WSPHA May Blog: COVID-19, Behavioral Health, and Washington State 
By: Ginny Weir, MPH, Director, Bree Collaborative 

We are all experiencing trauma from living through this pandemic. The world as we knew it has changed – we have lost connection with our loved ones, many of us have lost jobs, we have all lost a sense of stability. I’ve learned that the discomfort I am feeling, as outlined in the Harvard Business Review, is grief. I am feeling myself cycle through denial, anger, bargaining, sadness, and acceptance, sometimes daily. 

I am trying to take a lesson from Brene Brown on running emotionally intelligent virtual meetings by asking everyone to give a two word check in, acknowledging that people feel multiple emotional reactions to stress. As I write this, I feel grateful for our public health community and anger that we have been underfunded for so long, increasing the severity of this outbreak. I also recommend joining 2019 WSPHA conference speaker Sarri Gilman’s listserv for tips on self-care. 

Other than (hopefully) more funding for public health, I see population-level mental health impacts as being one of the longest-lasting effects of this pandemic. Whether we work as health care providers, administers in hospitals, epidemiologists tracking this virus’s behavior, champions of health equity, grocery store workers, mail carriers, have lost a job that we loved, or are trying to stay grounded with school-aged kids at home, our lives have all changed. JAMA published an article outlining the reactions of healthcare workers in China to COVID-19 including depression, anxiety, insomnia, and distress. Analysis of the 1918 pandemic show population-wide reactions similar to those that we are seeing today including denial, to mistrust of foreign nations, widespread panic, depression, disturbances in sleep, and even increases in suicide

I also think it is important to remember that while we are all impacted, this looks different for everyone. Lady Gaga reminds us that, “the fight that I’m in — or that you’re in, right? — is very different than the fight of a woman that is in, perhaps, an abusive relationship and has a child and lost her job and can’t feed her kid and can’t feed herself and also can’t get the help that she needs because she’s in a violent situation.” The inequities that existed before still exist and are in many cases are being magnified. Our work to close these equity gaps matters even more. 

We know that our behavioral health delivery system is fragmented and has many barriers to access. Trust for America’s Health is holding a webinar May 6, available on their website, on Mental Health and COVID-19: How the Pandemic Complicates Current Gaps in Care and What Can Be Done. I anticipate the behavioral health needs will be greater than before, and our delivery system needs to be better supported just as our public health infrastructure needs to be better supported. 

The Bree Collaborative is working to educate and engage our community on integrating behavioral health into primary care to increase access and quality. I invite all of you to attend our newly virtual, and free, behavioral health summit – scheduled for two 3.5 hour days on June 16th and on June 23rd

Day One: June 16th 1:00 – 4:30pm includes background on our collaborative, thoughts from state leaders, how-tos on building trauma-informed care into practice, and we will have a conversation on telehealth and integration. 

Day Two: June 23rd 8:30 – 12:00 includes discussion of the mental health of health care providers; concrete steps for screening, brief intervention and referral to treatment; on medications for opioid use disorder; on suicide care; and on reimbursement. 

I hope you will join us for at least one of our virtual summit days and remember to care for yourself as well as for your community. 

In partnership and health, 

Ginny Weir 

 

 Past Blogs

 

Sustaining Self-Care, Compassion, and Boundaries
By: Sarri Gilman, LMFT

I am looking forward to meeting you at the upcoming  Washington State Public Health Association Conference in Wenatchee Oct 1-3. I see everything through the lens of our boundaries, the same way the public health touches every aspect of our lives and our communities, I see boundaries as touching every aspect of our lives and our communities.

 

At the conference, I will be sharing some tools to get you started on using this boundary lens to explore the ways you can strengthen your self-care and strengthen your boundaries.

I know that you are all about passing along the most helpful tools and skills to others. But in order to equip others, I can’t just pass this to you in a handout that you can then transmit. I need to first pass it through you. You need to embody this to be able to share it with others. Read more.


