Vermont public health association

Thank you Gov. Phil Scott for issuing the following proclamation:

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Monday: Rebuilding

For science.
Rebuilding doesn’t mean getting back to where we were before the COVID-19 pandemic – it means having the vision to create a better, more inclusive, more just world through public health. Public health infrastructure needs to be rebuilt and reinvested in: less than 3% of U.S. health spending is on public health.1 Amid the COVID-19 pandemic, the U.S. faces a growing shortage of health care providers.2 Racism is a public health crisis, causing health disparities, including in the rates of COVID-19 diagnoses and deaths.3 The pandemic has illuminated how race, place and income can affect a person’s health, and even survival, in the U.S.4 A lack of investment in maintaining the built environment, such as removing lead pipes from city water, is costing the U.S. money, health and lives.5 And one in four people in the U.S. does not have access to high-speed internet, which can prevent academic and economic achievement.6

For action.
We must build and reinforce public health infrastructure to protect against future public health emergencies. Call for funding essential public health agencies like CDC and HRSA need to protect the public before, during and after national and global health crises. Continue to declare racism as a public health crisis, but also listen to and follow Black, Indigenous and other people of color, who have long led efforts to protect and support their own communities. Work on the state level to remove barriers to voting, such as ID laws and restrictions against returning citizens with prior felony convictions.7 Build back environmental protections that have been removed, with a greater focus on communities of color. Prioritize rebuilding community infrastructure to remove health risks, such as lead pipes.

For health.
When we trust the science and act accordingly, wearing masks and physically distancing, COVID-19 infection rates drop.8 Investing in public health shows better health outcomes and lower health spending overall9 and saves lives – 19,000 from the expansion of Medicaid through the Affordable Care Act alone.10 Children with access to high-speed broadband internet have better education and health outcomes.11 Asthma is the third-leading cause of hospitalization for kids in the U.S. Each case costs about $4,000, but every $1 spent on national- and state-level programs saves $71 in asthma-related expenditures.5 We all have a hand in rebuilding for better health and can look to the successes gained, for instance, by organizers of color, who have mobilized their communities for environmental justice12 and historic voter turnout to protect public health.13

For justice.
Black families and rural communities are more likely to be without access to high-speed internet,14 which is no longer a luxury, but a requirement for school and workers who telecommute. COVID-19 does not only take a higher toll on patients of color, but also on providers.15 Supporting those already doing the work within their communities recognizes community members as experts and leaders and builds their power.16 We can create a better, more inclusive, more just world through public health.

[1] Trust for America's Health [2] AAMC [3] American Journal of Human Biology [4] Journal of Public Health Management & Practice [5] APHA [6] AJPH [7] Southern Poverty Law Center [8] CDC [9] AcademyHealth [10] Center on Budget and Policy Priorities [11] The Atlantic [12] NRDC [13] Slate [14] NDIA [15] MEDPAGE TODAY [16]  Center for Health Progress 

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Tuesday: Advancing Racial Equity

For science.
The COVID-19 pandemic has highlighted long-standing inequities in health care, income, housing, education and many other factors that influence health and well-being. These inequities are largely driven by racism and bias that are embedded in our systems, institutions, policies and practices. This structural racism results in a lack of access and opportunity, increased sickness and premature death among communities of color. Compared to white women, Black women (across socioeconomic status) are three times more likely to die within one year of childbirth.1 American Indian/Alaska Native, Black and Latinx youth graduate high school at rates significantly lower than white youth.2 In addition, Black, American Indian and Latinx Americans all have a COVID-19 death rate that nearly triples that of White Americans.3 The public health community must address racism as the key driver of health disparities.4

For action.
We must transform our systems and dismantle policies and practices that uphold racism and continue inequities. We must make racial equity central to health equity. Work with your local leaders to enact resolutions, policies and programs that address racism as a public health crisis. Urge your members of Congress to support health equity legislation that can help address the health disparities and inequities disproportionately affecting Black, Hispanic, Indigenous and Pacific Islander communities. Advocate for policies like hazard pay and eviction protections to protect communities of color from further disadvantage and displacement as a result of the COVID-19 pandemic. Apply a racial equity lens to all decisions about policies and programs.

