An article from the "In the Spotlight" section, January issue of the NHPHA e-Newsletter

Active Recreation in NH: Healthy People Healthy Places begins to make its mark

Beth Gustafson Wheeler, MS
Director of Community Health
Foundation for Healthy Communities

HEAL NH PIC6Since the fall of 2014, HEAL NH has been the lead organization responsible for forwarding the goals of the 2014-2019 NH Healthy People Healthy
Places (HPHP) Plan.  While the plan boasts four hearty objectives in the areas of active transportation, active recreation, healthy food access and healthy food promotion, today we will highlight one in particular that has been moving the ball forward:  Active recreation. 


The active recreation objective states “All NH communities have access to indoor and outdoor recreation facilities within a reasonable distance.”  While lofty in its presentation, the folks behind the curtain responsible for accomplishing it are used to striving towards such ambitions…one step at a time.

In 2014, HEAL NH formed the Active Recreation Workgroup pulling together a variety of partners across NH dedicated to increasing access to places to play and recreate for NH residents.  A list of them can be found below, and include professionals who have the passion and the networks to push the needle in the right direction.  In fact, they are already making great strides.**


HEAL NH PIC3The workgroup is focused on three main strategies as outlined in the HPHP Plan:

1.     Increase access to public and community facilities for physical activity through     coordinated statewide education, outreach, and advocacy for Joint Use Agreements.

2.     Increase public and private investment to create and improve access to healthy and safe parks, playgrounds, open spaces, and other places for community recreation.

3.     Increase use of parks, playgrounds, open space and other places for community recreation.

All three of these strategies, and most of those within the new Healthy People Healthy Places Plan, prioritize this work for NH’s highest need communities. 


What are the accomplishments to date?


1.     Joint Use Agreement resource page:  The NH Recreation and Parks Association posted a list of Joint Use Agreement resources for communities and organizations who are interested in taking advantage of sharing use of facilities to increase access to recreational opportunities.  At the 2014 HEAL Conference, the active recreation workgroup held a workshop outlining the advantages of JUA’s as well as a “step by step” process for creating one in your community.

2.     Active Recreation Inventory:  The workgroup has completed Phase 1 of its Active Recreation Inventory.  The purpose of the inventory is to HEAL NH PIC2gather the amount, type, and location of recreation spaces and facilities in 10 of NH’s high need communities. Included in the data are the amenities and features offered at each park as well as maps showing neighborhood proximity.  The results are being presented in a poster session this month at the Active Living Research Annual Conference and will be used to write a preliminary report this winter regarding the state of recreation access in NH’s high need communities.  

3.     The next step for the workgroup is to develop an advocacy campaign that makes the case for increased funding for recreation in high need communities across NH.  We are also working together to plan further research using a community based participatory model.  Our intention is to acquire a deeper understanding of the barriers to active recreation in NH’s highest need communities, as well as the opportunities for improving access. 

This work has been inspired and informed by the previous work of two HEAL community grantees:  the cities of Laconia and Berlin.  Wyatt Park in Laconia is a great example of how a neighborhood can champion a park renovation to transform a debilitated, run down park into a social, family gathering place.  Berlin, another example, bulldozed abandoned, dilapidated buildings and created a neighborhood park and community garden in a neighborhood that lacked access to a place for families to play and socialize.  You can find their case studies on the community page of the HEAL NH website.

HEAL NH PIC4Through the work of the Active Recreation Workgroup, we can form a better picture of recreation in NH and use this new understanding to advocate for further funding to provide easier and safer access to recreational opportunities in NH communities. 

For more information on the Active Recreation Workgroup and our project, please visit the Active Recreation page on the HEAL website at www.HEALnh.org.

