Please send items of interest for the E-News -- and any other feedback -- to E-News editor Kevin Sherin, MD, MPH.  . Thanks!


PLEASE JOIN US: AAPHP Meets in San Diego THIS SUNDAY, October 26, 2008!

1) Your AAPHP annual meeting at APHA in San Diego
3) Tobacco Harm Reduction Material for the San Diego meeting
4) Resolutions submitted for November AMA Meeting in Orlando:
      Texting while Driving and Prevention of Disaster
      Oppose Sale of Tobacco in Pharmacies
      Oppose sales of Firearms where patients receive health care
5) Model Ordinance Requiring Menu Labeling at Chain Restaurants
6) Membership and Recruitment
7) From the CDC and AAP: Vaccine Safety: Gardasil (HPV Vaccine)
8) The economy and public health equity
9) Please Help Us to Help You


1) Your AAPHP annual meeting at APHA in San Diego:

Your AAPHP will have its annual business meeting at the APHA in San Diego on SUNDAY, OCTOBER 26, 2008, from 10-12 am AND from 2-3:30 pm on the day of the APHA opening session.
We will meet in the LAGUNA ROOM at the SAN DIEGO MARRIOTT HOTEL AND MARINA, 333 West Harbor Drive, San Diego,
(619) 234-1500.

Our business meeting will be held from 10 am to 12 noon.
This includes officers reports; report from our AMA delegation, which is carrying three resolutions to the AMA?s November 2008 meeting on our behalf; discussion of a recently posted White Paper on tobacco harm reduction; consideration of proposed tobacco harm reduction policy; and other reports/discussion.

After the business meeting, we will recess to allow our members to attend the APHA Opening Session from noon to
2 pm.  After the APHA Opening session, we will reconvene for a 1.5 hour forum, from 2-3:30 pm.

Our invited speaker for the afternoon forum is the Deputy Secretary of Health for the State of California, Dr. Bonnie Sorenson. Dr. Sorenson is an endocrinologist and expert on diabetes and obesity as a risk factor for chronic diseases, as well as a tobacco control expert who oversees California?s huge tobacco control program.

A special invitation is being offered to Deans of Schools of Public Health who may be in attendance at the APHA to attend our forum for networking and physician recruitment opportunities.  Please extend personal invitations to your local Deans of Schools of Public Health for this networking opportunity.



THE FDA TOBACCO BILL PASSED THE HOUSE.  AAPHP OFFICIALLY NOW IS ASKING FOR MODIFICATIONS OF THIS LEGISLATION IN THE SENATE.  HOPEFULLY A STRONGER MORE SCIENTIFICALLY SOUND BILL CAN BE FORTHCOMING NEXT YEAR.  IT APPEARS TO BE DEAD IN THE SENATE FOR THIS TERM.  TO LEARN MORE ABOUT THE FDA TOBACCO LEGISLATION AND STEPS TO PROTECT U.S. YOUTH, please see all of the updates from the AAPHP Tobacco Control Task Force.  Example letters to the editor and review of the 160 page plus legislation, as well as the AAPHP positions and explanations can be found under "Tobacco Issues" on our website at .


3) Tobacco Harm Reduction Material for the San Diego meeting

   From Joel Nitzkin, Chair of AAPHP's Tobacco Task Force:

A resolution urging Tobacco Harm Reduction has been prepared for action at our AAPHP General Membership Meeting in San Diego, October 26.  This resolution urges federal and other authorities to dramatically modify their approach to reducing future tobacco-related illness and death by educating the public to the dramatic differences in risk between cigarettes and the lowest risk smokeless tobacco products, and urging smokers who are unwilling or unable to discontinue their addiction to nicotine to switch to these lower risk smokeless products on a short term or long term basis.  Experience in Sweden clearly indicates that this can be effectively done without increasing the number of teens who initiate smoking or reducing the number of smokers who quit entirely.  Such a policy, for the United States, would give us a fundamentally new, highly feasible and effective way to dramatically reduce tobacco-related illness and death.

To see the full wording of the resolution and the literature review justifying this approach, please see
(long link; you may need to "cut and paste".)

