APHA 2007 PROGRAM:

The Spirit of 1848 is happy to present its program for

the 135th annual meeting of the American Public Health Association

November 3-7, 2007,

Washington, DC

(For a 2-page pdf version of the 2007 Spirit of 1848 Program click here.)

SESSIONS

All Spirit of 1848 Sessions will take place in the Washington Convention Center (WCC).

Mon, Nov. 5:

10:30 am to 12 noon:
Policing Reproduction: Lessons and Legacies of Eugenic Sterilization (Session 3161.0; WCC 103A) <more info>

2:30 pm to 4:00 pm:
Introducing the US RWJ Commission on Health Equity: Evidence, Politics, and Action (Session 3363.0; WCC 146B) <more info>

4:30 pm to 6:00 pm:
The Spirit of 1848 presents: “Unnatural Causes: Is Inequality Making Us Sick?”-- integrating politics, passion, and public health (Session 3432.0; WCC 146B)
<more info>

Tues, Nov. 6:
8:30 am to 10:00 am:
Broadening teaching about health inequities and social justice (Session 4070.0; WCC 144C) <more info>

12:30 pm to 1:30 pm:
Social Justice & Public Health: Student Posters (Session 4100.0 WCC Exhibit Halls D/E) <more info>

6:30 pm to 8:00 pm:
Spirit of 1848 Caucus Business Meeting (Session 418.0 WCC 304)

Note: we are also co-sponsoring:

1). the P. Ellen Parsons Memorial Session: Congressional Update on Hot-Button Issues (Session 4242.0) on Tues, Nov 6, 2:30 to 4:00 pm <more info>

2). the Tuesday night OHS HEALTH ACTIVIST DANCE PARTY (8pm -- midnight) at The Brass Monkey 2317 18th St NW [in Adams Morgan, between N. Belmont Rd & N. Kalorama Sq, near the Woodley Park-Zoo/Adams Morgan stop (red line)]. Tickets are available at the Occupational Health & Safety Booth & at the door.

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MON, NOV. 5

Mon, Nov. 5, 10:30 am to 12 noon:
Policing Reproduction: Lessons and Legacies of Eugenic Sterilization (Session 3161.0; WCC 103A)
A Resource List of Books, Articles, and Websites (Session Handout)

10:30 am
Introduction: History, public health, and social justice -- the Spirit of 1848 & reproductive health.
Anne-Emanuelle Birn, MA, ScD (Department of Public Health Sciences, University of Toronto, Faculty of Medicine, 155 College St., Room 662, Toronto, ON M5T 3M7, Canada, (416) 946-5792, ae.birn@utoronto.ca) and Kirby Randolph, PhD (History and Philosophy of Medicine, University of Kansas Medical School, 2025 Robinson, Mail Stop 1025, Kansas City, KS 66160, (913) 588-0076, krandolph@kumc.edu)
• In this introduction, I will highlight the importance of social history to work for social justice and public health and why this area is a focus of the Spirit of 1848 Caucus. I will also situate the panel and its focus on the social history of sterilization abuse and reproductive rights in relation to racism, class, and gender, both in terms of the topic itself and also prior Spirit of 1848 sessions.

10:35 am
Why the history of reproductive health matters to public health.
Alexandra Stern, PhD (Center for the History of Medicine, University of Michigan, 100 Simpson Memorial Institute, 102 Observatory, Ann Arbor, MI 48103, 734-332-1309, amstern@umich.edu)
• Stern will present a brief introduction of the panel as relates to a bigger collaborative project involving historians, physicians, bioethicists, museum designers, archivists, and activists, using the 100th anniversary of Indiana's eugenic sterilization law (1907 -- the first in the country) as a springboard to explore key issues in reproductive control, race, gender, class, choice, and coercion.

10:45 am
Looking back at Buck v. Bell.
Paul Lombardo, PhD, JD (Center for Health, Law & Society, Georgia State University College of Law, P.O. Box 4037, Atlanta, GA 30302-4037, 404 651 2087, plombardo@gsu.edu)
• Few opinions in United States Supreme Court history are as shocking as the decision written by Justice Oliver Wendell Holmes in the 1927 case of Buck v. Bell. That lawsuit, which challenged a Virginia law allowing the state mandated sexual sterilization of epileptics, the mentally retarded and others judged “socially inadequate,” concluded with Holmes declaring: “Three generations of imbeciles are enough.” The Buck decision is unique in the history of medical jurisprudence as the only occasion in which the Supreme Court has endorsed surgery on unwilling patients as a tool of state public health policy. The Buck case provided a precedent that allowed the majority of American States--more than 30 by the late 1930s--to sterilize citizens suspected of posing a threat to the nation's gene pool. This session will explore the Buck case and its aftermath..