** Members of the HPHP Active Recreation Workgroup include:

Robert Barcelona, Recreation Management and Policy, UNH Dept. of Health and Human Services; Katie Bush, Department of Health and Human Services, Division of Public Health Services; Paul Coats, City of Lebanon Department of Recreation and Parks; Cindy Heath, GP RED; Kerry Horne, NH Recreation and Parks Association and HealthTrust; Mike Loomis, Governor’s Council on Physical Fitness and Health; Barbara McCahan, Center for Active Living and Healthy Communities, Plymouth State University; Sandy Olney, Adaptive Sports Partners of the North Country; Chris Thayer, Appalachian Mountain Club; and Beth Gustafson Wheeler, HEAL NH.
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Last month, the Broad Street Parkway in Nashua opened and hundreds of people turned out to show their support for the new downtown connector that was decades in the making. The Nashua Telegraph published a letter from Robert Tourigny, Executive Director of NeighborWorks Southern New Hampshire. In the letter, Robert Tourigny applauds the project explaining that "...Affordable housing and transportation choices are directly connected to community revitalization and public health. Providing transportation choices and affordable housing near jobs, shops and schools supports the local economy and provides residents with the opportunity to live in a community that is safe, affordable and easy to get around and be active."

Robert Tourigny also mentions the work being done by a number of organizations, including NeighborWorks Southern New Hampshire, Great American Downtown and Plan4Health Nashua,  to support health, economic vitality and livability in Nashua.

Plan4Health Nashua in the News: 
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By Jeanie Holt, NHPHA Public Policy Committee Co-Chair

I will not take up time and space to repeat the content of the Health in All Policies (HIAP). (If you are not receiving this weekly legislative update, please send an email to info@nhpha.org to be added to the distribution list.) As you know, this year’s legislative session features many bills critical for public health from efforts to limit women’s access to affordable reproductive health and preventive services, to re-authorizing NH Health Protection Program (Medicaid expansion), to a bill that would severely limit public health’s ability to gather critical data from students in public schools, to legislatiion surrounding various aspects of clean energy.  We aslo contintue to work with a legislative task force and state health officials on issues surrounding food safety.Please follow our work by reading HIAP.


Of note, the Public Policy Committee celebrates our accomplishments in 2015:

·       21 issues of Health in All Policies published

·       87% of membership survey respondents reported reading HIAP and one commented, “the content is fantastic!”

·       8 of NHPHA’s current policy statements reviewed and revised if needed

·       2 new policy statements drafted and sent to the Board; Social Justice and Health adopted in October, Climate Change and Health adopted January, 2016.


To join the NHPHA Public Policy Committee send an email of interest to info@nhpha.org

Be part of an active team working for good public health policy!

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By Jeanie Holt

APHA--the Go-To Resource on Public Health


As you know, NHPHA is affiliated with the American Public Health Association. This is a multi-directional partnership. APHA depends on affiliates for on-the-ground expertise (both technical and political) on all public health topics. APHA depends on affiliates to get the word out on Federal legislation and to raise many voices in advocating for good public health policy. In turn, APHA provides us with resources for advocacy. Possibly the most critical resource is APHA’s policy statements. From mandating flu vaccine for health care personnel to nutrition to climate change, policy statements are the most complete analysis of the current science on a topic (search for a policy statement here). But the policy statements are not easy to read. They are long, detailed, and scientific. So APHA publishes fact sheets, info graphics, and videos to help us make the case. See, for example, the infographic “Can we become the healthiest nation (in one generation)?”. I could write much more about the importance of the two-way relationship between NHPHA and APHA.

But I also want to highlight another dimension of being affiliated with APHA. We are connected to all of the other APHA affiliates. APHA has 54 affiliates—one in every state, two in California, one in New York City, one in Washington DC, and one in Puerto Rico (field trip anyone?). These affiliates connect to each other within regions and across the country. Those connections help us to exchange ideas, celebrate each other, challenge each other, and give encouragement when the going gets rough. Last year, for example, North Dakota Public Health Association published several letters to the editor on public health topics. Being proud of this accomplishment, they challenged the rest of us to do better. By Annual Meeting in November, several states had out-done North Dakota in this form of advocacy. NHPHA is connected to the other affiliates through our Affiliate Representative to the Governing Council (ARGC). As Katie discussed in her President’s Message, NHPHA needs a new ARGC to represent NHPHA’s interests in the governance of APHA and to provide us with our link to the other affiliates.