For health.
Racism is an ongoing public health crisis that has played a significant role in widening health disparities.5 Racism shapes where and how people live, what resources and opportunities they have and directly affects the physical and mental health of people of color.4 “Weathering” describes how the stress coping with chronic toxic stress, from structural and interpersonal racism and bias, over a lifetime causes physiological changes. The result is accelerated aging and increased risk of chronic diseases and other adverse health outcomes, including premature death.6 Thankfully, many of these poorer health outcomes are preventable. For example, educating health care providers and hospital staff about racial and ethnic disparities in maternal outcomes, addressing implicit biases and improving quality of care through the implementation of patient safety bundles7 are important steps for reducing disparities in maternal mortality.8

For justice.
The fight for racial justice has continued well beyond the Civil Rights era and gained mainstream global attention in 2020 with the high-profile murders of Black Americans at the hands of police. We must build on the momentum of the 2020 uprising and Black Lives Matter movement with sustained attention and action by individuals, communities and government leaders to advance racial equity.9 Learn about the legacy of racism and its present-day impacts on health and well-being. Identify and address your internal biases and how you might perpetuate anti-Black sentiments or supremacy culture.10 Ask yourself how racism might be operating within your family, community and organization. Protect voting rights. Support grassroots organizations led by people of color. Ensure people of color are leading and/or leading decisionmaking efforts.11

[1] CDC [2] National Center for Education Statistics [3] APM Research Lab [4] AJPH [5] Cambridge University Press [6] AJPH [7] American Journal of Obstetrics & Gynecology [8] Clinical Obstetrics and Gynecology [9] APHA [10] Blindspot/Harvard [11] University of Michigan School of Public Health 

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Wednesday: Strengthening Community

For science.
Community encompasses every aspect of our lives – it’s where we live, work, learn, play and pray. These make up the social determinants of health, and too many people in the U.S. face community barriers to health and well-being. At least 4 million U.S. households are home to children exposed to high levels of lead,1 and around 6 million U.S. homes are considered substandard.2 Our social communities affect our health behaviors, too. Teens are more likely to engage in risky health behaviors like smoking,3 texting while driving or not wearing a seatbelt4 if their friends do the same. Additionally, elderly individuals, who live alone and feel lonely, are at 26% higher risk for mortality.5 Even among the general population, loneliness has been found to be a greater health risk than obesity.6

For action.
Get information on how your state uses public health funding and uses Health Impact Assessments to identify key public health concerns in your community. 

Engage your public health peers and elected officials on these topics through social media, including on Facebook and Twitter. Join a community garden or donate healthy canned food options to food pantries. Encourage local officials to support healthy community design that includes parks, sidewalks and bike lanes – and to fund programs to prevent poor living conditions. Stay informed about news within your school district to make sure low-income children are getting their needs met so they can learn. Ask questions at public forums, like virtual town halls, to start conversations about public health.

For health.
People with greater feelings of support and inclusion within their networks tend to live longer,7 respond better to stress and have stronger immune systems8 than those who are isolated from their communities. Social support and family acceptance among LGBTQ youth significantly reduce attempted suicide rates.9 Transgender youth have lower suicidal ideation and suicidal behavior when their chosen name is consistently used.10 Negative health behaviors, like smoking, alcohol and drug use, decrease as people in an individual’s social networks stop as well.11 Well-maintained sidewalks encourage physical activity,12 and safe biking networks lead to more cycling and fewer injuries among bicyclists.13 Rates of preventable deaths typically go down in communities where local public health spending goes up.14

For justice.
Communities of color often face greater health risks and have fewer health-promoting opportunities than their white counterparts.15 These risks have consequences that extend beyond the home: Inequalities in health care access and housing discrimination increase the rate of chronic illnesses,16 crime and violence17 and lowered levels of educational attainment.18 LGBTQ individuals face disproportionately higher risks for STDs, cardiovascular disease, obesity and suicide.19 The lack of minorities in leadership within their professions and communities contributes to the persistent disparities seen in public health.20 Build racial equity into the DNA of your public health work.21 Listen to community leaders and organizers who know what their communities need, and support the work they’re already doing to create change.

