 training center for their support of this conference and we would also like to acknowledge the excellent work of the conference planning committee under the leadership of Dr. Rudy Fadrizzi. At this time, I'd like to introduce the president of the Vermont Public Health Association, Joyce Gallimore, who will provide a word of welcome. Joyce. Hello and welcome to all our speakers and everyone. I'm Joyce Gallimore, president of the Vermont Public Health Association. On behalf of our board and members, thank you for participating. We seek to promote equity for all because we know that the health of individuals is closely related to social and economic factors, including the conditions in which people live, housing and food insecurity, violence, toxic exposure and barriers to achieving an income adequate to sustain a reasonable and healthy life. Access to health care when needed and the well-being of populations are directly related to these factors and race. Racism is a public health issue. The COVID-19 pandemic intensifies disparities and gaps that already exist. Our work on health issues is based on solid research and the passions, training and commitment that our board and members bring. The Vermont Public Health Association partners with other organizations whenever possible to work on common public health issues such as climate change, sustainable communities and social justice. These partnerships make us more informed and effective in achieving our goals. This is our first virtual conference and we are pleased to be able to offer it to you. Keynote speaker Pastor Arnold Thomas will describe the dramatic impact of racism on health. On the agenda that you see on this slide, our other speakers are Lisa Carlson and Melissa Alperin from the American Public Health Association of which Vermont is an affiliate organization. They will highlight national and regional health priorities and issues. The Vermont Public Health Association has been recognizing the outstanding work of public health professionals for many years with our Public Health Champion Awards. You'll hear more about the individual and team awards later in this program. In addition this year, the Vermont Public Health Association has chosen this occasion to recognize and thank all health care workers who serve others with incredible dedication, skill and selflessness. One of our goals is to identify and offer training and tools that will support their resilience in the face of such sustained demands. We invite you to join us so collectively we can address the many ongoing challenges of the COVID-19 pandemic. Whether you are a health care provider, caregiver, advocate or related professional, we know you are committed to helping others heal, survive and hopefully thrive as we find ways to combat the spread and toll of this disease. Together, we can make a difference in the well-being of others. We are all on this small planet together and interconnected. Now I'd like to turn it back to our moderator, Bert Wilkie. Thank you, Joyce. I would now like to welcome our keynote speaker, Pastor Arnold Thomas, Pastor of Good Shepherd Lutheran Church in Jericho, Vermont. Pastor Arnold will be speaking on racism in Vermont as a public health issue. If you have questions for Pastor Arnold, please type them into the chat box. Katie will be monitoring them and then at the end of Pastor Arnold's remarks, she will ask Pastor Arnold to respond to as many questions as time allows. Now I'd like to welcome Pastor Arnold Thomas. Pastor Thomas. Oops, you're muted. Okay. Can you hear me? I want to thank everyone for considering me and inviting me to this wonderful occasion. There's a passage of scripture often read in Christian funerals and memorial services in which Jesus at the last supper with his disciples before his capture in crucifixion says, these words, let not your hearts be troubled. Believe in God, believe also in me, in my father's house, there are many dwelling places. So if it were not so, I would have told you that I go to prepare a place for you. And if I go to prepare a place for you, I will come again and take you to myself so that where I am, there you may also be. In this age of gender neutral, non-binary language, I admit my difficulty in referencing God, which I comprehend as an all-encompassing, life-affirming spiritual presence in this gender-specific mode of father and king. For faith communities, as any place that attempts to prepare a welcoming space for all, must appropriate a hospitality of language and heart by which all, regardless of their condition, may feel at home. Now I serve a Lutheran church whose sanctuary is relatively young among the area houses of worship. Its barn-like structure was designed, was designed and built with the assistance of several members still living among us, including a master German carpenter who constructed the altar, lectern, pulpit, sanctuary cross, and wooden furnishings enabling all who enter this space to feel the warm, rustic environment in the place that has, for many, feels like a welcoming home in this rural setting of Vermont. But home is more than a physical structure and furnishings. It is an atmosphere of belonging where people gladly go out of their way to prepare a place, especially for others, joyfully receiving them into their lives. In fact, their presence influences a restructuring and reformation of their lives so that where they are, those who join them may truly also be. The German Protestant reformer, Martin Luther, had a keen sense of hospitality with some major exceptions that I will shortly share. He followed the instruction of the Old Testament book of Deuteronomy which said, there will be no one in need among you and the New Testament book of Acts in which the church in Jerusalem was described as a community where there was not an easy person among them. For those who owned land and houses, sold them and brought the proceeds of what was sold and distributed the proceeds to each as any had need. So before socialism and actually before Christianity embraced the Roman state, Christians desperately relied on each other through programs of mutual support. Inspired by this instruction from Deuteronomy and the example from Acts, Martin Luther set out to create in his hometown of Wittenberg, Germany, a municipal program, the earliest forms of universal health care in the western world, with other means by which most residents were afforded the basic needs of survival. Now this did not apply to all residents because Luther, like most Christians leaders of his day, was anti-Semitic and this bigoted behavior prevented a more equitable distribution of his social reformation. And while there are many sins of omission and commission from which the church must repent, the modern day legacy of this ecclesiastical effort has contributed to nations where Lutheranism is the state religion such as Iceland, Finland, Norway, Sweden, and Denmark, that the world economic form considers among the safest and most humane societies on the planet because of the strong support for their most vulnerable citizens. Now, mind you, I am definitely not advocating that everyone converts to Lutheranism, especially since like Vermont being one of the widest states in America, Lutheran is one of the widest denominations in America. However, because the topic of my the topic of my presentation focuses on race and public health, it remains crucial that every public health professional approach African American residents of Vermont as individuals well aware of the history of inhospitable treatment by Americans public health institutions toward us as part of an overall structure of systemic racism against us. What do I mean by public health? According to the Center for Disease Control, public health is the science of protecting and improving the health of people and their communities. This work is achieved by promoting healthy lifestyles, researching disease and injury, prevention, and detecting, preventing, and responding to