APHA 2011 PROGRAM:

The Spirit of 1848 is happy to share our final program for the

139th Annual Meeting of the American Public Health Association,

"Healthy Communities Promote Healthy Minds & Bodies"

October 29 - November 2, 2011

Washington, DC

(Download the 2011 Spirit of 1848 Program and the 2011 Spirit of 1848 Flyer.)

You can also access the Spirit of 1848 sessions and all other APHA sessions at the APHA annual meeting website:
http://apha.confex.com/apha/139am/webprogram/SPT1848.html

SESSIONS

All Spirit of 1848 sessions will be held in the Washington DC Convention Center (hereafter referred to as “WCC”).

Mon, Oct 31:

10:30 am to 12 noon:
Critical Histories of Community Health Centers (Session 3177.0, WCC 101) <more info>

2:30 pm to 4:00 pm:
Discrimination, Health, and the Politics of Public Health Data: New Evidence, Broad Perspectives (Session 3378.0, WCC 101) <more info>

4:30 pm to 6:00 pm:
Power, Politics, and Healthy Communities in Societal & Ecologic Context: From History and Evidence to Transformative Knowledge for Action (Session 3455.0, WCC Salon I) <more info>

Tues, Nov 1:
8:30 am to 10:00 am:
A Social Justice Perspective on Teaching and Capacity Building to Promote the Health of Communities (Session 4073.0, WCC 101) <more info>

12:30 pm to 1:30 pm:
Social Justice & Public Health: Student Posters (Session 4172.0, WCC Exhibit Hall D/E) <more info>

6:30 pm to 8:00 pm:
Spirit of 1848 Caucus Business Meeting (Session 345.0, WCC 141)

Co-sponsored sessions:

• We will, as usual, co sponsor the P. Ellen Parsons Memorial Session (Session 4321.0; Tues, Nov 1, 2:30 4:00 pm, Grand Hyatt, Latrobe), organized by Ellen Shaffer, sponsored by the Medical Care Section and additionally co sponsored by the Socialist Caucus and the Women’s Caucus; this year the theme is: “Can public health prevail on Medicare, social programs, reproductive rights”?

• We are co-sponsors of the special session “In Honor of Jack Geiger” (Session 207.0; Sun, Oct 30, 2:30-5:30 pm, WCC 101), organized jointly by the Socialist Caucus, Medical Care, Peace Caucus, and SOPHE

• We are co-sponsoring two sessions sponsored by the Community Health Planning and Policy Development (CHPPD) Section, one titled “Health Equity 2020” (Session 3226.0; Mon, Oct 31, 12:30 – 2pm, WCC 146A), the other titled “Implementing Health Equity 2020” (Session 4286.0; Tues, Nov 1, 2:30 – 4 pm, WCC 147A)

• This year, there are TWO parties (with music & dancing) we are co-sponsoring:

• on Sun, Oct 30, the first-ever Praxis World Party, with the “best beats from around the world,” WCC, Room 152A, 8 pm -1 am, FREE admission, no-host bar, live DJ!

• on Tues, Nov 1, the annual health activist dance party, organized by the Occupational Health & Safety section, 8-11:30 pm, Busboys & Poets, Cullen Rm, 5th & K St (1025 5th St NW); tickets available at the OHS booth.

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Mon, Oct 31

Mon, Oct 31, 10:30 am to 12 noon:
Critical Histories of Community Health Centers (Session 3177.0, WCC 101)

10:30 am
Moderator. Sarah Ramirez
• I will moderate this panel, introduce the speakers, and facilitate a discussion about the history of community health centers and their relationship to social movements, social justice, and the health of communities. Community health centers affirm that an access to health care and the opportunity to enjoy good health are basic human rights. Some of the questions that may be addressed by the panel include: How are the histories of Community Health Centers (CHCs) and social movements related? What have been the benefits and/or consequences of CHCs for promoting equity, justice, and reducing health disparities? How might these historical lessons inform the work of CHCs today and in the future?

10:35 am
Serving an Expanding Community: How a free HIV Clinic Transformed into a full Community Health Center. P. Justin Goforth
• Starting with a discussion of the history and development of the Whitman-Walker Health center in Washington, D.C., this talk will explore how a free HIV clinic, founded in the 1980s in response to the AIDS epidemic, transformed over the course of several decades into a full Community Health Center. More generally, the talk will address the relationship between HIV/AIDS activism, along the lines of Queer Nation and ACT UP, and the creation of community health programs to serve, first, sexual minorities, and later, a wider cross-section of underserved urban populations. The speaker will draw both from his professional experience as Director of the Medical Adherence Unit, Community Health Division, Gay Men's Health and Wellness Clinic, at the Whitman-Walker Health center, and his personal experience as a HIV+ openly gay man who has worked in HIV prevention and treatment for over 20 years.

