Looking Forward , Sarah Verbiest, founder of Every Woman Southeast, reflects on the new year and what it holds.
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Smithsonian American History Museum and the Suffragette Carriage.

The 2016 Presidential Campaign has been a historic event for many reasons. Shocking, stressful, upending – this campaign has exposed the under belly of America and it isn’t pretty. Racism, classism, religious intolerance, economic uncertainty, xenophobia, the political establishment and misogyny – something to make everyone upset. Democracy is messy. It may be tempting to many to just stay home this year.

If you are contemplating taking a pass on your vote, I hope you’ll pause for a moment and remember the 1848 Seneca Falls Convention – the first women’s right convention that passed a resolution in favor of women’s suffrage. Do the names Susan B. Anthony, Elizabeth Cady Stanton, Lucy Stone, Alice Paul and Carrie Chapman Catt ring a bell? For decades women filed lawsuits, marched, went on hunger strikes, picketed the White House, raised money and fought state by state for the right to cast a ballot.More Link

Ipuzzlen my eyes as a Public Health MD, there is a fundamental difference between prevention and intervention.   I practice prevention if I proactively address an outcome that has been experienced by some, and I make a concerted effort to trace that condition up stream and work to find opportunities for change, especially for those most at risk.  I practice intervention, on the other hand, when I wait until the disease process has already started and then start treating the symptoms. More Link

vote_500x279I am so glad the November elections are over. Living in a battleground state, I felt like it was the carpet baggers all over again, spending their money in North Carolina to tell me just how bad one or the other of our US Senate Candidates was. The ads would pop up on Pandora, internet searches, the TV, and the radio with dark, depressing messages… I finally lost my cool when three different full-page, multi-color glossy booklets arrived in my mail on November 3rd, all on the same day, filled with propaganda about the candidate that I hadn’t planned to vote for anyway. I am not a swing voter, never have been. And I voted early!

So $100 million dollars later, I still know very little about the Senate candidates and received no information in the mail telling me about our NC Supreme Court candidates, nor the Court of Appeals judges, or even an Amendment on the Ballot that I didn’t know existed, until I was in the poll booth, was confusing, and learned later, would likely put more low income people in the court system in jail. $100 million dollars later, we still have to look under rocks to find money to print booklets about smoking cessation and family planning for new moms much less to support programs to improve the health and wellness of our young men and women in North Carolina. We beg and borrow to find resources to get the lone women’s health message into the media – information that could make a difference in the lives of two generations. There are campaign staff and field teams galore, but we struggle to find resources to keep our coalition, focused on equity and the health of women and children in the southeast, funded.

I get frustrated when I think about the amount of money that was spent to sway political opinion…And thus, I blog…

Imagine what we could’ve done in public health with $100 million dollars in our state. What if campaign funds supported programs that improved the lives of people in North Carolina – they could show the candidates leading by example. What if they matched $1 in advertising with giving $1 to a local non-profit or charity or school bake sale – even better if given directly by the candidate? Sometimes this makes me feel powerless. And then I remember that much change is local and that is something we can influence. I remember that together we can speak truth to power. I remember that as women, we are 54% of the vote, that we manage a lot of household budgets and that we can innovate. Maybe the next time the South gets national political attention, we could insist that fundraisers be held on playgrounds or in community centers with food catered by local residents. We can find creative ways to better spotlight the issues on the real people who are impacted – by the election results and the issues at hand.

Sarah Verbiest, DrPH, MSW, MPH is the Director and Co-Founder of the Every Woman Southeast Coalition. She is also the Executive Director for UNC Center for Maternal and Infant Health and the CDC Senior Consultant to the National Preconception Health and Health Care Initiative.

11People of all income levels, employment categories, races, ethnicities, and locations in the United States are exposed to environmental toxins and toxicants. Such exposure is thought by many to occur primarily through the intake to food, water and air, but what some fail to realize is that the clothes they wear, detergent they use, housing they inhabit, furniture in their homes, or transportation they take are all sources of environmental contaminants. Unfortunately, exposure to toxic chemicals is an increasingly common part of everyday life.

Today more than 84,000 chemicals are in use in the US, the majority of which have yet to be tested for toxicity to human health and the environment. Of the chemicals that have been tested, most have only been evaluated for their acute consequences to adult males in industrial settings. Toxic chemicals that enter the environment pose health problems for women – especially women of color – that are unique from those for men, because women and minorities are more likely to work in lower-status, lower-wage jobs. They tend to be disproportionately exposed to a myriad of hazardous chemicals, including agricultural pesticides, home cleaning products, industrial cleaning products, and chemicals used in hair and nail salons. And as such, they bear a greater burden of the diseases and conditions associated with these exposures.

  • Breast cancer: Repeated exposure to toxic environments is related to an increased risk for breast cancer. While this form of cancer is diagnosed 10% less frequently in African American women than White women, the former are 40% more likely to die from the disease. Disproportionate environmental exposures, socioeconomic status, and inadequate access to quality health care all contribute to this higher rate of morbidity.
  • Asthma: The disparity in asthma prevalence and severity provides a striking example of the effect of disproportionate exposures and health outcomes. The prevalence of asthma is highest among multi-racial Americans, Hispanics of Puerto Rican descent and non-Hispanic blacks, and is also higher among those living in poverty.
  • Birth Outcomes: African American women have consistently had higher rates of preterm and low birth weight babies, in spite of prenatal care usage, behaviors during pregnancy, and socioeconomic status. A growing number of studies have associated certain environmental contaminants with these poor birth outcomes.