infectious diseases. The communities that public health encompass may be as small as individual families, as large as the world population, or as focused as the residents of Vermont. Public health is more than treating the illness or injury. It is also about challenging the disparities and promoting greater accessibility to quality care for all regardless of race, religion, or income. However, as public health professionals attempt to challenge the inequities that prevent quality care for all, they must also turn the mirror back on themselves and consider the sacrifices they are willing to make and the enormous changes and challenges they themselves must undergo if the public health system is truly to encompass the entire public. Public health professionals in their attempt to protect and improve the health of people in their communities are realizing that the communities they serve are diverse and multifaceted in ways for which they were not trained, partly because the growing number of poor and people of color communities are demanding to be noticed and heard unlike before. No longer complacent and docile recipients of textbook medical diagnosis insensitive to the social, sexual, psychological, ethnic, racial, regional, economic, spiritual, and environmental conditions in which they live. As a result, they are experiencing a need for wake up and smell the fertilizer under your feet kind of courses by which the reality they have long known and researched but seldom encountered now comes crashing on them like a tornado. I have spent most of my vocational career in predominantly white settings of ministry and an attempt to build partnerships with predominantly black ministerial settings. One such attempt involved a confirmation class of the church I served in a college town in western Massachusetts. We had formed a partnership with a predominantly black and Latinx church in Harlem which had invited our confermans and chaperones to join them for a weekend of programs and fellowship by which we would become better acquainted with their confermans and their community. Not long after I shared the invitation with my church what I expected actually occurred. Parents who considered themselves progressive and open-minded expressed reluctance, resentment, anxiety, even guilt about the prospect of sending their children to an African American and Latin American neighborhood of Harlem. And even though and even with an equal number of adult chaperones for every child we still barely managed to convince my members that their children will be safe and well cared for. They had been conditioned to seeing themselves as the benefactors of resources and aid as the great white hope and savior to the world's needs. So the thought of a community of color hosting, directing, protecting and caring for their most precious possessions caught them embarrassingly off guard. This conventional sentiment of white noblesse oblige was not confined to parents. Once the confermans had left their familiar settings of rolling hills, tailored lawns, color coordinated wood-framed and red-brick New England homes well behind. Once this all was well behind them and they stepped out into the darkly different new world of wall-to-wall pavement, storefronts and row houses in mostly black and brown communities, the words of one of the youth summed up when she turned to her friend and said, Toto, I have a feeling we're not in Kansas anymore. Many of you will remember those famous words as having been spoken by the character Dorothy, a Kansas farm girl in the story, Wizard of Oz, written by Lyman Frank Baum, who having been uprooted from her Kansas home entered and was swept into another worldly dream-like realm of Oz. The line has become widely used by those who realize the radical transformation their surroundings have taken. Toto, I have the feeling we're not in Kansas anymore. And I suggest that such a transformation has occurred within the social and ecological environment of Vermont. Vermont, if public health in its fullest form can be achieved. This requires the science of public health, which as earlier defined is that of protecting and improving the health of people and their communities. This requires that the science assumes and takes seriously the psychological, emotional, and spiritual dimensions of people and their communities to more accurately address the internal and external environments that influences the well-being of individuals. What is the environment in which African American Vermonters live? Vermont and Maine have occupied a topsy-turvy battle as to which is the widest state in the nation. Presently, according to the World Population Review, Maine occupies that unenviable role with 96.56% of its residents identifying as white, followed closely behind by Vermont, with 96.15% of its residents so identified. We represent, as African Americans in this state, 1.4% of the population. Yet in 2017, the rate at which black adults entered correctional facilities in Vermont was more than seven times higher than the rate of white adults. Furthermore, in 2014, the state had the third highest incarceration rate of black people in the country, and one in 14 black men in the state were in prison, the highest proportion of any state. Furthermore, a recent report supported by the Vermont state's police also revealed that black and Latinx drivers in Vermont were two and a half to four times more likely to have their by law enforcement than white drivers, and between 30 to 50% less likely to have those searches result in recovering contraband. So when we consider one of the fundamental elements of public health, African Americans crave, which is a sense of security from unjust treatment and harm in their living environment. Vermont is sorely lacking, and in some cases exemplifies more biased and bigoted behavior than other parts of the country. The assuring note is that these realities have been acknowledged by many facets of the state's legal, legislative, and law enforcement branches, and efforts are underway to correct these abuses. Still the question of the psalmist lingers in the air, how long, oh Lord, more specifically, pertaining to the topic of public health. Each generation of African Americans, including black Vermonters, have passed on an historical narrative of future to future generations for mistrusting our healthcare system. Historically, the American medical establishment has exploited black people without their consent for its own advancement of white cultural perspectives and pursuits, while enforcing systemic oppression and racism. In the antebellum period, enslaved African Americans were forced to participate in physical dissections and medical examinations. Their dead bodies were robbed from graves as a continuous source of surgical and anatomical experimentation. The psychiatric diagnosis known as draptimonia or runaway slave syndrome was created to diagnose enslaved African Americans who fled their white enslavers. Their desire for freedom was considered a disease, the treatment of which was often amputation of extremities. Before and following the Civil War, white American doctors supported by political and religious leaders argued that formerly enslaved black Americans could not thrive in a free society because their minds could not cope psychologically with freedom. This belief was supplemented by the sentiment many whites had against free black people competing with them for jobs. These combined notions prevailed even among Vermonters, especially in the early 1800s, and fueled the American Colonization Society, which attempted to urge African Americans to migrate to West Africa and missionize Liberia or Sierra Leone. During the civil rights area, psychiatrists used the concept of schizophrenia to portray black activists as violent hostile and paranoid because they threatened the status quo of white supremacy. However, the Tuskegee Stiflis study, which began in 1932 in which 600 black sharecroppers, two-thirds of whom had