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Inside NHPHA - Message from the NHPHA Executive Director

Inside NHPHA - Message from the NHPHA Executive Director

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NHPHA Member Spotlight - Adriana Tejada

NHPHA Member Spotlight - Adriana Tejada
 
 
What’s your favorite part of being a member of NHPHA? 
My favorite part of being a member of NHPHA is knowing that there is a vast network of individuals serving communities like myself. Public Health is a broad field, and it can feel isolating to navigate when you are alone. NHPHA makes me feel as though I am a part of something greater and that I always have a resource or community of people to rely on when I am stuck or looking to reignite my passions.
 
What is your current occupation?
I am currently the Child Nutrition and Communications Coordinator at New Hampshire Hunger Solutions. We are an advocacy organization with a mission to eliminate hunger statewide. 
 
What do you love most about the public health profession?
There is so much to say here! I believe in the power of prevention. Public health is critical because it is all the behind-the-scenes action planning that takes place prior to someone getting sick, lacking resources, etc. I love that public health skills are transferable and can be used in a variety of different settings. Public health is all around us, and I began to love this profession more when I realized that all of the precautions and actions we take on a daily basis all contribute to public health. One of my favorite quotes is from William Foege, who said, “There is no human endeavor that is outside the realm of public health.”
 
How do you define success?
I like to think of success as a process rather than an outcome. I am in an early stage in my career, and I love to take mental note of all my achievements, both big and small, as they all propel me forward to become a better and more competent version of myself. I look at my skill set and see consistent growth over time, and that makes me feel very accomplished. I also view success from the perspective of helping my organization reach its goals and expand our audience reach, which is a huge part of my role.
 
Who inspires you?
I am greatly inspired by my mother. Although she may not have the greatest understanding of public health, she has always been a phenomenal role model for me and has advocated for me to be in spaces that I could never have imagined I would be in. I now wish to do the same for others, especially in the field of public health, which is always growing.
 
If you could choose anyone as a mentor, who would you choose and why?
This is a very difficult question. I am stuck between Michelle Obama and Dr. Maria Gloria Dominguez Bello. I would choose Michelle Obama for her immense courage and knowledge of policy, as well as her advocacy for healthier school meals for all. I would choose Dr. Maria Gloria Dominguez Bello for her work in the microbiome in humans, but specifically in infants. I find her work very interesting!
 
What advice would you give to someone who wants to enter the public health profession?
Take your time and volunteer with different organizations (healthcare, nonprofit, technology, etc.) to figure out what interests you. Ask yourself. “Which of the public health disciplines are being exercised in these settings?”, “Am I passionate about ____?”. Create a LinkedIn account and begin networking and searching for opportunities as soon as you can. If possible, try to schedule days where you can shadow people in positions you admire. And lastly, try your best to stay updated on the latest public health news and research!
 
What’s one thing — either industry-related or not — you learned in the last month?
I read an opinion article last week on fad diets I found particularly interesting. It was titled, “Why We Fall for Fad Diets .”It talked about the motive for dieting shifting from biological needs to socio-cultural needs. I thought it was incredibly insightful. Here is a significant line from the article: “When examined together, it’s clear that fad diets really aren’t about the food, but they do signal group belonging and self-identity— two qualities central to the psychological health of most humans.”
 
What is your favorite hobby?
My favorite hobby is baking, specifically for others! I make banana bread. I also enjoy weightlifting.
 
Are you currently binge-watching any shows?
I finished Stranger Things season 4 at the beginning of July, and I cannot wait for season 5. I’m currently watching Virgin River, which is a corny, hallmark-like show with a complex love story.
 
If you had to eat one meal every day for the rest of your life, what would it be?
If I had to eat one meal every day for the rest of my life, it would probably be tacos al pastor. I would also choose macaroni and cheese if I needed a second option. My third option would be something Dominicans call “Pastelon de Arroz.” It’s essentially a beef, rice, and cheese casserole. It’s yummier than it sounds!
 
What’s one item you can’t live without?
I can’t live without my music. I listen to music every day! It helps me romanticize my life and makes me feel like I’m constantly in a movie. If you love Latin music, you must listen to Bad Bunny! 
 