12People of color now comprise a majority in neighborhoods with poor air quality, disproportionate exposure to toxic hazards, unhealthy housing conditions (e.g., mold, dampness and pest infestation), and lack of safe areas for physical activity. Race and socioeconomic status are highly correlated with living near harmful sources of pollution (e.g. commercial hazardous waste facilities); in fact, 46% of low-income housing units sit within about a mile of factories that report toxic emissions to the EPA. These poor environmental conditions have led to higher-than-average rates of asthma, lead poisoning, and exposure to contaminated water, pesticides and mercury, especially among women and children living in these areas.

Environmental racism – the disproportionate impact of environmental hazards on people of color – is the reason so many people, especially women, have become involved in the environmental justice movement. This movement seeks to abolish environmental harms by improving environmental conditions, identifying and mitigating structural inequalities, and finding solutions to empower traditionally marginalized people. While there is plenty of work yet to be done, the fact that these issues are being taken into account indicates that the environmental health of minority women is becoming a national priority.

To ensure your environmental health and to help protect that of minority communities:

  • Recognize that women suffer unique effects of environmental hazards and advocate for policies that improve reproductive health and pregnancy outcomes.
  • Push for stricter regulation through legislation such as the Toxic Substances Control Act that establishes health and safety testing, bans the most toxic chemicals, and protects the most vulnerable populations.
  • Support the equitable distribution of green space, walking and biking trails, and playgrounds in low-income communities.
  • Urge regulatory protections and safer labor practices for those exposed to toxic chemicals in industries dominated by low-income workers and women of color.

Health inequities have persisted in this country for decades – in health care, housing, education, and even in the environment. But the fact of the matter is that they are and always have been avoidable. Poor communities and women of color are systematically and unjustly exposed to environmental contaminants that hinder them from being the healthiest individuals they can be. And until the environmental health of these populations is accounted for, the generations that follow will never know what it feels like to be truly free from environmental contamination.

Amanda Zabala is a graduate intern at the Center for Maternal and Infant Health. She is currently attending the University of North Carolina at Chapel Hill, Gillings School of Global Public Health, and majoring in Maternal and Child Health.

SarahDownsRecently, my fellow graduate interns and I had the opportunity to participate in the March of Dimes 2014 Lobby Day at the North Carolina Statehouse. As volunteers, our mission was to visit lawmakers in their offices and garner support for funding of the You Quit Two Quit program, an evidence-based program that focuses on tobacco cessation among pregnant women by providing support for women, and training for healthcare providers; and for maintained funding of the Healthy Baby Bundle of programs aimed at reducing infant mortality in North Carolina, including the NC Folic Acid and Preconception Health Campaign, Safe Sleep, and the East Carolina University high risk maternity clinic. All of these programs have been recommended and endorsed by the North Carolina Child Fatality Task Force as important initiatives to reduce the rate of infantAdvocacy Day mortality in North Carolina, which is among the highest in the nation.

When we arrived in the morning, dressed in purple to indicate our support for March of Dimes, we met the people we would be working with that day. We were given packets with the names of the legislators we were assigned to drop in on, and talking points for each of the programs for which we were going to be advocating funding. Afterwards, we were briefed by several individuals from the March of Dimes, including Tiffany Gladney, the Communication Coordinator, and the coordinator of Lobby Day, and Peg O’Connell, the North Carolina Chapter Advocacy and Government Affairs Consultant. They reviewed the talking points with us and answered all of our questions. We then broke into small groups, and began our visits with the legislators.

In all, my fellow graduate interns and I dropped in on 8 senators and representatives, including Senator Josh Stein, Senator Mike Woodard, Representative Susan Fisher, Representative Jean Farmer-Butterfield, Representative Susan Martin, Senator Don Davis, Senator Louis Pate Jr., and Senator Ronald Rabin. Throughout the day, we benefited from the expert advice and guidance provided by the leaders of our teams, Catherine Heindselman, Director, Eastern Carolina Division of the North Carolina Chapter of the March of Dimes, and Gwen Carmon, the National Director of Volunteer Diversity and Development at March of Dimes.

Lobby day attendees at briefingOccasionally, we were able to speak directly with the lawmakers, though in most cases, we spoke with an aide, and left materials for the senator or representative. When speaking to representatives and aides, we emphasized the importance of funding these programs for the reduction of infant mortality, and improving the lives of mothers and babies in the state of North Carolina. All of the lawmakers and aides expressed support for the March of Dimes, and were eager to learn more about the programs for which we were advocating funding.

At the end of each meeting, we took pictures with the Senator or Representative with which we met, and invited them to enjoy apple pie with us in the courtyard. Unsurprisingly, this was a big hit, and many people joined us for “Mom and Apple Pie”. This gave us an additional opportunity to speak with lawmakers and their staff about why the funding for these programs is so essential, and how it can save not only healthcare costs, but also the lives of so many North Carolina infants who die in the first year of birth.

3interns.AdvocacyDayBy the end of the day I was struck both by the astounding bipartisan support of March of Dimes we encountered, which I found particularly surprising and refreshing in this time of partisan division, and by the importance of talking directly to our representatives about those issues we find worth speaking up for. This was my first experience lobbying lawmakers, and while it seemed intimidating at first, it was the ideal introduction. The event was well organized, and a lot of effort was put forth to make sure that all of us volunteers were prepared for our meetings with legislators, and felt confident in our ability to advocate for the issues we feel strongly about. The cause of reducing infant mortality is certainly worth standing up for, and I felt confident representing March of Dimes, a well-respected organization with a 76-year history of improving the health and lives of mothers and children, from defeating polio to reducing infant mortality.

While I have always been interested in the political process, this was the first time that I involved myself in the process so directly, and it reminded me that the only way a democracy can truly function is if its citizens get involved.

Sarah Downs is a graduate intern at the Center for Maternal and Infant Health. She is currently attending the University of North Carolina at Chapel Hill, Gillings School of Global Public Health, and majoring in Health Behavior.
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