Student Reflection: SOPHE 2023 Advocacy Summit

In October, I attended Society for Public Health Education’s 2023 Advocacy Summit to present on my experience as a Health Policy Ambassador. Together with other Ambassadors from the 2022-2023 cohort, I developed a poster and discussed the structure of the program, our projects, and some of the benefits and challenges of this unique, community-engaged program. I decided to attend not only showcase the HPA program in the poster presentation portion, but to learn more about advocacy in health policy, including approaches to stakeholder engagement, policy development, and community engagement.

This was the first national conference I have ever attended. With that, I was a bit nervous and unsure what to expect, especially since I wanted to make the most of my time there. However, I was definitely expecting the Summit to be very busy with presentations by public health practitioners working in health policy, along with interesting keynotes related to this year’s theme of voting. I was also very excited for special events related to being in Washington, D.C., such as being on the Hill.

I benefitted from the conference in many ways. First, I got some interesting ideas of how to tackle issues related to some of our projects with Health Policy Ambassadors, particularly about assessing stakeholder engagements. My poster presentation was very well received, and many attendees were interested in establishing similar programs at their institutions. Personally, I enjoyed traveling to Washington, D.C., and I learned a bit more about navigating professional spheres. Additionally, this was the first time I did legislative visits, and I visited the offices of Senators Tommy Tuberville and Katie Britt as well as Representative Terri Sewell. It was fascinating but challenging to work in the Capitol environment, and I think I can bring that to potentially working with policymakers at the state/local level.

One of my favorite presentations that I attended featured Lieutenant Janesia Robbs in the U.S. Public Health Service. She spoke to the audience about stakeholder engagement. She went very in depth about what stakeholder engagement is and is not, including how to work with key stakeholders who may have missions that go against yours. Though I’ve had some basic experience with this concept, this presentation was very enlightening for me. The presentation touched on general principles of stakeholder engagement, as well as many of the smaller details that she believes needs to be done before, during, and after stakeholder engagement. Stakeholders may or may not hold the same mission or vision as your group, so sharing your general goals may help focus your meeting to get the most out of your time and narrow down your scope. I found this very helpful for our work with Health Policy Ambassadors, as we sometimes have limited time to get extremely important information from or share an ask with a government official, community member, and so on.

If you are interested in advocacy and health policy, I would recommend SOPHE’s Advocacy Summit – especially if it is your first national conference. To prepare, I would plan to network, and I would also reflect on your own experiences with health policy and think about what you would like to gain from the conference, particularly in terms of policy advocacy. I would also think about what to do in exciting cities like Washington, D.C.! I was shocked by both the beauty of D.C. as well as the amount of action in the city, especially when I walked down one street and saw the White House, visited a Smithsonian Museum, saw the US Department of Justice, US Environmental Protection Agency, and the US Capitol. I also got to kayak on the Wharf and eat at some local restaurants. Overall, it was a great trip, both professionally and personally!

 

Kevin Joseph participated in the HPA program in the 2022-2023 academic year, and is currently participating again. Co-authors on his presentation include his fellow Erik Angus, Ritika Samant, Mikayla Rigsby, and the program’s director, Sean McMahon. Kevin utilized the LHC’s Health and Policy Conference Travel Scholarship to attend the SOPHE Advocacy Summit.

Student Submission: Ocular Trauma and Nonpowder Firearms

August 11, 2023 | Ayaka Fujihashi, Medical Student

 

Amidst the political climate on gun control and gun safety, there is another aspect of public safety that is often overlooked: nonpowder guns. Firearms such as BB guns, airsoft guns, and paintball guns. These guns differ from their powdered counterparts in their mechanisms. Nonpowder firearms use plastic or pellet bullets, and, instead of relying on the high pressures created from chemical reactions using powder, nonpowder guns utilize springs, compressed air, or CO2 to send their projectiles flying. Nonpowder firearms are often seen as toys, with marketing campaigns specifically targeting male children. Yet, these devices are deceptively dangerous.