10:55 am
A Matter of Principle: Community Health Centers and Health Care as a Right. Fitzhugh Mullan, MD
• The Community Health Center of the latter 20th century was born of the War on Poverty, an offspring of the Civil Rights movement. The first centers and the law that governed them represented an enormous departure for the federal government. CHCs leapfrogged states and – then as now – authorized grants directly from the federal government to community organizations to operate centers. This was a purposeful political reaction to the failures of states (particularly Southern ones) in providing services to their citizens and a purposeful national effort to make care available to people who could not buy into the predominant private system of the time. The advent of CHCs made health care a right in practice – if not in name – for many Americans.

Those first few CHCs (then called Neighborhood Health Centers) have grown to a national web of more than 1000 centers serving 18 million people. The CHC story has been one of steady growth but constant struggle. Creating pressure to grow the movement, battling the vicissitudes of the economy, working in an environment of public ambivalence about health care as a right have made the success of the health center movement to date hard to predict and an extraordinary accomplishment.

This presentation will explore the future. Will health care reform cement the accomplishments of CHCs as a cornerstone of health care as a right in America or will a business model of care delivery fracture the 50 year old movement?

11:15 am
Young Lords and the Struggle for Racial Justice and Public Health in New York. Johanna Fernandez, PhD.
• While social scientists understand the movements built by people of color in the 60s within the framework of civil and political rights, narrowly defined, deeper study reveals the range of social problems with which these movements were concerned. Focusing on the activism of the Young Lords in NY, the Puerto Rican counterpart to the Black Panthers, this talk explores 1) how the nation's postwar racial economy created a crisis in public health for urban dwellers and 2) the forces that propelled the Young Lords (and by extension the Black Panthers) to orient so much of its work around issues of Public Health. For ex, in 1973, the American Journal of Public Health credited Young Lord activism for the passage of NY's anti-lead poisoning legislation, and in 1970, the Young Lords' 12-hour occupation of Lincoln Hospital in the Bronx dramatized the healthcare crisis in poor black and Latino communities; challenged the advent of privatization policies in the public sector, and led to the creation of one of the principle acupuncture drug treatment centers in the western world. This talk will ANALYZE 1) the postwar demographic, social and economic forces that made health such an important feature of activism in northern cities in the 60s 2) the coalitions that radical Puerto Rican and African American activists built alongside healthcare staff in the run-up to the takeover of Lincoln Hospital 3) the relevance of this history, and the relationship between racial justice and the struggle for public health in the Sixties and today.

11:35 am
Question & answer period

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Mon, Oct 31, 2:30 pm to 4:00 pm:
Discrimination, Health, and the Politics of Public Health Data: New Evidence, Broad Perspectives (Session 3378.0, WCC 101)

2:30 pm
Introduction to: “Discrimination, Health, and the Politics of Public Health Data: New Evidence, Broad Perspectives.” Vanessa Simonds, MS, ScD.
• Introduction of speakers and session, which will critically examine the many ways that community and individual health is harmed by discrimination - of multiple types, at multiple levels, and across both the lifecourse and multiple generations, via multiple pathways.

