CHICAGO—Presidential Cabinet members and past and present surgeons general appeared at the American Public Health Association's annual meeting. But the names that seemed to be on everyone's mind were Freddie Gray and Michael Brown, the two black youths who died earlier this year in altercations with police in Baltimore and Ferguson, Mo.
Public health officials were called upon to heal those communities after the violent protests ignited by the young men's deaths. Those officials were in Chicago at the APHA meeting, which wrapped up Wednesday, and they vowed to do whatever they can to prevent violence and poverty from undermining communities and the health of their residents.
“I wish the names Michael Brown and Freddie Gray represented something positive,” said Faisal Khan, St. Louis County director of public health. Instead, he said, Ferguson was a symptom of what happens in racially segregated areas with concentrations of generational poverty and people completely disconnected from the resources they need to be healthy.
“Ferguson was a classic example of a community under a toxic amount of stress,” Khan said.
U.S. Surgeon General Dr. Vivek Murthy kicked off the meeting with a call for healthcare equality. The APHA's new president, Dr. Camara Jones of the Morehouse School of Medicine in Atlanta, closed it by calling for a national public health campaign against racism, which she said is sapping the strength of society through a waste of human resources.
Jones clarified that she wasn't talking about racism as an individual character flaw, but as a system of power and structured inequity. “Public health is built on a commitment to social justice,” she said.
Public health experts are also stressing that the social determinants of health rather than the delivery of healthcare services are the main predictor of longevity. Khan acknowledged that life expectancy in his county varies from 56 to 91 years depending on the ZIP code.
The association has called for a “reframing” of public health and moving public health officials beyond their traditional role of inspecting restaurants and promoting vaccinations.
Khan said he took a step in this direction by adding the word “public” to the name of the county's health department. This was done to signal to the community and to department staff that public health was going to be seen through a different lens. Not everyone embraced the change, but they are no longer with the department.
“I was glad to give them a good letter of reference,” Khan said in an interview.
This year's annual meeting of the APHA, its 143rd, was attended by about 13,100 people.
Its leaders describe the new approach to their mission as “health in all policies.” It calls for public health professionals to work with law enforcement, transportation officials, environmentalists, educators, beauticians and barbers, churches and anyone else who can help APHA's effort to make healthy choices the easy choices.
“We need to stop asking for a seat at the table,” said Dr. Karen DeSalvo, the acting assistant secretary for health at HHS and the former health commissioner for the city of New Orleans. “We need to show why we belong at the head of the table.”