11:05 am
Poor women, poor choices: dilemma of civil rights and reproductive health in the 1970s.
Gregory Dorr, PhD (Center for the Study of Diversity in Science, Technology, and Medicine, Massachusetts Institute of Technology, 77 Massachusetts Ave, E51-185, Boston, MA 02139-4307, 617-253-4041, gdorr@MIT.EDU)
• In 1973, social workers in Montgomery, Alabama persuaded Minnie Relf, an illiterate African-American mother, to make her mark on a form. Believing she was authorizing “shots” for her daughters, Mrs. Relf was shocked when doctors sterilized her two youngest daughters, ages 14 and 12. The Southern Poverty Law Center helped the Relfs to file a federal lawsuit. Suddenly, women across the country complained that they, too, had been sterilized without informed consent. As sinister links to the Nixon Administration's population policy emerged, the Relf case spurred changes in federal health policy, ironically reducing poor women's access to sterilization, then and today the favored form of birth control.

11:25 AM
“We will no longer be silent or invisible”: Latinas organizing for reproductive justice.
Elena Gutierrez, PhD (Programs in Gender and Women's Studies and Latin American and Latino Studies, University of Illinois, Chicago, 1802 UH m/c 360, 601 S. Morgan, Chicago, IL 60607, 312 996-9039, elgut@uic.edu)
• My talk will involve a response to the papers given by Dorr and Lombardo that incorporates examples from my own research on Latinas and reproductive health and control, specifically on the forced sterilization of Chicanas in southern California in the 1970s, and subsequent struggles to obtain access and attain equity in reproductive health.

11:40 am
Question & answer period

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Mon, Nov. 5, 2:30 pm to 4:00 pm:
Introducing the US RWJ Commission on Health Equity: Evidence, Politics, and Action (Session 3363.0; WCC 146B)

2:30 pm
Introduction to Politics of Public Health data session
Catherine Cubbin, PhD (Center on Social Disparities in Health, UCSF, 500 Parnassus Ave, MU-3E, Box 0900, San Francisco, CA 94143-0900) and Luis Alberto Aviles, PhD (Sociology, University of Puerto Rico, P.O. Box 9266, Mayaguez, PR 00692-9266, 939-640-3265, laviles@uprm.edu)

2:35 pm
Introducing the US RWJF Commission on Health Equity: Evidence, Politics, and Action.
Paula A. Braveman, MD, MPH (Family and Community Medicine, University of California, San Francisco, 500 Parnassus Ave., MU-3E, Box 0900, San Francisco, CA 94143-0900, 415-476-6839, braveman@fcm.ucsf.edu) David R. Williams, PhD, MPH (Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Avenue, 6th Floor, Boston, MA 02115) and Robin E. Mockenhaupt, PhD (Health Group, Robert Wood Johnson Foundation, College Road East and Route 1, P.O. Box 2316, Princeton, NJ 08543-2316)
• During the Spring or Summer of 2007 the Robert Wood Johnson Foundation (RWJF) will officially launch a major initiative to create a high-profile, national commission on health equity, possibly to be called the RWJF Commission for a Healthier America. The non-partisan/bi-partisan commission will be made up of 10-12 prominent individuals from all sectors with major influences on health, e.g., education, urban planning, child development, public policy, business, labor. The commission's goal is to stimulate public awareness and discussion about socioeconomic as well as racial/ethnic inequalities in health and the most promising directions for reducing those gaps, with particular emphasis on social conditions and social policies. This session will discuss the rationale for this initiative, and why the RWJF is launching this effort now. Presentations will discuss the rationale for this initiative (Dr. Robin Mockenhaupt), the conceptual framework and research effort supporting the Commission's work (Dr. Paula Braveman), the current and planned activities of the Commission (Dr. David Williams), and the Commission's strategies, obstacles anticipated, and approaches to overcoming them (Commissioner, TBN).

3:20 pm
Comments from an international perspective.
Jeannette Vega, MD, PhD (Commission on Social Determinants of Health, WHO, 20 Avenue Appia, Geneva, Switzerland, 41 22 791 1998, vegaj@who.int)
• This discussion will provide a critical international perspective on the US RWJ Commission initiative within the framework of current work on the WHO Commission on Social Determinants of Health.

3:30 pm
Discussant: on the US RWJ Comminssion on Health Equity and evidence, politics, and action.
Nancy Krieger, PhD (Dept of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Kresge 717, Boston, MA 02115, 617-432-1571, nkrieger@hsph.harvard.edu)
• As discussant, I will consider the issues raised by the US RWJ Commission on Health Equity regarding evidence, politics, and action. This presentation will draw on the Spirit of 1848's concerns about the politics of public health data and the inextricable link between social justice and public health.

3:40 pm
Question & answer period

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Mon, Nov. 5, 4:30 pm to 6:00 pm:
The Spirit of 1848 presents: “Unnatural Causes: Is Inequality Making Us Sick?”-- integrating politics, passion, and public health (Session 3432.0; WCC 146B)

4:30 pm
Introduction: passion, politics, and public health – The Spirit of 1848 presents “Unnatural Causes: Is Inequality Making Us Sick?
Nancy Krieger, PhD (Dept of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Kresge 717, Boston, MA 02115, 617-432-1571, nkrieger@hsph.harvard.edu)
• Passion, politics, and public health: these are the hallmarks of any movement working for health equity. They are also core to the mission of the Spirit of 1848, an APHA Caucus whose work focuses on the inextricable link between social justice and public health and does so in relation to the politics of public health data, progressive pedagogy, and the social history of public health. In this spirit, we are happy to devote our Spirit of 1848 integrative session to public discussion about the ways progressive public health workers can use the upcoming PBS broadcast on “Unnatural Causes: Is Inequality Making Us Sick?” as a way to galvanize US national, state, and local organizing around issues of social justice and public health. Join us for a session in which we can collectively figure out effective ways to spread the word and do the work!