2:35 pm
Racial Discrimination and Health: My Body, My Story – As Told by Explicit and Implicit Measures of Exposure, in Context. Nancy Krieger, PhD, Pamela D. Waterman, MPH, Anna Kosheleva, MS, Jarvis Chen, ScD, Elmer Freeman, MSW, Dana Carney, PhD, Kevin W. Smith, MA, Gary Bennett, PhD, David R. Williams, PhD, MPH, Beverley Russell, PhD, Gisele Thornhill, MD, MPH, Kristin Mikowlowsky, BA, Rachel Rifkin, MPH, Latrice Samuel, BA.
• To date, most research on racial discrimination and health has relied on self-report exposure data – which necessarily reflect only what people are willing and/or able to say, and thus may not capture the health impact of internalizing racial discrimination. Building on our pilot work with the Implicit Association Test (IAT) to measure exposure to racial discrimination, we used the IAT along with two explicit self-report measures (“Experiences of Discrimination” [EOD]; “Everyday Discrimination Scale” [EDS]), in our newly established study: My Body, My Story. Participants include 526 self-identified US-born black non-Hispanic Americans and 509 self-identified US-born white non-Hispanic Americans, age 35-64, who at the time of recruitment (August 2008 – December 2010) were members of diverse community health centers in Boston, MA. Among the 1229 eligible members reached, 94% agreed to participate (black: 97%; white: 91%), of whom the majority were women, had a high school but not college degree, and had household incomes below $48,000/year. Among the black and white participants, self-reported exposure respectively equaled: (a) for 3+ situations of racial discrimination (ever), 64% and 18% (EOD), and (b) for unfair treatment based on race/ethnicity (in last year), 19% and 4% (EDS). In this presentation, we examine: (1) the distribution of the explicit and implicit measures of discrimination in relation to race/ethnicity, socioeconomic position, gender, age, and both explicit and implicit measures of racial identity, (2) the association of the discrimination measures with each other and with selected chronic disease health outcomes, and (3) interaction effects among the measures.

2:55 pm
“My Heart Has Been Strengthened by Having to Go Take This Journey”: Embodiment of Historical Trauma and Microagression Distress among American Indians and Alaska Natives. Karina L. Walters, PhD.
• American Indian community discourse suggests that historical trauma as well as contemporary microaggression distress can potentially become embodied in health outcomes and health risk behaviors and that these factors may play a significant role in present-day health inequities. Historical trauma, which consists of traumatic events targeting a community that cause catastrophic upheaval, and microaggressive events, which consist of environmental and interpersonal denigrating and discriminatory message, have been posited by Native communities to have pernicious intergenerational effects through a myriad of mechanisms from biological to behavioral. Consistent with contemporary societal determinants of health approaches, the impact of historical trauma and microaggression distress calls upon researchers to explicitly examine theoretically and empirically how these processes become embodied and identify how these factors affect the magnitude and distribution of health inequities. This presentation describes how historical trauma and microaggression discrimination distress impact indigenous embodiment of health based on the findings from the national 6-site HONOR project study (N=447). Preliminary results indicate that historical trauma over generations may impact mental health in the current generation; and, that different types of historically traumatic events may produce different mental health symptom expression (e.g., depression vs. PTSD). Finally, findings also suggest that historical trauma loss and discrimination distress may be risk factors for embodiment of physical pain and health risk behaviors. Moreover, positive Native identity attitudes played an integral role in buffering the impact of discrimination on health risk behaviors and outcomes. Decolonizing public health practice implications for American Indian and Alaska Native communities will be highlighted.

3:15 pm
Structural Racism and the Architecture of Health. Makani Themba-Nixon.
• Discrimination in health is only a symptom of a much larger web of systems that intersect to create patterns and policies of bias – and privilege. This presentation will explore frameworks for analyzing and surfacing these historic patterns in health systems, including health education, research, service delivery and financing, and explore how structural racism has been a primary force in creating and maintaining the health systems we have today.

3:35 pm
Question & answer period

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Mon, Oct 31, 4:30 pm to 6:00 pm:
Power, Politics, and Healthy Communities in Societal & Ecologic Context: From History and Evidence to Transformative Knowledge for Action (Session 3455.0, WCC Salon I)

4:30
Introduction to "Power, Politics, and Health Communities in Societal & Ecologic Context: From History and Evidence to Transformative Knowledge for Action". Nancy Krieger, PhD.
• The introduction will introduce and frame the objectives of the session, which are: (1) to provide critical examination of issues of social justice and public health as they pertain to the conditions – from global to local – that enable healthy communities to flourish versus block their development, and (2) to so in relation to the 3 foci of our Spirit of 1848 Caucus: the social history of public health, the politics of public health data, and progressive pedagogy for public health.

