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Wednesday 3 June 2009

Funding of Public Health – a Necessity now more then ever

Commissioner Jon Auerbach of the Massachusetts Department of Public Health (DPH) spoke Friday afternoon to a packed room as part of Brown Bag Luncheon Series. Commissioner Auerbach’s talk covered three hot-issue topics: the current H1N1 virus pandemic (more commonly known as Swine Flu), the effects of the current budget debates on DPH, and a new Public Health initiative to combat obesity, chronic disease, and promote wellness.

The Commissioner began his talk by addressing the government’s response to the H1N1 outbreak. Commissioner Auerbach stressed that while the spread of the disease was unfortunate, the occurrence has provided a great opportunity for the state to exercise its emergency response network. Moreover, he explained that the initial fear over the virus re-affirmed the need for the state to have a robust health system and method of accurate reporting in order to react to outbreaks of unexpected illnesses.

Commissioner Auerbach detailed many elements of the state’s response to Swine Flu. While early reports out of Mexico suggested that the virus was extremely deadly, Massachusetts did its due diligence in both monitoring and responding to the virus. The state has uncovered a wealth of information on H1N1 including the fact that the virus in general is not deadly (rather it is symptomatically consistent with the general flu) as well as some key differences between the general influenza virus and this strain. For example, while the general virus most severely affects the very young and the very old, the H1N1 virus is most prevalent in the 0-20 age group. While, DPH does expect the flu to become wide-spread, they plan to have a vaccine ready for dissemination by next flu season.

Moreover, the H1N1 outbreak has highlighted some considerable strength in Massachusetts’ health response system. Primary among these achievements was the state’s public communication and outreach. Within just 10 days after the first case in Massachusetts, educational materials were available in 14 languages, and state provider help-lines were able to provide medical information to over 4,000 callers, helping to stanch tides of concerned citizens looking to emergency rooms for care. As Commissioner Auerbach eloquently stated, “without a robust health system people will die, become more seriously ill or more injured than they otherwise would be.”

The Commissioner detailed how the current economy will affect DPH, as public health needs have only become greater as the economy has dipped. HCFA has advocated for level funding for many crucial public health programs, including funding for its quality bureau, oral health programs and tobacco cessation programs. Many programs in DPH have been reduced by over 20% in the past year. The Senate did include a proposal that was supported by the Governor and the Department, the removal of the sales tax exemption on alcohol. This revenue stream would dedicate an addition $70Million to critical programs for the states’ most venerable populations.

Commissioner Auerbach concluded his talk on a positive note by discussing the state’s new public health campaign to combat obesity and prevent chronic disease Obesity, with a very high rate in Massachusetts, is a primary cause of many chronic diseases including diabetes and heart failure. In Commissioner Auerbach’s words, the aim of the campaign has been to “change default behaviors” so that diets and exercise feel more like every day life rather than a chore. The campaign has three main legs: the first has been a statewide regulation for restaurants to post the calorie contents of their foods. As studies of a similar law in New York City have shown, when armed with information, people alter their behaviors. Not only have patrons in New York changed their ordering habits once given caloric information, but restaurants themselves have altered their menus to provide consumers with healthier alternatives.

All in all, Commissioner Auerbach demonstrated how crucial strong public health programs can be and how important it is for Massachusetts to have, and to continue to have, a robust public health department.


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