Health is a Human Right

Health is a Human Right
By Jayme H. Simões, President, Louis Karno & Company Communications, LLC & Dr. Randy Hayes, Retired Family Doctor, Co-Convener of the Kent Street Coalition Healthcare Working Group, and Member of Canterbury Citizens for Democracy
 
The Supreme Court has overturned Roe v. Wade, reversing a 50-year precedent and eliminating the federal right to abortion care. After many years of a coordinated, well-funded crusade against abortion rights, Republicans finally got their way. Now, millions have lost control over their bodies and safe access to essential care. 
 
Republicans in Congress have been sabotaging access to contraception, ignoring the maternal mortality crisis, and resisting Medicaid expansion. They continue to attack common-sense reforms to lower health care costs and expand affordable coverage. Now, in light of the Supreme Court’s decision to overturn Roe, protecting women’s access to care and passing reforms to help mitigate some of the worst impacts is paramount. 
 
In New Hampshire, the Republican leadership in the Legislature scuttled a maternal health bill with bipartisan support, SB 407. This bill would have extended the length of Medicaid coverage for women who have delivered a baby from 60 days to 12 months postpartum, a key reform to reduce America’s tragic position of leading all industrialized nations in the rate of maternal deaths. The GOP leaders would only support this bill if Democrats agreed to dangerously increase the ability of employees of hospitals and many nursing homes to refuse any and all required vaccinations traditionally required for employment.
 
The Republican majority on the New Hampshire Executive Council refused to renew the usual million-dollar grant to Planned Parenthood of Northern New England which has supported discounted or no-charge care to women throughout our state. Such care includes contraception, cancer screening, health maintenance exams, and the diagnosis and treatment of sexually transmitted infections. The reason Republican Councilors gave for this non-renewal of funding for tens of thousands of women was the fear that some of this money would go towards supporting Planned Parenthood’s abortion care. However, a careful audit showed no direct use of state funds by Planned Parenthood in NH for abortions. The State Attorney General and the Commissioner of the NH Department of Health and Human Services both supported the legality of continuing to provide the grant money to Planned Parenthood.
 
Republicans have spent more than a decade trying and failing to repeal the Affordable Care Act (ACA) and its protections for millions of Americans. Importantly, the ACA’s contraceptive coverage requirement is needed now more than ever as new abortion restrictions pop up all over the country. The ACA also requires coverage without cost-sharing for many preventative services for women, including screenings for cancer and certain diseases, well-woman visits, and of course, contraception. Instead of working to strengthen and protect access to this vital care, Republicans continue to go to court to dismantle the ACA’s protections. 
 
Stripping access to safe and informed reproductive health care puts lives in jeopardy. Republicans are ignoring the maternal mortality crisis by blocking legislation that provides critical preventative care services. America now has the highest maternal mortality in the industrial world — and the problem is only getting worse. Hundreds of lives are claimed by this crisis every year, and that number has only been increasing for the past 20 years. This disproportionately impacts Black mothers, who are 3 to 4 times more likely to die a pregnancy-related death than white mothers. These deaths are completely preventable. 
 
In spite of this grim reality, Republicans unanimously oppose the Black Maternal Health Momnibus Act, which would provide millions in funding to address the root causes of America’s maternal mortality crisis. In addition to advocating for 12-month postpartum Medicaid coverage.
We should note that our own Governor signed the first anti-abortion bill in our state’s history as part of the state budget on June 28, 2021. New Hampshire Law now forbids abortion after 24 weeks of gestation except to save the life of the mother or to address a fatal fetal anomaly inconsistent with life outside of the womb. Amazingly, this bill makes no exceptions for rape or incest.
 
Generations of inequality have resulted in women experiencing high coverage costs, poor health outcomes, and health inequities. While Democrats have worked tirelessly to expand access to quality, affordable care, Republicans continue to stonewall progress. Despite robust incentives to expand Medicaid in the American Rescue Plan, Republicans in 12 states continue to lock millions of Americans out of affordable coverage. They also continue to oppose legislation to lower premium costs and prescription drug prices. Americans continue to pay more for their health care than anyone in the world, which only serves to burden women and their families. 
 
The Supreme Court decision has not only opened the floodgate for states to ban and criminalize abortion, but it threatens the future of safe and equitable reproductive care — and urgent reforms by lawmakers are needed to avert the further eradication of health care access. Reproductive health care is not a special interest issue; it’s life or death. 