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By Marie Mulroy, NHPHA Past President

As of this writing, two very different bills have come out of the House to address the need to expand the New Hampshire Health Protection Plan (Medicaid Expansion) beyond its December, 2016 expiration date.  The bills are HB 1690 from Rep Thomas Sherman which proposes to have Medicaid Expansion move forward without any expiration date  and HB1696 from Rep. LaChance  which has the support from the Senate and House Republican leaders and has the following major components.  


Please note that there are potential revisions to some of the components, so by the time of the hearing on either January 26th or 28th several of these could look very different.  At present, however, the components are:

·       Extending the expiration to December 31, 2020

·       Dedicated premium insurance tax revenues from Medicaid Expansion

·       Retaining some of the Medicaid Enhancement Tax (MET) dollars that  normally would go to the hospitals

·       Having an “active work seeking” requirement for any unemployed, but able-bodied individual seeking coverage under Medicaid Expansion.

·       Premiums for all but the medically frail to be collected by the insurers

·       A 6-month disenrollment provision to anyone on Medicaid Expansion who fails to make a premium payment within 60 days.

·       A co-pay penalty of $8 for the first non-emergency visit to an emergency room and $25 for each additional non-emergency visit thereafter.

Even though we do not know what components are in the process of revision,   it is most likely that the section regarding charging premiums to enrollees will change.   If this happens, it is in direct response to insurers who have raised issues of how difficult and expensive the mechanism to collect those premiums will be.  They point to  the state of Arkansas, which had similar proposal and who found that the cost of collecting the premiums far exceeded the premiums that were collected.   Some sources are saying that it cost Arkansas $1.5 million to collect just $200.000 in  premiums.  In addition, the “actively seeking work” component could come under scrutiny because it would require that New Hampshire seek a waiver from the federal government.   Historically CMS, who oversees Medicaid, generally has disallowed “work” requirements for individuals who seek Medicaid coverage.

Regardless of party affiliation and ideology, what is becoming apparent is that most of NH state legislators do not  want  to see approximately 47,000 to potentially 58,000 New Hampshire citizens suddenly having no healthcare coverage.    While both sides of the aisle are looking to see what initial economic benefits have occurred since Medicaid Expansion, the point of division between the parties is how New Hampshire pays for its portion of expenses.   The cost to New Hampshire in 2017 should be around $13 million for the balance of the 2016-2017 budget and then rise and level off around $20-$25 million by the year 2020.     Republican leadership feels that is not the taxpayers’ responsibility to cover the cost and that the expense to the State should be borne by those who benefit most from the expansion of Medicaid.  Namely, the current and potential insureds, the hospitals and the insurance carriers are who they feel should pick up the cost.   In addition, the Republicans have ruled out the possibility at this time of any new taxes to pay for the extension this program.    While Democratic leadership, on the other hand, regard insuring the health of 47,000 citizens on Medicaid Expansion as an investment in New Hampshire’s future.   In an interview with NHPR, Senator Woodburn  said  “I think the Democrats believe that wise and prudent use of our taxpayer dollars is important, but so are investments — investments like the gas tax, that is making great roads, our roads much better, our bridges much safer, and is important to the economic development of our entire state”.   At NHPHA, we could not agree more with Senator Woodburn.

Below are resources for additional information:

NH Health Protection Plan Fact Sheet

Affordable Health Care Coverage for Over 44000 Granite Staters


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By Jeanie Holt

APHA has a goal. A BIG goal. In fact, the leadership at APHA calls it a BHAG (Big Hairy Audacious Goal): the US will be the healthiest nation in the world by 2030. During the Affiliate Day at APHA Annual Meeting we questioned APHA’s Executive Director, Dr. Georges Benjamin, about this. Is this even remotely realistic? Dr. Benjamin made several points in his response.