4:35
Impact of Corporations on Community Health: Disease Promotion and Its Remedies. Nicholas Freudenberg, DrPH.
• In the 21st century, the business and political practices of corporations have become a dominant social determinant of health. This session describes some of the pathways by which the global, national and local practices of corporations influence health and health inequalities at the community level. Through business practices such as product design, advertising, retailing and pricing and political practices such as lobbying, campaign contributions, and public relations corporations and their allies influence lifestyles, living conditions and social and physical environments. These in turn determine the prevalence and distribution of illness and health. In recent decades, public health professionals, community organizations, some public officials, and social movement have mobilized to confront the health damaging practices of the alcohol, automobile, food and beverage, firearms, pharmaceutical, tobacco and other industries. For example, activists have forced tobacco companies to withdraw products targeted at African Americans, drug companies to lower prices of needed medications, fast food companies to re-formulate their products, and automakers to improve safety and pollution control. At the same time, however, multinational companies have dominated trade agreements, resisted more effective public health regulation and moved marketing of their most dangerous products to poor communities and nations, thus exacerbating health inequalities. By analyzing the accomplishments, limitation and challenges of these initiatives, public health professionals can identify new approaches to improving population health.

4:55
Growing Smarter: Achieving Healthy and Sustainable Communities Through Environmental Justice. Robert Bullard, PhD.
• The Environmental Justice Movement in the U.S. has always emphasized prevention and precaution—taking on issues ranging from smart growth, transportation equity, food security, parks and green access, green jobs and green careers, clean and renewable energy, and climate justice. Communities that ensure access to quality services, that are designed to promote good physical and psychological well being, and that are protective of the natural and physical environment, are essential for health equity. Healthy places and healthy people are highly correlated. More than 100 studies now link racism to worse health and more than 200 environmental studies have shown race and class disparities. The poorest of the poor have the worst health and live in the most degraded environments. Race maps closely with pollution, vulnerability, and poor health. People of color make up the majority (56%) of those living in neighborhoods within two miles of the nation's commercial hazardous waste facilities, over two-thirds (69%) in neighborhoods with clustered facilities. African Americans in 19 states, Latinos in 12 states, and Asians in 7 states were more than twice as likely as whites to live in neighborhoods where pollution poses the greatest health danger. People of color bear more than half of the human health impacts from the top toxic air releases from the top ten companies on the nation's “Toxic 100 Industrial Polluters.” Environmental justice groups are working with government officials, planners, policy makers, and other practitioners to reshape the built environment to improve individual and community health outcomes.

5:15
Taking Action to Build Health Equity. Barbara Ferrer, PhD, MPH, MED.
• Although we have made significant progress improving the health status for many Boston residents, there are groups of people who have not benefitted equally from our progress and who bear a severe and disproportionate burden of diseases. To tackle this imbalance, the Boston Public Health Commission has developed a framework for organizing our work that addresses the interpersonal, community, and societal influences of disease transmission and health, paying particular attention to how racism and poverty limit opportunity for many to make healthy choices.
Our work is organized under three principles: 1. We are data-driven and responsible for collecting, analyzing, and reporting information that explains inequities in health. This information is used to guide programming, resource allocation and advocacy, and allows us to advance the health of our communities by eliminating persistent racial inequities in health. 2. Our work supports and builds community capacity to lead and engage in efforts to eliminate inequities. The voices of our clients and residents must be central to the design and implementation of programming and policy development. 3. Building strategic partnerships to address root causes/social determinants of health inequities is a priority and requires collaboration with a diverse group of organizations in order to identify and adopt policies that promote health equity. Strategies for organizing our work differently involve an investment in education and training for residents and employees; mobilizing to promote policies, regulations and laws that promote social justice and racial/economic equity; retooling programming to support transformative learning and empowerment; and benchmarking progress.

5:35
Question & answer period

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Tues, Nov 1:

Tues, Nov 1, 8:30 am to 10:00 am:
A Social Justice Perspective on Teaching and Capacity Building to Promote the Health of Communities (Session 4073.0, WCC 101)

8:30 am
Introduce session and speakers. Cheryl Merzel, DrPH, MPH.
• The purpose of the introduction is to open the session and share information about the speakers.

8:35 am
THRIVE: A Toolkit for Community-Led Initiatives to Address Health Equity. Xavier Morales, PhD, Rachel Davis, MSW, Melissa Cannon, BS.
• Using Freireian approach to educating communities for self-advocacy, the Tool for Health and Resilience in Vulnerable Environments (THRIVE) seeks to enable the raising of community consciousness of their critical role in addressing social determinants of health. The original THRIVE tool was developed with funding from the Office of Minority Health (HHS) between 2002 and 2004. The tool was successfully piloted in an urban, suburban and rural setting between 2004 and 2007. In 2010, a partnership between the National Network for Public Health Institutes and Prevention Institute received additional support from OMH to update the tool, develop a training for health practitioners to coach communities across the nation in locally led efforts to address the social determinants of health, and also to update the toolkit that is available on-line. A focus of THRIVE II is to develop appropriate training methods that build on the diverse strengths of communities across the nation. Attendees will be presented with the work to date, lessons learned, and how these learnings have been incorporated into THRIVE II. Results from THRIVE I and the first training sessions from THRIVE II will be shared as well as the plan for increasing community focused dissemination of project results and tools for local use.