[1] CDC [2] National Center for Healthy Housing [3] Preventive Medicine [4] Psychological Science [5] Psychosomatic Medicine [6] WebMD [7] Scientific American [8] Harvard Medical School [9] Pediatrics [10] Journal of Adolescent Health [11] Oxford University Press Blog [12] Journal of Public Health [13] League of American Bicyclists [14] Health Affairs [15] CDC [16] Biomedical Research International [17] HUD Office of Policy Development & Research [18] Economic Policy Institute [19] Cureus [20] Clinical Journal of the American Society of Nephrology [21] APHA 

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Thursday: Galvanizing Climate Justice

For science.
Climate change creates a series of interconnected impacts on human health.1 As global temperatures rise, heatwaves become more frequent2 and increase the risk of heat stroke and make cardiovascular illnesses worse.3 Warmer temperatures and changes in precipitation expand the geographic range of disease-carrying insects,4 leading to more cases of vector-borne diseases, such as Zika virus.5

Increased greenhouse gas emissions makes air quality worse by trapping pollution and increasing allergens that aggravate respiratory and cardiovascular illnesses.6 Drought causes more frequent and intense wildfires, whose smoke further reduces air quality. Flooding from intense storms leads to property and infrastructure damage, mold growth, food scarcity and water contamination. Flooding can cause injury and death due to trauma and drowning7 and increase stress and anxiety that adversely affect mental health and wellness.8

For action.
Share your story to be a climate communicator: Personal stories from trusted sources make the health effects of climate change relatable. Urge lawmakers to help public health and medical communities prepare for and respond to health threats caused by climate change. Advocate for policies that support a just transition to a low-carbon economy. Support your local health departments to advance health equity and climate resilience. People of color and those with lower incomes experience worse health harms from climate change than white and wealthy people, despite being the least responsible for the problem. To address social inequities and improve our health, we need to strengthen partnerships with communities most impacted by climate change, support community-directed solutions and improve access to health care.

For health.

For justice.
While climate change affects everyone, not everyone is affected to the same degree. Structural racism has pushed lower-income communities and many people of color to areas that have fewer resources and more climate vulnerability, such as flood zones and urban heat islands.13 Race is the number one indicator for the placement of toxic facilities in this country.14 Because climate change worsens air quality, these communities are more vulnerable to the health effects of climate change. And certain climate-sensitive populations, like children, are more susceptible to heat-related illness, dehydration or diarrheal illness.15 The growth of climate change is an environmental injustice.

[1] APHA [2] 2018 Lancet Countdown on Health and Climate Change [3] APHA [4] APHA [5] Climate Nexus [6] CDC [7] APHA [8] APHA [9] APHA [10] Public Health Institute/Center for Climate Change & Health [11] Clkimate4Health [12] U.S. Call to Action on Climate, Health and Equity [13] APHA [14] NAACP [15] APHA 

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Friday: Constructing COVID-19 Resilience

For science.
The COVID-19 pandemic has shown that when governments fail to act before and during a public health crisis the public’s health suffers tremendous consequences.1 By January 2021, the U.S. had nearly 24 million reported cases of COVID-19 and almost 400,000 deaths.2 When response to the pandemic has been slow, other parts of life in the U.S. have suffered: Millions of people lost their jobs, and more than half of the people who were laid off at the beginning of the pandemic are still unemployed.3 Food insecurity only increased during 2020, and the number of people facing food insecurity could climb to as high as 50 million in the U.S.4 Where schools weren’t prepared with plans on how to continue students’ learning during crises, including natural disasters and pandemics, students’ educational attainment suffered.5 And more than half of U.S. adults say their mental health has been negatively affected by the pandemic.6 In short: The U.S. is suffering, and without action, things are likely to get worse.

For action.
Share facts and science about COVID-19 to battle misinformation. Send an Action Alert to Congress in support of investment in public health infrastructure and expanded paid sick leave. We need to better equip our public health system to respond to future public health emergencies. Urge Congress to prioritize equitable vaccine distribution. Stay informed on vaccine progress and how the novel coronavirus will continue to affect us with APHA’s COVID-19 Conversations webinar series. Vaccines are here, but they will take time and we must remain vigilant. Stay home when you can and wear a mask, stay at least six feet away from others and wash your hands frequently if you do have to go out. Get a flu shot to protect yourself, your family and your community and to reduce the burden on our health care systems fighting COVID-19, and get the COVID-19 vaccine when one becomes available to you.

