During my tenure on Capitol Hill, one of the most interesting federal agencies, often overlooked by psychology, was the Centers for Disease Control and Prevention (CDC). What psychology brings to society's most pressing needs often falls within its jurisdiction. When Rodney Hammond was there, the Director proffered that: "child maltreatment is a serious public health problem with extensive short- and long-term health consequences. Abused children often suffer physical injuries, including cuts, bruises, burns, and broken bones. In addition, maltreatment causes stress that can disrupt early brain development, and extreme stress can harm the development of the nervous and immune systems. As a result, children who are abused or neglected are at higher risk for health problems as adults, including alcoholism, depression, drug abuse, eating disorders, obesity, sexual promiscuity, smoking, suicide, and certain chronic disorders. Fortunately, there is a growing body of evidence that documents the effectiveness of primary prevention strategies…. (I)ntegrating behavioral health approaches into primary care systems can be an important component of health reform (10/23/09)."
The CDC Fiscal Year 2014 budget highlights several behavioral and psychological initiatives which should be of considerable interest to our state associations (SPAs). CDC has a long history of working closely with public and private agencies to explore mutually shared programmatic interests. Why not with SPAs? This year, for example, in response the nation's epidemic of obesity: "CDC is currently in the process of collaborating with national groups, and in FY 13 entered into a Memorandum of Understanding (MOU) with the Culinary Institute of America to educate volume food service leaders on strategies to increase the number of healthy and tasty menu options for children and adults." Addressing the issue of falls among older adults, CDC uses: "the public health model and focusing on primary prevention, CDC uses the best available scientific data to identify effective fall interventions and to determine the optimal strategies to promote widespread adoption of proven programs. CDC develops, disseminates, and supports proven strategies that prevent older adult falls. This is done through research, capacity building, dissemination, and implementation of evidence-based programs, and by developing resources to help healthcare providers incorporate fall prevention into clinical care." Both of these priorities are fundamentally behavioral.
"CDC's mission, simply put, is to keep Americans safe and healthy where they work, live, and play. Our scientists and disease detectives work around the world to put proven prevention strategies to work, track diseases, research outbreaks, and respond to emergencies of all kinds. CDC works with partners around the country and world… preventing the leading causes of disease, disability, and death." The range of behavioral issues CDC addresses is impressive: gun violence, rape prevention and education, smoking, community transformation, racial and ethnic approaches to community health, preventing motor vehicle crashes, AIDS/HIV, teen pregnancy, Alzheimer's disease, and promoting breastfeeding to new mothers. Focusing upon its success in addressing chronic diseases, which are the leading causes of death and disability in the nation, CDC notes the importance of environmental approaches to promote health and reinforce healthful behaviors. Close to Rodney's heart, CDC described its enhanced capacity to collect child maltreatment mortality data and its efforts to engage parents, communities, and states in ensuring child well-being and preventing child maltreatment. It's Core Violence and Injury Prevention Program provides support to states to prevent all forms of violence.
SLC: At this year's exciting State Leadership Conference (SLC), Katherine Nordal highlighted for the 500+ colleagues in attendance that: "The clock is ticking towards full implementation of the law [President Obama's Affordable Care Act (ACA)] andJanuary 1, 2014 is coming quickly. ButJanuary 1st is really just a mile maker in this marathon we call health care reform. We're facing uncharted territory with health care reform, and there's no universal roadmap to guide us. Many of our practitioners increasingly will need to promote the value and quality they can contribute to emerging models of care. These are factors that create 'value-add' for psychologists on health care teams and in integrated, interdisciplinary systems of care. No one else is fighting the battles for psychology… and don't expect them to."
Hawaii: Beth Giesting, Healthcare Transformation Coordinator for the State of Hawaii: "We were fortunate to get a State Innovations Planning grant. Heading toward the half-way mark I can say we've made a lot of progress and learned a lot. Among our lessons -- there's a lot of support in the health care community for this organized effort and general agreement on what needs to be done. On the other hand, there is so much infrastructure that needs to be put in place, especially in HIT, before we can do a lot we need to do. You won't be surprised to know that the most intractable problem that pops up everywhere concerns behavioral health – it is among the top issues for avoidable ER and inpatient use, a big unmet need for the VA, a major concern for the public safety system, in short supply and confusing of access for kids, adults, and the elderly. Obviously, we need to do something about the behavioral health workforce shortages. Also in our plan is trying to figure out ways to support expansion of FQCHCs and have them collaborate with the Native Hawaiian Health Centers to provide case management." There are numerous opportunities for those with vision and who get involved. Aloha,
Pat DeLeon, former APA President – Division31 – June, 2013