8:55 am
From Building Capacity to Building Power: Lessons for Public Health Pedagogy. Makani Themba Nixon, Cheryl Grills, PhD.
• The very idea of capacity building, though often necessary and important, is a bit presumptuous. We work with people, with communities to draw out their assets and expand upon them – if we do it well – in order to help them gain greater power and agency over the institutions and systems that affect their lives. This session explores a model developed through the work of Communities Creating Healthy Environments (CCHE), a capacity building initiative that supports community organizing and policy advocacy to address childhood obesity in 22 communities and indigenous nations nationwide. It's unique, community-led policy development process; focus on grassroots organizing; and culturally competent capacity building is part of a shift in practice from focusing on organizational development and support toward a more expansive orientation toward movement building. This session will explore emerging lessons from this multi level collaboration that, from application process to evaluation, has sought to forge a collaborative “action space” where everyone is both teacher and learner accountable to each other as agents of change.

9:15 am
Paradox of Public Health and Social Justice: Being a Professional in the Social Change Process. David Chavis, PhD.
• The social determinants of health are rising to the top of the agenda in public health and other fields. Research has been demonstrating that factors like poverty, discrimination, poor education, powerless, access to healthy food and facilities, access to health care, and other social justice issues have the greatest effect on health. There are two paradoxes this challenge raise. First, public health professionals (and others) generally work in risk adverse institutions such as government, foundations, academe, and funder depended non-profits. There are few rewards, and frequent resistance to actual social change. Conflict, a critical component of change, is denied as an option. The second paradox is that unlike many other social movements, the need for scientific knowledge is substantial in health justice work, yet public health and other professionals see their knowledge and the status it gives them as disempowering. The need for knowledge in health justice gives greater power to public health professionals who are uncomfortable with (or often opposed) to having the authority in their work with disenfranchised groups. This blanket position that "the community knows best" frequently unnecessarily puts communities in the position of having "to re-invent the wheel. Many professionals see the same mistakes made over and over again, but find comfort in knowing it was a community decision. These paradoxes will need to be addressed if public health is to be a major force in promoting social justice. Some ideas and examples for how this may be better addressed in the future will be presented.

9:35 am
Question & answer period

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Tues, Nov 1, 12:30 pm to 1:30 pm:
Social Justice & Public Health: Student Posters (Session 4172.0, WCC Exhibit Hall 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.

Board #1
Society, Justice, and Health: A Student-Initiated Course. Wellington Davies, MBA, Ameth Aguirre, MD, Jean Bae, JD, Katie-Sue Derejko, MA.
• What does health justice require? Does it require economic equality? Does it require extensive social connectedness? Does it require more citizen participation in the political process? Does it even require a certain type of citizen – informed and morally engaged? To answer these questions one needs to examine literature concerning economic development, democratic theory, the social determinants of population health, and philosophical literature on population health ethics. This graduate student-led, faculty advised reading group will approach this complex task with the help of insights gained in core MPH courses, supplementary coursework in graduate microeconomics, and an interdisciplinary course reading list of significant breadth. A close inspection of syllabi of other graduate courses with similar objectives reveals several recurrent themes. Some seek more disciplinary depth, often through greater engagement with primary source material in political philosophy. Others strive for less depth and a broader scope, perhaps including bioethical issues. A small contingent stresses service learning, usually at the expense of a critical examination of the moral underpinnings of this collective action. In contrast, this course aims for a broad survey of political philosophy and the social sciences, especially economics, while using praxis as an essential learning tool. As we analyze historical and current accounts of policy agenda setting, institutional reform, and social action we will seek constant engagement with an overarching question of what is the role of global health professionals in implementing health justice.