stiflis but were not told they had it in an effort to better understand the disease, became the landmark example of the way American healthcare and medical research were weaponized against African Americans. Only after the death of two-thirds of these victims, along with the disclosure and public outcry against this research in 1972, 40 years later, that the study finally in with legal action preventing the repeat of such inhumane research. Even here in Vermont, African Americans are well aware that during this coronavirus pandemic, despite the outcry from leaders of color, that testing sites should be immediately placed in neighborhoods with a high concentration of black and brown, mostly blue-collar residents who don't have the luxury of staying or working at home and shielding themselves from the virus. The state dragged its feet until Winooski, the most multiracial community of the state, experienced a spike in COVID cases, mostly among black and brown Vermonters. Finally, a study of African Americans ranging from 25 to 75 years old by the National Institute of Nursing Research concluded that depression was the most common mental illness and there were no gender differences in prevalence. All seemed aware of some of the symptoms and factors contributing to mental illness, but were not open to acknowledging psychological problems for fear of the stigma associated with them. They were mildly open to seeking mental health services, but preferred spiritual outlets in their faith communities as an alternative. The research suggested that community awareness programs designed to increase openness to psychological problems and reduce stigma are needed. Also exploration of partnerships between faith-based organizations and mental health services could be helpful to African Americans. Now, this brings me back full circle to the premise from which I began my remarks, specifically that the science of public health in its effort to improve the health of people and their communities must see spirituality as one of the vital routes by which trust is gained among African Americans toward public health. By spirituality, I mean the inner environment of the human soul that places a priority in trusting and caring for others in an effort to create a physical external environment whereby one can feel safe, secure, and whole. An environment where one's heart may not be troubled. Such pursuits require systemic change in the public health establishment along with the caste system of a nation that determines one's worth by capital rather than compassion. I am requesting that public health professionals, agencies, establishments, and hospitals seek inroads into communities where African Americans and people of color congregate and work with their leaders in providing ways where trust can be developed and public health resources may be employed. Even in Vermont where African Americans and people of color together barely comprise 5% of the population, such communities may be found through state representatives and senators of color, city councillors, and town selectors of color, through faith communities such as New Alpha Baptist Church in Burlington or the Islamic Society of Vermont in South Burlington, through organizations advocating human rights such as Justice for All and the Vermont Racial Justice Alliance and the Association of Africans Living in Vermont all based in Burlington or the NAACP in Rutland and Wyndham Counties or the Root Social Justice Center in Brattleboro. I am urging that public health education and employment, especially within one of the nation's widest states, generate proactive and assertive efforts to develop greater numbers of black and brown professionals so that racial and ethnic communities long oppressed by the insensitivities of public health administration may develop trust through practitioners who look like them and relate to their experiences. All we need to do is look at the numbers to know how woefully lacking public health care remains as it relates to people of color. Recent data by the Association of American Medical Colleges reveals that only 5% of physicians and less than 10% of registered nurses are black. Additional mental health surveys reveal that only 2% of psychiatrists and psychologists are black and only 4% of social workers are black. Clearly much more needs to be done to remedy these gross disparities. I am also urging that the administration and practice of public health be pursued with the intent of providing affordable and quality health care as a right rather than a privilege for all so that as African Americans and people of color benefit all Vermonters regardless of race and economic conditions benefit as well. No longer should people need to worry about forsaking needed public health care to pay their rent or utilities or provide for their families. But these objectives can only be achieved through the overhauling of an entire system of government designed to benefit and protect the rich against the poor, designed to benefit and protect white Americans against black and brown Americans. We are a nation that claims to be founded upon divine notions of equality for all while in fact promoting and practicing an inhumane idolatry by which capital rather than compassion determines the worth of an individual. Let not your hearts be troubled, said Jesus to his anxious followers who had every reason to worry about their physical fate. And as long as we live in a nation and world of misdirected and distorted priorities we too have every reason to worry. In closing I return to the Wizard of Oz for when the wicked witch was destroyed her followers were suddenly transformed into caring compassionate individuals. Truly something needs to die within and among us in our nation if we are to fully and finally live. Thank you Pastor Arnold. You're welcome. Um we really appreciate your remarks and your insights and we are at a point unfortunately where we don't have time for questions but I was going to ask maybe if people can submit those and we can work with you to perhaps put any responses on to our website. So thank you again. That's fine. Your thoughts and your and your insights it's been very much appreciated. I'd like to move to our next speaker and our next speaker is Lisa Carlson. It gives me great pleasure to introduce to you the immediate past president of the American Public Health Association. The Vermont Public Health Association is an affiliate of the American Public Health Association and in 2020 we would have it would have been the year for us to invite the current APHA president however that did not happen because of COVID. We're very pleased that Lisa has accepted our invitation to join us on this virtual conference. In order to observe Lisa and her presentation as she speaks please move your cursor over the view box at the upper right hand corner of your zoom screen you can click on the speaker side by side view. If you have any questions and if time allows we'll ask them please put them in the chat box. Now I'd like to welcome Lisa Carlson. Thank you Bert. I'm really excited to be with you this evening although I am of course sorry that I'm not with you in Vermont. We had a nice little conversation as we were getting started about whether or not there's going to be snow in Vermont following the rain in Georgia. I would have liked to have been with you in person but I am happy to be with you from my makeshift office to into yours. So let's talk I talked with Bert about just talking a little bit about having served as the president of the American Public Health Association in 2020 during the greatest public health challenge in a generation certainly wasn't what I had planned. It certainly didn't go as planned but I think it really gave us a lot of fodder to talk about sort of public health 2020 and where are we and so I want to just talk a little bit about some of those ideas a little bit because we were not naive in public health before COVID. You know we we knew that