A guest blog entry from Jeanie Holt, NHPHA Policy Committee Co-Chair

Among the benefits NHPHA receives by being affiliated with APHA is advocacy at the federal level on behalf of public health. Like NHPHA, APHA bases advocacy on policies adopted by the Governing Council. And like NHPHA, those policies are carefully researched and based on the best evidence available.

A proposed policy that will be considered by the Governing Council is on the topic of preemption. I’m sure many of you are as unfamiliar with this concept as I was before I read this proposal. Preemption is a legislative tool whereby the federal or state government withdraws the authority of a lower level of government to act on a particular issue. Preemption can set a floor below which no state or local government is allowed to go. Minimum wage is a good example of floor preemption. Alternatively, preemption can set a ceiling and no lower entity can put in place policies that are stricter than the ceiling.

This is important for public health because so much of public health occurs at local and state levels. Once an idea gets started at a locally, it has a better chance of moving up to higher bodies of government. We see this clearly in indoor smoking bans. Many towns and cities put such bans in place before any states adopted clean indoor air laws. And we still don’t have such policies, for the most part, at the Federal level. Big tobacco companies tried for years to get national legislation passed that would have preempted the right of communities to ban indoor smoking. They knew that it would be easier to fight smoking bans (and win) in Congress than to have to work against such legislation in many towns and states. Fortunately, they lost that particular battle.

The policy being proposed to APHA’s Governing Council would authorize our public health advocates to:

·        urge federal and state legislators to avoid preempting the ability of state or local governments to act to further public health goals;

·        urge federal and state legislators to enact minimum requirements, or floor preemption, with strong public health protections;

·        urge federal and state legislators to insert savings clauses in legislation to explicitly avoid preempting lower levels of government;

·        urge federal and state legislators to consult with APHA to determine whether legislation is sufficiently favorable to public health when faced with legislation that includes preemptive language;

·        urge legislator to engage local leaders, stakeholders, and grassroots movements to gain their perspective on perspective during the legislative process;

·        urge public health and public policy education programs to educate their students about the potential negative consequences of preemption.

The NHPHA Board of Directors is considering formally endorsing this proposed policy.  Read the full proposal


A guest blog entry from Jeanie Holt, NHPHA Policy Committee Co-Chair

HB600: ". . .workers in New Hampshire can address their own health and safety needs and the health and safety needs of their families by requiring employers to provide a minimum level of paid sick and safe days including time for family care. . ."

I am in a check-out line at a store I shall not name.  As I place my tiems on the counter, the cashier couged, covering her cough with her hand. Then she picked up my first item. . .

One can view paid sick leave from several differnt perspectives.  For public health, paid sick leave is an important tool in limiting the spread of disease.  I suspect others have had similar experiences to mine.  People who come to work sick put all of us at risk.

A 2010 national survey of more than 4,300 restaurant workers, 88% of the respondents reported not having paid sick leave and 63% admitted that they cooked and served food while sick.1  Using data from the Centers for Disease Control and Prevention (CDC) Drago and Millerestimated that infected imployees who reported to work caused the infection of an additional 7 million peole during the 209 H1N1 pandemic.  Other researchers interviewed a nationally representative sample of U.S. adults and found that workplace policies such as lack of paid sick leave were correlated with higher incidence of influenza-like illness.  This study estimated 5 million additional cases of influenza-like illness in the U.S. population owing to the absence of workplace policies such as paid sick leave3.  A study that modeled influenza epidemic scenarios showed that universal paid sick days reduced workplace infections by 6%4.  Clearly, lack of paid sick days puts all of us at greater risk for contagious illnesses inlcuding the flu.

From an economic point of view, paid sick leave can be a burden for businesses and employers who will be required to pay employees who are not at work, generating income.  Even from this perspective, however, employees working sick are likely to be less productive.  And sick workers infecting other employees prolongs this diminished productivity and the resulting loss of income for the business.  Paid sick leave makes sense for keeping our communities healthy and our workforce productive.

The house hears this bill on Thursday; another opportunity for you to take action by attending the hearing, testifying on this bill, and/or writing to your state representative.  