Between 1990 and 2016, roughly 360,000 cases of nonpowder firearm related injuries were treated in emergency departments, which equates to about 13,500 cases annually.1 Most injuries occur in children between 6 and 12 years old, and 87% occur in boys. The majority of the injuries occur in the head and neck region, and many injuries specifically involve the eye. Of the total, 16% suffered an open injury to the eye. 3.5% were left with legal blindness—defined as visual acuity of 20/200 or less in the better eye with correction—and 11.1% were left with visual defects.2

While accidents do happen, 98% of these ocular injuries occur without eye protection and could have been prevented.1  Currently, there are no federal law regulations on the use, possession, or transfer of nonpowder firearms. Because these forms of firearms are considered a consumer product, the regulating body would be the Consumer Product Safety Commission (CPSC), but it has not adopted any specific regulations. Some states have laws limiting the possession, use, or sales to minors, but there are no laws at any government level mandating the use of eyewear protection.

The American Academy of Pediatrics and American Academy of Ophthalmology issued a joint statement recommending the use of protective eyewear for all participants in sports in which there is a risk of eye injury. Nonpowder firearms were categorized in the “high risk” category, meaning an increased risk of the eye being impacted with sufficient energy to cause injury.3

However, statements of recommendation with no actionable authority can only go so far. In order to help reduce needless injuries, legislation on the state/federal level is necessary. While these laws may be difficult to enforce, especially considering that many of these injuries occur in private homes, laws could provide a motivator for proper safety. The implementation of such a change can bring about awareness on the importance of eye protection, be the instigator of changes in social norms, and create a culture of social responsibility.

Ocular trauma is the leading cause of monocular blindness in the United States. But it doesn’t have to be. Well written legislation addressing this could be the difference between full, binocular vision or a life of permanent disability.

 

References:

  1. Lee R, Fredrick D. Pediatric eye injuries due to nonpowder guns in the United States, 2002-2012. J Am Assoc Pediatr Ophthalmol Strabismus. 2015;19(2):163-168.e1. doi:10.1016/j.jaapos.2015.01.010
  2. Jones M, Kistamgari S, Smith GA. Nonpowder Firearm Injuries to Children Treated in Emergency Departments. Pediatrics. 2019;144(6):e20192739. doi:10.1542/peds.2019-2739
  3. Protective eye wear for young athletes. A joint statement of the American Academy of Pediatrics and the American Academy of Ophthalmology. Ophthalmology. 1996;103(8):1325-1328.

Student Submission: Throwing Away Free Money

August 11, 2023 | Akshay Aluri, Medical Student

 

Do you like free money?

Everyone seems to except Alabama state legislators. In 2010, the Affordable Care Act expanded Medicaid to cover nearly all adults up to 138% of the Federal Poverty Line. As of today, Alabama remains one of only ten states that has refused to expand Medicaid to provide, per the Kaiser Family Foundation, 350,000 citizens access to healthcare. Recently, the Republican-led North Carolina state legislature came to an agreement with the governor to expand Medicaid by levying a small tax on big hospitals. One of the reasons behind North Carolina’s tentative Medicaid expansion was the dismal state of its rural hospitals and the extra financial incentive from the federal government.

The situation of rural hospitals in Alabama is, if anything, a great deal worse than the one that North Carolina is dealing with. The Alabama Hospital Association has reported that a dozen rural hospitals in our state are on the verge of immediate shutdown. While these hospitals have faced issues for years, the pandemic resulted in record losses of $1.5 billion since 2020–greater than any other state in the country–and their closure would have a deleterious impact on the health of our rural population by forcing them to drive farther to see a doctor. In addition to meeting the healthcare needs of 250,000 Alabamans, the expansion of Medicaid would provide much-needed relief to prevent these hospitals from shutting down. Furthermore, The Kaiser Family Foundation found that Medicaid expansion, in addition to bolstering rural hospitals, would decrease the share of our uninsured populations and, from a physician’s point of view, ensure a decline in uncompensated care.