This is a 38 page .pdf file covering everything you ever wanted to know, but were afraid to ask about tobacco harm reduction.  If you have any questions or comments, please contact Dr. Nitzkin by e-mail at or by phone at 504 606 7043.


4) Resolutions submitted for November AMA Meeting in Orlando

Three resolutions have been submitted on behalf of Public Health Physicians for the AMA's November 2008 Interim Meeting in Orlando, Florida:


AAPHP Resolution for I-2008
Subject:  Texting while Driving: Preventing Disaster Submitted by:  The American Association of Public Health Physicians

Whereas, message texting has rapidly become the favorite form of communication for millions of people, and

Whereas, the NY Times (Sept. 20, 2008) reported the dangers texting poses by distracting people while driving different types of vehicles or crossing streets, and

Whereas, due to public safety concerns, some states have banned text messaging and hand held cell phone use while driving, and

Whereas, the American College of Emergency Physicians reported an increase of injuries and deaths seen in emergency rooms related to texting messages while driving or performing other hazardous activities, and

Whereas, the National Transportation Safety Board said its investigators had determined that one of the train engineers was texting messages just before a recent two train collision in California that killed 35 and injured 130, and

Whereas, the Alberta Medical Association testified in August 2008 that text messaging causes a 400% increase in time spent with eyes off the road; therefore, be it

Resolved, that our AMA encourage physicians to educate their patients regarding the public health risks of text messaging while operating motor vehicles or machinery and be it further,

Resolved, that our AMA study the implications on society and the health care community of the traffic safety of hand held communication devices with an emphasis on text messaging, and be it further

Resolved, that our AMA draft model state legislation prohibiting the use of hand held communication devices and text messaging while operating motor vehicles or machinery.


AAPHP Resolution for I-2008

Subject: Oppose Sale of Tobacco in Pharmacies Submitted by: The American Association of Public Health Physicians

Whereas, the health hazards associated with tobacco use are well known, and the tobacco use continues to remain our number one preventable public health challenge; and

Whereas, many pharmacies are now seeing patients in their in-store clinics and marketing themselves as comprehensive healthcare stations; and

Whereas, those pharmacies that sell cigarettes and other tobacco products, do so to generate additional profits, while making it convenient for people to use a product which can only harm the health of the user and those around him/her; and

Whereas the current AMA Policy opposes the sale of tobacco at any facility where health services are provided and supports that the sale of tobacco products be restricted to tobacco specialty stores, but does not go far enough to prevent the pharmacies from selling igarettes; be it, therefore

Resolved, that our American Medical Association publicly oppose the sale of tobacco products including cigarettes in a pharmacy, and be it further,

Resolved , that our AMA communicate with the Bureau of Alcohol, Tobacco and Firearms, the various pharmacy trade groups, and the media seeking their help in removing tobacco products including cigarettes from the pharmacy shelves.


AAPHP Resolution for I-2008

Subject: Oppose Sale of Firearms Where Patients Receive Health Care Submitted by: The American Association of Public Health Physicians

Whereas, violence with firearms continues to escalate, killing young and old across the country, therefore placing enormous burdens on our already strained public health systems; and

Whereas, it is undesirable and probably unethical for professionals and organizations who promote themselves as advocates of public health and seek to expand their role in health care selling pharmaceuticals and seeing patients in their in-store clinics, and at the same time profiting from the sale of firearms under the same roof; be it therefore

Resolved, that our American Medical Association publicly oppose the sale of firearms at any facility or store where healthcare is delivered or where prescriptions are filled.


5) Model Ordinance Requiring Menu Labeling at Chain Restaurants

Public Health Law and Policy (PHLP) have developed a model ordinance for communities interested in passing a local nutrition information menu labeling law.  The ordinance is based on California Senate Bill 120, a menu labeling bill vetoed by the governor in October.  For a copy of the PHLP ordinance and recommendations for ways to draft a local menu labeling law to increase the likelihood that it will withstand a legal challenge, visit .


6) Membership and Recruitment:

All AAPHP physicians are urged to go to, and download the 2009 Membership Invoice form, and remit the
2009 Dues at your earliest convenience.  A check is preferred for transaction purposes, to reduce the costs to the organization.