there were deeply embedded social and racial inequities as we've been talking about. We knew that Americans had pre-existing conditions no national paid sick leave little or no savings. We knew we were at risk. You knew we were at risk and public health you have been sounding the alarm about that. We know that the social determinants impact health. We know that your zip code can be a greater determinant of your health than your genetic code because place matters place determines your access to good schools affordable housing safe neighborhoods even green space. Then when these things are distributed unevenly across neighborhoods and we know that there's inequitable health outcomes as well. And so I want to talk for just a second about one of those that may not seem like the most obvious which is the idea of green space. This is one that's really important to me. You know trees impact heat which impacts health. So I think of trees really as part of the public health team. I mean they filter the air they filter water they provide habitats and then this issue about heat is really important particularly for those of us in the south but I think in a growing number of places because when trees vary in their coverage by income level in neighborhoods. So in poorer neighborhoods there are fewer trees and there's more heat and so lower income communities can be as much as 10 degrees hotter than wealthier ones which has a direct impact on health. I also know that good health and well-being people report better good health and well-being when they spend 120 minutes a week in nature that's two hours and it doesn't sound like a lot but most people spend more than 90 percent of their time indoors and that was before the widespread isolation caused by COVID-19. We weren't naive about inequities writ large before COVID-19. I mean if you think about the green space one you know we knew that when we asked people to stay safely indoors in the quarantine we said get safely outdoors and there were a lot of people who couldn't get safely outdoors near their homes and so this inequity in green space to me is really important. Look at this list though there are things here that we have been talking about for a long time hunger unemployment housing insecurity we're going to talk more about structural racism the lack of transportation or access to health insurance lack of health care resources certainly the divestment of public health and and poverty you know public health hero Dr. Bill Fagy was here in my hometown a few years ago and somebody asked him at the end of his talk if you had your entire illustrious career to do over again what would you focus on and he said simply poverty because of its dose response relationship to health. So you know we know that poverty racism and housing aren't just correlated with poor outcomes but can actually cause them so these realities have been really laid bare by COVID and I think are harder to ignore and the simple fact is inequity kills and this has been magnified by the pandemic and we aren't experiencing the risks of this pandemic equally so I would argue that early in the pandemic few people knew someone who had been infected with COVID but many people knew someone who had been economically impacted and even all these months into this have whatever number wave we're on I still know very few people who've been infected with the virus but I know multiple people who've lost their jobs and if we think back to the quarantine in March we told people work from home stock up on food avoid public transportation shelter in place not recognizing that there were a lot of people who don't have the option to work from home who can't afford to buy two weeks of food at one time who don't have private transportation and for whom home is not safe and when we exacerbate these things with our structures like the coupling of health insurance with employment people lose their jobs and they lose their health insurance lack of child care and structural racism as the pastor has been talking about very eloquently I want to say it very clearly racism is a public health crisis and people of color are disproportionately affected by COVID-19 we know that but there's a lot we don't know because there's a lack of reporting of race statistics which contributes to our inability to really truly understand how this epidemic and pandemic is happening in communities of color we do know though that systemic racism and bias in the healthcare system have long been factors and they are certainly apparent in the pandemic if we are going to tackle these big issues like poverty and racism which are clearly clearly impact health the simple fact is that we're not going to be able to do that alone in public health and so I want us to think about how we can bring other people to the table because I think in public health that we're good at this we are conveners we are naturally collaborators we understand the power of synergy and so we can bring all of these people education employment housing food transportation health care we can bring all these people to the table and talk about how together we can have a cross-sector approach to public health which is what I really think the future of public health is is working with people outside of traditional public health now where we can get these people who are outside of of traditional public health I think that our our schools of public health are graduating 30 000 students a year most of whom aren't going into governmental public health they're going into other areas of like technology and academia and I think they're going to be in those sectors that we want to partner with and they have our public health lens they speak our language and I think they can be our partners and so while we're thinking outside the box about how we think about public health I also want to think a little bit about mental health and I want to encourage us to think clearly about mental health being essential to public health because in an average year one in five U.S. adults struggles with poor mental health but I would argue that in the COVID-19 pandemic everyone knows someone who's struggling with mental health if they aren't struggling themselves and nearly half of Americans say the pandemic is harming their mental health and we should be passionate in public health about mental health because all these hard things are connected poverty unhealthy environments violence and suicide substance abuse and a global pandemic they're all related to and impacted and impact by mental health so this is a critical time really for us to acknowledge the impact of mental health broadly when we talk about COVID-19 every time we talk about COVID-19 we should talk about mental health every time we talk about public health we should talk about mental health that's my challenge to you because the same social determinants are are impacting mental and physical health alike it's the same factors this is public health and we are the right group to convene these groups to make change in this area this is our lane and the fact is that right now it's also very personal I don't know if you've seen this article the pandemic experts are not okay you maybe this sounds familiar are you demoralized from missed opportunities the multiple crises of the pandemic and racism at once the wrath of a nation on the edge I mean who thought we'd be talking about threats to public health professionals have you have you feel like you're making the same recommendations over and over again or shouting evidence-based advice into a political void and we certainly had a nationally disjointed response it would not be surprising if you felt like your batteries were a little bit low and so what I want to say to you very clearly tonight and this is the most important thing I want to say is that you are not alone in public health I have been talking to the country this year talking to people like you all over the country who are on the front lines of public health