While the prospect of our rural hospitals shutting down may seem terrifying to ordinary Alabamans, our state legislators and governor continue to insist that Alabama lacks the money to expand Medicaid. It is time to dispel this myth. If our state chooses to expand Medicaid, according to the ACA, the federal government would cover 90% of the costs for the expanded Medicaid coverage. But the incentive to expand Medicaid increased substantially in 2021 when President Biden signed The American Rescue Plan. The ARP offers every state willing to expand Medicaid a “signing bonus” and the additional funds–amounting to nearly a billion dollars per Jane Adams, the former Executive Director of Cover Alabama, a coalition of organizations supporting Medicaid Expansion–would pay for the cost of the expansion for nearly the first five years. Currently, 10% of Alabama’s population is uninsured and the Medicaid expansion would reduce that number substantially. It would allow for patients to get screened for heart disease, cancer, and diabetes early and get treatment for their chronic medical conditions. According to a study from University of California-Davis, the states that expanded Medicaid saw a decline in annual mortality among their most vulnerable populations.

For all the reasons listed above, it is high time that the politicians in Montgomery do right by our poorest citizens and expand Medicaid. It makes economic and moral sense to do so.

Student Reflections from APHA 2022

The mission of the Lister Hill Center for Health Policy (LHC) is to connect and support those seeking to improve health outcomes through policy. A key aim in achieving pursuing our mission is to empower students to affect policy change. We support students’ growth in public health policy and advocacy through our Health Policy Ambassadors program, internship opportunities, and resources available to all UAB students. We have also collaborated with the Sparkman Center for Global Health on the annual Global Health Case Competition, connected students with community partners, and hosted MPH internships. In 2022, thanks to the initiative of a group of four students, we supported four students in attending the American Public Health Association’s annual meeting in Boston, Massachusetts.

The American Public Health Association hosts its Annual Meeting and Expo (APHA) in late October or early November each year. This is an opportunity for over 12,000 public health professionals – clinical researchers, health officers, lawyers, academics, and so many more – to engage with and learn from one another. Hundreds of concurrent sessions over four days feature the latest developments on programs, policies, commentaries, interventions, and research in public health. Four students who had participated in LHC programs decided to submit two abstracts to the conference organizers. Both were accepted!

Four Exceptional Students

From left to right: Banks Stamp, Emma Kate Sellers, Katie Lovelady, and Sarah Van Winkle

Students who participated in last year’s Global Health Case Competition and Health Policy Ambassadors cohort submitted abstracts to APHA in the spring semester. These students include:

  • Katie Lovelady, an undergraduate Industrial Distribution major;
  • Emma Kate Sellers, who graduated in the fall with her MPH;
  • Banks Stamp, an Accelerated Bachelor’s/Master’s student pursuing an MPA; and
  • Sarah Van Winkle, an undergraduate Physics major.

The 2022 Global Health Case Competition tasked participants with addressing the health needs of Maasai elders in southwestern Kenya. The case was developed in close partnership with the Nashulai Maasai Conservancy, with the goal of generating innovative solutions to promote lung health, eye health, and cancer prevention. One group – comprised of Lovelady, Stamp, and Van Winkle – submitted their proposed intervention as an application to Clinton Global Initiative University, a program which supports college students in their commitment to change the world. Their proposal was accepted, and they have diligently worked with Conservancy leadership and UAB faculty to fine-tune their proposal for implementation. This team participated in the roundtable “Promoting Education and Awareness Across the Cancer Continuum.”

The Health Policy Ambassadors program pairs interdisciplinary teams of students with Birmingham-area community partners to identify and address policy issues. Sellers, Stamp, and Van Winkle participated in the 2021-2022 cohort on three separate teams and decided to share their experiences in the program at APHA. The objective of the presentation was to encourage other public health programs to adopt similar strategies to promote engagement in advocacy among public health professionals. This group presented in the “Student Training and Public Health Workforce Development” poster session. All four students were asked to reflect on their experience at APHA. General themes from these reflections are outlined below.

Project and Professional Development

When asked why they decided to go through with attending the conference, each noted the potential benefit to the projects they were presenting. The Conservancy group sought to learn from experts in cancer prevention and global health. “I knew I needed to learn from experts on how to successfully collaborate with international partners on a joint program,” recalled Van Winkle. “Because we were able to present to national global health leaders, our team was able to refine our plan and build a more successful program.” The Ambassadors group also sought to learn from public health experts engaged in advocacy, with an additional goal to encourage other academic public health programs to engage students with advocacy. All four students were determined to use the conference to improve their work.