Campaign Launched to Address Childcare Worker Shortage in New Hampshire

Campaign Launched to Address Childcare Worker Shortage in New Hampshire
By Colleen Whitcomb, Academic Advisor, Southern New Hampshire University

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Who is “Women’s Health” for? LGBTQ+ Inclusion in Sexual and Reproductive Health Care

Who is “Women’s Health” for? LGBTQ+ Inclusion in Sexual and Reproductive Health Care
By Evan England, National Science Foundation Graduate Research Fellow, University of New Hampshire
 
Many cross-sectional and community-based studies in the U.S. have verified the high rates of health care discrimination that LGBTQ+ minorities face, which also vary by rural or urban location (Healthy People 2020). Additionally, much of the existing research tends to focus on the general health care setting with little attention to the inclusiveness of sexual and reproductive health services. This is alarming given the increasing need for these services by LGBTQ+ individuals as they gain more and more visibility in society.
 
These services, under the widely accepted and celebrated term “women’s health”, have traditionally taken a cisgender women-centered approach. This approach alienates transgender, transmasculine, and non-binary individuals who do not identify as cis-women but are in equal need of life-saving screenings, treatments, and counseling services. Cisgender women who have other LGBTQ+ identities report similar concerns related to their access to affirming care. While it is vital that LGBTQ+ people are included in the development of health programs and clinic protocols, it is equally important that sexual and reproductive health care is delivered using culturally competent methods that are specific to LGBTQ-specific needs (APHA, CDC).
 
LGBTQ-competent sexual and reproductive health care must be available to all NH residents regardless of their location. Participation in health research is key to understanding the current state of care delivery, which will help to inform future directions. Health clinic staff, regardless of job position, are invited to participate in a University of New Hampshire research study (#IRB-FY2022-136) to share their thoughts on LGBTQ+ inclusive sexual and reproductive health care in NH. You can help by sharing this confidential survey with your networks to ensure your regions are represented: https://unh.az1.qualtrics.com/jfe/form/SV_7NSvlL7i4FKg2oe. Contact Evan England at [email protected] with any questions.
 
Competent care includes many different elements and must be reflexive to individual patient needs. From gender neutral language in brochures and signs to the use of chosen names and correct pronouns by front desk personnel, clinical support, and providers, all clinic staff have a stake in developing a truly inclusive environment. By practicing inclusion, “women’s health” professionals have the capacity to become leaders who help to deconstruct gendered health norms that exclude LGBTQ+ people and limit quality care.
 
References
American Public Health Association. (2016) Promoting Transgender and Gender Minority Health through Inclusive Policies and Practices. Retrieved from: https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2017/01/26/promoting-transgender-and-gender-minority-health-through-inclusive-policies-and-practices 
 
Healthy People 2020. (2022) Lesbian, Gay, Bisexual, and Transgender Health. Retrieved from: https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health#:~:text=Research%20suggests%20that%20LGBT%20individuals,%2C2%2C%203%20and%20suicide
 
Stroumsa, Daphna, and Justine P. Wu. (2018) “Welcoming Transgender and Nonbinary Patients: Expanding the Language of ‘Women’s Health’.” American Journal of Obstetrics and Gynecology 219(6):585-589.
 
U.S. Centers for Disease Control and Prevention. (2014) About LGBT Health. Retrieved from: https://www.cdc.gov/lgbthealth/about.htm

The National 988 Suicide & Crisis Lifeline is Here

The National 988 Suicide & Crisis Lifeline is Here
By Leah Elliot, LICSW, CPS, Behavioral Health Specialist at the City of Nashua Division of Public Health and Community Services
 
According to the National Alliance on Mental Illness (NAMI), 221,000 adults in New Hampshire (NH) have a mental health condition, which is five times the population of Concord. In February 2021, 37.7% of adults in NH reported symptoms of anxiety and depression, and 17% were unable to access needed counseling or therapy. Of the 70,000 adults in NH who did not receive needed mental health care, 41.7% did not go because of cost, as 6.4% of people in the state are uninsured. Cost is not the only barrier to residents receiving services, as 92,510 people in NH live in a community that does not have enough mental health professionals. 
 