4:35 pm
Introduction to the PBS series “Unnatural Causes: Is Inequality Making Us Sick?” and screening of excerpts.
Larry Adelman (California Newsreel, 500 Third Street / 505, San Francisco, CA 94107, 415-284-7800, LA@newsreel.org)
• Unnatural Causes is a four-hour series, broadcast by PBS and available on DVD, that popularizes and makes compelling the surprising findings of the past two decades on the social determinants of health disparities, interweaving the research with human stories. It is not about the ‘repair shop' end of health, that is, medical care, but why some populations get sicker more often in the first place. The opening episode paints the big picture—who gets sick and why. It is supported by six additional 30-minute stories set in different racial/ethnic communities. They provide a deeper understanding of different pathways by which the social environment affects health, while chronicling innovative initiatives for strengthening communities and moving us towards health equity. We will screen clips from the episodes Bad Sugar, which explores the impact of historical and structural forces on the health of Native Americans today and Place Matters, which explores how and why neighborhoods develop differently, some promoting health and well-being while others reduce our chances for health.

5:15 pm
Using “Unnatural Causes” and other tools to build a movement: presentation and guided dialog.
Makani Themba-Nixon (The Praxis Project, 1750 Columbia Rd, NW, Second Floor, Washington, DC 20009, (202) 234-5921, mthemba@thepraxisproject.org)
• Public policy change is critical to achieving health equity, but social movements that pressure government and other key actors are a precondition to the adoption of policies that advance equity and justice. How can we as public health practitioners help build a compelling movement for health equity? Unnatural Causes has emerged as an effective tool for this movement. Advocates are convening screenings, forums, town meetings, and trainings around the country. They are assisted by the series companion Web Site, Discussion Guides, Neighborhood Health Justice Report Cards, Community Action Tool-Kit and other tools, all geared towards pushing the health dialog “upstream” and building this movement. Using a guided dialog, participants will be introduced to the support tools and begin to identify opportunities where they can use the series to educate, organize or advocate. We will discuss the distinctions between these three uses, review case studies, and begin a planning process that can yield successful events, including how to identify possibilities within and outside the health community, contextualize screenings, conduct follow-up discussions, and determine appropriate next steps.

5:55 pm
Discussant: “Unnatural Causes: Is Inequality Making Us Sick?”
Nancy Krieger, PhD (Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Ave, 7th Floor, Boston, MA 02115, (617) 432-1571, nkrieger@hsph.harvard.edu)
• As discussant, I will consider the issues raised by the session's dialogue on using “Unnatural Causes: Is Inequality Making Us Sick” as a tool for movement building to advance the work of social justice, public health, and health equity. The presentation will draw on the Spirit of 1848's concerns about the inextricable link between social justice and public health and why contemporary public health work must be grapple with the politics of public health data, engage in progressive pedagogy, and ground itself in the social history of public health.

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TUES, NOV. 6:

Tues, Nov. 6, 8:30 am to 10:00 am:
Broadening teaching about health inequities and social justice (Session 4070.0; WCC 144C)

8:30 am
Introduction.
Suzanne Christopher, PhD (Department of Health and Human Development, Montana State University, 318 Herrick Hall, Bozeman, MT 59717, 406-994-6321, suzanne@montana.edu) and Lisa Dorothy Moore, DrPH (Health Education, HHS 326, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132)

8:35 am
Social justice as the organize theme in undergraduate education.
Mary Beth Love, PhD(1), Vicki Legion, MPH1, Amanda R. Goldberg, MPH(1), Ingrid Ochoa, MPH(2), Savi Malik, BA(3), Rachel Poulain, MPH(4), Cathy Rath, MA(5), and Sarah Rodriguez(1). ((1) )Department of Health Education, San Francisco State University, HSS 326, 1600 Holloway Ave., San Francisco, CA 94132, 415-338-2708, love@sfsu.edu, (2) Department of Health Education, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132, (3) Community Health Works, San Francisco State University, 1600 Holloway, HSS 301, San Francisco, CA 94132, (4) California Newsreel, 500 Third Street, #505, San Francisco, CA 94107, (5) Solano County Public Health Department, A.T.O.D. Reducing Rates Coalition, C/O CG Rath Consulting, 1 Weatherly Drive Suite 206, Mill Valley, CA 94941)
• After an intensive process of dialog, the faculty of San Francisco State University identified social justice as the University's number one strategic goal. Following this decision, the campus has generated many innovative approaches for teaching social justice. Four of these will be discussed in this session. The first is the development of the Metropolitan Health Academies, with City College of San Francisco, funded by Fund for the Improvement of Post Secondary Education. The goal of this project is to use health and social justice as an organizing theme for an integrated general education curriculum for urban undergraduates who are interested in health professions. Public health content will be infused with the “golden four” skills of writing, public speaking, and both critical and quantitative thinking, along with advocacy skills. The second innovation is a three unit course entitled “Health and Social Justice: Burning Issues, Taking Action.” This is a documentary film and lecture course exposing students to cutting edge films (including the forthcoming Unnatural Causes mini-series); to public health experts; and to community activist campaigns. The third innovation is a course co-offered with the Cinema Department, in which public health students collaborate with cinema graduate students to produce documentary films. The final innovation is a teach-in model which exposes people from the larger campus community to important issues (Katrina; the Unnatural Causes mini-series). Organized around such an issue theme, teach-ins are designed to expose attendees to powerful films, faculty and community speakers, group discussion, and to food, music and visual arts.