First, he acknowledged that it is a pretty big goal, bordering on unrealistic. But, he said, a “stretch” goal, pushes you to achieve what you didn’t think was possible. Even if we don’t make it all the way to the BHAG, we will be much closer to it than we could have imagined if we had set our sights lower.

Secondly, Dr. Benjamin pointed to one segment of the APHA strategic map: Create a Public Health Movement. He pointed out how much has been happening in that sphere. “It is no longer just public health folks who are demanding sidewalks and walkable communities. It is no longer just public health folks who push for healthy menu options and health information at restaurants. And public health are not the only people talking about justice and living wages and affordable housing.” The movement is underway.
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YMCA of Greater Nashua participates in Complete Streets study 

On November 4, members of the YMCA of Greater Nashua provided valuable feedback about the research being conducted by the Nashua Regional Planning Commission on how ‘friendly’ Nashua streets are for walking and bicycling.

Over the past few months, The Nashua Regional Planning Commission (NRPC) has been testing the City’s streets for bicycle and pedestrian friendliness using Level of Traffic Stress (LTS) data as part of the Plan4Health Nashua “Complete Streets” project. The goal of the project is to advance street planning and design that support safer and easier ways to get around for pedestrians and bicyclists in Nashua.In addition to the quantifiable data the LTS methodology provide, scores can be adjusted for other variables that commonly affect a bicyclist’s or pedestrian’s comfort level, including lighting and overall feeling of safety, pavement conditions, steep hills, and traffic volumes. Bringing the 
maps to members of the YMCA was an important part of ensuring the LTS data matches the public sentiment regarding stressful areas and it will help inform the Complete Street recommendations and guidelines that will be developed as part of the project.  Publication1


 In October, Mike LaChance, chief executive officer of the YMCA of Greater Nashua, joined members of the Plan4Health Nashua coalition along with 18 other community members from a wide range of organizations who met to discuss efforts to make the streets safer and more accessible for pedestrians and bicyclists. (See Nashua Telegraph article for more information.)

 “We are very excited to be partnering with this team of organizations who are focused on improving healthier options for area residents. The Y is committed to strengthening the Greater Nashua region with a focus on youth development, healthy living and social responsibility,” said Mike LaChance.

The Plan4Health Nashua project has been recognized regionally and nationally as an example of how community organizations such as the YMCA, along with planning and public health, can work together effectively to advance health and community livability. 

The project is supported by the Greater Nashua Public Health Advisory Council, and was selected as a priority project for implementation in Nashua’s 2015 Community Health Improvement Plan. Plan4Health Nashua is a collaboration between planning and public health professionals, including the Nashua Regional Planning Commission, the City of Nashua, New Hampshire Public Health Association (NHPHA), and Healthy Eating Active Living (HEAL NH).

For more information about the coalition or how to support Complete Streets in your community, go to http://healnh.org/plan4healthnashua
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Submitted by Marie Mulroy

NHPHA and its partners are still meeting several times a week to prepare to get this important piece of legislation passed.  To date, there are two pieces of legislation filed in the House of Representatives and we are still waiting to see the language on both of these bills.   


During December and January, NHPHA and its partners will be hosting several town meetings across the state designed to make the case to legislators that NH people want and need the Medicaid Expansion to be reauthorized.    If you see an event near you and are interested in attending, let Deanna Bennett info@nhpha.org know.   As of now, the following is the list of meetings.  If there is one in your area, if you could call your State Representatives or Senator to let them know that would be very helpful.    Also, if you or your organization want to participate in any of the partnership committees working on this bill, let Deanna know that also.  

