherapy facility in the entire country. On the screening side, many developing nations do not have the health care infrastructure or funds to provide regular cancer screenings.  The same gaps in access to care and resources can be said about different areas of socioeconomic status in the United States.

Current efforts to develop prevention and treatment programs across the globe are focused on the WHO’s recommended 4 main approaches or areas of: prevention, early detection, diagnosis and treatment and palliative care… and there have been successful feats! An example of a successful cancer prevention program is in Sudan. Their program focuses on promoting public awareness of breast cancer and early detection through in-home breast exams done by trained female volunteers. Another positive program was implemented in India in 2013. This program increased breast cancer awareness in the study urban area, and a subsequent increase in early stage diagnosed breast cancer increased from 74% to 81% in 3 years (2013-2016). Most cancer prevention and reduction programs in developing nations focus on the initial stages of increasing awareness and education about cancer as they are cost efficient and effective.

To fight these discrepancies in cancer death rates, many use this day to spread social media messages about cancer prevention and early screening, attending festivals or walks that raise awareness or support and encouraging public government officials to make cancer issues a priority in their own countries through policies and research. In general, the day brings people together with a common cause and mission: getting rid of preventable cancer. This map is a great resource to find and join activities anywhere on the globe related to World Cancer Day.

In addition, 2019 introduces the start of a 3-year campaign called, “I Am and I Will”, and focuses on the personal commitments required to help decrease the global burden of cancer as a whole. The American Cancer Society highlights a few ways people can personally decrease the effects of cancer as well as support others in their circles by:

  • Making healthy life choices such as saying no to tobacco products, limiting alcohol, being conscientious about time spent in the sun and eating an overall healthy and wholesome diet
  • Knowing the signs and symptoms of cancer and seeking early treatment when identified
  • Sharing cancer experiences with decision makers in government and advocating for change and funding to go into cancer research
  • Encouraging schools and businesses to adopt healthy practices such as nutrition, physical activity and no tobacco policies to support their students and workers

Visit www.worldcancerday.org before February 4th to learn more about this day and how you can get involved in your own personal way.  Every little action makes a difference in shining a light on the importance of defeating cancer on many different scales. #IAmAndIWill

Mark your calendar for WORLD AIDS DAY – December 1st!

The first global health day ever recognized, World AIDS Day, is observed on December 1st every year. This day is an opportunity for people all over the globe to support those living with HIV, support the fight and research against HIV, and remember those who have died because of AIDS-related illnesses.

Since the beginning of the AIDS epidemic in the 1980’s, over 70 million people have acquired the infection and an estimated half have died from AIDS related complications. Today, there are over 37 million across the globe that live with the disease. Twenty-two million of the 37 million are currently on treatment.

Today, an HIV diagnosis is not a death sentence. There are many different treatment and prevention options (such as PrEP) and services for those in vulnerable populations. Still, access to care and treatment remains a significant problem, especially in developing nations, and more needs to be done to address this issue and increase access. There is also still a general gap in awareness. This year’s theme is “Know Your Status” because one in four people with HIV are unaware that they have the disease. Unfortunately, this may be due to barriers to getting tested.

The WHO recommends the use of self-tests for HIV in areas where there is a lack in availability of HIV tests. This is where a person can collect their own specimen, typically oral fluid or blood, and perform the test in a private setting such as their home. Currently, 59 countries have started using HIV-self tests.  The largest HIV self testing programs have been implemented in six countries in south Africa by the WHO with help from international organizations such as Unitaid.

The UN has a target of diagnosing 90% of all people with HIV by year 2020 and the world has committed to ending AIDS by 2030. Self tests are a huge step in getting vulnerable populations and communities access to testing and knowing their status. Knowing your status and getting on antiviral treatment as soon as possible are the consequential steps to ending AIDS. However, it all begins with awareness and access to testing.

What are some ways YOU can spread awareness and recognition for World AIDS Day and contribute to the goals for 2020 and 2030?

  1. Rock the RED Ribbon to show everyone you support the movement – this symbol became part of the AIDS awareness movement in 1991 when New York artists created it. Fun Fact:  It was the first disease-awareness ribbon made and was later adopted by other health awareness causes, such as breast cancer awareness and mental health awareness.
  2. Print out #ROCKTHERIBBON posters or share them on social media to spread the message. Find these images here!
  3. DONATE to organizations that support AIDS research. Be sure to do your own research to make sure the organization’s mission aligns with your motivations.
  4. Volunteer at a World AIDS Day event near you!
  5. GET TESTED & KNOW YOUR STATUS!

World Rabies Day: Rabies Prevention Around the World

September 28th is World Rabies Day! This day of observance was created by the Global Alliance for Rabies Control (GARC) to spread awareness about the disease and educate others on how to prevent it. This year’s theme is Rabies “Share the message. Save a life.” 