Unfortunately, this is a concern across the United States (US), as more than half of people with a mental health condition in the US did not receive any treatment in the last year. Mental health conditions do not discriminate based on age, race, color, gender, or identity
 
According to Mental Health America, 17% of Black people and 23% of Native Americans live with a mental illness, and people who identify as belonging to two or more races are most likely to report any mental illness within the past year than any other racial or ethnic group. Research has shown that BIPOC groups are:






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State's New Outreach Program and SNAP Related Training for Direct Service Partners

State's New Outreach Program and SNAP Related Training for Direct Service Partners
By Laura Milliken, Executive Director at New Hampshire Hunger Solutions
 
The cornerstone of the federal food assistance safety net is the Supplemental Nutrition Assistance Program or SNAP (also known as food stamps). It is our country's first line of defense against hunger and food insecurity. 
 
We know that:
  • New Hampshire is now 39th in the nation in SNAP participation.
  • Analysis of SNAP participation by NH Hunger Solutions shows that only about half of eligible people are enrolled
  • The majority – 60% - of eligible older adults in NH are not enrolled.
  • Estimates are that as many as ⅓ of eligible children may not be enrolled.
  • In the week ending June 13:
    • 79,912 NH residents said they didn't have enough food
    • More than a third of NH residents reported it was somewhat or very difficult to pay for usual household expenses (that's nearly 400,000 people). (US Census Pulse Survey).
  • The rising inflation that we've all experienced is also affecting food prices, which have increased by 12%.
NH Has not had a SNAP Outreach Program since September 2017. Senate Bill 404 to establish a SNAP Outreach Plan, passed in the last legislative session, will ensure that NH will always have a SNAP outreach plan in years to come. DHHS recently released an RFP for a SNAP Outreach contractor who would help eligible people know about and access the program.
 
SNAP not only keeps our neighbors from hunger, but communities gain from the multiplier effect of SNAP dollars being spent in the local community. For every SNAP dollar that comes into our state, it is estimated to stimulate at least $1.50 in local economic activity. For example, in a recent research report, the New Hampshire Fiscal Policy Institute estimated that 17,000 children may have been eligible for SNAP benefits in 2019 but weren't enrolled. If they had been, that would have brought nearly 38 million dollars in economic stimulus to New Hampshire in a single year. Outreach and education are powerful tools in overcoming barriers to SNAP participation. Even a small increase in SNAP participation can have a substantial impact on families and local communities. 
 
Our system of food and nutrition supports is like a power grid that moves nutritious food to communities throughout the state, but that grid now is patchy in some communities and nonexistent in others. This bill will help us plug more communities into the grid, ensuring more children, older adults, and other eligible Granite Staters benefit from the nutrition support they deserve.
 
New Hampshire Hunger Solutions (NHHS) is a statewide advocacy organization working to connect New Hampshire residents to federal nutrition programs such as SNAP, WIC, and School/Summer Meals. One of the ways in which they hope to reach those who are eligible but not enrolled in SNAP is through SNAP training for community health workers. NHHS is collaborating with New Hampshire Legal Assistance to provide these training sessions.

Back to School Preparation Should Include Vaccinations for New Hampshire Students

Back to School Preparation Should Include Vaccinations for New Hampshire Students
By Colleen Whitcomb, Academic Advisor, Southern New Hampshire University
 
The COVID-19 pandemic has impacted access to healthcare services and basic childhood vaccinations across the world. This has caused many children to fall behind on the recommended immunization schedule. According to the World Health Organization, in 2020, there were 23 million children who did not receive routine vaccinations (WHO, 2021). The United Nations reports that this number grew to 25 million children in 2021 who missed routine vaccinations (Rigby, 2022). Routine childhood vaccinations are critical to children’s health as they protect against several diseases which can be life-threatening (Rigby, 2022). Adolescents are a population who have seen decreased wellness visits since the beginning of the pandemic. 
 
It is important for New Hampshire children to get caught up on vaccinations that may have been missed since the beginning of the pandemic. Schools have a higher risk for transmission of diseases that are preventable with vaccines. The New Hampshire Division of Public Health Services monitors immunization rates for schools throughout the state. During the 2021-2022 school year, public schools in New Hampshire had 94% of enrolled students up to date on required vaccines and 92% of enrolled students in private schools (NH Division of Public Health Services, 2022). 
 