In District Meetings:

Laconia
December 17, 2015 - 1pm to 2pm
Boys and Girls Club of the Lakes Region
876 North Main Street, Laconia
Sponsor:  New Futures, Joe Gallagher

Derry/Londonderry

January 5, 2016 - Public Library reserved
Sponsor:  New Hampshire Citizens Alliance

Nashua 
January 6, 2016 - 5pm
Harbor Care Health and Wellness Center
615 Amherst Street, Nashua
Sponsor:  Bi-State Primary Care Association

Manchester
January 7, 2016 - 5pm
Manchester Community Health Center
145 Hollis Street, Manchester
Sponsor:  Bi-State Primary Care Association, Kristine Stoddard

Seacoast
Tentatively somewhere in lower Rockingham County (not Portsmouth)
Will probably be held on a Saturday in January
Sponsor:  Dupont Group, Jim Monahan
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Submitted by Marie Mulroy

As lawmakers prepare for the 2016 Legislative Session -- two of the biggest issues that they are going to be facing will be:  (1) extending the New Hampshire Health Protection Plan (Medicaid Expansion) beyond December 2016; and (2) the myriad of legislation that will be needed to resolve the opioid crisis in New Hampshire.   To get the necessary bills ready to deal with the complex problem of addiction, a special Joint Legislative Task Force convened by Governor Hassan has worked over the last several weeks to determine what pieces of legislation are needed and in what order they will be heard in 2016.   On December 15th recommendations will go before the full task and any items that the task force votes to expedite will have a joint public hearing in early January. While those that may require a more thorough examination will go through the normal legislative process and be appointed to be heard in Committee.  For a complete list of the legislation from the Task Force, click here.  


As the issue of Medicaid Expansion and the issue of Substance Abuse move forward, what is becoming obvious to many is that by passing Medicaid Expansion they will be putting into place one of the greatest tools to address the Heroin and Opioid crisis.  Since Medicaid expansion includes substance use disorders and behavioral health in its ten essential benefits, Medicaid Expansion represents a significant source of new funding for treatment.  Unlike traditional Medicaid, the expansion program covers a variety of substance abuse treatment and recovery programs. With more than 400 drug deaths and approximately 7000 emergency room visits in New Hampshire last year, without Medicaid Expansion the burden will fall to the hospitals and providers as uncompensated care and the ability to solve this public health crisis will be compromised.   In addition, providers and services are on hold waiting to see signs of some stability in the reimbursement stream before they commit to building more capacity for these much needed services.

According to a recent factsheet published by New Futures “Of the 42,000 people currently enrolled in the New Hampshire Health Protection Program – 7,560 are estimated to meet the clinical criteria for Substance Use Disorders – 5,880 of these individuals will likely access treatment services.   While addiction touches individuals across incomes, adults living between 0-133% of the federal poverty level are particularly sensitive to the opioid epidemic experiencing addiction rates upwards of 19.4%.   Statewide approximately 10% of New Hampshire’s adults (nearly 106,000) have a Substance Use Disorder.”  To read more, click here.    These facts make passing Medicaid Expansion even more imperative.
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An entry from the November issue of the NHPHA e-Newsletter

NHPHA would like to welcome and introduce the Healthy Homes and Environments Section, our newest organizational member and Public Health Partner.

The Healthy Homes & Lead Poisoning Prevention Program, along with the Asthma Control Program and the Health Officer Liaison, is a section within the NH Department of Health and Human Services, Division of Public Health, Bureau of Health Protection.  Staff within this section train and certify contractors for lead safe work practices, investigate lead hazards in homes,  provide health education and outreach, provide case management for lead poisoned children, coordinate asthma control work, and appoint and provide Healthy Homes logotechnical assistance to New Hampshire's Health Officers.

According to Jessica Morton, Health Promotion Advisor,  “The Healthy Homes Steering Committee is  comprised of 20 to 30 individuals that are all focused on various aspects of what a health home needs, but the outcome is the same: maintaining, creating, or establishing healthy homes.  It's amazing the work we can do together vs. individually”.

Jessica enjoys collaborating with other groups and speaking to the public about ways to keep their homes safe, but feels that meeting and training the 234 Health Officers is the most enjoyable part of her work.  "Taking phone calls from residents on housing condition concerns from bed bugs to mold to radon to many other things, it's always something new." 