 

Climate Change and Our Health
Submitted By: Herakles Li, MPH, WSPHA Member


Most of us who have lived in the Pacific Northwest for a while probably have had the same question on our mind with August rolling around. How bad will the smoke be? In the last few years our region has seen record breaking numbers in wildfire as well as generally hotter summers. It is no coincidence that these numbers are on the rise. All over the news, whether here, or across the nation and the world. We have been experiencing record breaking hot summers. These heat waves are just one of the consequences of climate change and an example of how it will, and already has, impacted our region and our health.
Climate change is predicted to cause numerous harmful human health effects, some of which we are already experiencing.We need to take steps now to safeguard the health and well-being of people in our community. Read more.




“Emotional and Connected”: The Role of Community Health Workers in Promoting Immunization

Submitted By: Leigh Wallis, MPH, Adult Immunization Health Educator, Washington State Department of Health

The fifth annual Community Health Worker Conference was held in Wenatchee on April 11 and 12. This year's theme was You are EPIC: Equitable, Passionate, Invested & Collaborative! More than 400 community health workers (CHWs) attended. For those who don’t know, CHWs are trusted community members who serve as connectors to needed resources, helping individuals and families navigate the health care system.  

With 40 learning sessions and trainings at the conference, there were many opportunities to connect and learn from one another. Here’s a sneak peek into a learning session on the hot topic of immunizations and what it means for CHWs.

Department of Health (DOH) Flu Health Educator Barry Iverson and 2018 Washington CDC Childhood Immunization Champion Dr. John Merrill-Steskal co-presented on the importance of flu vaccination. They shared general information, gave advice on how community health workers can talk to their clients, and answered lots of questions. Barry also spoke at the final day's plenary session along with Assistant Secretary of Health Lacy Fehrenbach about vaccine hesitancy and shared multilingual resources that support community health workers and their clients. Read more


 Public Health and Wikipedia: Your Patients Are Here, Why Aren't You?
Submitted By: Ann Glusker, MPH, MLIS, Librarian, University of California, Berkeley (formerly librarian with the National Network of Libraries of Medicine/University of Washington, and epidemiologist with Public Health – Seattle & King County)

 
We’re all used to thinking of Wikipedia as among the more unreliable of resources—anyone can edit it, right?  However, librarians like me and many public health professionals and healthcare providers are starting to have a more nuanced understanding of this widely-used tool.  For starters, there is a strong culture of fact-checking, and the use of references means that it’s easy to check out where people are getting their information from; in fact, the quality of medical content is often better, for these two reasons.  The title of this post is taken from an article entitled “A Perspective on Wikipedia: Your Students Are Here, Why Aren’t You?” (by Meghan Dowell and Laurie Bridges) and this post hopefully will convince you to at least take a new look at the ubiquitous online encyclopedia. Read more.




Addressing the Unique Needs of the LGBTQ Community
Submitted By: End AIDS Washington Team, Washington State Department of Health

LGBTQ pride is a celebration of confidence, self-respect, and solidarity as expressed by LGBTQ communities and associated with openness regarding sexual orientation, gender identity, and gender expression. It honors the resilience and strength of LGBTQ communities in the face of historical and systemic oppression.

 In support of the community, the End AIDS Washington team wants to highlight some of the work around the state to foster and build systems that allow everyone to have fair access and opportunity to be safe, healthy, and free from discrimination.

LGBTQ Commission and Reproductive Health Access for All Act

Thanks to Washington’s LGBTQ Caucus, the legislature recently passed two bills to advance equity and health. Senate Bill 5356  creates an LGBTQ Commission, seated in the Governor’s office, to work with state agencies to develop and implement policies to address the unique needs of the LGBTQ community.  The Reproductive Health Access for All Act continues to strengthen the foundation for equity-driven policy and health care. Senate Bill 5602 advances equity by removing barriers to reproductive health care, by prohibiting health care discrimination on the basis of immigration status or gender identity and improving coverage and access to healthcare that meets the unique needs of LGBTQ persons. Read more.