AAPHP Active Member dues have not increased and are still
$95 per year.  We wish to maintain optimal stewardship of our transactions during the harsh economic times and make the wisest use of our resources.  Please share our website and opportunities for advocacy and collaboration on national health, public health policy, and AMA policy via our low budget organization, with as many of your colleagues as possible.  AAPHP strives to be the best value for your membership dollars of any organization you belong to!


7) From the CDC and AAP: Vaccine Safety: Gardasil (HPV Vaccine)

CDC and AAP continue to reassure the public about the safety of Gardasil brand HPV vaccine.  While there have been news stories about adverse events, FDA's and CDC's postmarketing surveillance continues to yield reassuring results.

Syncope has been seen, but it is common among adolescents.
Other adverse event reports have been rare, and do not appear to exceed the expected rates for similar events.
A single case of progressive muscle weakness is under study.

The American Academy of Pediatrics continues to recommend routine HPV vaccination for 11-12 year old girls and catch up vaccination for 13-18 year old girls.  Safety in pregnancy is still under study; HPV vaccine is not currently recommended for pregnant women.  CDC and FDA are conducting an ongoing study of Vaccine Adverse Event Reporting System (VAERS) reports describing adverse events following Gardasil.  The VAERS system, and its results so far, are described at .

A CDC-FDA statement on Gardasil safety is posted on CDC's Immunization Safety Web site at .

Additional information for providers and parents about HPV, HPV vaccine and a summary of Gardasil reports to VAERS can be found at the following websites:
CDC: HPV Vaccination page:
CDC: HPV vaccine Q and A for the public:


8) The economy and public health:  A commentary

Editor's Note:  With the crashing global economy, public health equity is foremost in the minds of all public health physicians.  Dave Cundiff, MD, MPH, AAPHP Secretary and past editor of the AAPHP E-News, shared the following commentary:

In a New York Times article on 2008-10-07, Tara Parker-Pope asks, "Are Bad Economic Times Good for Health?"

Overall long-term economic gains are generally helpful to the public's health, but "good times" can lead to bad health habits -- so data are mixed.  A key excerpt on this point:

"[W]hether the current economic slump will take a toll on your own health depends, in part, on your health habits when times are good.  And economic studies suggest that people tend not to take care of themselves in boom times ? drinking too much (especially before driving), dining on fat-laden restaurant meals and skipping exercise and doctors'
appointments because of work-related time commitments."

When people are less fully employed and less busy, children's care may improve.

Equity matters:  "The issue that may matter most in an economic crisis is not related to jobs or income, but whether the slump widens the gap between rich and poor, and whether there is an adequate health safety net available to those who have lost their jobs and insurance."

The data on whether hard times are bad for health is mixed according to the article.  The high gas and food prices, may work in reverse.
Although access to care may be short, prevention of chronic diseases may be offset in some ways by increased walking and perhaps lighter meals and less high calorie convenience meals.


9) Please Help Us to Help You

AAPHP is the voice of public health physicians and welcomes all physicians who work to improve public health.

AAPHP accomplishes its work with a maximum of volunteer labor and a minimum of cash expense.  We are proud to make the E-News and other AAPHP materials available without charge to physicians and medical students interested in public health.

If you haven't done so already, please download AAPHP's 2009 Membership Form right away at and send it to us by fax or postal mail.  Please make your 2009 membership as generous as you can.  Consider "Supporting" or "Sustaining"
membership for 2009 if you are able to do so.

AAPHP is a 501(c) (6) professional membership organization that informs and represents Public Health Physicians.  AAPHP dues may be deductible as an "ordinary and necessary"
business expense under the Internal Revenue Code.
Details may differ based on your individual situation.

AAPHP dues can be paid by credit card -- either by faxing the membership form to (847) 255-0559 or by calling the AAPHP Secretary's secure mobile/voicemail at (360) 870-2483.

Please also tell your friends and colleagues about AAPHP's representation of Public Health Physicians.  E-News subscriptions are still free, on request, to any interested physician or medical student.  We welcome new subscribers and members. Thank you for your support!

Kevin Sherin, MD, MPH ( AAPHP President-elect and E-News Editor
321-239-2718 or e mail:



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