and I I had a little bit of imagery I was using this year about I like to you know trees part of the public health team I like to think of us as a healthy forest of public health and our partners and so I want to want to call on you the heroes of the greatest public health challenge in a century to make use of that forest both literally and figuratively I want you to go out among the trees and into the forest of public health to restore your public health spirit so go out among the trees tomorrow next weekend again and again every day to restore your inner spirit it's good for your public health and your mental health and then do things like you're doing tonight being part of the Vermont public health association be part of APHA and restore your public health spirit as well in our healthy forest of public health if you are interested in the kinds of things that I have been talking about very quickly this evening I would encourage you to engage with me on Twitter I talk about all these things a lot on Twitter and so I'd be happy to have this conversation some more so these are the things I've been thinking about in this year this crazy year of being a president of APHA and so I hope they give you some food for thought thank you Lisa thank you so much for your remarks I don't know if there are any questions for Lisa Katie if there are we may have time for one there is one um in the chat it says why do we put the focus on poverty I prefer impoverishment of black and brown people we have a system that has preyed on members of minority groups including white women yeah it's a good point I think the reason that I chose the word poverty was because of dr fagey's comment uh which really struck me with his his comment about the dose response relationship uh to health and that was the context he put it in and the one that struck me and so that's why I chose that language but I think your point is very well taken thank you again Lisa very much appreciate your joining us this evening and I know you have to leave in a few minutes but uh uh welcome to Vermont virtually anyway thank you thanks for having me with you I really appreciate it um the American public health association has a relationship with all state public health associations within APHA there's a formal body called the council of affiliates which brings together all the state affiliates and serves to strengthen the relationship between affiliates and APHA councils headed up by a chair and the immediate past chair of the council affiliates is melissa moose alperin we have invited her to share some thoughts with us this evening if you have questions for moose please type them in the chat box and as time allows at the end of her remarks we will ask them now please welcome moose alperin thank you burt and thank you all um for inviting me and and welcoming me um in addition to my role as the council of affiliates immediate past chair I am also a member of the georgia public health association and um what I would like to do um tonight is briefly cover three topics I want to do a real quick sort of APHA American public health association primer uh through an affiliate lens I'd like to celebrate public health and I'd like to end with some thoughts about the year ahead and I will give you a heads up that I'm a bit of an amateur photographer so a little later you're going to see some of my photographs that I'm going to use to accompany this but I'll start with a little bit about the American public health association and um in particular the value added that the Vermont public health association and then you as a vtpha member have by being connected to other affiliates and to the association let's start with the building blocks which are the state and regional affiliates there's the vermont public health association there's the georgia public health association and there's 51 others and we really champion the same goals as APHA to promote to protect to advocate for the public's health but we're all independently established with our own infrastructure our own policies and procedures and our own activities although I think um if you were to look across all of us we all probably do some kind of annual meeting we have program development um you know continuing education um opportunities a lot of us do advocacy and every affiliate has something called an ARGC or an affiliate representative to the governing council which is an APHA representative and in Vermont Burt is y'all's ARGC um there is also something called the council affiliates which Burt has just very quickly told you about and what I will say um sort of about the the coa as it is known is it really is the bridge that connects the affiliates with the association and it's got a multi-step purpose but really the the just behind it the the real role of it is to make sure that there's a win-win relationship between APHA and the affiliates and that um they are empowered by each other and that APHA can provide resources and training and support to strengthen affiliates and to help affiliate um members as well so there are activities at three different levels of the APHA organization that benefit affiliates and or you as a member of an affiliate the council affiliates and then affiliate affairs have activities that focus specifically on affiliates and specifically on affiliate members and then APHA may have activities that are broader than the affiliates but often those activities are still applicable so what I'd like to do on the next couple of slides is I want to share some examples of places where you might plug in where you can take advantage of some of the activity I have focused on things where you don't have to be an APHA member to take advantage of the opportunity and I'm going to organize my comments by webinars advocacy and policy diversity equity inclusion and then sharing in resources and then a few sort of miscellaneous things thrown in at the end. There are all kinds of webinars and other learning opportunities that you can take advantage of including affiliate specific webinars some of the topics that have been offered over the last couple of months include things like how to hold a virtual meeting something y'all that are very experienced in advocacy non-profit governance fundraising best practices and these are all available in archived form now that they've already happened so you can access them there are also recordings of the scientific sessions that the council of affiliates sponsors every year at the annual meeting those are made available to all affiliate members this year there were a number of sessions or a number of speakers that talked about issues of diversity equity and inclusion as well as other best practices from affiliates and then APHA holds webinars that are open to everybody not just members and of note are two series that I want to point out the first is the COVID-19 conversation series which has been around for the eight or nine months that we have all been dealing with COVID I've got the link on this slide and the slides will be made available to you after tonight but these are all archived you can go back and watch and watch those that have passed you can watch those in their archived version or watch ones that are upcoming there has also been a series called advancing racial equity and again I've given you the webinar excuse me the the link on their website for the information about these and as part of this webinar series there is a discussion guide and although that discussion guide was developed as a companion piece for the webinars their discussion questions their resources and other activities that might have broader applicability to some of the work that y'all are doing and want to be doing in Vermont. APHA has a very robust advocacy and policy set of activities their webpage is full of resources that you can get to whether or not you're an APHA member this screen capture includes some of the information that's available on the website I also want to point out that APHA