Rabies is a preventable viral disease that affects only mammals and is transmitted through the saliva, cerebral spinal fluid or brain tissue of an infected host. If untreated, rabies is fatal. Most commonly, the disease is transmitted through a bite, but can also be transmitted if the infectious material gets directly into the eyes, nose, mouth or an open wound.  Rabies infects the central nervous system and causes a “disease of the brain.” Early symptoms of rabies can include fever, headache and fatigue – symptoms that are similar to many other illnesses such as the flu or common cold. However, as the disease develops, symptoms specific to rabies begin to appear: insomnia, paralysis, hallucinations, agitation, hypersalivation, difficulty swallowing and hydrophobia. The disease typically results in death within a few days after the onset of these rabies-specific symptoms.  

In the United States, reported rabies cases have shifted from mainly domestic animals to predominantly wildlife animal reports. Specifically, more than 90% of all rabies cases today are from wild animals. In addition, the number of rabies-related deaths in humans has decreased dramatically from 100 cases per year in the 1900’s to 1-2 per year. Our efforts to encourage prophylaxis after an exposure and the effectiveness of the vaccine have proven successful in decreasing rates of rabies in the United States.

However, rabies is found on every continent other than Antarctica and some continents struggle with the burden of rabies more than others. The overall death rate for rabies around the world is estimated at a staggering 59,000 people a year. Countries in Africa and Asia are affected by rabies disproportionately than the other continents and almost half of the victims of rabies in these countries are children younger than 15 years.

A main reason that such a young population affected is due to uncontrolled canine rabies in these countries. Canine rabies – which spreads from dog to dog – is actually the cause of 98% of human deaths globally. In the United States it has been eliminated because many people keep their animals vaccinated to prevent this type of rabies from re-entering our environment.  However, in many other countries, stray dogs roam around neighborhoods freely and when they contract rabies, they likely spread it to many people (primarily children) they come in contact with. Scientists predict that if 70% of dogs are vaccinated for rabies in an area, rabies can be controlled and human deaths will decrease.

Haiti has the highest number of human deaths by rabies – around 2 deaths per week. CDC and the Government of Haiti have started an animal rabies surveillance program (2013) to detect and have situational awareness of which regions of the country are greatly affected by rabies. In 2015, CDC also evaluated how many dogs were vaccinated in the country and found that only 45% of dogs received their shots. In addition, the total amount of dogs in the country was actually double the number they initially predicted. After these studies were done, the CDC helped train animal health workers to conduct large dog vaccination campaigns and continue rabies prevention efforts.  Many children started bringing their puppies to the events and were proud of their certificates ensuring their dogs had been vaccinated. It is CDC’s (along with the Government of Haiti) hope to reach a 70% vaccination rate among their dog population and sustain it for five years – long enough to create a ripple of effect among human deaths due to rabies.

CDC has helped establish similar campaigns in other countries. For example, they have trained animal control officers in Ethiopia to capture, vaccinate and release stray dogs as well as monitor human exposure cases and keep track of post-exposure prophylaxis (PEP) treatments.  In Vietnam, while there is not a high human death rate for rabies – 91 per year, the government spends an extraordinary amount of money on expensive PEP. It is much more feasible to vaccinate dogs than provide the costly post exposure treatment – $1.32 dollars vs one course of PEP at $153 dollars.  The CDC has helped support Vietnam in improving their rabies surveillance and coming up with new approaches to vaccinate their dogs and achieve the 70% canine vaccination goal.

The World Health Organization has been having meetings to discuss ways to eliminate rabies in Africa too. This past month, representatives from 24 countries in Africa met in Johannesburg to share information from a study they conducted regarding rabies.  The representatives pitched ideas for implementing the new recommendations for human rabies vaccines and how to improve surveillance dog vaccination campaigns. These meetings are exciting as they provide new insight for the global plan to achieve zero deaths from rabies.

Single countries like the Philippines, have proved to be great examples for national campaigns organized against rabies. The Philippines holds a nationwide World Rabies Day celebration as part of its educational outreach campaigns each year. The celebration has continued to grow yearly as more and more events are added to the agenda. It’s success emphasizes the importance of a program that is led and supported by their own national government and how the topic of rabies elimination is valued by the country’s leaders.

Overall, targeting the countries where rabies poses a significant risk and coming up with goals, campaigns and new tactics to eliminate rabies are substantial goals for the globe and many lives will be impacted by the CDC, the WHO and its many public health partners. But what can YOU do on a personal level that can also impact many lives? Here’s a quick checklist to follow:

  1. To start, you should always take your pet to the vet to get vaccinated for rabies regularly.
  2. Spaying or neutering your pet can also help with decreasing the amount of stray and potentially dangerous animals into your pet’s environment.  
  3. Always supervise your pet when they are outdoors. Wild high risk animals for rabies such as raccoons, coyotes or opossums can be in your backyard.
  4. Lastly, avoid contact with wild or unfamiliar animals (including dead animals). As tempting as it is to pet a stray cute kitten or dog, it is in your best interest to not feed or handle them.
  5. Continue sharing the message and saving lives!  Happy World Rabies Day!

What’s Being Done to Promote Vaccinations Across the Globe?

August is National Immunization Awareness Month (NIAM)! Every year, the public health community focuses on spreading awareness of the importance of vaccinations for people of all ages. There are four main messages that are promoted through this campaign:

1) Vaccines protect against serious diseases

2) These diseases still exist and outbreaks do occur

3) Vaccines are recommended throughout our lives

4) Vaccines are very safe.