The 5th Annual Healthy Homes Conference was held on October 28th at the Grappone Conference Center in Concord.  Keynote speakers included Murray Banks, Ellen Tohn of Tohn Environmental Strategies LLC, and Mary Jean Brown, Chief, Lead Poisoning Prevention Branch at the Centers for Disease Control and Prevention.  A variety of breakout sessions were offered including such topics as Home Fire Safety, Preventing Mold in Your Home, and Safety for Home Visitors.

"We are working on increasing the number of children who are screened for elevated blood lead levels. The American Academy of Pediatric guidelines recommends that all children be screened before age 1 and before age 2.', Jessica replied when asked about current and future projects.  "We are also working with partners to create better linkages among schools, hospitals, primary care, patients, and caregivers in order to ensure better care for asthma control.

In closing, Jessica shared that the Healthy Homes & Environment Section first got involved with NHPHA through former President, Marie Mulroy.  "Marie has been an active partner in our Healthy Homes Steering Committee and has worked on a number of advocacy initiatives for Healthy Homes.  We really appreciate the partnership we've had over the years with the NHPHA.”
NHDPHS Logo            HH Steering Committee logo            NHAC Logo
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The NH Health Protection Program (Medicaid Expansion) is scheduled to sunset on December 31, 2016, unless it is reauthorized by the legislature and Governor.  As you know, Medicaid Expansion is critical to work that all of us are doing and your help will be needed as we move forward with this endeavor.   Pursuant to federal statute, starting January 1, 2017, the State must cover a portion of the total funding for Medicaid Expansion by the following percentages:

          ·       0% now and through December 31, 2016
          ·       5% in calendar year 2017;
          ·       6% in calendar year 2018;
          ·       7% in calendar year 2019; and
          ·       10% in calendar year 2020 and thereafter.

Because of this requirement, in addition to extending Medicaid Expansion, leaders in the House and Senate will simultaneously be considering how to fund New Hampshire’s 2017 share of its cost.

Some of the funding methods being explored are: an assessment on the hospitals, adding premiums and/or increasing co-pays for enrollees, personal responsibility measures and/or work search requirements.  For full detail of these proposed methods of funding being considered, click here.

How the State will fund Medicaid Expansion is as important as extending the plan and we will be working with all of our partners across the state to ensure that we get legislation that both extends Medicaid and does not do so at the risk of increasing costs to the point where many of its 42,000-50,000 enrollees will no longer be able to afford the good quality healthcare that the rest of us take for granted. 

As we move forward, we will keep you informed as to what you may do to help.   In addition to helping educate and inform your district representatives of the importance of Medicaid Expansion to New Hampshire, if your organization can help now, below is a list of committees that are forming that you can participate in.

          ·       NHHPP Reauthorization Meetings will be held every other week through the end of the year.  The purpose of these large meetings will be to share information & compare notes

          ·       NHHPP Grassroots Team This group will initially meet weekly at a time and location TBD.

          ·       NHHPP Communications Team This group is focused on several elements.  First, they will help create materials, develop calendars; lift up stories of beneficiaris.  This group will meet weekly at a time and location TBD.

          ·       In-District Meetings   5-7 in-district meetings beginning in December and continuing through January.  They will need volunteer lead organizations that will help to identify a location, organize speakers and invite targeted Representatives. 

If you can participate in any of the above committees that would be great! Send an email to info@nhpha.org, and you will be put in touch with the heads of those committees.  As always, the health of all citizens in New Hampshire requires all of us to do our part.   So thank you for whatever you can do to ensure that Medicaid Expansion becomes a permanent part of New Hampshire’s insurance fabric for those who most need it.NH Health Protection EnrolleesDownload the map
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Submitted by Amanda Cosser, MPH - Biomonitoring Program Manager, NH Public Health Laboratories

The New Hampshire Public Health Laboratories (NH PHL), a bureau of the New Hampshire Division of Public Health Services, is excited to announce the start of their new biomonitoring program, biomonitoringNewHampshire.  With financial and technical assistance from the Centers for Disease Control and Prevention’s (CDC’s) National Center for Environmental Health (RFA EH14140202), biomonitoringNewHampshire will be conducting two studies over the next four years evaluating environmental chemicals in humans.  Biomonitoring is the study of natural or man-made chemicals (or their metabolites or reaction products) from the environment in human specimens such as urine, blood, or tissue.  Epidemiologists and scientists at the NH PHL will be working side-by-side to design and conduct two studies which will give public health professionals valuable information regarding whether and how much chemicals from the environment are entering our bodies.  These studies are crucial to many objectives of the State Health Improvement Plan (SHIP) as they go hand-in-hand with the overall approach of the SHIP: population health. 