8:50 am
Alameda County Public Health Department’s pedagogy for social justice.
Mia Luluquisen, DrPH(1), Sandra Witt, DrPH(2), Katherine Schaff, BA(3), and Sandi Galvez, MSW(2). ((1) Alameda County Public Health Department, Community Assessment Planning and Education/Evaluation Unit, 1000 Broadway, Suite 500, Oakland, CA 94607, 510-267-8020, mia.luluquisen@acgov.org, (2) Community Assessment, Planning and Education/Evaluation Unit, Alameda County Public Health Department, 1000 Broadway Suite 500, Oakland, CA 94607, (3) Alameda County Public Health Department, Community Assessment Planning and Education/Evaluation Unit, 1000 Broadway Suite 500, Oakland, CA 94607)
• In 2006, Alameda County Public Health Department (ACPHD) launched a series of strategic planning sessions, social justice dialogues, retreats on addressing institutional racism and trainings to build essential public health knowledge. Combining Freirian popular education pedagogy with Technology of Participation approaches, we created learning activities that foster deep understanding of social determinants of health and build commitment to eliminate health inequities in our diverse population. Our participatory strategic planning process aims to create a department-wide strategic plan to eliminate health inequities based on the principles of social justice. We have conducted several visioning and organizational analysis sessions around health inequities with ACPHD staff and community partners. With ACPHD “Leadership Fellows,” we have conducted in-depth social justice dialogues on institutional racism, gender exploitation and discrimination, and class exploitation. With division directors and program managers, we have held one-day retreats to address institutional racism utilizing California Newsreel's Race: The Power of an Illusion documentaries. The videos serve to trigger dialogue, reflection and action planning about undoing racism within the health department and in the community. Our Community Assessment, Planning, Evaluation, and Education (CAPE) Unit has been holding monthly dialogues on institutional racism that have raised consciousness about institutional racism. We also aim to improve our epidemiological efforts and community capacity building practices, and develop stronger approaches to empower communities. Moreover, PH 101 is a five-module training series that includes presentations and dialogues on cultural competency and cultural humility; social determinants of health and health inequities; undoing racism; and community capacity building.

9:05 am
Linking health inequities and social justice: teaching the social determinants of health.
C. Linn Gould, MS, MPH (Population Health Project, 2015 14th Avenue East, Seattle, WA 98112, 206 324-0297, ErdaEnv@aol.com)
• The Population Health Project (PHP) promotes dialogue, debate, and action around the ways in which political, economic, and social inequities interact to affect the health of our society (social determinants of health). PHP is currently developing, teaching, and disseminating a population health curriculum as an alternative health education model to both complement and expand upon the traditional individual health paradigm currently taught in U.S. schools. The curriculum framework addresses the underlying structural causes influencing individual health behavior, population health indicators, health disparities, policies and practices that cause health inequalities, and actions that can be taken to improve population health. Modules are designed to engage youth and adults in critically thinking about links between social justice and health equity and in using this knowledge to become strong advocates for social change (critical health literacy). Teaching youth and adults population health concepts and how to take social action is believed to result in beneficial health outcomes at both the individual and community levels. Twelve modules addressing the social determinants of health are being developed for a PHP population health manual. This presentation describes five curricular modules developed and taught by the PHP to date: Population Health Concepts; Civic Engagement, Food Security & Hunger; Environmental Justice; and World Health & Art Activism. PHP will discuss its teaching methodology, lesson examples, student civic action projects, process and impact evaluation, as well as challenges and successes of the curriculum.

9:20 am
Using “Unnatural Causes” to educate and advocate for health equity.
Rachel Poulain, MPH (California Newsreel, 500 Third Street, #505, San Francisco, CA 94107, 415-284-7800 ext 314, RP@newsreel.org)
• The WHO Commission on the Social Determinants of Health wrote: “Evidence is rarely if ever sufficient by itself to catalyze political action. In political terms, what might be at least as crucial as the evidence itself is the ‘story' in which it is embedded.” But how do we construct a new health story? How is the prevailing individual, bio-medical discourse—a story of doctors, drugs, behaviors and genes—ruptured and replaced by an ecological, or social determinants, story rooted in social justice? What role can a film play in expanding this dialog? Unnatural Causes, a four-hour series for PBS broadcast and available on DVD, explores the underlying causes of the nation's socio-economic and racial disparities in health—and searches for solutions. In Fall 2007, organizations across the country will start using the series and its support tools as part of a national campaign to reframe the debate over health and what we as a society can and should do to tackle health inequities. The case studies of three organizations using Unnatural Causes in non-classroom settings—a city health department, an advocacy organization, and a community-based organization—help us better understand how new paradigms for health can get ‘traction' with the public. How are these groups organizing their events, eliciting audience pre-conceptions before the screening, providing a framework for ‘active' viewing, throwing attention off the screen and back upon the audience and their own community, and promoting further investigation and involvement in the issues? What resistances do they encounter? And how effective are they?

