Public Health

A rapid home test for HIV, similar to early pregnancy tests, will be considered by a federal advisory committee on Tuesday, a move that many public health experts believe could eventually help calm Americans' fears of HIV, leading them to view it as just another serious chronic illness. An over-the-counter test offers new hope against an epidemic whose numbers in the United States have hardly budged in more than 15 years. An estimated 50 percent to 70 percent of the more than 50,000 new HIV cases annually are transmitted by people who were unaware that they were infected.

If you see a man on the street bleeding, you might apply pressure to his wound if you know what you're doing, or call an ambulance if you know that you don't. How about if you see a woman panicking, or mumbling incoherently? Do you talk to her? Ignore her? Call 911? "Most people don't have a clue what to do," said Arthur C. Evans, Philadelphia's director of behavioral health, who on Thursday rolled out a "Mental Health First Aid" campaign that officials described as the biggest implementation of a relatively new concept, at least in the United States.

By Robert Field, professor of law and public health at Drexel University:   Do you know anyone who died of polio or from a cup of water? If you live in America, probably not. But in many countries, such tragedies are still common. We in the United States owe our good fortune to the work of public health. It protects our health and well-being on a national scale. Public health is different from health care. The latter is the range of services we receive from doctors, nurses, and others.

In November 1989, the voters of Montgomery County overwhelmingly voted to create a county health department - 52,734 in favor, 31,646 opposed. Rosellen Burcin was one of the naysayers. Burcin is the local health officer for Lansdale Borough - and far from the only opposition voice among her counterparts. "It's a touchy subject," she says of the long-standing controversy over local health monitoring versus countywide monitoring. "The populace is perceiving that we (health officers)

At a time of growing public-health concerns - bioterrorism, West Nile disease, obesity - programs to develop experts to deal with such problems are sprouting in the Philadelphia region - and across the nation. These new programs train people for jobs in health departments, health systems, drug firms, and community health groups. There are now at least six graduate-level public-health programs in Southeastern Pennsylvania and one in South Jersey. Four have been launched in just the last year.

What is public health? Well, it's the health of the public. And its practitioners include engineers (designing water-treatment plants), nutritionists (developing healthy diets), even politicians (passing laws on bioterrorism and insurance). And bloggers. In "The Public's Health" ( www.philly.com/publichealth ), their new blog, Michael Yudell and Jonathan Purtle are on a mission to help us understand why we as a nation or a city or a neighborhood are ailing or not - and to begin a dialogue with readers on what can be done about it. "I'd like to hear creative ideas and solutions to some of the challenges we face," says Yudell, an associate professor at the Drexel University School of Public Health.

Delaware County residents would benefit from leadership in and coordination of public health systems, according to a study discussed Wednesday night at a rare nighttime County Council meeting. The study also identified gaps in coverage that indicate room for improvement in such areas as outreach for smoking and alcohol consumption, bicycle helmet use, Lyme disease, and sexually transmitted diseases. About 50 people attended the meeting with the council and researchers. In June 2008, the county contracted with Johns Hopkins University's Bloomberg School of Public Health to survey its public health services and identify needs.

Philadelphia's only school of public health has a new dean. Marla Gold, an infectious disease specialist, stepped into the job this month at Drexel University. She replaces Robert O. Valdez, who resigned to become a professor in Drexel's business school, according to university officials. Gold didn't need to move far to become dean. Her new digs at 1505 Race St. are only a block from her AIDS/HIV clinic on Vine Street, where she and colleagues put together the largest practice of its kind in Philadelphia.

A rapid home test for HIV, similar to early pregnancy tests, will be considered by a federal advisory committee on Tuesday, a move that many public health experts believe could eventually help calm Americans' fears of HIV, leading them to view it as just another serious chronic illness. An over-the-counter test offers new hope against an epidemic whose numbers in the United States have hardly budged in more than 15 years. An estimated 50 percent to 70 percent of the more than 50,000 new HIV cases annually are transmitted by people who were unaware that they were infected.

I've been having some crappy mornings lately - literally. I walk out my door, admire the contrast of the cherry blossoms against the crisp blue sky, and then hobble over a fresh mound of dog droppings. The Spring Garden section of Philadelphia is scattered with such treasures, occasionally encased in blue plastic bags. On trash day, I return home to a recycling bin containing at least three of these goody bags to bring back into the house. Let's face it: Dealing with dog waste, whether you own a dog or not, is a fact of life.

When Pennsylvania's new natural gas law, which takes effect Saturday, was being debated, the focus was on high-profile issues such as the new impact fee. But just before it passed, medical provisions were added that now have some physicians worried it will compromise public health. Except in an emergency, a physician who needs proprietary information about chemicals used in natural gas drilling to assess a patient must provide "a written statement" to a company, according to the act, and must sign a confidentiality agreement.

The city government and Children's Hospital of Philadelphia are planning to join forces to provide health care to South Philadelphia adults and children in a unique arrangement that might also include a new library and recreation center. The plan, announced by Mayor Nutter during Thursday's budget address, moves two existing clinics - a pediatric practice owned by the hospital and a city health center that mainly serves adults, each of them in need of expansion - into one building that would be constructed by the hospital on city land and outfitted by both.

With the smart goal of transforming the Delaware waterfront by reconnecting Philadelphia to the river, it's not a question of building new attractions to attract visitors. Rather, it's about opening up more routes for people to reach the river that's there. So the progress reported last week toward creating a permanent network of trails and public spaces at the water's edge represents an important step forward. The acquisition of four piers and five acres of land by the agency overseeing public waterfront development means it's no longer a question of whether but of when greater waterfront recreational options will arrive.

If you see a man on the street bleeding, you might apply pressure to his wound if you know what you're doing, or call an ambulance if you know that you don't. How about if you see a woman panicking, or mumbling incoherently? Do you talk to her? Ignore her? Call 911? "Most people don't have a clue what to do," said Arthur C. Evans, Philadelphia's director of behavioral health, who on Thursday rolled out a "Mental Health First Aid" campaign that officials described as the biggest implementation of a relatively new concept, at least in the United States.

Sarah Boardman Furnas, 68, of Chestnut Hill, a senior administrator with the Philadelphia Health Promotion Council who helped simplify health-care and medical literature for consumers, died of cancer Thursday, Dec. 22, at Pennsylvania Hospital. The nonprofit council, on which Mrs. Furnas served from 1986 to 2002, was founded in 1981 as the Southeastern Pennsylvania High Blood Pressure Control Program. Funded by the Pennsylvania Department of Health, its mission is to implement community-based programs to fight hypertension.

It has been almost two years since Delaware County commissioned Johns Hopkins University to conduct a survey of the gaps in public-health coverage. And it has been seven months since George Avetian, a family-practice physician in Upper Darby, was appointed senior medical adviser to help coordinate public-health efforts in the county and fulfill the first of the study's recommendations. The county does not have a county-based public health department. The county's Department of Intercommunity Health acts as a referral center on public-health issues.

City sadly lacking in public health I was proud to attend Day 5 of Occupy Philadelphia as a physician interested in the general issue of fairness in our city and in our nation. The issue that I believe is unique to our city, in contrast to similar gatherings in other U.S. cities, is what I refer to as medicine vs. health. Our city and region have a unique abundance of world-class, high-tech, and high-cost medical institutions and supporting industries. But we are sadly lacking in public health - especially our growing number of poor.