The first study is a targeted biomonitoring evaluation of arsenic and uranium from residents in three high risk counties in southern NH (Rockingham, Strafford, and Hillsborough).  Research conducted by the US Geological Survey has shown that the bedrock in these counties is highly conducive to leaching arsenic and uranium into water.  If left untreated, humans consuming, cooking, and bathing with arsenic-contaminated well water at levels above the Environmental Protection Agency (EPA) maximum contaminant level of 10 parts per billion have been shown to develop bladder, skin, and lung cancer.1  Arsenic exposure has also been linked to negative effects on respiratory, cardiovascular, and immunological health and has been shown to cause developmental delays in children.2  The toxic effects of uranium in the general population have not been as widely studied, however occupational exposures to uranium in miners and other workers have been found to cause respiratory disease such as fibrosis and emphysema.3  Since 40% of NH’s population uses private wells as their main water source and because the EPA does not have the authority to regulate well water quality, it is important to evaluate possible contaminants in order to identify at-risk populations and develop effective public health interventions.

The second study biomonitoringNewHampshire will be conducting is a state-wide surveillance project looking for various metals, pesticide metabolites, perfluorochemicals, and nutritional biomarkers.  This surveillance project is vital to having NH-specific biomonitoring data.  Annually the CDC conducts the National Health and Nutrition Examination Survey which gives a snapshot of the health and nutritional status of the US as an aggregate.  Important data are collected regarding the prevalence of and risk factors for many diseases.  Unfortunately that data cannot be broken down by state and so evidence-based state-specific public health interventions cannot be implemented.  For that reason, biomonitoringNewHampshire is excited to start collecting NH-specific data that can be used to assess the health of NH residents, to evaluate public health interventions that are already in place, and to inform policy makers as new interventions are proposed.
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By Jeanie Holt

As you know, I represent NHPHA on the Governing Council of APHA. Since GC meets only twice a year, we need a governing body that manages APHA business between GC meetings. This group is the Executive Board. At the Annual Meeting, GC elects representatives to EB. Elected EB members serve 3 years on a rotating basis. So what do I look for in deciding whom to vote for? First, keeping in mind that EB manages a large non-profit including overseeing the work of APHA staff (through Dr. Benjamin, CEO) and makes decisions about finances, policies, and implementation of GC directives, I look for experience on non-profit boards and/or experience managing organizations. A candidate may have great academic credentials, interesting research or a lifetime of working in public health but without a solid foundation in management, they may not be the best candidate. I do not automatically rule out such folks, especially those with a lifetime of working “on the ground”. These public health workers bring valuable life experience and perspectives. I look at the balance of people already on EB to see what other voices might be needed. The other thing I look for in candidates is leadership in a state affiliate. While each affiliate is unique, we share some common needs, perspectives, and issues so experience with those are very important to me, and to NHPHA. We elected three excellent people to the EB: Benjamin Hernandez is Chief Financial Officer at City of Houston Health and Human Services and brings enthusiasm, skills, and a very warm and friendly personality to the EB; Aaron Guest has been active in several state affiliates as he has moved around pursuing first an MPH and now a PhD (in gerontology and public health), and he is an active leader in the Student Assembly; and Elena Ong who has been active in the California South Public Health Association, APHA, and the Asia-Pacific Islander Caucus for Public Health.