  1. Restaurant Opportunities Centers United.  Serving while sick: high risk and low benefits for the nation's restaruant workforce, and their implact on the consumer.  Serving While Sick
  2. Drago R. Miller K. Sick at Work: infected employees in the workplace during the HINI epidemic.  Sick At Work
  3. Kumar S. Quinn SC, Kim KH, Daniel LH, Freimuth VS.  The impact of workplace policies and othe rsocial factors on self-reported influenza-like illness incidence during the 2009 HINI pandemic.  Am J Public Health.  2013; 102(1):134-140.
  4. Kumar S. Grefenstette J. Galloway D. Albert SM, Burke DS.  Polices to reduce influenza in the workplace; impact assessmetns using an agent-based model.  Am. J Public Health. 2013; 103(8); 1406-1411.                                                                                           

A guest blog entry from Jeanie Holt, NHPHA Policy Committee Co-Chair

SB135: Relative to Lead Poisoning In Children: changes the notice requirements for blood lead levels found in a child’s blood; establishes the lead screening commission to assess existing screening rates in relation to the department of health and human services’ screening guidelines; and establishes a task force to determine the feasibility of developing a program establishing essential maintenance practices to be used in pre-1978 rental housing and pre-1978 buildings containing child care to reduce exposures to lead from lead-based paints.

Public health activists joined with environmental activists to craft and submit a bill to further reduce lead poisoning in NH’s children. NHPHA has joined this team to help get this important public health measure passed. Marie Mulroy crafted testimony which Jay Smith will deliver at the Senate hearing on Tuesday. You, too, can be part of the team. We will report back on progress and let you know when letters of support will have the most impact. It takes a village…and a team!

Action by NHPHA members:  Sometimes NHPHA is unable to take a position on a bill. This most often happens because we lack the expertise to analyze the implications of the proposed policy and lack the time to find the experts among our members to supplement the Policy Committee’s knowledge. But that does not stop individual members from taking action. Jay Smith testified on HB 499, not as NHPHA’s Policy Committee Co-Chair but as a concerned public health professional.  If you’ve taken action on behalf of the public’s health, we’d love to hear about it. You can email Jay (jaycmd7699@gmail.com) or Jeanie (jeanieNHPHA@gmail.com). Include a copy of your letter, email, or testimony.

A guest blog entry from Jay Smith, MD, MPH, NHPHA Policy Committee Co-Chair

As many public health advocates know, we lost some of our legislative champions in the last election cycle and control of the legislature is now firmly in the hands of those who often see any governmental programs as inherently suspect.  This includes safety and health measures to some degree.  Yet there are thinking individuals among the new Republican majority in the House and the increased number in the Senate.  I think it would be a mistake to write them off and just concentrate on obtaining vetoes from our governor and then sustaining those vetoes in the legislature.  My recent experience with HB 288 is illustrative.  It is not a health bill per se but there are health implications involved and energy use and health are main passions for me.

This bill would allow towns and cities to opt out of the energy code for new construction.  In committee hearings, experts spoke in opposition to the misinformation being provided by the builder/legislator who is sponsoring the bill.  But the questioning from committee members made it clear that some felt that this energy code might be causing health problems from “sick buildings”.  So I sent the committee members all a letter to provide a health perspective.  I had responses from two Republicans on the committee, one saying he agreed with me and the other asking for information that I was able to supply after a small amount of research.  In the committee’s executive session, the committee didn’t send the bill on to the House for a vote but retained it for further study.  I don’t know that my letter shifted the vote at all and it doesn’t mean this is dead but we now have until next year to marshal testimony from other builders who have no problem with the code.

The legislative process is a bit mind-numbing and many important bills are being considered in many different committees at the same time so it is difficult to follow and influence.  But, if we don’t start early and get good information to our legislators about bad legislation (or good bills that we support), there may be a couple of votes that we lose that could have made a difference.  It can be quite discouraging but allowing that to sap our determination is not something the world can afford.  In future newsletters, there will be more information about bills heading in to executive session and then floor debate and votes.  This all leads up to crossover on April 2nd when every bill passed in the House goes to the Senate and vice-versa.  Then we start getting even more serious about getting everyone to understand what is at stake.

From the desk of Jeanie Holt, NHPHA's representative to the American Public Health Association's Council of Affiliates

APHA Update: Building a Public Health Movement

As you may know NHPHA has a half-time Executive Assistant who manages many administrative and support functions. Most of the work of our Association is done by volunteers, including the Board of Directors. So our Board meetings require a balance of reporting on the “nitty gritty” and discussing the “big picture”—strategic thinking. Recently we watched a video on creating a movement. As we talked about the video we came to the conclusion that we want to create an “internal” movement—an active, passionate, expanding membership—as well as an “external” one—non-public health professionals understand what public health does and why it is important.

We invite you, our readers, to join this discussion. Watch the video, even if you have seen it before, thinking specifically about generating energy within NHPHA, an internal movement.