9:35 am
Question & answer period

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Tues, Nov. 6, 12:30 pm to 1:30 pm:
Social Justice & Public Health: Student Posters (Session 4100.0; WCC Exhibit Halls D/E)
This session highlights posters prepared by students of public health and health-related programs focused on intersections between social justice and public health from a historical, epidemiological, global, and/or methodological perspective.

Poster #1
Health and social justice: a model for creating an interdisciplinary, student-driven course.
Julie Self, BS( Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road, Atlanta, GA 30319, 404-312-4200, jself@emory.edu) Carey Melmed, BSN, RN (Global Health, Rollins School of Public Health, 1518 Clifton Road, Atlanta, GA 30322) and Tamika Davis, BS, MS (Candler School of Theology, Emory University, Bishops Hall, Atlanta, GA 30322)
• Health as Social Justice (HSJ), GH507/NRSG686, is a student-initiated, student-driven Masters level course at Emory University in Atlanta, Georgia. Originally offered in 1996, the course was collaboratively developed by students and faculty in response to student demand for a course examining the interrelationship of public health and social justice. HSJ is cross-listed among theology, public health, and nursing schools, creating an interdisciplinary approach which fosters idea-sharing and common understanding. Course content and learning outcomes for HSJ are modified to reflect each class's unique learning objectives. Each semester, students develop course expectations, agree upon community norms, and explore definitions of health, social justice, and health as social justice. The participatory learning style of HSJ fosters a deeper and richer learning than would have been garnered through a traditional lecture format. For example, students identify qualities and characteristics of leadership which are best able to effect health as social justice. A series of assignments designed to build capability, confidence, cooperation, and reflection empowers students to recognize and enhance personal leadership qualities. Students have the opportunity to critically evaluate social justice issues and to propose policy recommendations for those issues, enabling them to recognize their unique ability and efficacy in promoting health as social justice. Course grading and evaluation is based upon critical self-analysis and reflection as well as objective academic outcomes. By modeling aspects of social justice in the classroom setting, students develop a more thorough understanding of justice and acquire individual skills and the efficacy to promote justice locally and globally.

Poster #2
Identifying supports and barriers among dental hygiene students of color in program completion and serving their respective communities.
Rheena Yangson, MPH (c), Jason Lim, MPH (c), Kanwarpal Dhaliwal, MPH (c), Craig Wingate, MPH (c), and Kristina Spurgeon, MPH (c) (Community Health Education, San Francisco State University, 1600 Holloway Avenue, HSS 326, San Francisco, CA 94131, 415-338-1413, kanwarpal@sbcglobal.net)
• Purpose--The purpose of this community health assessment is to assess the psychosocial and material needs of students of color in dental hygiene programs at Chabot College, Foothill College, and Diablo Valley College (DVC). Methods--Surveys were conducted with students enrolled in the three Bay Area community college programs (N=114). Key informant interviews were conducted with the program directors (N=3) and practicing dental hygienists of color who reside and work in the Bay Area (N=3). Findings--Descriptive results of the assessment do not indicate a significant difference in the needs of students of color versus white students to enter or complete such programs or identify any factors that support or hinder entrance into the field. Students of color placed greater importance on attention to diversity and cultural competence than did white students. A significant number of respondents (97%) indicated the private practice setting as their primary choice for employment. Qualitative results suggest that education and training models are geared towards dental board certification and licensure requirements, with little room to integrate or include public health or community-based models of care. Recommendation-- Pursue policy efforts to expand the scope of dental hygiene care to community-based and public health settings in order to meet the oral health needs of underserved communities of color.

Poster #3
Results of a public advocacy campaign to increase access to condoms in Washington, DC.
Shumaya Ali, MPH candidate(1), Suja Shunmugavelu, MPH candidate(1), Sophia Vourthis, MPH candidate(1), Carolyn Watson, MPH candidate(1), and Caroline H. Sparks, Faculty Advisor(2). ((1) Department of Prevention and Community Health, The George Washington University School of Public Health and Health Services, 2175 K St. NW, Suite 700, Washington, DC 20037, 202-467-2277, shumaya@gwu.edu, (2) School of Public Health and Health Services, The George Washington University, Dept of Prevention and Community Health, 2175 K St. NW, Suite 700, Washington, DC 20037)
• Graduate public health students participating in a community advocacy course in the School of Public Health and Health Services at The George Washington University developed a public health advocacy campaign to increase access to condoms in Washington, DC, the city with the highest AIDS rate in the USA. The target for the advocacy campaign was the CVS corporation which was locking condom displays and impeding customer access. The students visited the 51 CVS stores in the District of Columbia and constructed a GIS map that illustrated that condoms were only locked in the wards with the highest AIDS rates and whose residents are primarily African American. To redress this injustice, the students organized a community coalition called “Save Lives: Free the Condoms” and designed a campaign to influence the CVS corporation to adopt a nationwide policy of free access to condoms. The campaign framed the issue as “health” not “theft” and all media materials and negotiations with the CVS corporation emphasized that frame. The Coalition focused on CVS's inherent discrimination of locking condoms only in the poorest, primarily African American neighborhoods. Within three months, the Save Lives: Free the Condoms coalition had achieved favorable television and newspaper coverage and the national CVS corporation had agreed to unlock small packages of 3, 6, and 12 condoms. Larger packages remained locked and CVS continued to refuse to adopt a national written policy of free condom access. The Coalition continues to press CVS for complete free access to condoms in the future.