has a database of policy statements that the organization has adopted since way back in 1948 what I did in the screen capture here is I searched for equity I searched that database for equity and there were 90 different results that came up so a policy and advocacy is is your area and that is your passion I hope that you will explore some of these resources because I think they'll be tremendous resources for you APHA also has topical information on a variety of different topics and issues is seen from this screen capture you know they range from COVID-19 to public health accreditation tobacco vaccine social determinants of health and all kinds of other topics in between. In the last year the council of affiliates has been very intentional about engaging in activity around diversity equity and inclusion of note we have a new workgroup and that workgroup is going to be working to assist affiliates in addressing issues around DEI and racism within affiliates in their communities if this is something you'd like to be involved with let me know let Bert know let um other leadership of uh vtpha know they can figure out how to get to me and I can pass that word along additionally another activity um of the council this past year was an action toolkit for organizations and the goal of this interactive toolkit is to stimulate to guide small nonprofit organizations like affiliates as they work to integrate equity diversity and inclusion best practices into their governance and organizational structure the toolkit has a series of worksheets where affiliates or it's another organization but the users of the toolkit can assess themselves and five focus areas of governance mission driven programs partnerships communications and advocacy what I've included here is an example of what one of the assessment worksheets looks like and then for each of the focus areas there are resources and places to go for additional information as well and then there are other ways to engage with affiliates and other affiliate members the what's known as the affiliate online community allows for discussion board posts and file sharing it is a great location to seek advice from other affiliates um every year the presidents and the president's elect of the affiliates meet several times each year and COVID permitting the president's elect get together every July in that in DC for a meeting that the association pays to bring everybody in for those who plan activities around national public health week the national public health week website is a great resource and has great materials to help you think about some of the activity that you're developing and then periodically there's small grant opportunities that Lindsay who is the director of APHA affiliate affairs office shares with affiliates recently five affiliates were funded to do some DEI work diversity equity and inclusion work and then finally I will tell you that there are opportunities for your affiliates to be recognized every year there are council affiliate annual awards that are given you do not have to be an APHA member to nominate a colleague or to nominate your affiliate and you don't have to be an APHA member to receive an award and then finally the nation's health is APHA newsletter and if your affiliate is doing something pretty cool I am sure that the nation's health would love to tell others about that activity and about that the final activity that I will mention to you before I shift into the next section is something that we're calling affiliate day three it is open to all affiliate members again regardless of if you are involved with APHA or not it's going to be next week on December 9th one to three mountain time or three to five eastern time and it's going to be a session that provides an opportunity to hear from current and emerging public health leaders about existing and being in public health and the challenges that we're we're facing during these times I'm really looking forward to that session we have panelists who are going to provide perspectives from Arizona from Iowa there's a student perspective there'll be an opportunity for folks to get into breakout sessions and talk within those breakout sessions and I'll make sure that y'all have the registration link for that so enough about ways to plug into APHA I'd like to shift and celebrate public health and to celebrate you and I'll do this using some of my own photographs but let me say as you all know better than I 2020 has been a year unlike any other things have been coming at us fast and furious we haven't had the luxury of waiting for the perfect wave before responding and among the issues that public health has addressed and that many of you have tackled are health disparities and inequities physical activity nutrition oral health mental health climate change vaccinations driver safety diversity and inclusion clean air and safe water maternal and child health emergency preparedness injury prevention racism environmental health and of course COVID-19 you all have advocated and you have educated you have met with elected leaders on a variety of different topics you are truly the heroes of 2020 and I am thrilled to join you tonight as you celebrate some of your own local champions when I am finished here I'm looking forward to that in the year ahead it is truly my wish that we are no longer physically distanced that we are in a year and that it is a year where different ideologies are able to work together this is my example of bipartisanship at the US Capitol in Washington DC it should be a year when we remember to be a little easier on ourselves and others and perhaps give ourselves some grace and some love and finally it is my hope that a year from now the world is a much much safer place we have had far too many tragic deaths over the last few months this is a safety sign I found in Denver at Union train station Denver Colorado a couple of years ago and you will see that it lists dumb ways to die and it felt appropriate to share this with you all because as you will see the first one is to dress up like a moose during hunting season so I thank you for all you have done this year and I thank you for all you will continue to do and thank you for having me thank you so much moose I don't know if there are any questions in the chat box Katie there aren't any right now okay again really appreciate all the work that you've done for the council of affiliates and for APHA and really appreciate you spending your time with us here in Vermont moose it's it's much appreciated I'd like to move on to the last part of our um virtual conference today and I want to just let you know that for the last several years the Vermont public health association has recognized a public health champion to tell you more about the public health champion process and to reveal this year's winners please welcome Aaron Flynn chair of the public health champion awards committee Aaron thank you for and good evening everyone um as Bert said my name is Aaron Flynn and I'm a member of the Vermont public health association board and it's my honor to be able to introduce the public health champion awards series to you tonight this is the third year that the vtpha has featured public health champions at its annual meeting however this is the first year we are proud to announce that in addition to an individual award we will be presenting our first ever team champions award the Vermont public health champion award honors an individual and a team who have made extraordinary contributions to public health within the state of Vermont nominees were scored on criteria ranging from leadership collaboration and partnership innovation and creativity building community capacity and supporting the health of all Vermonters although all nominees are truly public health warriors it is my honor to present to first present the team award and then I will turn it over to my colleague Joellen Tarallo who will present the individual award dating back to the early 