Public Health: What is Happening in Olympia
By: Anne Burkland, MPA, Government Relations Specialist, Public Health - Seattle & King County
Board of Directors, Washington State Public Health Association

With just under a month left in the 2019 legislative session, we’ve seen great advances in public health priorities. Below is a sampling of key priorities that are still in play.

 House Bill 1074: Last week the Legislature approved prohibiting the sale of cigarettes, tobacco products and vapor products to people under the age of 21. The Governor is expected to sign the bill, and the law will take effect on January 1, 2020.

Read More.



 How You Can Help Create the Healthiest Washington During National Public Health Week
By: Heather Thomas, MPA, Public and Government Affairs Manager, Snohomish Health District

National Public Health Week will be celebrated April 1-7, and we want you to join us in recognizing the work of public health all week long. The American Public Health Association (APHA) makes it easy for all of us to participate by developing an annual theme and daily topics. The 2019 theme is “For science. For action. For health.” Come meet with us for networking and discussion on April 3rd before starting your workday for Public Health over Bagels and Coffee from 8:00 – 9:00 at 705 second ave, 6th floor meeting room, Seattle WAStart giving some thought now for how you—and hopefully your organization—can take part. APHA has created a communications toolkit online, with logos, social media content and fact sheets that you can use. Better yet, look at their framework and see how you can share information, resources or photos of your work around these daily topics... Read more.

 


 Investing in the Future of Our Public Health System
By: Ian Corbridge, Director of Quality and Performance, Washington State Hospital Association


Like most Americans, investing and thinking about the future is not easy for me. Investing money now for when I’m 70 is a lot less appealing in the moment than buying a new carbon fiber mountain bike.

This said, pivotal moments or crises in our lives often help us reprioritize what is important. My daughter was diagnosed with a serious medical condition after her first birthday. As new parents we were devastated, and we immediately began treatment. Once her care began, we started thinking about her long-term needs. What would she need to be successful? What would happen to our daughter if we, her parents, were no longer around? Faced with mounting challenges, we made the critical decision to invest in our daughter’s future to ensure she has a vibrant and happy life. Read more.

 

 


 Public Health in the New Year
By: Ginny Weir, Director, Dr. Robert Bree Collaborative

I’d argue that nearly everything we do falls under the umbrella of public health. From responding to natural disasters to city planning, every sidewalk (or lack thereof), drop of (treated) water, and medical procedure has an effect on our health. Bill Foege, a past Director of the Centers for Disease Control and Prevention, said this more poetically, “There is no human endeavor that is outside the realm of public health.” This is powerful and inspiring – but also makes telling the story of public health more difficult. How do we talk about public health if everything we do is in fact public health? Who can speak for public health if public health is part of all that we do? Read more.

 


 Live Well San Diego

By: Nick Macchione, MS, FACHE, Agency Director, Health and Human Services, County of San Diego


When asked, what is Live Well San Diego? I say it’s all about improving lives. 

Live Well San Diego is a regional vision that we have adopted, which outlines what we are doing collectively to build better health, live safely and thrive. In County government, it’s our north star that helps guide the provision of housing, health and human services and resources. It’s how we do business and improve the lives of one in three or approximately 1.3 million San Diegans. It all started in 2008. I was the newly promoted director of the County’s Health and Human Services Agency. I was tasked with answering one question: “How do we help over 3 million San Diego residents lead healthier lives?” Seeking solutions was no simple or straightforward task. Complex problems require complex solutions, and in order to create sustainable improvements across a diverse and geographically vast region, we had to seek input representing a range of diverse perspectives in the brainstorming process.  Read more

 



 Let's Talk Immunization
By: Mackenzie Melton and Izzy Brandstetter, WithinReach Immunization Experts
 
August 1, 2018
Since August is National Immunization Awareness Month, we felt it’s only appropriate to highlight why the rush and overwhelm to immunize, in the summer months especially, are so crucial to maintaining health and wellness among our families and throughout our communities.With children spending the majority of the day together in a classroom during the year, it’s also the optimal breeding ground for many bacteria and viruses that can cause serious illness. Fortunately, a large portion of these illnesses can be prevented through routine immunizations. And for those with pre-existing health conditions that hinder them from being immunized themselves, we vaccinate so that they can be protected from illness, and benefit from community immunity. Read more.
 
