Chiropractic Well Represented at Annual American Public Health Association Meeting

At the recent annual meeting of the American Public Health Association (APHA), many top leaders in the chiropractic profession again participated at all levels, adding to the credibility established within APHA in the past few years and enhancing communication between the chiropractic profession and the public health leadership establishment.

The APHA's annual meeting was held in Washington, D.C., November 15-19, with the theme of public health and managed care. Billed as the most important public health event of the year in the U.S., the attendance of 13,840 far surpassed last year's meeting in Indianapolis.

There were 1,300 scientific and technical papers presented in 1,058 educational sessions. Topics included: managed care; health care reform; quality care and access issues; convergence of managed care and public health interests into a health care system for all; health economics; family planning; communication; drug abuse; global health communities; the environment; epidemiology; rural health; ethics; minority populations; women's and children's health; physical activity; gerontology; tobacco; violence; alternative therapies; prevention; and AIDS/HIV.

The APHA is the oldest, largest and most influential public health association in the world, with well over 50,000 national and affiliate members from 70 occupations involved in public health.

The American Chiropractic Association (ACA) established its committee on APHA in February 1987. John Pammer Jr., DC, has served as its chairman since 1995. The committee acts as liaison between APHA and ACA. It monitors APHA activities, participates in the APHA political process, and is active during the APHA annual meeting, which is held in a different city each fall. Members of the committee attending the annual meeting were Drs. John Pammer Jr., Kurt Hegetschweiler, who serves as the liaison to the ACA board, and myself.

Chiropractic Booths

The APHA exhibit hall is the largest of its kind in the world. There were over 433 exhibit booths, three of which were chiropractic: an ACA booth; a Association of Chiropractic Colleges booth; and a booth representing the chiropractic health care section of the APHA. Each sponsored an educational booth, distributing literature and answering questions for thousands of attendees.

The ACA booth was staffed by Nell Handley, Lauren Bhattacharya, and Virginia Kessinger. The ACC, exhibiting for the fifth time at an APHA meeting, was staffed by its executive director, David O'Bryon. Palmer faculty and student volunteers, joined by local field doctor Marissa O'Malia, DC, coordinated the third chiropractic health care section booth. The ACA (Sherri Herren and Barbara Dobberthien), the ICA (Ron Hendrickson), and some of the chiropractic colleges generously donated a great deal of display literature, promotional items and article reprints.

Chiropractic Educational Program

The APHA program was multidisciplinary and multimedia. There were scientific sessions, films, poster sessions, policy deliberations, technical exhibits, award presentations and business meetings.

For the 14th consecutive year, chiropractic was represented among the over 1,300 scientific and technical paper presentations covering over 30 specialty areas. There were three full program sessions dedicated to chiropractic topics, including 15 paper presentations prepared by 51 co-authors; several of the co-authors were associated with more than one paper.

Chiropractic Health Care (CHC) Sessions

Chiropractic Care and the Elderly

Presider: Maria Hondras,DC,MPH

Coming of Age: Means and Methods in Chiropractic

Presider: Gary Cutter,PhD

Chiropractic Professional Issues: Scope of Practice, Utilization and Consumer Attitudes

Presider: Craig Nelson,DC

These three sessions were all well attended and quite well received. Multidisciplinary audiences of 25-30 or more were in attendance, and there were several requests for copies of papers and additional information afterwards. Several other sections and SPIGs co-sponsored the chiropractic sessions.

Dr. Cheryl Hawk of Palmer College of Chiropractic arranged for 4.5 hours of CE credit for the sessions and achieved considerable visibility for the profession as this was only the second time CE credit for chiropractors was formally coordinated in APHA's structure. Unfortunately, very few DCs took advantage of the CE program; less than 20 states will be accepting the credits earned.

Section Activities -- Business Meetings

The members of the chiropractic health care section (CHC), and the chiropractic members who belong to various other sections, participated in several APHA meetings and functions while making contact with key people. Every section holds its annual business meeting(s) in conjunction with the APHA annual meeting.

