270: Tracking Polio in New York

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Monday, September 26th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

JAMES MCDONALD:

I've been a pediatrician for over 32 years and I'm offering the safest vaccines I've ever had to offer, and yet I can't even give 'em way free to some people

JOHNSON:

Dr. Jim McDonald, medical director for the state of New York, on the discovery of polio in wastewater in at least two counties and the difficulty with convincing people to get vaccinations.

MCDONALD:

We thought polio was gone—and not just gone, but long gone. And so, that's really why this is such a historic event. When you think about polio—not just, you know, in New York, but you know, this is the paralytic case we saw. So, it really begs the question. It's the tip of the iceberg, so how many non paralytic cases are out there, you know? And that's really something where it's hard to quantify, 'cause we're not routinely testing for polio. That's part of why we got into wastewater testing.

JOHNSON:

McDonald says wastewater surveillance and a diaper study are the best tools currently available to track this devastating disease.

MCDONALD:

What we see is that one case of paralytic polio, you know. What we're not seeing is what we're not looking for, right? In other words, there's a vulnerability 'cause there's no rapid test, right, so it's not like doctors' offices are screening for this. So, really we're fighting polio in the wastewater 'cause that's where we can look for it right now.

JOHNSON:

McDonald adds the state is doing all it can to remind people how bad polio can be if they aren't vaccinated.

MCDONALD:

It's really not a vaccine that causes problems. It's a vaccine that causes solutions and it really prevents terrible disease. Because I think one of the things people forget about polio is if you end up paralyzed from polio is you don't generally get better from that. It leads to permanent disability when people do have that, you know, nerve damage, and this is really quite a problem. And it's like—it's not like there's a great treatment for it either, you know. Like, what I got for polio was a vaccine. That's what I got.

JOHNSON:

Congress is moving legislation to reauthorize the Maternal Infant and Early Childhood Home Visiting Program. Carolyn McCoy is on ASTHO's government relations team. She says the bill would raise base spending from $400 million to $500 million a year and create a new mechanism intended to raise even more for the program.

CAROLYN MCCOY:

There is a proposed increase to a new stream of funding that would require states to match these funds with 25% investment of state funds—non-federal funds—and that would ramp up from $50 million to $300 million at the end of the five-year reauthorization. So, it would essentially total a doubling of the investment in the program.

However, ASTHO really does wanna dig in and learn more about what that would mean for states and what they are able to put forward for the match.

JOHNSON:

McCoy says ASTHO is tracking several key components of the proposal as it continues its journey through Congress.

MCCOY:

We're also keeping an eye on the proposed tribal set-aside that is doubled from 3% to 6% in the bill.

And then, we're also keeping an eye on the proposed flexibility for remote home visits that was pioneered during the COVID-19 pandemic when programs saw the need to pivot and continue their important work but deliver those services in another way.

JOHNSON:

Ultimately, McCoy says the program's popularity should be enough to get it to the president's desk.

MCCOY:

We know that this program is wildly popular across the country, across the aisle, both sides of the aisle, because it is very focused on families that are in the most need out there in states.

And, really importantly, it is evidence-based. The outcomes to families and children and parents are shown to improve with this sort of intensive voluntary program.

So, with a health equity lens, a social determinants of health, a future mindset, states really do not wanna see this program go away.

JOHNSON:

You can read the ASTHO Legislative Alert with more details about the Home Visiting Bill using the link in the show notes.

Also today, frontline workers are critical to the nation's public health, but do you know how to integrate them into your organization?

O'Keyla Cooper has more.

O'KEYLA COOPER:

Community health workers play an essential role in patient care and social determinants of health work.

A new ASTHO report highlights hiring practices that support states integrating community health workers into their workforce throughout the COVID-19 response and beyond. Read the full report using the link in the show notes.

JOHNSON:

Finally this morning, today is World Contraception Day.

ASTHO has two resources available to help you address contraception equity and accessibility in your jurisdiction. You can read a special report in the American Journal of Public Health and a blog article exploring inequities that still exist despite gains made during the pandemic access, both using the links in the show notes.

Also, remember to tell others about the show on your social media channels and follow us on your favorite podcast player.

That'll do it for today's newscast. We're back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.