Board #2
Healthy Habitats and Gentrification in New York City (1990 to present). Jocelyn Apicello, MPH.
• Public health, as well as housing and community development, practitioners and policy makers have long recognized that where we live matters for our health. The urban habitat, defined as the natural, built, social and cultural environments of an individual or population where they live out their daily lives, shapes our living patterns and influences health and quality of life. As communities change due to processes of gentrification, urban habitats and their health-related features consequently change. Using repeated cross-sectional data from the New York City Housing and Vacancy Survey and other publicly available datasets, this research (1) identifies characteristics of the urban habitat (i.e., housing and neighborhood context) which plausibly influence health; (2) constructs a healthy habitat index to classify the health of the habitat; (3) reveals how characteristics of the habitat related to gentrification have changed in New York City neighborhoods since 1990; and (4) describes habitat and gentrification-related changes in health inequalities and other health indicators and outcomes. Results displayed both quantitatively and spatially paint a comprehensive picture of how the contextual effects of the habitat influence the health of residents, entire communities and vulnerable subpopulations, highlighting the intersection between social justice and public health from a methodological perspective. Findings directly address measurable and targetable health-related features of housing and neighborhood, place-based health outcomes and consequences of urban development and neighborhood change.

Board #3
Access to Ambulatory Care According to Type of Health Insurance and Income in Chile, 2009. Maria Martinez-Gutierrez, MD, MPH, PhD Student.
• Introduction: Given the structure of the Chilean Healthcare System, Chileans can be sorted at least into four distinct groups: publicly insured/low-income, publicly insured/middle-income, privately insured/middle-income and privately insured/high-income.
Hypotheses: (1) middle class privately insured groups will have worse access to preventive services than privately insured high income and all other publicly insured groups regardless of income after controlling for all other relevant variables because of higher co-pays and a scantly regulated delivery system (2) a higher income and being privately insured significantly predicts better access to specialty visits.
Methods: Using the CASEN 2009 database, fixed and random effects models were used controlling for clustering at the municipality level.
Results: There was no significant difference in access to health check-ups between low-income publicly insured individuals and middle-income privately insured individuals. Being privately insured was associated with a higher probability of having a pap smear in the last three years compared to low and middle-income publicly insured groups. Specialty visits showed the predicted relationship between income/insurance groups and utilization.
Conclusion: The results for access to a pap smear did not support our hypothesis however in terms of health check-ups at least, low-income groups get the same access as middle income privately insured groups, a fact that can be explained by some features of the Chilean public healthcare delivery system. A better set of measures of preventive care would be needed to explore differential access to these services in the Chilean Health System.

Board #4
Healthy Communities Begin with Inclusion. Anjali Truitt, MPH, Megan Moriss, MSCCC.
• Health communities represent the health needs of all community groups. Disability has been ever-present in our communities and is becoming more evident, as veterans return from war, Baby Boomers age, and autism prevalence rises. Given these changing demographics, the purpose of this project is to describe practices that public health students and professionals can utilize to foster inclusion of people with disabilities in community health planning and policies. This project uses the Americans with Disabilities Act (ADA) of 1990 and Healthy People 2020 Disability and Health objectives as guidelines for promoting the health and access to quality healthcare services of people with disabilities. These texts express the interests of people with disabilities and health professionals committed to improving health outcomes. By analyzing these, the project assessed areas of commonality between this law and the current public health agenda. The project identifies opportunities for public health professionals to address the needs of this underserved and marginalized group. The project's findings suggest several key areas for community-centered health planning and policy: 1) recognizing the diversity among those whom identify as people with disabilities and their health needs; 2) creating health information in multiple, alternative formats that goes beyond language translation; 3) advocating for physical and programmatic access to and participation in healthcare and community activities. These findings can be used as a toolkit for public health students and professionals to promote healthy minds and bodies, in a manner that better represents the needs and interests of people with disabilities.

Board #5
Privileged Discourses of Asthma Management Disparities. Robin Evans-Agnes, RN, MN, PhC.
• Background: Asthma management disparities (AMD) between African-American and White-American adolescents are an alarming and persistent threat to the health of the world's people. The way advantaged and disadvantaged groups write and talk about these disparities, their discourses, reveals important public health knowledge for a social justice critique of statewide and national asthma policies.
Purpose: A critical discourse analysis (CDA) of privileged AMD discourses within a Washington State planning process for asthma.
Aim 1: Describe the AMD discourses that are introduced, promoted, and/or minimized by public health leadership in the course of a statewide planning process.
Method/Research design: January - March 2011: 1) record and observe a State asthma planning meeting (n>17); 2) Observe the conclusion of an asthma Photovoice event produced by disadvantaged African American adolescents for public health leadership. Measures: audio-transcripts, meeting materials, and observations; procedures: participant-observation.
Analysis: This CDA will use linguistic and contextual analysis of texts and observations to identify how persons, events, actions, and arguments are introduced, promoted, or minimized between and amongst groups.
Results: As part of a larger study that also examines the discourses of the disadvantaged, this poster presentation will identify important discourses of asthma management disparities and illuminate which of these are introduced, promoted, or minimized by privileged public health leadership in Washington State.
Implications: CDA utilizing recorded texts and contextual observations from public health leadership meetings is an innovative and appropriate technology for policy analysis and social justice research .