  • At 0:38, the first follower calls to his friends to join him. Do you encourage your colleagues to join NHPHA?

  • 1:17: the narrator talks about the gathering momentum. We celebrate the work of the Membership Committee which has grown our membership from a low of around 100 four years ago to over 150 members today. We have momentum. Can you give us an extra push?

  • 1:34: here is what we want to look like. People running, jumping over obstacles, practically pushing each other to join the movement. What ideas do you have for making NHPHA that attractive to potential members?

  • 2:07: in the recap, the narrator says, “be public. Be easy to follow.” Do you talk about NHPHA? Do you tell others what you get from being part of this statewide public health organization?

Among the ideas the Board came up with:

  • Find ways to attract more Department of Public Health Services employees into membership.

  • Communicate to everyone that “public health” is a broad umbrella that includes environmental health, occupational health, nursing, health education, even agriculture and transportation.

  • Survey non-members to learn more about what they want from a public health organization; what would make membership of value to them.

  • Review the survey we conducted of our own members to see if we are doing what we, the members, want us to do.

What ideas can you add to the list?  Email us: info@nhpha.org

NEXT MONTH: Creating an external movement for public health.

The NH Public Health Association is pleased to feature this guest blog entry from Callie Carr, MPH, Project Director at the University of New Hampshire's Insitute for Health Policy and Practice.

MapNH Health LogoWhat will the state of New Hampshire's health look like over the next two decades? What will the challenges be in meeting the health care needs of our residents? A new website (www.MapNHHealth.org) provides a novel way to examine what the state’s people and their health could look like in 2020 and 2030.  MapNH Health is targeted to community and business leaders, policy makers and engaged consumers in the state, and is designed to inform both public policy and community conversations about how New Hampshire can best prepare for the future health and health care needs of the sta
te's residents.

The MapNH Health project was developed by the NH Citizens Health Initiative (NH CHI) and the Institute for Health Policy and Practice (IHPP) at the University of New Hampshire.

The user-friendly website provides information mapped geographically by County and Healthcare Service Area and allows users to view projections of demographics, health behaviors and health outcomes.  The ultimate goal is to engage stakeholders in community conversations that will examine what might happen, given the data, in order to formulate plans and public policy that will address New Hampshire's future health needs.

The interactive website was built through collaboration between University of New Hampshire’s Web and Mobile Development and the Applied Population Laboratory at the University of Wisconsin, utilizing data modeling and projections performed by the Applied Population Laboratory’s health geographer and demographer. Projections are based on current New Hampshire health indicators and population projections for 2020 and 2030.

"MapNH Health provides a lens through which we can look at New Hampshire's health care  landscape across three points in time: 2010, 2020 and 2030,” said Jeanne Ryer, Director of NH CHI.  “By understanding how our population, health behaviors, outcomes, and our access to health care will change over time, we can start to talk about how to meet New Hampshire's future health and health care needs."
NH Businesses for Social Responsibility

New Hampshire Businesses for Social Responsibility
 is a membership-based organization focused on fostering socially and environmentally responsible business in New Hampshire recognizing that people, principles and profits must be linked. We strive to provide programming, education and networks to help businesses understand the important role they play in addressing challenges and opportunities in our communities, workplaces and in advancing the greater good.

Our membership is not limited to businesses. We actually have many nonprofit and government agency members because we encourage the development of relationships and partnerships to collaboratively work for positive change. NHPHA is one of the partnerships that we firmly believe is important in creating a stronger New Hampshire community. The health and wellbeing of all our citizens is a critical component of healthy communities, which contributes to a healthy business environment.

Sustainable business principles consider the impact of operations, environmental and social, on all stakeholders – community members, customers, suppliers, supply chain and employees. They strive to minimize waste, maximize resource efficiency, minimize toxins, provide healthy and engaging workplace cultures, and a commitment to strong communities.

In partnership with Business NH Magazine, we encourage companies to share best practices in their workplace through the Best Companies to Work For competition. Strong health and wellness benefits are central to all winning companies. Leading companies like Hypertherm encourage wellness through active lifestyle programs and program support for healthy habits. Companies like Wirebelt, C&S Wholesale Grocers and Timberland provide employee and community gardens for healthier eating. We hope that by sharing these stories, other companies will be encouraged to offer similar benefits to employees based on the bottom line benefits demonstrated.