2000s much like the rest of our nation opioid addiction was raging in and ravishing communities across Vermont as governor Peter Shumlin indicated in his 2014 state of the state address Vermont was in a full blown heroin crisis stretching to every corner of our state tonight we honor the team of leaders responsible for creating Vermont's hub and spoke system of medication assisted treatment which supports people in recovery from opioid use disorder the hub and spoke has truly changed the course of the epidemic in Vermont and served as a north star for communities across the nation the model brings together public health primary care and community health teams to develop a system of treatment and wrap around services that has produced outstanding results for more than 6000 people since the program inception in 2013 it's my honor to present the 2020 public health champion team award to Dr. John Brooklyn Dr. Harry Chen Barbara Somoglio and Beth Tansman we thank you all for your extraordinary work to support Vermonters and their time of greatest need I would like to now invite the hub and spoke team to each offer a few brief remarks and I think to keep it organized we'll just go in alphabetical order starting with Dr. Brooklyn so feel free to take yourself off mute turn on your camera and the floor is yours hi everybody thank you very much Erin for that great introduction so Mary Lou Bolt sent me a copy of what she had remembered from a meeting that we had at the health department a number of years ago and I always chuckle when people bring up things that they had heard me say in the past because it makes me remember how important it is to be careful about what we say in public settings and in that particular case I proposed a program that I was thankful enough that Vermont's governmental agency had people who were open-minded enough to listen to new ideas that were different and that they were brilliant enough to craft such an ambitious plan and so I think in deference to my colleagues I'd like to thank Barbara Somoglio for her wisdom about being brought in our approach in the hub and spoke and not just thinking about treating opioid use disorder but treating much more of the total person in that in that setting and Beth Tansman and her wisdom to create such a marvelous payment structure to create a model where teams are involved in taking care of of opioid use disorder and then finally Harry Chen for his wisdom for years of being in an emergency room doc and seeing opiate users leaving oftentimes without treatment and really appreciating what was needed to to make this work so I'm grateful to my colleagues for having helped me create such a wonderful program and I thank you all for the award. Thank you Dr. Brooklyn. Dr. Chen I think I see you on would you like to say some remarks? Sure thank you Erin and thank you to the Vermont Public Health Association for this honor and really I think that the point I would like to make here is that this is public health team sport and I think if not if you know not clearly we've seen this so dramatically during this epidemic and I think this pandemic and we you know really address the epidemic of opioid addiction with the hub and spoke and and I just say I'm so gratified to receive the award but also just to acknowledge that it's people like John Brooklyn on the ground who really knew how to how to treat opioid addiction it's people like Barbara Samaglio who could who could we could just sit together every few weeks and just say how's it going and just kind of support you know let's keep going let's keep going and people like Beth Tasman who could collaborate with with Barbara and all of us to really make it happen I mean really this I had to say it's gratifying I remember several times being across the nation talking a little bit about the hub and spoke and people just you know standing up in applause because it really was a concept that they was foreign to them that that Medicaid agency or a substance abuse agency and primary care could actually work together so effectively to and change the paradigm really of how we treat and how we address opioid use disorder so it's every you know the every year a couple of times a year somebody comes up to me and thanks to me I mean that's really the gratitude that I need and importantly during this these times we really have to thank all of you who are still all of us who are doing public health because what we do is really important and it's an opportunity for us to kind of leverage some of the really sad and tragic things that are going on now for the future so thank you. Thank you Dr. Chen and Barbara Samaglio would you like to give some remarks. Hi thank you Erin and thank you to the public health association and Mary Lou for the nomination and it's just a real pleasure to be here with you all even though it's virtual I left Vermont about three years ago and when I got this email about the award it just was it was just thrilling to me especially during these times when we can't see each other in person I had planned to come back to Vermont before now but you know with COVID and all it just hasn't happened so this is a beautiful substitute and it's wonderful to be remembered and honored and to be among my colleagues John, Harry, Beth and and many of you who I see and see your names and it's a it's a wonderful gift at this time of year. They say that imitation is the sincerest form of flattery and I think that what I've seen since I've moved back home to the Chicago area and had a chance to talk with people around the country the hub and spoke model is now recognized across our country as one of the evidence-based approaches for opioid use disorder treatment that it has been widely implemented and copied with the federal funds that are available for opioid treatment so it's surprising that to see this model carry such weight all around the the United States since I've been home to Chicago I've been working with Illinois to do some work in this area here in Wisconsin our neighbor is also doing doing some work in this space so you know a good idea spreads and grows and I think it's nurtured through the collegiality that was mentioned this model could not have been born I don't think anywhere but Vermont because we had the support from the highest level to the people on the ground the wisdom of John and Harry and Beth uh and and as uh as Harry said it's it's a real team approach and I am just proud and grateful to have been part of it and thank you for the recognition it it means a lot to me because I have such beautiful memories of of my time in Vermont so thank you and happy holidays to everyone and safe safe new year thank you thank you Barbara and last but certainly not least Beth would you like to offer some comments thank you so much for this honor and it's such a delight Harry to see you Barbara to see you John hear you although we see each other more often in Vermont um you know this hub and spoke system the original clinical innovation and idea for it is really John Brooklands and a few other people who who had the vision and the programmatic know-how of what actually needed to happen and then what we were able to do in the Medicaid team and in blueprint was sort of put together the financial and staffing package that allowed it to be statewide and systematic which is so important and thanks so much to Harry and Barbara for their political savvy on how to actually get this to happen in a complicated system and I would also like to just sing some praises to some of the people who are here with the public health association who were original implementers on the ground Barbara all of your team at ADAP amazing work Sarah Narcowicz Laurel Ruggles you guys helped actually create integrated teams that did exactly what John said we needed which was team-based care and integrated settings with ready access to higher levels of care so we are extremely proud to say we're treating actually over 9000 people right now in Vermont Southern