New Hampshire Public Health Association's VaxWell New Hampshire is launching the Vaccination Starts with You campaign in partnership with the New Hampshire Division of Public Health Services. The campaign will launch on August 8, 2022. According to NHPHA Executive Director, Hanan Bedri, “The campaign brings together a wide range of stakeholders, including healthcare providers, school nurses, community health workers, and other key influencers, to remind families that summer is a perfect time to catch up on wellness visits and vaccinations so that their children and teens don’t miss out on school and other activities next fall.” The campaign will use email, posters/flyers, and social media to spread the message that families can follow these simple steps to get caught up on well visits and vaccinations: 
  1. Contact your healthcare provider and schedule a yearly wellness visit
  2. Ask them to make sure all vaccines are up to date
Public health providers can share the resources below with the populations they serve to make sure they are aware of the required immunizations for New Hampshire schools. If you have any questions about the Vaccination Starts with You campaign, please reach out to Hanan Bedri ([email protected]). 
 
Resources

References
NH Division of Public Health Services. (2022). Annual School Immunization Report. Retrieved from: https://www.dhhs.nh.gov/sites/g/files/ehbemt476/files/documents2/surveyresults-2022.pdf
 
Rigby, J. (2022). Pandemic behind ‘largest backslide in childhood vaccination in a generation,’ UN says. Reuters. Retrieved from: https://www.reuters.com/business/healthcare-pharmaceuticals/pandemic-behind-largest-backslide-childhood-vaccination-generation-un-2022-07-15/
 
World Health Organization (WHO). (2021). COVID-19 pandemic leads to major backsliding on childhood Vaccinations, new WHO, UNICEF data shows. Retrieved from: https://www.who.int/news/item/15-07-2021-covid-19-pandemic-leads-to-major-backsliding-on-childhood-vaccinations-new-who-unicef-data-shows

Inside NHPHA - A Monthly Column Written by NHPHA Leadership

Inside NHPHA - A Monthly Column Written by NHPHA Leadership
Message from the NHPHA Vice President and Acting Board President

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COVID-19 Vaccines Available to Children Aged 6 Months to 5 Years

COVID-19 Vaccines Available to Children Aged 6 Months to 5 Years
By Colleen Whitcomb, Colleen Whitcomb, Academic Advisor, Southern New Hampshire University

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New Hampshire Organizations Address Food Security During Summer Months

New Hampshire Organizations Address Food Security During Summer Months
By Colleen Whitcomb, Academic Advisor, Southern New Hampshire University

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Sounding the Alarm on Health Insurance Premium Hikes

Sounding the Alarm on Health Insurance Premium Hikes
By Jayme H. Simões, President, Louis Karno & Company Communications, LLC Strategic Communication

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Gun Violence is a Public Health Crisis

Gun Violence is a Public Health Crisis
By Nicole Chute, Health Promotion & Communication Specialist, City of Nashua Division of Public Health & Community Services 

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Climate and Health: Not Just Crazy Weather

Climate and Health: Not Just Crazy Weather
By Paul Friedrichs, MD, a family doctor in Exeter NH

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June 2022 Inside the NHPHA

Inside NHPHA - A Monthly Column Written by NHPHA Leadership
Message from the NHPHA Executive Director

Dear Members:




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NHPHA Member Spotlight

NHPHA Member Spotlight: Colleen Whitcomb

What’s your favorite part of being a member of NHPHA?
As a student who is looking to enter the public health profession, I value learning about the work that NHPHA’s members are doing and what public health issues are most important in New Hampshire.



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Formula Shortage

Feeding Infants During a Formula Shortage
By Kate Graves, RD, LDN, Healthy Living Program Manager, UNH Extension - Nutrition Connections

Many parents are, rightfully, concerned about the formula shortage right now and are looking for solutions to get through this dangerous time. Although it is tempting to find homemade recipes, it is NOT recommended to make your own formula. Infants are still building their immunity and are a high-risk population, thus food poisoning and kidney damage are a real danger for them. UNH Extension’s Healthy Living Program Manager and Registered Dietitian, Kate Graves, shares these recommendations for families:




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May 2022 Inside NHPHA

by Ashley Ithal, NHPHA Board President

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NHPHA Member Spotlight: Lisa Bujno

Each month, the NHPHA Newsletter does a spotlight on an NHPHA member. For the May issue, we are honored to feature the NHPHA Past Board President and the President Award recipient, Ms. Lisa Bujno.

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Food and Nuitrition Support System in NH

by Laura Milliken, Executive Director, NH Hunger Solutions

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