All four students noted that their professional skills and networks developed in addition to their projects. Sellers had presented other conferences before, but due to the pandemic those opportunities were virtual. For her, this “first opportunity to present a poster in person was a really great opportunity for personal and professional growth.” Stamp described taking full advantage of the opportunity to “practice skills in networking, public speaking, and communicating academic research to subject-matter experts and the public.” Indeed, all four students identified networking as a key benefit to attending the conference. Lovelady added that connections she made with industry professionals have already proven beneficial to her!

A Sense of Learning and Community

APHA showcases the broad scope of public health. In addition to attending their own sessions, students found they were able to learn from presenters in other sessions with topics unrelated to their own expertise. Sellers recalled attending her peers’ roundtable session, noting that it became a highlight for her. “I have not learned much about cancer or done any research on the topic, but I learned so much from the presentations and was able to relate the content to migrant health,” said Sellers. “I learned about cancer screening within specific migrant communities in NYC, a cancer education pilot program used for migrant farm workers in Oregon, and cancer caused by H. Pylori which mainly affects immigrants from East Asia.”

As a Physics major, Van Winkle worried she might not find people with similar interests or sessions that aligned with her academic background. However, she this worry “was quickly washed away” by the interdisciplinary nature of public health. Van Winkle recalled attending the “Innovations in Global Health Technology” session, saying it “stoked my growing passion for leveraging my background in physics and medical technology in my future career to create healthcare technology for resource-limited environments.”

“I was not expecting everyone to be so open to connecting and meeting new people,” recalls Lovelady. “Overall, the sense of community among the attendees was great.” Reflecting on the School of Public Health Alumni Reception, Stamp appreciated the “respect and spirit” that alumni hold for our school. Each student attended networking sessions and the 150th anniversary celebration. Sellers, the only public health student in the group, noted that she “gained a sense of unity within the public health workforce and felt rejuvenated and hopeful about public health upon returning home from the conference.”

4/4 Would Recommend

All four students said that they would encourage their peers to submit abstracts to APHA in the future. As Stamp puts it, “This experience is perfect for those who are determined in their mission, passionate about social impact, and desire to be active change-makers in our world!” Tips from these students for future presenters include practicing and reviewing your presentation/project, planning a schedule beforehand, taking breaks throughout the conference, and being open to connect with anyone you run into. APHA was a great benefit to these students, and we hope to support others in the future.

Student Submission: Reflections on SB 10

As a part of a weeklong course for Health Equity Scholars in April 2021, students in the UAB School of Medicine researched current health issues around the world. The Lister Hill Center for Health Policy will be share these evaluations from different students over the next few weeks to shed light on various situations. This post was written by Jasper Kennedy before the end of Alabama’s 2021 Legislative Session. SB 10 passed the state senate this year but its counterpart in the state house of representatives (HB1) never came up for a vote. A similar bill may or may not be proposed next year.

 

I have lived in Alabama all my life. I was born, raised, and educated here, including my ongoing training as a medical student at the University of Alabama at Birmingham. I am also a transgender person surviving in this state, and I’m worried about what SB10, which would criminalize providing healthcare to trans youth, would mean for my trans community as well as my colleagues.

Transgender youth are an incredibly vulnerable population that is at a greater risk than their peers for violence from others as well as suicide1. We know that the risk of suicide for trans youth drops dramatically when their gender identity is affirmed by the people around them2,3. SB10 would do more than prevent trans youth from accessing affirming healthcare; it would also enlist teachers and school counselors in outing trans students to their parents. In a population that already experiences increased discrimination, harassment, and outright violence at school1, this removes any possibility of finding supportive adults in an educational environment. Trans young people can have healthy, happy lives when they are supported by their families and schools. This bill would disrupt the tenuous balance many trans youth in our state have found. Make no mistake, this legislation will cause suffering and harm to young Alabamians.