spoke system some of the highest rates of treatment in the nation and yet here we are in a time of pandemic when this treatment and close connection with people has become even more important and what we built together ends up being durable even if we have to close offices staff and people are still in place to interact every day with people and recovery and so thank you so much for this honor but mostly thank you wonderful team for having done this work and for all of you on the ground who make it possible thank you thank you very much best I'm now going to pass the floor over to my fellow board member Dr. Joellen Tarallo who will take the lead for introducing our individual award greetings everybody yes I'm Joellen Tarallo executive director of the Center for Health and Learning a non-profit partner to many statewide initiatives that address priority health issues in Vermont and I've been on the board of the Vermont Public Health Association since 2017 it is my pleasure to present this award to Dr. Mercedes Avila she has been a tireless advocate for health equity and justice in Vermont and nationally I've known Dr. Avila since 2008 when she served as an evaluator for a suicide prevention grant we received from the Substance Abuse Mental Health Services Administration she has been involved in more than 21 federal grants in Vermont including those from the Office of Minority Health and Health Resources and Services Administration and at the national level providing consultation training and technical assistance on cultural and linguistic competence health equity and social justice and health care to more than 152 organizations for the last two decades Dr. Avila has been involved in federal programs focusing on first generation 11th graders interested in health and science careers Dr. Avila as director of the Vermont LEND program in the Department of Pediatrics has been recognized nationally for her work towards diversifying the workforce and Vermont LEND is recognized nationally as the leading program in equity and inclusion in the developmental disabilities field during the COVID-19 Dr. Avila has advocated for and secured funding for refugee serving organizations and expanded the critical positions of community outreach workers her innovative work in the state of Vermont includes development of the health disparities and cultural competence committee refugee and immigrant cultural brokering community health outreach program and the multicultural youth program Dr. Avila has trained more than 10,000 professionals across 27 states in understanding the connection between racial gender social economic educational and health disparities and the role social determinants if health play in populations health outcomes since 2011 she has been invited to lead 58 national presentations 100 regional sessions on topics related to social justice and health care culturally responsive care social determinant of health and equity and addressing racial biases in systems of care she is a treasure and we are fortunate to have her here in Vermont Dr. Avila thank you Joelynn thank you Vermont Public Health Association for this recognition I'm honored and humbled champions do not work alone they are part of collaborative teams that help advance equity for all communities I could not do this work without the ongoing support of my family the teams I work with put endless of hours of work to ensure all communities have equitable access to resources I want to share this award with the Vermont LEND program Medialis-Fabro Esther Doe Ivanya Mangas Vidur Dahal my incredible colleagues the health disparities and cultural competency advisory group and the cultural brokering teams I envisioned these ideas many years ago and are now a reality thanks to funding from the Vermont Department of Health I'm a member of many councils and committees one I am honored to serve in is the governor's racial equity task force a group of remarkable champions and leaders who advocate for change daily I'm also sharing this recognition with every one of them finally I want to share this award with every front line an essential worker in our state who put themselves on their loved ones at risk daily very especially a group that is very dear to my family a group of first responders that has come to our aid when we were dealing with medical emergencies the Vermont Air National Guard firefighter team they are our very own champions and deserve every recognition for what they do for their professionalism for caring for our communities and keeping us safe Luca my five-year-old son wants to be a firefighter when he grows up because he has seen this team help our family and many others in our community children want to grow up and be like the hero they witness we see you we value we value you and we thank you for your service and outstanding work COVID-19 has resurfaced many inequities and racial disparities nationally and in our own state I have been advocating for systemic change for almost two decades in Vermont sharing best practice models we had to engage in ongoing education and training about systemic issues in our society we need to work with communities and not in communities creating meaningful partnerships with historically underserved communities we must diversify the workforce by investing in pipeline programs of under represented students in health and sciences we need to actively work to implement policies aiming at reducing and eliminating health disparities and inequities thank you again for this award it is everyone's job to address and eliminate health disparities and inequities I look forward to continuing this important work with every one of you thank you again thank you very much and thank you to Aaron and Joellen and my congratulations our congratulations to all of this year's awardees incredibly inspirational work that you've done I would also like to once again thank our three speakers for their remarks and and insights that they shared with us this evening so now please welcome once again the Vermont Public Health Association president Joyce Gallimore for some closing remarks hello I hope that you can hear me can you hear me yes okay thank you so much thank you to our speakers and all the participants to our award winners and to the funding from the northeastern public health training center we have heard about the toll that racism for centuries has exacted and that we face the results off now and we know that COVID has it has intensified the gaps and disparities that we're dealing with our keynote speaker helped us understand how racism drives poor health and a tremendous challenge to us we've also recognized that there are wonderful heroes and that the workers every day are heroes in their environment the volunteers who help and assist and we've heard several times the importance of partnership from Dr. Chen and the the entire team we've we've heard from Dr. Avila that there are a series of steps to bringing diversity to the workforce training and supporting and making sure that children are growing up in an environment that is safer and provides possibilities and equity equity diversity so the charge is tremendous but what we hear is that it's while individuals are dealing with this every day that the answers lie in creating going into communities in creating teams that are effective and so bringing that back to our individual and collective role we hope that you will look to the resources that we can offer and to the support of each other and that we have resources as a public health association and and invite you to join us because we are strong or working together so that I hope you will provide feedback to let us know if we've met some of the needs that you had and come in joining us tonight and that you'll remember the work of all the the professionals who are striving to help health help individuals have better health and that we can work on this together thank you very much that's the end of our program tonight and be well take care