The United States backs up the importance of these messages with strict school attendance policies regarding vaccinations. Each state has their own laws, but they each require vaccines for children not only attending public schools, but also private schools, universities and daycares. All states allow for medical exemptions, but only some states offer religious or philosophical exemptions. In addition to these policies, the country pushes out amazing social media campaigns that focus on this observance in August. These messages are promoted in many diverse social media outlets in the United States. To name a few, the National Public Health Information Coalition has a toolkit with multiple social media strategies promoting on-time vaccination, and the American Academy of Pediatricians has created and shared a video with many doctors across the country sharing their perspective on why they vaccinate. There are dozens of news articles published everyday with questions and answers regarding the importance of vaccines and reminding parents to get their kids vaccinated before school starts. There are even great articles stressing the importance of adult vaccination – which we don’t see very often! So much good material is pushed out towards the public during this month to promote the truth in how they protect ourselves and our communities.

From an international health perspective, diseases impact everyone, all over the globe.

What are some things being done in other countries around the world? Do they encourage and push out vaccine efforts and policies as much as the United States? Is it just as important?

It turns out, yes! Vaccines are important in many different countries across the world. Here’s a quick spotlight from CNN and other current articles on a few countries that have recently improved their efforts through policy to increase vaccination rates in their countries.

France just passed a new law that requires all children born after January 1st to receive 11 mandatory vaccines. The Ministry of Health is trying to increase their vaccination coverage to meet the World Health Organization’s recommendation of 95% with this new law. The ministry did not want to use forceful methods to motivate the public into getting vaccinated, however this new law will strongly incentivize parents to get their children their shots – otherwise they will not be allowed to attend schools or daycares.

To address the recent measles outbreaks going on in Europe, Italy has followed the United States’ lead and required vaccinations for school entrance. However, they are different from the United States because they are NOT allowing conscientious objections and their citizens will be issued a fine if they do not choose to vaccinate.

Germany recently introduced legislation that makes it required for Kindergarten schools to report to their health departments any parents who have not submitted proof of vaccination for their children. The vaccinations have been required in the past, however reporting parents to the health department is a new stronger twist in ensuring vaccination coverage in schools across the country.

Canada has worked on increasing their vaccination rates by combining vaccine appointments with their routine check ups, providing home visits, creating more vaccine clinics and sending out reminders. This makes it easier for those living further out from clinics and larger cities to get their kids’ vaccination needs taken care of.

In 2016, Australia’s government passed a law that allows families with lower incomes to get “tax rebates” if they keep their child up to date on vaccines. More than 210,000 families have participated since the program was implemented in January 2016 – that’s a lot of kids vaccinated!

On August 6th, 2018, Brazil launched a nationwide vaccination campaign for measles and polio after a large outbreak of measles that resulted in five children deaths. In states where measles is more concentrated, the Ministry of Health has given out free shots in clinics and citizen homes. Their ambitious goal is to vaccinate 95% of children ages 1 to 5 by the end of August.

In an article by Nicholas Dugan, we see that progress has been made in the South Asian countries of Nepal and Bhutan regarding 90% diptheria-tetanus-pertussis (DTP3) coverage since the adoption of the Global Vaccine Action Plan (GVAP) in 2012. Bangladesh has also increased their DTP3 rates by over 20% after the 1980’s when they invested in health infrastructure and training regarding immunizations. These rates are encouraging to hear, as the region of South Asia has typically lagged behind other regions in their vaccination requirement efforts.

Lastly, about 20 million infants worldwide have not been reached through immunizations services and about 60% of those 20 million can be pinpointed to live in 10 countries: Afghanistan, Angola, the Democratic Republic of Congo, Ethiopia, India, Indonesia, Iraq, Nigeria, Pakistan and South Africa. The WHO is working with these countries through initiatives like the Global Vaccine Action Plan mentioned above. In 2017, the GVAP was revamped to further encourage government to improve monitoring and surveillance systems regarding immunization rates so that the data from these systems is up to date and able to guide policy and decision-making for the future. It also requests the WHO Secretariat support these countries continuously to achieve these goals.

Overall, each of these country policies are a little different, but they all encourage and strive to increase vaccination coverage in their respective countries – some with help from other organizations like the WHO.  Over the last few years, the proportion of children across the world with recommended vaccines has stayed stable according to the World Health Organization. With all of these different methods for bringing awareness to the importance of vaccinations through social media this month and different health policies around the world, I am encouraged and optimistic about efforts to increase the proportion of children across the world covered by these essential vaccinations.

Getting involved with health policies that encourage vaccinations is worthwhile and leads to great changes in many different countries as seen above, but if you want to be involved in a smaller (but still impactful) way, I’ve included a few different resources you can use via social media, regardless of where you live, and do your part in increasing awareness and importance of vaccines during the month of August:

  • Health.gov’s toolkit (includes information to add to a newsletter, tweets, community events)
  • American Academy of Pediatricians toolkit (blogs and articles to share)
  • CDC’s recommended immunization schedule

Retweet, post and share away the importance of this observance!