Poster #4
Associations between perceived discrimination and hypertension in African-Americans: the Pitt County Study.
Calpurnyia Roberts, BS, MS(1), Anissa I. Vines, PhD, MS(2), Jay Kaufman, PhD(1), and Sherman A. James, PhD(3). ((1) Epidemiology, University of North Carolina at Chapel HIll, Bank of America, Chapel Hill, NC 27514, 919-357-3108, calp@email.unc.edu, (2) Department of Epidemiology, University of North Carolina at Chapel Hill, Campus Box 7400, Chapel Hill, NC 27599, (3) Public Policy Studies, Duke University, 213 Sanford Institute Building, Box 90245, Durham, NC 27708)
• Persistent exposure to discrimination may have a deleterious effect on blood pressure. To date, few studies have examined the impact of the frequency of discrimination on the risk of hypertension. The main purpose of this study was to assess the association between racial and non-racial perceived discrimination and hypertension status in African-Americans. The study was conducted among 1,110 middle-aged African-American men (n=393) and women (n=717) who participated in the 2001 Pitt County North Carolina Hypertension Follow-up Study. The data was weighted in order to provide a population representative sample. Gender-specific unconditional weighted logistic regression was used to estimate odd ratios (OR) adjusted for age, body mass index, education, social support, and the frequency of discrimination (Frequently, Infrequently, Rarely, and Never). More than half of the men, 56%, and women, 57%, were hypertensive. The prevalence of perceived racial, non-racial, and no form of discrimination in men was 58%, 28%, and 14%, respectively, and in women 42%, 42%, and 17%, respectively. In the adjusted analysis, women recounting frequent non-racial discrimination versus those reporting no exposure to discrimination showed the highest odds of hypertension [adjusted OR = 2.29 (95% confidence interval 1.13, 4.67)]. Among men, those reporting frequent exposure to either type of discrimination had lower odds of hypertension than men reporting no exposure. A similar effect was also observed for women who reported perceived racial discrimination. These results indicate that the type and frequency of discrimination may differentially impact hypertension in African-American men and women.

Poster #5
Wrong side of the river: overcoming health disparities in rural North Carolina.
Arin Ahlum Hanson(1), Katie M. Keating(1), Jiang Li(1), Anne M. Morris(1), Ellie M. Morris(1), Jennifer M. Wieland(1), Melvin R. Muhammad, AA(2), and Taro Knight, BA(3). ((1) Department of Health Behavior & Health Education, University of North Carolina at Chapel Hill, School of Public Health, Campus Box 7440, Chapel Hill, NC 27599, 215-868-6319, arin@email.unc.edu, (2) Community Enrichment Organization & Rocky Mount OIC, P.O. Box 1475, Tarboro, NC 27886, (3) East Tarboro/Princeville Community Development Corporation, 1118 Edmondson Avenue, Tarboro, NC 27886)
• Background/Purpose: Underlying the disproportionately high rates of chronic disease, other health conditions, and associated poor health outcomes among African Americans is limited access to healthcare, fueled by an array of environmental and social factors. This paper presents the results of a community diagnosis performed in the African American communities of two towns in eastern North Carolina, focusing on the ways these communities have overcome a history of racism and poor geography to begin resolving existing disparities through improved access to healthcare services. Methods: An Action-Oriented Community Diagnosis (AOCD) was conducted with these African American communities over a seven-month period. Three qualitative data collection methods were used to assess the strengths and challenges facing these communities. These methods were participant observation field notes; semi-structured individual interviews with 40 community residents and service providers; and secondary data sources such as historical archives and technical documents. Data were analyzed using a transcript-based analysis approach to determine patterns of meaning related to community and identity. Results/Implications: Preliminary findings indicate striking differences in both health outcomes and access to healthcare, based on race and residential location. In an effort to reconcile existing health disparities within the communities, public health practitioners must continue collaborative efforts with government and community leaders to advocate for structural changes that will improve the population's health. Advocating for a public transportation infrastructure, particularly to medical facilities, will be an important first step in promoting equal access to care and developing policy-level interventions to eradicate health disparities in this population.

