By Kristen Porter, MS, MAc, LAc and Beth Sommers, PhD, MPH, LAc
The American Public Health Association (APHA) held its 131st annual meeting in San Francisco in November 2003. Welcoming almost 14,000 attendees to 900 workshops in four days, the association provided an expanded venue for acupuncture in a variety of ways.
Public health professionals, health activists and educators from all backgrounds attended the 2003 meeting. Each specialty area of public health has its own group within APHA's umbrella structure; the special interest group for individuals interested in CAM or integrative health is called the Alternative and Complementary Health Practices Group. This section has approximately 300 members from many backgrounds, including acupuncturists. The group's online newsletter, published on APHA's Web site, is edited by an acupuncturist.
Special guest speakers for the meeting included Julie Gerberding, MD, the director of the Centers for Disease Control and Prevention, and Zackie Achmat, a South African AIDS activist. Awards for public health legislation were presented to Maine Gov. John Baldacci and California Reps. Barbara Lee and Nancy Pelosi. Part of Barbara Lee's message to those attending the meeting was that health care should be a basic human right, not an industry.
David Heynmann, MD, from the World Health Organization's Polio Eradication Program, was a keynote speaker. One of the APHA's most prestigious awards was given to Bill Gates for his work in the international health arena.
Two elements highlighted the role and growing importance of acupuncture in public health practice. An unprecedented number of presentations discussed Asian health modalities and, for the first time, sample acupuncture treatments were administered in the exhibit hall by licensed California acupuncturists.
Presentations included public health considerations for acupuncture in the U.S.; a national perspective on treatment for chemical dependency; professional issues of licensing and practice in California; and acupuncture's role in preventive health services. During the sessions a number of topics were discussed, including the integration of acupuncture into HIV/AIDS treatment in Africa. Alan Trachtenberg, MD, who chaired the planning committee for the 1997 Consensus Panel on Acupuncture sponsored by the National Institutes of Health, presented an historical overview on acupuncture in the U.S. Barbara Garcia, PhD, the Deputy Director of the San Francisco Department of Public Health, spoke of the uses and benefits of treatment that acupuncture has provided in the city's public health programming.
The California legislature recognizes acupuncture as a comprehensive healing system, and views licensing as providing a framework for the practice of the art and science of Oriental medicine.1 The California Board of Acupuncture describes the practice of acupuncture in the following way:
"Far more than a technique of inserting tiny threadlike needles along meridian lines of the body, acupuncture's complex system of diagnostic methods takes into consideration the person as a whole, not just isolated symptoms. Acupuncture treats and strengthens the physical condition and controls pain. The aim, as practiced in Oriental medicine, is not necessarily to eliminate or alleviate symptoms. The objective, rather, is to increase both the ability to function and the quality of life."2
Duchy Trachtenberg, MSW, Chair of the Alternative and Complementary Health Practices Group, stated, "Acupuncture is now a part of the public health equation, offering effective prevention and treatment services."
An example of innovative and visionary integrated health services was described by Linda Wardlaw, DrPH, of the Charlotte Maxwell Complementary Clinic in Oakland, Calif. The clinic, incorporated in 1989, is based on the premise that all women have the right to basic medical care and access to CAM therapies. Free CAM treatments are provided to low-income women with cancer while they are undergoing chemotherapy, radiation or surgery; treatments include acupuncture, Chinese and Western herbs, massage therapy, homeopathy, and therapeutic imagery. Additionally, the clinic provides social work assistance, transportation to and from appointments, food, educational workshops, and access to a treatment fund that provides financial assistance for services not provided by the clinic. In-home care has just been added to the roster of services. Two hundred and fifty clients are currently served, and the center has a pool of 115 volunteer practitioners.3
More than 30 presentations described a variety of CAM-related areas of interest. Models for integrating CAM curricula into medical education addressed a number of perspectives, including developing innovative research paradigms, designing baccalaureate programs, and using distance learning. Presentations addressing issues of integrating body, mind and spirit raised thought-provoking ideas such as how to use nature and the outdoors to re-invigorate hospital personnel during their work breaks. Approaches incorporating spiritual practices were discussed in the context of addressing the current obesity epidemic in the U.S.
Cross-cultural issues were also addressed in workshops on cancer prevention and treatment among Asian Americans and Pacific Islanders. One of these discussions was entitled "Heat in Their Intestines - Colorectal Cancer Beliefs Among Older Chinese Americans" and was presented by John Choe, MD, MPH, of the Fred Hutchinson Cancer Research Center at the University of Washington.
Adam Burke, PhD, MPH, LAc, organized a corps of acupuncturists from the Bay area to provide sample treatments to interested conference attendees. Treatments were given in the exhibition hall at the information booth of the Alternative and Complementary Health Practices Group. While treatment was available, acupuncturists were busy answering questions ("Does it hurt?") and administering mini-sessions. The sample treatments proved to be a very popular addition to the booth, and attracted many inquisitive APHA members.
The next annual meeting will be held in Washington, D.C. from Nov. 6-10, 2004. The meeting's theme will be "Public Health and the Environment." Information about APHA and the upcoming meeting can be accessed at: www.apha.org/meetings.
Recognition from our colleagues in public health is a valuable and challenging privilege. Having earned our place at the table, we can continue to envision, innovate, and create programs that nourish the essence of people's health.
Dower C. Acupuncture in California. UCSF Center for the Health Professions, April 2003.