照片：Mike Saunders

实践

SPH Faculty Brief 麻萨诸塞州 Legislators on State’s Public Health Priorities

公共卫生学院举办了马萨诸塞州参议员和公共卫生联合委员会代表的一系列新濠影汇赌场演讲，这是自2023年以来举行的第二次此类活动。

更多的 than a century ago, the landmark U.S. Supreme Court case 雅各布森诉马萨诸塞州案 affirmed the authority of states to steward public health. 从那时起，州立法机构和公共卫生机构主要负责制定和执行法律和政策，以保护其公民的健康，而新濠影汇赌场政府在很大程度上发挥了支持作用，疾病控制与预防中心（Centers for Disease Control and Prevention）等机构提供了专业知识和财政援助。

On April 16, nine 公共卫生学院 faculty shared their expertise in a briefing to 麻萨诸塞州 state senators and representatives from the 公共卫生联合委员会. 在两个小时的简报中，来自SPH各个部门的新濠影汇赌场就一系列与马萨诸塞州居民健康相关的主题进行了15分钟的演讲。

“纵观历史，新濠影汇赌场政府一直是各州增加医疗保健和公共卫生资源的可靠合作伙伴。 To have that spigot turned off without warning, I think is unique in our history,” said 妮可Huberfeld, Edward R. Utley Professor of 卫生法、政策与管理“，. 这是自2023年以来在波士顿大学医学院举行的第二次此类会议。

Rep. 马约莉德克, committee chair of house members and an instrumental force in organizing both briefings, noted that approximately 90 percent of her colleagues are new to the committee and expressed gratitude for SPH’s continued partnership.

“We’re certainly in 州议会 at a time in which we’re going to struggle together…. You are probably very familiar with a lot of the cuts that have come down that will impact public health in 麻萨诸塞州 but specifically also DPH,” said Decker, referring to the Trump administration’s 最近终止了110亿美元 in federal grants to state public health agencies, including millions for behavioral health care, disease prevention and treatment, public health workers, community health centers, and laboratory operations in 麻萨诸塞州. “We will have to use this lens in trying to figure out what we can advance, what’s feasible and what’s not, and what the consequences are and what the workarounds might be.”

While 马萨诸塞州依赖较少 on federal funding than many other states, the Commonwealth has frequently leveraged federal dollars for its public health agenda, including to gain its first-in-the-nation status for 扩大医疗保健覆盖面 to nearly all citizens in 2006.

“我想，你们在政治生涯中试图回答的很多问题都是围绕着没有这些钱我们该怎么办？ 如果我们必须为自己提供资金，我们如何向前发展？” 她建议德克尔和她的同事们以“根据现有证据减少疾病、受伤和死亡的风险”为目标采取新濠影汇赌场行动，并建议委员会将精力和资源集中在健康的社会决定因素上，换句话说，就是影响一个人健康的上游因素，比如他们的生活和工作条件。 她的建议得到了其他几位SPH教员的赞同。

玛德琳Scammell环境卫生副教授在活动开始时介绍了地方公共卫生部门的作用； 安德鲁·斯托克斯全球健康副教授谈到了心血管疾病和GLP-1药物； and 洛伊斯麦克洛斯基, professor of community health sciences and director of the BUSPH妇幼保健卓越中心, and 凯瑟琳•汤普森, assistant professor of community health sciences, discussed maternal health.

卡洛斯Rodriguez-Diaz社区健康科学主席兼教授警告立法者，马萨诸塞州LGBTQ+社区的健康状况可能会恶化。 他预测，考虑到影响全国LGBTQ+人口的政策变化，马萨诸塞州更进步的法律将——很可能已经——刺激移民到该州。 他敦促将“健康纳入所有政策”，强调LGBTQ+社区面临的持续健康差距，包括更高的精神健康问题、物质使用障碍和某些身体健康问题，这些问题往往源于耻辱、歧视和缺乏文化上合格的医疗保健。 Rodriguez-Diaz highlighted two studies undertaken by his SPH colleagues to better understand and address the drivers of these inequities: 完整自我计划 on healthy relationship building for trans and nonbinary youth and the 新濠影汇线上赌场研究政策对社区的影响：弹性和大学生心理健康的趋势（SPECTRUM）新濠影汇线上赌场研究. 不幸的是，这两个项目的资金最近都被终止了，他告诉立法者。

In interim Dean 迈克尔•斯坦’s opening remarks, he also drew the legislators’ attention to disparities in U.S. spending priorities. “America spends $11,000 per person on medical care and $200 per person on public health,” he said, citing 2019 疾病预防控制中心 and 卫生保健费用新濠影汇线上赌场研究所 data. “这表明公共卫生的重要性还不到医药的十分之一。 We here don’t think that.”

In total, nine legislators participated in the briefing, including Sen. 小威廉·j·德里斯科尔, chair of senate members; Rep. 莎莉·p·克兰斯, vice chair of house members; Rep. 布鲁斯·艾尔斯, Rep. 米歇尔·l·西科罗; Rep. 汉娜•凯恩 (Questrom ‘93); Rep. 肖恩·里德; Rep. Amy Mah Sangiolo; 众议员Decker; 众议员Montaño。 Ramla萩城，委员会新濠影汇线上赌场研究主任和SPH即将入学的学生； 蒙特罗丹妮娜 （SPH ' 23），委员会的新濠影汇线上赌场研究分析师，也是SPH校友； 莎拉·皮尔森委员会的法律顾问； and 瑞安Telingator, the chief of staff to Rep. Decker, also joined the event. 克雷格·安德雷德, associate dean for 实践 and director of SPH’s 激进的实验室, presided over the briefing schedule to ensure efficient use of the group’s time.

大卫·哈默尔, professor of global health and a member of the faculty of the 波士顿大学新发传染病新濠影汇线上赌场研究中心, called the room’s attention to the ongoing measles outbreak and other diseases of rising concern. 他说，虽然马萨诸塞州的总体风险很低，但考虑到麻疹的高繁殖率，或者在没有免疫力的情况下，通过接触一个感染者而被感染的人数，该州必须保持其免疫率。

在整个简报中，公众教育和打击错误信息是反复出现的主题，许多新濠影汇赌场都强调了它们的重要性。

莫妮卡王社区卫生科学副教授，以关于公共卫生传播战略的介绍结束了简报会。 她指出，大多数人——甚至许多医生——不知道健康的社会决定因素指的是什么，也不会说公共卫生术语。 她说，该领域应该超越收集事实和证据，考虑如何根据不同受众的价值观和优先事项构建数据。 She also raised the importance of trusted messengers, providing the example of 多萝西奥利弗, an Alabama retiree, whose door-to-door advocacy got her community over 95 percent vaccinated for COVID in 2021 when the overall state vaccination rate was less than 50 percent.

The prevailing narrative is “you’re responsible for your own health,” Wang said. “公共卫生和社会决定因素的工作是相反的叙述，即你的环境很重要，你的社会关系很重要——你的收入，你的住房，你的教育，你的种族和民族都很重要。 这些都是影响政策的不同说法。”