Poster #6
Breast cancer mortality: a social justice perspective.
Monica Taylor-Jones, MPH (Bloustein School of Planning and Public Policy, Rutgers, The State University of New Jersey, 33 Livingston Street, New Brunswick, NJ 08901, 732-932-5475, taylorjo@eden.rutgers.edu)
• Background: Black women have the highest breast cancer death rates when compared to any other racial or ethnic groups. Significant research efforts have focused enormous attention towards factors such as race often juxtaposed with socioeconomic status as social determinants for such disparities. The purpose of this research is to explore how the relationship between political and other economic factors could lead to disparities in breast cancer mortality. These factors include investments in crucial social welfare programs and the degree of income inequality. Methods: Using data from the National Cancer Institute and the Health Care Safety Net's Data Book II on States and Counties in a multivariate analysis, the primary independent variable included income inequality, while the political variables included the presence of health care safety net institutions, public assistance programs and Medicaid expenditures at the county level. Results: Income inequality was positive and significantly correlated to breast cancer mortality while being uninsured, the presence of social welfare programs and the presence of health care safety net institutions also had a strong effect. The measure on income inequality was not significant when race was included in the regression models. Being black was positive and significantly associated with breast cancer mortality while the presence of safety net institutions and being uninsured continued to have a strong effect. Conclusions: Including political and economic factors could be crucial to our understanding of the social determinants that lead to disparities in breast cancer mortality.

Poster #7
Racial and ethnic disparities in Medicaid expenditures for infants in North Carolina.
Stephanie Z. Moultrie, MPH(1), Dara Mendez, MPH(1), Vijaya K. Hogan, MPH, DrPH(1), and J. Tim Whitmire, PhD(2). ((1) Maternal and Child Health, University of North Carolina, Campus Box 7400, Chapel Hill, NC 27599, 919-914-8260, moultrie@email.unc.edu, (2) Department of Health and Human Services, State Center for Health Statistics, 1908 Mail Service Center, Raleigh, NC 27699)
• Maternity Care Coordination was established in North Carolina (NC) as a component of Medicaid's prenatal care services. This study explores the racial and ethnic disparities in the associations between NC's perinatal care regions and counties and the number and costs of Medicaid infant claims within the first year of the infant's life. Chi-square and logistic regression analyses were conducted to determine associations between county of residence, perinatal care regions and Medicaid infant claims and costs. Preliminary results show associations between type of county and total number of infant claims and amounts paid by Medicaid (p<0.0001) as well as perinatal region and total number of infant claims and amount paid by Medicaid (p<0.0001). The number of infant diagnoses significantly predicts Medicaid expenditures above the mean costs for NC for infant claims (OR=3.890; CI: 3.584,4.221). Black (non-Hispanic) and Asian/Pacific Islander race/ethnicities significantly decrease the odds of having Medicaid expenditures exceed the mean for infant claims [OR=0.827; CI(0.749,0.913)] and [OR=0.439;CI: (0.245,0.785)], respectively; although, both ethnic groups are more likely to live in urban areas, (71% of blacks and 82% or API live in urban areas) and have infants with at least two diagnoses at birth. These results suggest that race, county type and the division of perinatal care regions for maternity care coordination may influence provision and utilization of Medicaid infant services. Furthermore, these results suggest that there are disparities in Medicaid costs for infants born to black and Asian/Pacific Islander mothers.

Poster #8
Politics of HIV/AIDS data reporting.
Dana Thomson (Department of Anthropology, George Washington University, c/o Robert Shepherd or Barbara Miller, 2112 G Street NW, Washington, DC 20052, 202-558-7917, danafer@gwu.edu)
• This project explores how data both empowers and destabilizes local HIV/AIDS case management and care programs. It first analyzes which data is foregrounded and how this data shapes our conversations about HIV/AIDS prevention and care. Strict bio-cultural “indicators” including age, race/ethnicity, gender, and sexual orientation, restrict the range and nature of questions that can be asked about causes and modes of transmission in a socially stratified society. Secondly, this project explores the types of data and reporting methods required of front-line HIV/AIDS workers. Through an analysis of the reporting requirements and data collection structures at a clinic in Washington, DC, this project demonstrates how the politics of data hinder quality of care and HIV/AIDS program stability. If data relays a “truth” about HIV/AIDS and it is used as a foundation for decision making, we must regularly reevaluate what “truths” and whose “truths” are told. This research seeks to more effectively empower local HIV/AIDS programs with data so that they can ultimately provide the stable, quality care that all clients deserve.

Poster #9
Human trafficking: a social justice issue for women and children.
D. Paxson Barker, RN, BS(1), Jeffrey V. Johnson, PhD(2), and Kathleen Mc Phaul, PhD, MPH, RN(1). ((1) Family and Community Health, University of Maryland School of Nursing, 655 W. Lombard, Baltimore, MD 21201, 443-927-6571, dbark001@umaryland.edu, (2) Work and Health Research Center, University of Maryland School of Nursing, 655 West Lombard Street, Room 655B, Baltimore, MD 21201-1579)
• The proposed paper aims to examine the utility of social justice coursework for public health students. Using the issue of human trafficking, an important social justice issue, the authors will illustrate how course work in social justice connects public health students to emerging public health issues and provides a framework for stimulating students to analyze the associated public health, political, policy, and legal issues. Examining the health consequences to the victims of human trafficking and the available resources to treat victims is an aspect of the issue that public health students/practitioners can have the greatest impact. A full literature review was conducted using both academic and public sources. The issue was examined in four subtexts; victim, trafficker, government, and consumer of sex trade. The focus of the literature review and the paper is on the social injustice that human trafficking visits upon women and children. The literature demonstrated that this is the third highest profit industry for organized crime after drugs and guns. It is estimated that 600,000 – 800,000 people are trafficked each year and 80% are women and children. The issue of human trafficking is complex but is best treated as a human rights violation. There remain wide gaps in the delivery of healthcare to the victims of trafficking and this paper will identify and explain the causes of those gaps. Students conducting coursework in social justice can impact those emerging injustices through research and publication illuminating the issue for public scrutiny.