 
 

 Rethinking Our Approach for Urban Indian Studies
By: Adrian Dominguez, MS and Rose James, PhD
Urban Indian Health Institute, Seattle Indian Health Board
 

July 1, 2018
American Indian and Alaska Native (AI/AN) communities have an understandable mistrust of research.  This stems from the misleading efforts by non-Native scientists to assess American Indian and Alaska Native (AI/AN) communities and the drawing of pre-conceived outcomes and descriptions that would support the genocide of a community that was once believed to be inferior, barbaric, savage-like, and uncivilized. Practices involved deception, dishonesty, and trickery, resulting in physical harm, such as radiation studies among AI/AN people presented as clinical care and the forced sterilization of AI/AN females.As non-Native scientists completed their research, they reported findings that were inaccurate, false, and unreliable, and that paved the road to openly stigmatize and misrepresent AI/ANs. Read more. 
 

 Summer Break with or without Hunger
By: Debra French, Director, WSPHA Board of Directors


June 1, 2018

Schools out and its summer break, for many a time for relaxation, vacations, fun and some sunshine but for some, it’s a bit more stressful.  Millions of children who rely on free and reduced-priced school breakfast and lunch during the school year, lose access to those meals when summer break begins. The federal government provides funding for the Summer Food Service Program (SFSP) and the Seamless Summer Option (SSO) both are key to bringing nutritious meals and snacks to children during the summer months. Read more.

 


 Adverse Childhood Experiences and Public Health
By: Amy Person, MD, Director, WSPHA Board of Directors

mental health

May 1, 2018
Behavioral health disorders are common – but what role can public health play? One in eight adults in Washington State reports poor mental health and one in three Washington 10th graders reports depressive feelings. We cannot achieve the highest health potential for individuals, families or communities without including behavioral health as a public health priority. Applying the public health model to behavioral health can also shift the focus to include primary prevention as well as improving access to treatment. Read more
 
 
 

Celebrating National Public Health Week
By: Ginny Weir, MPH, Director, Bree Collaborative


April 1, 2018
Public health is essential to building a healthier Washington and stands on foundational public health services like chronic disease and injury prevention, maternal and child family health, access to clinical care, environmental public health, vital records, and communicable disease control. Although Public health week has already passed, there are still plenty of ways to get involved and advocate for a healthy community. Read more.
 
 
 
 

Legislative Education Day: What Comes Next?
By: Heather Thomas, MPA, Public & Government Affairs Manager, Snohomish Health District

March 1, 2018

On February 7, more than 150 public health ambassadors from around the state gathered in Olympia for our annual WSPHA Legislative Education Day. The morning session kicked off with a welcome from WSPHA president David Reyes, followed by remarks from Secretary of Health John Wiesman. Secretary Wiesman shared his perspectives on a variety of public health issues at the state and federal level. Read more.

 

 


 Legislative Education Day
By: Anne Burkland, Government Relations Specialist, Public Health Seattle and King County
 
February 1, 2018
Join public health officials from across the state and have your voice heard at our annual legislative education day on February 7, 2018.Your day will begin with Secretary of Health John Wiesman. You’ll also hear from state lawmakers and your colleagues who are leading the charge for more funding dedicated to public health. You’ll be provided talking points and an opportunity to develop and practice the key messages you want your representatives to hear. Read more
 
 
 
 

 The Opioid Epidemic in Washington
By: Ginny Weir, Program Director, Dr. Robert Bree Collaborative
 
January 1, 2018
The opioid epidemic has impacted every community in Washington State. Across the country, opioid overdose is now the leading cause of accidental death. But some counties are hit harder than others and disparities exist between how racial and ethnic groups are burdened with the epidemic. Solutions must be both based in local communities and supported across the state. Our Washington state opioid response plan calls on all of us, state government agencies, local health departments, professional groups, community organizations, health care systems, and others to work together on priority areas. Read more.