Dr. Craig Nelson, the third chairman of the CHC section, presided over three CHC business meetings. Dr. Nelson reported on the considerable achievements of the section during 1998. Topics discussed at the section business meetings included:

1. Plans for a workshop and model curriculum for the teaching of public health in chiropractic colleges were discussed for presentation at the ACC meeting in March in Orlando, Florida.


2. There were credibility issues raised because of ACA and ICA official policy statements that are not supportive of APHA policies on immunization and fluoridation. The ACA and ICA both hold agency membership in APHA.


3. The feasibility of a website for the CHC section was debated.


4. External funding and section manual changes were discussed.


5. Dr. Robert Jusino's proposed to provide input from the chiropractic profession and the CHC section to the "Healthy People 2010 Objectives" document currently being considered for adoption by the Office of Disease Prevention and Health Promotion.


6. The need for better liaison and communication between the ACA legislative and lobbying staff and the CHC was discussed.

The CHC business meeting was also attended by APHA staff and visited by candidates for APHA's national offices.

It was observed that although still small, there is an ever-increasing number of DCs who hold or are pursuing formal academic credentials in public health, i.e., the MPH or public health doctorate degrees. FCER has provided grants and financial assistance to several of them. A cadre of chiropractors with public health degrees active in APHA would ensure continued success for chiropractic and inspire others. It is axiomatic that the best choices to bridge the gap between chiropractic and public health would be those with dual professional training and degrees in both disciplines.

Bad News: Dangerous Membership Drop

Membership in the chiropractic section dropped in 1998, averaging below 400 members and dropping below 300 on Aug. 31 for the first time in recent years. That day is the official "count" day used annually by APHA for purposes such as section budget allocation, governing council seat determination, etc. The section operating budget for 1999 has been reduced due to the drop in our membership.

Of the 24 APHA sections, our membership has dropped to only 0.98% of the total. We now rank 22nd in size. Although continuing to attract a fair number of new members, our renewal and retention rate is lower than most sections. We still have a disproportionately high percentage of student members (26.54%) than is ideal, and it is very alarming that the majority of all our new members in 1998 were from the two Los Angeles chiropractic colleges and were all recruited by one person! The 1998 intersectional council report noted that we have the worst percentage of variance of any section, a very damaging statistic for us as the newest section of APHA.

Election Results and Leadership Positions

The members of the chiropractic section elected these officers during a mail ballot last summer, choosing among several excellent candidates proposed by the nominating committee.

Chiropractic Health Care Section Officers for 1999 (term expires after annual meeting in year listed)

Chair:	Mitchell Haas,DC,MA	(1999)
Chair-elect:	Maria Hondras,DC,MPH	(1999)
Past-chair:	Craig Nelson,DC	(1999)
Secretary:	Lisa Killinger,DC	(1999)
Program Chair:	Roni Evans,DC	(1999)
Awards Chair:	Rand Baird,DC,MPH	(1999)
Membership Chair:	John Pammer Jr.,DC	(1999)
Nominating Chair:	Fred Colley,PhD,MPH	(1999)
Newsletter Editor:	Thomas Carpenter,DC	(1999)
Resolutions Chair:	William Meeker,DC,MPH	(1999)
Publicity/PR Chair:	Rand Baird,DC,MPH	(1999)
Section Manual Chair:	Mitchell Haas,DC,MA	(1999)
Continuing Ed. Chair:	Monica Smith,DC,PhD	(1999)
Section Council:	Fred Colley,Phd,MPH	(1999)
	Michael Perillo,DC,MPH	(1999)
	John Hyland,DC	(2000)
	Ellen Bokina,DC,MPH	(2000)
	Margaret Seron,DC	(2001)
	Rand Baird,DC,MPH	(2001)
Governing Council:	William Meeker,DC,MPH	(1999)
	Michael Loader,DC	(2000)
	Christine Goertz,DC,PhD	(2001)

Drs. Haas, Nelson and Hondras will also serve on the APHA intersectional council (ISC) as chair, past-chair and chair-elect of the CHC section at the 1999 annual meeting. Dr. Roni Evans will be on the overall APHA program planning committee. Dr. John Pammer will be on the APHA committee on membership. Dr. Kurt Hegetschweiler serves on the managed care task force.