We also elect the President-Elect. The role of APHA President is a little different from NHPHA’s President. Rather than leading meetings and making organizational decisions, APHA’s President travels. The Pres visits 1/3 of the Affiliates and represents APHA at many national and international meetings. So for this office I look more at wide and deep public health experience. Does the candidate know first-hand about working “in the field”? About navigating tricky political waters? About being a student and mentoring students? About listening? About finding common ground in diverse opinions? Does the candidate have vision? And can the candidate speak compellingly? This year we elected Tom Quade who was the obvious choice for me He meets the qualifications I just discussed. In addition, he has been an important mentor for our star student, Addie Murray. For those who saw her stunning Ignite presentation at our 25th Anniversary Celebration, you’ll understand more about why I am so excited about Tom when you know that he helped Addie shape and refine that presentation.

Don’t stop reading! I want to share one important success the Council of Affiliates had (in addition to helping elect some really stunning people to the EB!). Many NHPHA members ask me every year why they can’t write one check to join both NHPHA and APHA. Some of you may also know that several years ago (11 to be exact) APHA and four states started a Joint Membership Pilot (going to be the longest “pilot” in history) to explore how joint memberships might work. APHA proposed ending the pilot this year saying, “it isn’t working for APHA.” But the Council of Affiliates basically said, “prove it!” As a result of our advocacy on behalf of all 54 affiliates, the EB appointed a committee to decide what metrics to use to measure the success/failure of the JMP and to then evaluate the pilot on the basis of those metrics. The committee will report to GC at our mid-year meeting in June, 2016.

And, finally, the Council of Affiliates elected me as Chair-Elect of the Council of Affiliates and also appointed me to bring the Affiliate “voice” to an APHA task force that will help shape APHA’s global initiatives.
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P4H Nov Pic 1Members of the Plan4Health Nashua coalition met on October 19 to discuss efforts to support Complete Streets in Nashua. The day began on the steps of Nashua’s City Hall when 18 community members from a wide range of organizations met with Mayor Donnalee Lozeau to discuss the City’s efforts to make the streets safer and more accessible for pedestrians and bicyclists.

Matt Makara, Program Manager at the American Public Health Association in Washington, D.C., attended the meeting and was quoted in a Nashua Telegraph article covering the event: "I feel one of the big successes of the project is that it's having these different groups working together in a non-competitive way," Makara said. "I think Nashua has done a phenomenal job of working together for these common goals."

Other meeting attendees included representatives from the Nashua Regional Planning Commission (NRPC), City of Nashua, Great American Downtown, YMCA, HEAL NH, Police Athletic League (PAL), New Hampshire Public Health Association (NHPHA), Boys & Girls Club of Greater Nashua, NeighborWorks, and other community members.

After meeting with the Mayor, the coalition hit the streets, walking along the Nashua Heritage Rail Trail and through other areas of the City. The group discussed Plan4Health Nashua's Complete Streets Project, what improvements have already been done in Nashua, and other priority areas for improving access to safe walking and bicycling, including streets around the PAL building and the Boys and Girls Club.
P4H Nov Pic 2
The meeting continued at the Nashua Transit System offices to review the Level of Traffic Stress (LTS) data the NRPC had collected about how “friendly” Nashua’s streets are for biking and walking. Community partners then reviewed the maps showing the data overlay and provided feedback to ensure accuracy.

While the focus of the coalition’s work is on supporting Complete Streets in Nashua, the Plan4Health Nashua project has been recognized regionally and nationally as an example of how planning and public health can work together effectively to achieve shared goals. Plan4Health partner and Nashua Community Development Division Director, Sarah Marchant, was invited to Washington, D.C. to present an overview of the project at the American Planning Association Conference in late September. The Plan4Health Nashua project was also featured at the HEAL NH Conference on October 1 in Concord. A week later, Plan4Health Nashua was highlighted in a presentation at the NHPHA Celebration at the Red River Theater in Concord.

The Plan4Health Nashua coalition continues to grow and gain support. If you would like more information about the coalition or how you can
support Complete Streets in your community, go to
http://healnh.org/plan4healthnashua or contact Nik Coates. 
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