SB10 would not only endanger trans youth but also interfere with the provider-patient relationship and medical decision making. It would make it a felony to provide any kind of transition care, including puberty blocking medications. These therapies have been used safely for years in the treatment of a variety of conditions from early puberty in youth to prostate cancer in adults. Puberty blocking therapies allow time for trans youth to think about what they want for their future without the urgency of impending changes to their bodies. Even more compelling is the evidence on the mental health benefits of these medications– puberty blockers are associated with decreased lifetime suicidality in trans people who want access to them4. Under SB10, a physician who provides a patient with this lifesaving therapy would face up to a decade in prison.

Alabama has long struggled to keep enough primary care providers in its borders to provide for our population. At UAB and other medical schools across the state, students are familiar with entreaties to stay and practice in Alabama, particularly in our underserved rural communities. Like many of my classmates, I am excited to be part of the next generation of primary care physicians, but we have to weigh our desire to stay and help the community we love against the opportunity to get the medical training we need to be competent physicians. As someone who cares deeply about the wellbeing of all youth and particularly vulnerable populations like trans kids, I would not be able to learn about the full breadth of comprehensive pediatric care in Alabama if SB10 were made law. In a state with a shortage of primary care providers, it seems a particularly risky gamble to reduce the pool of thoughtful and compassionate trainees even further.

Within the trans community, we talk often about how our narratives are boiled down to trauma and fear without any room for nuance or joy. To be trans in this state is simultaneously a story of beauty, resilience, and sadness. It’s more than just trauma, but the risk of trauma looms large with the possibility of this legislation passing. SB10 represents a scramble by a select few in our state to deny the inevitable– trans children will continue to be trans regardless of what we do. The only thing we can influence is how many of them make it into adulthood.

 

1. Johns MM, Lowry R, Andrzejewski J, et al. Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students — 19 States and Large Urban School Districts, 2017. Morbidity and Mortality Weekly Report. 2019; 68: 67–71. DOI: http://dx.doi.org/10.15585/mmwr.mm6803a3.

2. Russel ST, Pollitt AM, Li G, Grossman AH. Chosen Name Use is Linked to Reduced Depressive Symptoms, Suicidal Ideation and Behavior among Transgender Youth. Journal of Adolescent Health. 2018 Oct; 63(4): 503–505. DOI: https://doi.org/10.1016/j.jadohealth.2018.02.003.

3. National Survey on LGBTQ Youth Mental Health. Trevor Project, 2020. Access at: https://www.thetrevorproject.org/survey-2020/.

4. Turban JL, King D, Carswell JM, et al. Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation. Pediatrics. 2020; 145(2): e20191725. DOI: https://doi.org/10.1542/peds.2019-1725.

Student Mental Health at UAB

October 12, 2021 by Anushree Gade, LHC Student Assistant

 

Mental health is often defined as “emotional, psychological, and social well-being” (U.S. Department of Health and Human Services, 2020). It was not until recent times that there was more awareness of mental health. Furthermore, there is also a stigma associated with the discussion and acceptance of mental health which may vary with culture.

In certain Asian cultures, the stigma surrounding mental health is colossal. Discussing mental health is considered taboo in these cultures. These aspects of culture that impact mental health cause people of that culture to undermine their mental health and well-being. As a result of this, many avoid seeking medical care to address it and avoid talking about it (Nishi, 2012). This stigma can also be seen in African American culture. In one study, 63% of African Americans responded that mental illnesses are seen as signs of weakness (National Alliance on Mental Illness [NAMI], n.d.). In Hispanic culture, it is common to keep private challenges to one’s self. This lack of discussion on such topics inhibits the acknowledgement of mental health and also creates a gap in knowledge in mental health issues and symptoms. Furthermore, this can contribute to strengthening the stigma surrounding mental health in this culture (NAMI, n.d.). As we can see through these examples, culture influences the level of stigma that surrounds the topic of mental health; it can positively reinforce that stigma if there is a lack of awareness around it.

 

Development of Mental Health at UAB

The mental health of college students has been of growing concern in the past couple of years. A survey conducted by Dr. Sarah Ketchen Lipson in 2020 revealed that half of the students that were surveyed presented symptoms of depression or anxiety and at least 83% said that their mental health was negatively impacting their academic success (McAlpine, 2021). With increases in mental health issues in students across college campuses, it is necessary for university administrations to implement policies, programs, and services which address this.

