APHA 2015: “Health in All Policies”

Editors note: We are delighted to host a guest contributor blog from Abby Schachter, who was a recipient of a HPSA scholarship to attend the APHA meeting this month. She shares her experiences at the conference below. Thanks, Abby!

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Last week, I attended the American Public Health Association (APHA) Annual Meeting in Chicago. It was a whirlwind event with 13,000 attendees and hundreds of panels, poster sessions, and film screenings. It was difficult to choose which of the dozens of interesting presentations to attend during any given session! The sessions I did attend exemplified the theme of this year’s meeting, Health in All Policies.

Health in All Policies is “an approach to public policies that systematically takes into account health and health systems implications of decisions, seeks synergies and avoids harmful health, in order to improve population health and health equity” (WHO). The opening general session began with a keynote address by U.S. Surgeon General Vivek Murthy, who coupled humorous remarks (e.g., “Keep an eye out for my upcoming report, ‘Why physical activity is overrated’”) with an earnest plea for each of us to begin valuing each other as much as we value ourselves when it comes to protecting and promoting health.

 The author (back row, far right, in teal) with other students from the University of Michigan School of Public Health at the conference.

The author (back row, far right, in teal) with other students from the University of Michigan School of Public Health at the conference.

In a clear manifestation of the conference theme, two of the other keynote speakers were not public health professionals at all: Actor and environmentalist Ed Begley Jr. spoke about how he has long advocated for environmental protection due to the inextricable relationships among the natural and built and environments and human health, and renowned educator Dr. Freeman Hrabowski, president of the University of Maryland, Baltimore County, gave a rousing address that exemplified the importance of higher education to foster curious minds, a healthy population, and an equitable society. 

I attended many panel sessions focused on food access and food security, which together highlighted the flip side of the conference theme: not only should all public policies consider health impact, but many different policies also affect any given health issue. A few examples…

  • One speaker presented an impact analysis of the “Healthy Happy Meals” bill proposed in New York City on the nutritional content of children’s fast food meals.
  • Several presenters focused on how food marketing and labeling can inform or deceive customers when it comes to nutritional quality, and how regulations can guide these practices toward improving consumers’ food choices.
  • A talk on food industry donations to academic and health institutions emphasized how requiring disclosures of conflicts of interest can enhance public accountability and trust.
  • Multiple speakers spoke of recent efforts to improve food access through urban agriculture and farmers markets, and the challenges they have faced with land use policies and zoning restrictions.
  • One panelist talked about how lax antitrust laws have resulted in only a handful of big food companies acquiring many brands, creating an “illusion of choice” when it comes to the grocery store.
  • A researcher demonstrated how monthly SNAP (i.e. food stamps) payments lead to cyclical patterns of food insecurity and called for alternate disbursement schedules to eliminate this “SNAP cycle.”

These presentations demonstrate how policies across a wide range of domains can have tremendous impact on food systems, food security, industry, and nutritional quality of the American diet.

 The view from the conference's main hall with busy exhibits at APHA 2015.

The view from the conference's main hall with busy exhibits at APHA 2015.

One of the last panels I attended addressed how the policymaking process relates to another timely topic: vaccinations. Dr. Ross Silverman from Indiana University spoke about the state policy creation process for determining allowable exemptions to required vaccinations. He noted that these decisions are purely political; that is, while medical exemptions are standard, states are not required to allow for religious or “personal belief” exemptions. As we have seen with the Disneyland measles outbreak, these policies are consequential; states with personal belief exemptions have roughly 2.5 times as many opt-outs than states with only religious exemptions. Given the politically charged debates surrounding vaccinations, some states have gone through regulatory rather than legislative processes to eliminate personal belief exemptions in order to strengthen protections against vaccine-preventable diseases.

The APHA Annual Meeting was overwhelming, enlightening, and inspiring. It was reaffirming to be in a place with so many professionals from varied disciplines who are working together toward the same goal, echoing APHA’s mission to make America “the healthiest nation in one generation.” Thank you to the Health Policy Student Association for their support of my attendance to the conference.

By: Abby Schachter, MPH Candidate, University of Michigan School of Public Health, Department of Health Behavior and Health Education