Board #6
Human Trafficking and Health: Setting a New Public Health Agenda through a Gender Analysis. Natalia Linos, MS.
• Trafficking in persons is a global phenomenon that has received significant attention from human rights advocates, international organizations, and the media. Public health research has recently begun to examine the health impacts of trafficking, but has only examined the health needs of victims of sex trafficking. The lack of research on potential health outcomes associated with other forms of exploitation, including trafficking into domestic labor, construction, factory or agricultural work, may negatively impact the availability and quality of services for victims of such exploitation. A review of international reports and legal frameworks to combat trafficking reveals that both men and women, boys and girls, can be victims of human trafficking. Public health research to date, however, has only examined the needs of women and children who are the majority of victims trafficked into sex work. This gender analysis tries to reframe the discourse around trafficking in public health and calls on researchers to consider the different exposures and potential health outcomes faced by male and female victims of trafficking because of their gender and sex, separately and synergistically, as well as the power dynamics related to age, class, race, ethnicity, and religion, that make some women and some men more vulnerable to trafficking and poor health outcomes. The suggested framework emerging from this gender analysis hopes to inform future research as well as policies and programs for combating trafficking and serve the needs of victims.

Board #7
Understanding Neighborhood Contexts of the Obesity and Diabetes Epidemic in the Los Angeles Area. Stephanie Hsieh, ScM.
• Application of a neighborhoods perspective, in our efforts to address health disparities related to obesity and diabetes, compounds a complex set of challenges. Low SES neighborhoods have limited access recreation space, bear an unjust share of hazardous environmental exposures, and food access conspicuously lop-sided. Neighborhood opportunities for physical activity and food access are couched in a socio- political- and economic- system that concentrates the burden of this injustice on minority populations. These complex dynamics have coalesced into the simultaneous public health challenges of obesity and diabetes, borne disproportionately by the working class and by people of color. For this presentation, I will outline some aspects of the social and political context for understanding Latino/a health in the Los Angeles area, including relevant historical dimensions. I will also describe the methods of a new study that applies an interdisciplinary approach to understanding how local food environments and ultimately become embodied in the health and wellness of Hispanic youth in the L.A. area. This secondary data analysis will add geocoded data participant data from the USC Childhood Obesity Research Center (CORC) and layer them onto an existing built environments database for analysis. Results will produce a portrait of how residents imbibe the risks and benefits associated with differences in food access and opportunities for physical activity of their respective neighborhoods. Significant results could be powerful evidence for a more active public health role in creating and maintaining a healthy and just food system, and for neighborhoods that promote active living.

Board #8
Incarceration as a Social Determinant of Health: A Conceptual Framework for Considering the Health of Minority Communities in the United States. Zinzi Bailey, MSPH.
• Background: The incarceration rate in the United States is the highest in the world, increasing nearly 400% since 1980. This marked increase and the creation of what critics call the "prison-industrial complex" stems directly from policy measures enacted in the 1970s and 1980s. Like most social phenomena, these mass incarceration rates are socially patterned by both race and class.
Methods: This paper proposes a multilevel, life course conceptual framework for considering incarceration as a social determinant of health in minority communities.
Results: With one in 21 African American men and one in 279 African American women currently incarcerated and almost one-third of African American men incarcerated at least once in their lifetime, incarceration must be considered when evaluating the health of African American populations, specifically, and racial health disparities, in general.
Discussion: Racialized and class-based distortions in the definitions of crime have affected the patterns of disease distribution. Furthermore, given residential segregation in the United States, mass incarceration arguably has compounded social and health disadvantage in already disadvantaged populations. Incarceration policies in the United States should be re-evaluated and attention should be paid to the intersection of "incarceration status" with other minority social statuses as it relates to population health.

Tues, Nov 1, 6:30 pm to 8:00 pm:
Spirit of 1848 Caucus Business Meeting (Session 345.0, WCC 141)
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!

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