UAB has implemented several initiatives and services that aimed to address the issue of mental health on campus. One such initiative was the UAB CARES Suicide Prevention Initiative. CARES stands for “communicate, assess, refer, educate.” The goal of the UAB CARES initiative is to help connect students experiencing mental health concerns to resources that are on campus and off in order to help them. This initiative was started in the Fall of 2018 and was unanimously approved by the University’s President and senior cabinet (University of Alabama at Birmingham [UAB], n.d.).

Through the development of the UAB CARES initiative, several recommendations were made after reviewing the existing policies at the time (and were unanimously approved). These recommendations are categorized into three main groups: Prevention and Awareness; Education; and Policies, Procedures, and Services. The full listing of recommendations can be found here. As a result of this initiative, UAB has established that students and faculty should all be able to have continuity in care to support their mental health. Furthermore, the initiative prompted campus wide education efforts on the various crisis response teams available to UAB faculty, students, and staff. Crisis Text Lines specific to UAB were established and the University also began to offer training through the Kognito At-Risk program. Below is a list of resources that UAB provides for students’ mental health!

 

Spring 2021 Events!

Happy New Year, Blazers! The past year has been quite eventful, to say the least. Last semester, we honed in on the manifestations of racism in America, ranging from mass incarceration in Alabama to the lives of the formerly incarcerated after prison. A key takeaway from our Fall 2020 events is that our policies are informed by a long, gruesome history of white supremacy and systemic racism. Additionally, our policies are often informed by several other prejudices, such as ableism, sexism, xenophobia, classism, and the like.

This semester, we will be exploring the manifestations of another pervasive prejudice which can be summarized as queerphobia. Individuals in the LGBTQ+ community face health disparities that often result in significantly poorer health outcomes relative to their straight and/or cisgendered counterparts. This is especially the case for transgender people, who are often denied medical treatment options and violently targeted by people both within and outside the LGBTQ+ community. Further, this experience is exacerbated for transgender people of color.

In light of this, with our Spring 2021 Semester Spotlight we will explore LGBTQ+ health issues through a policy lens while exploring ways to remedy institutional homophobia/queerphobia with policy change. We’re beginning the semester on January 25th with Dr. Vin Tangpricha, who will share his experiences in working with transgender medical care and shed light on the obstacles that he and his patients have faced. On February 17th, we will then shift our focus outside of the country to explore queerness in Palestine with Dr. Sa’ed Atshan, a distinguished professor of Peace and Conflict Studies who specializes in global LGBTQ social movements. Subsequently, we will shift the focus back to UAB on March 10th to highlight some of the ongoing LGBTQ+ research that UAB faculty are engaged with. To finish the semester, Dr. Billy Caceres of Columbia University will share information from his team’s project to map LGBTQ+ policy in The United States on April 7, providing an overview on the current state of LGBTQ+ policy across the country. All of these events are virtual and are open to the public.

For more information about these events and the other events we’re planning for the spring, make sure to follow us on social media or sign up for our newsletter.  We look forward to engaging with you all this semester!

A Big Week for the LHC

Last week was a big one for the Lister Hill Center (hence, the delayed blog post). We sent one member of the team to Washington, DC while the rest stayed in Birmingham for the long-awaited seminar/workshop from the Alan Alda Center for Communicating Science. On top of all this, we teamed up with Undergraduate Student Government Association and the Graduate School to host a voter registration drive! Use the tabs below to navigate between the different undertakings of LHC staff last week:

Spend Your Fall Semester with the Lister Hill Center!

It’s nice to see students on campus again. Every summer and winter break, UAB empties and campus feels like a ghost town. Welcome back, to all the students returning for another semester of study; and welcome to your new home, to all of the new students just coming to UAB for the first time.

The School of Public Health is sponsoring some really great Welcome Week events. Check those out here. The exciting thing about going to school at UAB is that there is constantly something happening. The Lister Hill Center has an outstanding lineup of speakers coming this semester, and a symposium to top it all off! All of our scheduled events can be found on the timeline below, and we have more information on upcoming events on both our homepage and our Semester Spotlights page.

 

Fall Timeline