Dr. Mitchell Haas, who served as a member and secretary of the ISC steering committee in 1998, was elected by the ISC members to be the chair-elect of the ISC for 1999. Dr. Haas will become the chairman in late November of 1999 and serve most of the year 2000. This is one of the highest positions ever held in APHA by a doctor of chiropractic and is yet another example of the advances our profession has made thanks to the dedication of these individuals.

Future Meeting Dates

The 1999 annual meeting will be held in Chicago, Illinois, 7-11, 1999. The program theme for the 127th annual meeting will be, "Celebrating a Century of Progress in Public Health." It would be a tremendous showing for our profession if several hundred doctors of chiropractic would attend.

The annual meetings are held in the late autumn each year. Because of their huge size, they are scheduled years in advance.

Year	Location	Meeting Dates
1999	Chicago, IL	Nov. 7-11
2000	Boston, MA	Nov. 12-16
2001	Atlanta, GA	Oct. 21-25
2002	Philadelphia, PA	Nov. 10-14
2003	San Francisco, CA	Nov. 16-20
2004	Washington, DC	TBA
2005	Denver/New Orleans	TBA
2006	Boston, MA	TBA

Funding

The ACA, through its committee on APHA, the ICA and several of the chiropractic colleges generously provided needed and much-appreciated funding to participants; several dedicated participants and registrants received only partial or no funding and paid most or all of their own expenses so that this vitally important work could continue.

Institutional Members

Several chiropractic organizations support APHA by maintaining institutional or agency membership status. These are:

International Chiropractors Association

Cleveland College of Chiropractic-Los Angeles

Western States Chiropractic College

New York Chiropractic College

Palmer College of Chiropractic

National College of Chiropractic

Life University

Los Angeles College of Chiropractic

It would be helpful to the cause and enhance credibility if additional chiropractic organizations would also seek agency status in APHA. The cost is nominal and the positive potential is great. APHA has 209 agency members. For the chiropractic discipline to have both of its major national professional associations and seven of its colleges as agency members is a better percentage than any other discipline, exceeded only by graduate schools of public health.

Recommendations

The ACA and ICA representatives to APHA made these recommendations after the annual meeting concluded.

1. ACA and ICA should continue to support, encourage and fund chiropractic participation within APHA, and encourage all chiropractors to join and renew membership in the chiropractic health care section of APHA.


2. Chiropractic editors, authors and researchers should be encouraged to submit chiropractic or multidisciplinary papers for publication in the American Journal of Public Health (AJPH). The article by Eric Hurwitz,DC,PhD, et al., that appeared in the May 1998 issue of AJPH was the first accepted by this prestigious journal that had a chiropractic author or co-author. Additional articles by chiropractic authors would add greatly to our credibility, visibility and prestige in the scientific community.

   One method would be for chiropractic editors to identify suitable manuscripts from among their submissions and have the author(s) submit them first to AJPH. After the AJPH publication, any article could then subsequently be reprinted in the chiropractic literature.
   

3. ACA and ICA publications should promote APHA events and CHC section activities more prominently throughout the year.


4. ACA, ICA and the chiropractic colleges that hold agency membership status in APHA should publicize this fact more prominently; this is a repeat recommendation.


5. ACA, ICA and the closest state and local chiropractic associations and colleges should be solicited for their support and participation for the 1999 meeting in Chicago, Illinois.


6. ACA and ICA should review their policies on public health issues regularly to ensure that their content is consonant with the weight of scientific evidence, and with their support of proven public health preventative practices, and with their status as Agency members of APHA.

Note: Chiropractors are needed to become new members of APHA and to renew lapsed memberships. It is essential that our members increase so that we can continue our successes in this politically powerful organization. Please contact membership committee chairperson Dr. John Pammer at (610) 264-3344 or by fax at (610) 264-2081. You can also contact APHA's membership department at (202) 789-5674 for APHA application forms.