460: Big City Gun Violence Data, Drug Shortage Letter to Congress

ROBERT JOHNSON: 

This is the award-winning Public Health Review Morning Edition for Friday, July 14, 2023. I'm Robert Johnson. Now, today's news from the Association of State and Territorial Health Officials.

CHRISSIE JULIANO: 

Gun deaths in big cities were up in 2021. In our 35 member cities, nearly 8,000 people lost their lives because of gun violence. That's about 22 gun deaths a day.

JOHNSON: 

Chrissie Juliano is Executive Director of the Big Cities Health Coalition. The organization has a new analysis of gun-related violence in big cities.

JULIANO: 

You know, I always hope that sort of what we hear in the news is an outlier. And I think unfortunately, what we're seeing is it's not an outlier. We are seeing, you know, an uptick in violence. There are also huge differences between different race and ethnicity groups and who dies from guns and, you know, gun related injuries.

JOHNSON: 

Juliano says the latest data reveals a connection between poverty levels and higher gun death rates.

JULIANO: 

We talk a lot about the causal connections between racism and under-investment in communities and violence. But seeing those differences in the data, you know, hopefully sort of illustrate that for more people that think about the vast majority of policies that we need to address, not just gun control and things like that, but really making sure that communities have everything they need to be healthy and safe.

JOHNSON: 

The challenge with data is how to use it to affect change. Juliano wants to use these numbers to save lives.

JULIANO: 

I am hopeful that we can use these numbers as an advocacy tool to say to policymakers, 'We need to do something. These numbers are unacceptable. We shouldn't have these many people dying of gun related deaths each year.'

JOHNSON: 

The coalition works with the Drexel School of Public Health Urban Health Collaborative to produce the report. You can read more using the link in the show notes.

When drug supplies run low, public health is impacted. ASTHO is talking to Congress about the problem. We learn more from ASTHO's Jeffrey Ekoma in this week's View from Washington D.C. report.

Jeffrey Ekoma. Good to have you here today.

JEFFREY EKOMA: 

Pleasure to be back.

JOHNSON: 

You know, it's the middle of summer. I don't need to tell you or anyone else that, but it's always busy even during the summer time on Capitol Hill, and at ASTHO, I might say. So, let's start by talking about this new letter regarding drug shortages. Tell us what it says and who received it.

EKOMA: 

Yes, so our members have expressed concern with drug shortages and their impact on patient care. So, concurrently, Representative Cathy McMorris Rodgers, who is the chair of the House Energy and Commerce Committee, and Senator Mike Crapo, who's a ranking member of the Senate Committee on Finance, released a request for information seeking solutions to address the increase in drug shortages. So, we submitted comments to they're RFI and highlighted how a shortage of rifapentine is impacting care for those with tuberculosis. Additionally, there's a current shortage of Bicillin, which is the only approved and acceptable treatment to treat syphilis in pregnant people. And there's also a shortage of critical chemotherapy medications such as Carboplatin, methotrexate, and cisplatin, which has forced hospitals in some states to implement contingency and/or conservation strategy that directly impact patient care. We also provide a recommendation as part of our comments that include the establishment of a clearinghouse of existing drugs, medical countermeasures, and other critical products such as infant formula to increase visibility and support state and territorial health agency's understanding of potential shortages and convening a taskforce comprised of representatives from federal public health agencies, drug manufacturers, and state, territorial, and local health agencies to better understand the current issues related to drug shortages and develop a plan of action to be submitted to Congress, amongst other recommendations. This is an issue we'll continue to track and hopefully we'll update in the next couple of weeks.

JOHNSON: 

On another topic, you and I have talked a lot about the Pandemic and All Hazards Preparedness Act here on the newscast, but it's been a while. Is there anything new to report there?

EKOMA: 

There's been a lot of updates in this space, Robert. This past Monday, July 3, the Senate Health Committee released a bipartisan discussion draft to reauthorize PAHPA and saw feedback that was due this past Monday, July 10. We submitted feedback and our comments were focused on much of what was included in our initial feedback to the committee back in March. And that included the importance of reauthorizing the Public Health Emergency Preparedness Program or PHEP. And no less than $1 billion reauthorized in a hospital apprentice program, or HPP for no less than $500 million and also maintain the current list of eligible entities. The draft legislation did include language that would expand the list of entities for HPP, and we express concern that expanding that list without increasing the authorization will be very challenging for our members. The committee also did consider to ask those requests to have the GAO evaluate the impact of regional stockpiling, and clarify them an entity that was receiving an award for state stockpile coordinate with health officials, which is really great to see. The committee also considered ASTHO's comments for strengthening the Public Health Emergency Medical Countermeasures Enterprise, or PHEMCE, requiring that the Secretary solicit and consider input from public health departments as well as share information related to recommendations strategies made by the PHEMCE. The legislation also included a proposal to enhance domestic water surveillance for pathogen detection, by awarding grants to states for activities related to wastewater detection. It also reauthorized health agencies' ability to be able to temporarily reassigned federally funded employees during a public health emergency. We also talked a lot about the importance of reauthorizing the EOC program, the importance of supporting individuals with disabilities during emergency response, and also the impact of drug shortages. So, there's a lot of activity happening and we're happy that our members concerns are being considered by Congress.

JOHNSON: 

Hard to believe there could be more to this story right now, but what's next with PAHPA?

EKOMA: 

Yes, there's a lot more activity that's happening. There's a hearing this week before the House Energy and Commerce Health Subcommittee, that does include their markup of PAHPA and other related legislation. We're also hearing that there will be possibly a hearing with the full House and Energy Commerce full committee next week, pending the passage of the bills that will be marked up by the subcommittee this week. And we anticipate that more discussion will be happening on the Hill related to PAHPA and public health preparedness going forward.

JOHNSON: 

Jeffrey Ekoma, you've given us a lot to think about over the weekend. We hope you have a good one.

EKOMA: 

You too, talk soon.

JOHNSON: 

Read more using the link in the show notes.

Also today, ASTHO members are taking action to address the negative health impacts of wildfire smoke. Washington, California, and Minnesota all have developed messaging, collaborations, and recommendations for dealing with the problem. The EPA has a Public Health Guide on wildfire smoke. You can access all of these resources and more by clicking the link in the show notes.

Finally, this morning, professionals in ASTHO's Diverse Executives Leading in Public Health Program are writing about LGBTQ+ leadership in a new blog article now online. You can get their thoughts and advice by clicking the link in the show notes.

That'll do it for today's newscast. We're back Monday morning with more ASTHO news and information. I'm Robert Johnson. You're listening to the award winning Public Health Review Morning Edition. Have a great weekend.