For health.
The data is clear: when we take action backed by public health science, health outcomes improve. Non-medical mask-wearing by 75% of the population reduced infections, hospitalizations and deaths due to COVID-19 by 37.7%.7 States and local counties that enforced stay-at-home orders saw significantly decreased COVID-19 incidence and death rates.8 Health experts note that expanding access to testing helps achieve better health outcomes,9 and historical literature shows us that we can protect our communities by providing hazard pay to essential workers.10 Moreover, when people’s basic needs are met – when they are safely housed, have enough food to eat, enough money to survive, access to health care and other essentials – they have reduced stress and are more likely to have better physical health as a result.11

For justice.
We know racism contributes to negative health outcomes, and that’s true with COVID-19, too. Black, Indigenous and Latinx communities are disproportionately affected by the pandemic.12 That’s true for both patients and health care providers: While 60% of health care workers are white, most confirmed coronavirus cases and deaths among that group are people of color.13 Fewer Black and Hispanic workers than white workers are able to work from home, which means they are more likely to be exposed to COVID-19 at work — and more likely to die.14 Assuring equitable access to vaccines and treatment should be a top priority for public health professionals and state and federal governments.15 We must continue to strive for health equity in fighting the COVID-19 pandemic and beyond.16

[1] healthcare-in-europe.com [2] New York Times [3] The Commonwealth Fund [4] Feeding America [5] Economic Policy Institute [6] Kaiser Family Foundation [7] International Journal of Infectious Diseases [8] Annals of Epidemiology [9] New England Journal of Medicine [10] Journal of Medical Ethics [11] Harvard University Center on the Developing Child [12] CDC [13] Kaiser Family Foundation [14] World Medical & Health Policy [15] The National Academies of Sciences, Engineering and Medicine [16] CDC 

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Saturday: Uplifting Mental Health and Wellness

For science.
Mental health is a critical component of public health. It consists of emotional, psychological and social well-being and is important from childhood through adulthood.1 In the United States, mental illness is one of the most common health conditions.2 In a year, one in five Americans will experience mental illness. Fifty percent of mental illness begins by the age of 14, and 75% begins by the age of 24.3 People who identify as being two or more races are more likely to report mental illness than other races, followed by American Indian/Alaska Native, Caucasian and Black populations. For all racial groups, except American Indian/Alaska Native, women are more likely than men to receive mental health services.4

For action.
Advocacy for mental health is crucial, especially with the COVID-19 pandemic. Ask Congress to make mental health services readily available during the current and future public health emergencies.5  Get involved in Project 2025 – an initiative to 

For health.
The COVID-19 pandemic can affect mental health in many ways, including through loss of a loved one, isolation due to physical distancing mandates, exposure to the virus and loss of income.11 Given the past year’s strain, it’s not surprising that health care workers have a high risk of developing mental illness.12 Practicing strategies like being physically active, getting at least eight hours of sleep each night, eating a well-balanced diet, practicing gratitude, participating in activities you enjoy, developing coping skills, meditating and connecting with others can improve mental health.13 People who engage in physical activity have fewer days of poor mental health than individuals who do not exercise.14 Talking to a licensed therapist, joining a support group or 12-step program or considering medication under the supervision of a physician can all be beneficial.10

For justice.
Certain childhood risk factors, including growing up in poverty or experiencing abuse, can be an indicator for mental illness later in life.15 Each year in the U.S., more than 300 Black people are killed by police, which harms the mental health of Black people overall, even those who were not directly affected by the violence.16 The use of police force and violence during protests has been linked to worsening mental health among protestors.17 The COVID-19 pandemic has disproportionately affected the BIPOC communities. People of color have a higher morbidity and mortality rate due to racial and ethnic disparities in health care.18 The pandemic has also added more stress to caregivers – and two out of three are women.19 Access to better treatment and coping options is critical for those most at risk.

[1] MentalHealth.gov [2] CDC [3] National Alliance on Mental Illness [4] American Psychiatric Association [5] APHA [6] American Foundation for Suicide Prevention [7] APHA [8] National Alliance on Mental Illness [9] APHA [10] SAMHSA [11] New England Journal of Medicine [12] JAMA Network [13] MedlinePlus [14] The Lancet Psychiatry [15] American Mental Wellness Association [16] The Lancet [17] The Lancet [18] Mental Health America [19] CDC 

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Sunday: Elevating the Essential Health  Workforce

For science.
About three-quarters of all U.S. workers have jobs that are difficult or impossible to do from home – meaning the majority of us are at risk during the COVID-19 pandemic.1 Low-income workers have higher rates of COVID-19 hospitalizations and deaths.2 Millions of health care workers are not getting the supplies or pay they need during the pandemic.3 Where public health services are not being accessed, or where they’ve been cut, COVID-19 cases and deaths have increased.4 And family leave protections do not cover all workers, keeping many people, who work at large employers like grocery store chains, in health and financial peril.5

For action.
Tell Congress you support a loan repayment program for public health workers and other provisions to ensure public health readiness. Advocate in your workplace and your community for paid