Sustainable business is a journey – we are all in different places. Our Just One Thing campaign strives to inspire more businesses to get involved in any aspect of sustainability by sharing stories of simple sustainability initiatives and the impact they’ve had on businesses and communities. (Stories will be published this summer on www.nhbsr.org/jot and featured in the New Hampshire Business Review.)

NHBSR hopes to assist, encourage and inspire more sustainable business and thus stronger, healthier communities in New Hampshire Partnerships with organizations like NHPHA are key to achieving our mission.
With the birth of a new website, the NHPHA has devoted a section for our valued members to tell their public health stories. Every month, we’ll be highlighting one of our members and tell their story.

NHPHA Public Health Stories: What does public health mean to you?

February 2012 Member Spotlight - Jeanie Holt, NHPHA President

spotlight1 jh pic1-1 

How long have you been doing public health work?

Sometimes it is hard to decide when I started doing “public health work”. I can remember cleaning up trash, building and repairing hiking trails, and taking around flyers for polio vaccination days as a child! Public health and health promotion has been a part of my life ever since. But more formally, I really began working in public health in 2000 when the NH Minority Health Coalition hired me to direct a CDC grant to plan and test community interventions to prevent diabetes and hypertension in Latino and African-descendent communities in Hillsboro County.

How did you first get involved with NHPHA?

I attended NHPHA annual meetings for the first time in 2005 when Kathy Mandeville was Association President. Now, Kathy and I are the same age but I remember seeing her as so knowledgeable and capable and feeling pretty young and inexperienced! Five years later I am President of the Association?! When I look at the list of people who have served NHPHA as presidents or as Board members, I still like a public health novice. But I am so lucky that so many of these folks are still very involved and always so available to me!

What do you do as a public health “champion” or worker?

What I most want to do as a public health champion is to inspire and mentor younger folks and create an environment in which they can thrive. In my work as Association President, I have opportunities to interact with people working in public health across the state and beyond. I look for opportunities to reach out to students, to meet with people who are new to public health, and to create a broader understanding of and respect for public health. In addition to my Association work, I teach public health. Two years ago, I teamed up with my sister, a professor of finance, to create and teach a course on Microfinance and Public Health. We are preparing to teach this the 4th time. This year will be the 3rd time we have taught it to semester abroad students in the Dominican Republic—you can follow our experiences on our blog http://microfinancepublichealth.wordpress.com

Tell me about yourself?

Many of you know my husband, Dennis, who works at NH DHHS and is finishing his MPH after a long career as an engineer. We are ridiculously proud of our 5 sons and 5 grandchildren. John is married to a hydrogeologist and works as a database programmer. They have 2 school-aged children. Ben works for Apple computers as a software engineer. He and Abbie have a 5-year-old son. Jeff does lighting research for Sylvania. He and his wife, Alyson, are adopting a baby born in Ohio on January 6, 2012. Greg is a professional dancer—which means he basically supports himself by writing grants, fellowships, and the like. Maybe I should beg for some services for NHPHA from him! Steve teaches Spanish in a private middle school. He and spouse, Stevie, have adopted a beautiful baby girl, born May 30, 2011, in New Jersey.

And I am a rock climber. Most of the time, Dennis and I climb in a gym—Vertical Dreams in Manchester. Grandkids, work, NHPHA, and school have stolen a lot of our climbing time this past year. In prior years we climbed 4 to 7 times a week; this year I was lucky to get in one evening a week. Once Dennis graduates we sure hope to get back to the gym more regularly.

When you open a new building, you have a ribbon cutting ceremony.  I could not find much about the origins of this tradition but sources say it has been around for “more than a century.”

When you launch a new ship, you break champagne over the bow apparently an ancient custom that migrated from Europe to the United States.

But the launch of a new website?  A quick Google search revealed that “launch lunches” were popular in the 1990s—I don’t remember getting invited to any!  And they became “lavishly competitive affairs” (I don’t remember any lavish affairs!) with logo strewn giveaways (I don’t have the tee-shirt to prove it so I guess I haven’t “been there” or “done that”).

Well, ours is not a lavish affair though we are very excited about our new website and about sharing it with you all.  Our launch will not feature giveaways, unless you choose to “giveaway” a donation to NHPHA to help cover the costs of the website.  But we will have lots of fun!  

We will launch our new website during our Annual Open House on December 9, 2011 from 5 – 7 PM at our Park Street office (Suite 403B). You will see our new website, and, at the same time, reconnect with colleagues, meet other public health activists, and enjoy yummy appetizers!  You won’t want to miss it!

Jeanie Holt, NHPHA President


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