When Chiropractic Meets Public Health

I am proud to be a member of the American Public Health Association (APHA), and to be serving as the Chiropractic Health Care section chair-elect for 2008. Recently, I attended the chair-elect orientation meeting in Washington, D.C., and spent two days with an incredibly dedicated, enormously capable group of individuals who are passionate about the importance ofpublic health.

They want to see to it that people have a safe environment with healthy food and clean water. They want to make sure that we are prepared for an emergency. They want to see to it that people who need care get it, whether it is medical, vision, podiatric, dental or chiropractic care. They are interested in people's health from maternity to birth through school, family life, social and occupational health, and on to health aging.

I've returned from this meeting with a heightened respect for the altruism of the members of this organization. We discussed how to move the organization forward to reduce disparity and improve access to needed care. We discussed how to advocate for patients, educate the population and our legislators, and improve the health of communities. In a time when there is economic hardship and the daily practice routine becomes mired in increasing paperwork and ever-expanding regulation, it is good to have an organization such as the APHA to remind us of the real reason we are in practice: to help our patients be healthy.

There are currently 25 different sections of the APHA. Some have been in existence more than 100 years. Chiropractors have only had their own section for about 13 years, but we are full partners in all respects. The APHA is a diverse group with a broad and all-encompassing approach to our nation's health. You can find a complete list of the various sections on the APHA Web site (www.apha.org).

Once a year, all of these groups, as well as numerous Special Primary Interest Groups, forums and caucuses, come together for the APHA Annual Meeting. This is the most diverse gathering of health professionals in the United States, with anticipated attendance of 12,000-15,000. There is an extensive program, with the Chiropractic Health Care section providing five scientific sessions (outlined below).

These are sessions of contributed work that have undergone rigorous peer review. The reviewers are clinicians, educators and scientists who have clinical expertise, as well as expertise in health promotion, epidemiology and research methodology. The first session will explore chiropractic care in integrative environments as well as attitudes about Eastern and Western medical traditions:

Developing Integrative Approaches to Patient Care
Moderator: Paul Dougherty, DC

• Students' attitudes toward health care professions derived from Eastern and Western medical traditions.
• Scoliosis and sports participation: a review of the relevant literature and recommendations.
• Management of arthritis: chiropractic wellness approach.
• Emerging role of chiropractic in the emergency department setting.
• Relationship between posttraumatic stress disorder and clinical outcomes within a Veterans Affairs medical center chiropractic clinic.

The next two sessions will provide updates on current research. There will be presentations on the findings of clinical trials, interexaminer reliability studies, literature reviews and outcome-measure evaluation:

Current Research in Chiropractic I
Moderator: William Meeker, DC, MPH

• Chiropractic management of chronic lower back pain in older adults.
• Spinal manipulative therapy versus active exercise therapy for chronic lower back pain: a randomized clinical trial with subgroup analyses.
• Expectancy effects in an open-label randomized trial of manual therapy for the care of cervicogenic headache.
• Reliability of spinal motion palpation is enhanced when raters are confident about their calls: preliminary findings.

Current Research in Chiropractic II
Moderator: Mitchell Haas, DC

• Chiropractor's role and patient compliance to health promotion advice: user's perspective.
• Reporting adverse effects associated with chiropractic care: an analysis of literature in PubMed.
• Outcome measures in chiropractic research: how do we choose health services clinician-based measures?
• Predictors of patient improvement after 30 days of chiropractic care.

The fourth session will include discussions on student attitudes regarding public health, educational initiatives, strategies to incorporate more preventive practices in teaching clinics, and ethical theory:

Educational Research and Processes
Moderator: Gary D. Schultz, DC, DACBR

• Overview of ethical theory.
• Putting prevention into practice at a multi-site teaching clinic.
• An education campaign to increase hand and table sanitizing among chiropractic interns.
• Student attitudes toward public health education.
• Beginning a public health club on a chiropractic college campus: lessons learned.

The fifth session will provide information on chiropractic care and public health issues in Third-World countries, humanitarian missions and underserved populations, as well as an update on developing a master's degree program in health promotion in a chiropractic educational settings:

Health Promotion, Nationally and Internationally
Moderator: Dana J. Lawrence, DC

• Developing a master's degree program in health promotion.
• Healthy People 2010: reaching goals through proper behavior modification for overweight and obese patients.
• Chiropractic and public health issues in third-world countries.
• Standardized care practices for chiropractic providers during humanitarian missions to developing and chiropractically developing nations: the pros and cons.
• Chiropractic services to an underserved patient population: a comparative analysis of demographics and outcomes of a rural Veterans Affairs medical center and a Medicaid chiropractic clinic.

The Chiropractic Health Care section program is a very small part of the overall program. There are hundreds of sessions exploring nearly every aspect of public health. The opening session features Sir Michael Marmot, director of the International Institute for Society and Health. The closing session includes a panel of three former U.S. Surgeon Generals.

One of the highlights of the annual meeting is the exhibit hall. There are hundreds of exhibits by different agencies, organizations, schools and vendors. The Chiropractic Health Care section always has a popular booth that provides the opportunity to interact with the broad spectrum of health professionals.

The annual meeting is in San Diego this year. The first CHC business meeting is Sunday, Oct. 26, and the scientific sessions are all on Monday, Oct. 27.  I encourage you to visit the APHA Web page and review the program, the organization's mission and the resources. You will come away recognizing that this is a vibrant and influential organization. You will see that the chiropractic section is an integral and active component of the APHA and a full partner. You will see our section has dedicated and capable individuals interested in advancing the profession by putting patient health first.

I hope you will join us in San Diego. The annual meeting is a rare and excellent opportunity. If that won't work for you, please support us through your membership in the APHA - not for what membership does for you, but for what it does for your patients, your community and your profession. Join the APHA or renew today. Become a part of the community of health care professionals who care about the bigger picture.

To view the complete list of presenters for each of the chiropractic scientific sessions, visit www.apha.org/meetings/sessions/. Click on "2008 Online Program" and then "Chiropractic Health Care" under the section heading.