Poster #10
Rates, trends and socioeconomic characteristics of attempted suicide in Taiwan, 1996-2004.
Ruoh-Ning Wu and Cheng Yawen (Institute of Health Policy and Management, National Taiwan University, Room 617, No.17, Hsu-Chow Rd., Taipei, Taiwan, +(886) 2-3322-8056, ruohning@gmail.com)
• Background: Hospitalization rates for attempted suicide rose substantially in Taiwan in recent years. This study aims to explore the trends in attempted suicide for separate age bands and to assess the socioeconomic differences based on a nationwide level. Methods: Hospitalization rates and the percentages of socio-demographic data were calculated using computerized files extracted from the National Health Insurance Database, which was available from 1996 to 2004. Results: There was a substantially increasing trend in hospital admissions of para-suicide for all age groups between 1996 and 2004. The highest average age-adjusted rate of attempted suicide was 20.43 for men and 25.36 for women; the lowest age-adjusted rate was 10.68 for men and 15.96 for women. Higher hospitalization rates for attempted suicide were observed in men aged over 65 years and women aged 25-34 years; lower rates were shown among men aged 45-54 years and women aged 55-64 years. In consist with other countries, soft methods (poisoning and cutting) were used primarily across all age groups for both genders. Further analyses showed that above ninety percent of suicide attempters belonged to the lowest two premium levels and that more individuals worked in private sectors compared with the general population. Conclusions: This study suggested that socioeconomic differences may have great impact on suicide attempt. Future research should focus on understanding the base rates of the different socioeconomic variables in the general population, and the culture context behind such changes.

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Tues, Nov. 6, 6:30 pm to 8:00 pm:
Spirit of 1848 Caucus Business Meeting (Session 418.0; WCC 304)
Come to a working meeting of THE SPIRIT OF 1848 CAUCUS. Our committees focus on the politics of public health data, progressive public health curricula, social history of public health, and networking. Join us in planning future sessions & projects!

NOTE: we are also co-sponsoring:

The P. Ellen Parsons Memorial Session, organized by Ellen Shaffer and sponsored by the Medical Care Section and co-sponsored by the Women’s Caucus. Tuesday, November 6, 2:30 to 4:00 pm (Session 4242.0, WCC 158A). P Ellen Parsons was a founding member of the Spirit of 1848 Caucus, as well as a longstanding member of the Women’s Caucus and the Medical Care Section. The session information is as follows:

2:30 pm
Trade and health: Ways and Means perspectives.
Jason Kearns, JD MPP (Ways and Means Committee, U. S. House of Representatives, 1102 Longworth House Office Building, Washington, DC 20515, 202-225-3625, jason.kearns@mail.house.gov)
• The House Ways and Means Committee is helping to lead changes in U.S. trade policies that have adversely affected public health in the past, including access to medicines in low-income countries. This presentation will provide an update on recent and pending global trade agreements, and their implications for public health.

2:50 pm
Reproductive rights: Rep. Jerrold Nadler’s views.
Carole Angel, JD (House of Representatives, Office of Rep. Jerrold Nadler, 2334 Rayburn House Office Building, Washington, DC 20515, (202) 225-5635, carole.angel@mail.house.gov)
• This presentation describes how Rep. Jerrold Nadler and other members of Congress are responding to recent decisions by the Supreme Court that will limit women's reproductive rights.

3:10 PM
War in the Middle East: Perspective of Rep. Barbara Lee.
Ven Neralla (Office of Rep. Barbara Lee, U.S. Congress, 2444 Rayburn House Office Building, Washington, DC 20515, (202) 225-2661, ven.neralla@mail.house.gov)
• The war in Iraq continues to undermine public health. The U.S. has considered widening the war to Iran. This presentation will explore recent developments from the perspective of Rep. Barbara Lee, a member of the House Progressive Caucus and the House Black Caucus.

3:30 PM
Universal Health Care: Rep. Conyers and the Leadership Council.
Joel Segal (House of Representatives, Office of Rep. John Conyers, 2426 Rayburn House Office Building, Washington, DC 20515-2214, 202 731-5267, Joel.Segal@mail.house.gov)
• Universal access to affordable health care is an important public health priority. There are several proposals pending in Congress and presidential candidates are debating the issue. U.S. Rep. John Conyers is proposing a plan based an extending successful features of the Medicare program. This presentation will describe this proposal, and efforts to mobilize effective support for comprehensive reform among public health advocates and policy-makers.

3:50 PM
Question & answer period

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