Please send items of interest for the E-News -- and any other feedback -- to AAPHP's Secretary, Dave Cundiff, MD, MPH <cundiff@reachone.com>. Thanks!
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CONTENTS:
1) Justice Appeals Ruling on Tobacco Industry Penalties
2) Tobacco, Multiple Sclerosis Discussed in Latest "Notes"
3) Preventive Medicine Jobs Update
4) Resources on Health Disparities and Inequalities
5) AAPHP Member Update
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1) Justice Appeals Ruling on Tobacco Industry Penalties:
In response to urging from many health groups (including AAPHP and AMA), the U.S. Department of Justice (DoJ) has appealed a recent ruling of the District of Columbia Court of Appeals (DCCA) to the U.S. Supreme Court.
If allowed to stand, the DCCA ruling would have severely limited the remedies available to the government in the Racketeer Influenced and Corrupt Organizations (RICO) lawsuit against the tobacco industry.
RICO provides for remedies to "prevent and restrain" future violations.
Past court filings have allowed the courts to order "disgorgement of illegally-obtained proceeds" -- for instance, profits from past fraudulent activities -- if certain conditions are met. The DCCA ruling, which conflicts with rulings of other appeals circuits, would essentially eliminate this option.
In June 2005, AAPHP delegates won approval of AMA policy urging DoJ to appeal this ruling, and further urging DoJ not to enter settlement negotiations with the tobacco industry until the appeal process on this ruling is complete.
An electronic copy of the DoJ's appeal petition is available, courtesy of the Tobacco Products Liability Project in Boston, at:
<http://tobacco.neu.edu/litigation/cases/DOJ/dojricoscotuspetition.pdf>.
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2) Tobacco, Multiple Sclerosis Discussed in Latest "Notes":
Don MacCorquodale's latest "Notes in a Bottle"
(http://www.aaphp.org/bottle/2005/aug6.htm) notes a recent study about the perception of risk associated with cigarette smoking. Most smokers dramatically underestimate these risks!
This issue also briefly notes new European rules on tobacco promotion, and the effect of "acculturation" on Hispanics' smoking rates, then summarizes a case-control study showing that high levels of IgG against Epstein-Barr Nuclear Antigen are associated with multiple sclerosis in military personnel
25 years of age and older.
The full "Notes in a Bottle" collection is available at:
http://www.aaphp.org/bottle/allnotes.htm.
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3) Preventive Medicine Jobs Update:
As of this morning, the AAPHP/ACPM JMI page, http://www.aaphp.org/JobMarket/PHP_positions.asp,
shows 28 full page ads and 91 abstracted job listings for jobs requiring Preventive Medicine skills.
AAPHP member Anand Chabra, MD, MPH is recruiting a Deputy Health Officer for San Mateo County, California. Check it out at:
http://www.aaphp.org/Jobs/2005/august/080705casanmateodhd.htm.
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4) Resources on Health Disparities and Inequalities:
In recent years, we've seen much greater emphasis on the disparities in health care access, and in health outcomes, experienced by individuals and groups in the USA and worldwide. AAPHP has held educational sessions on health disparities, and has participated actively in the AMA's and others'
disparities reduction initiatives.
Some scholars and activists take primarily an ecologic perspective -- measuring differences in health status among the world's countries, then analyzing factors that could explain these differences. One thing stands out. While the amount of national wealth matters, the distribution of wealth and other social benefits seems to matter even more. Cuba, with very scant resources shared more equally, has a life expectancy at birth very similar to the wealthy -- but highly unequal -- United States. Most other industrialized countries do even better than the United States, despite the USA's much greater spending on the health care system.
One scholar/advocate who focuses on within-nation inequalities is Stephen Bezruchka, MD, MPH, from the University of Washington School of Public Health and Community Medicine. Dr. Bezruchka and others at the University have created the Equity Health web site
(http://depts.washington.edu/eqhlth/) to educate others on these findings.
A recent publication from Columbia University professors Bruce G. Link, PhD and Jo C. Phelan, PhD addresses "Fundamental Sources of Health Inequalities". Drs. Link and Phelan argue that a fundamental cause of health inequality is that, as knowledge advances, higher-income and higher-status groups and individuals are better positioned to translate this knowledge into health status improvements. That would seem to make health disparities both inevitable and permanent. However, interventions that help equalize resources (e.g., Social Security, public education, and Indian
gaming) can help ameliorate disparities, as can interventions that by their nature reach everyone regardless of income status (e.g., water fluoridation). An abstract of this paper, with links to the full text, is available at http://www.rwjf.org/research/researchdetail.jsp?id=1944.
The New England Journal of Medicine issue of July 7, 2005 published reviews of three related books: Embodying Inequality: Epidemiologic Perspectives, edited by Nancy Krieger (NEJM 2005;353(1):103); Universal
Coverage: The Elusive Quest for National Health Insurance, by Rick Mayes (NEJM 2005;353(1):103-104); and Vulnerable Populations in the United States, by Leiyu Shi and Gregory D. Stephens (NEJM 2005;353(1):104-105). These reviews are available, to NEJM subscribers only, at http://www.nejm.org <http://www.nejm.org/> .
The Social Determinants of Health (SDOH) listserve, at York University in Canada, is a discussion resource for many aspects of health inequalities.
The SDOH discussion involves Australia and the English-speaking areas of North America and Europe. Participants have diverse disciplines, with an academic and social sciences emphasis. The listserve generates several E-mails daily, of variable quality. To subscribe to the SDOH list, send the following message to listserv@yorku.ca in the text section, NOT in the subject header: SUBSCRIBE SDOH yourfirstname yourlastname.
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5) AAPHP Member Update:
Thanks to Arnold Barr, MD, MPA, and Kathleen H. Acree, MD, MPH, JD, for renewing AAPHP membership since the last E-news. We couldn't do it without you!
Membership/renewal information is available at http://www.aaphp.org, or call Rob Rader at (202) 207-0709.
Dave Cundiff, MD, MPH
AAPHP Secretary
cundiff@reachone.com
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