Thursday, March 31, 2011

Kegasus? Really?

Earlier this week, the Maryland Jockey Club unveiled a controversial new advertising campaign for the Preakness, Maryland’s leg of the triple crown of horse racing.

The star of the show isn’t the beautiful horses, or the determined jockeys who ride them to glory. Instead, we’re given Kegasus, a centaur who loves to party. REALLY? Why not Barney from the Simpsons, or other media symbols of alcohol overindulgence that appeal to largely adolescent boys?

Jockey Club President Tom Chuckas concedes the ads are designed to bring 21-40-year-olds out en masse for infieldfest, a big party on the track infield. The campaign, he told the Baltimore Sun, “talks their language.” “We have never hidden the fact that we want people to come to the infield and party.” 

Everyone loves to have a good time. The obvious problem here is that advertising ‘bottomless beer mugs” promotes binge drinking. Binge drinking, defined as consuming more than 4 (women) or 5 (men) alcoholic beverages on a single occasion, is especially problematic amongst young adults. According to the Robert Wood Johnson County Health Rankings, released the same day, in Baltimore City, 16% of people contacted in a CDC random telephone survey reported binge drinking at least once in previous 30 days. The national benchmark is 8% (90th percentile).

Excessive drinking is a risk factor for a number of adverse health outcomes such as alcohol poisoning, hypertension, acute myocardial infarction, sexually transmitted infections, unintended pregnancy, fetal alcohol syndrome, sudden infant death syndrome, suicide, interpersonal violence, and motor vehicle crashes.

Advertisers have a social responsibility to tell the truth about what they are selling. The truth in this case is that no where on the infieldfest website is there any message about the importance of drinking responsibly.

Legendary ad man Bill Bernbach said, “All of us who professionally use the mass media are the shapers of society. We can vulgarize that society. We can brutalize it. Or we can help lift it onto a higher level.”

Sadly, the Jockey Club has missed an opportunity to responsibly promote an event that puts Baltimore City and their sport in the national spotlight.

Wednesday, March 30, 2011

Snuffing out tobacco use in Major League Baseball

I love baseball.  I’ve been a fan ever since I can remember.  I have fond memories of going to the “house that Ruth built” in the Bronx and rooting for my heroes.  I played stick ball with the boys on the block and was on teams throughout my youth and into adulthood.  Not only did baseball (and softball) keep me active, but it taught me the values of being a team player. 

Yesterday I joined Health Commissioners from 14 other cities with Major League Baseball teams to urge MLB to prohibit the use smokeless tobacco.  Baseball players are an inspiration to millions of children and adults throughout the country. They should provide positive role models and take a stand against smokeless tobacco. 

Tobacco use is the number one cause of preventable death in the United States, killing more than
400,000 people each year. As cigarette smoking has declined, the tobacco industry has increased its
marketing of smokeless products and is spending record sums to promote them. But smokeless tobacco
use is itself very dangerous, causing serious diseases of the mouth, including oral cancer. In addition,
there is reason to worry that smokeless tobacco use by young persons may serve as a gateway to
cigarette smoking, this nation’s leading preventable cause of premature death and disease.

In his post "Motivation to quit chewing tobacco," Dr. Stephen Matarazzo, D.M.D., shares a poignant testimonial from Joe Garagiola, former ball player who regrets ever picking up the habit. He quotes Garagiola as saying:

“I chewed tobacco because it seemed to be the thing to do if you were playing baseball,” says Garagiola. “Everybody chewed when I was playing, and nobody knew the dangers of it.” But he’s seen the dangers since, losing three close friends to oral cancer and seeing the harmful effects of spit tobacco on other people.

“You won’t die of gum disease or yellow teeth, but develop oral cancer and it’s a terrible way to go,” Garagiola says. “Here you are with oral cancer from using spit tobacco, your jaw has been removed and you have to eat through a tube. You die one piece at a time. Spit tobacco is a horrible, horrible thing. I just wish I could get this message across to everyone.”

I urge you to join Garagiola and others as we speak out against smokeless tobacco. We need MLB to help us promote tobacco free lives.

Friday, March 25, 2011

Reflecting on Youth Violence Prevention Week

As Youth Violence Prevention Week draws to an end, I am reminded of a site visit I recently conducted with one of our staff in the Office of Youth Violence Prevention, Lori Toscano.
Lori is the community liaison officer, and like me she is from New York. She has a long and impressive history working with youth including a stint as a probation officer. She’s a ball of energy who regularly monitors the two Safe Streets sites we fund to make sure they are meeting their benchmarks.

About a month ago, we visited both sites, one in McElderry Park and the other in Cherry Hill, where we are implementing the Cease Fire model developed in Chicago. It’s an evidence-based approach at reducing violence in neighborhoods by engaging individuals in activities such as conflict resolution and mediation.
As we drove I would pepper Lori with questions about the importance of the work and why we should continue. Without hesitation, she replied “I’ve been in this work a long time and I stay because no one else does it like we do and it makes me feel good when we show that we are getting results. We are demonstrating that we are reducing the amount of violence in these communities.” 

In speaking with the outreach workers, what struck me the most was the eloquence with which they spoke about how they came to this demanding work. Many of them have histories of “wreaking havoc” in their communities and see this as a way of making amends. Others see themselves more through the lens of a medical model and refer to the work they do as a “vaccination (against violence) that goes into a community and works with people to help them see that there are other ways to deal with issues.” What was common to both groups was their assertion that “everybody wants a way out” of a life of violence. What they provide is an invaluable and life-saving service to their communities oftentimes on a 24-7 basis.

I remember the story an outreach worker shared in McElderry Park of what his father said to him when he visited him in jail: “It’s time for you to put a stop to this. I was in your seat and your grandfather was in your seat. I failed you. You don’t have to fail your kids.”

These are powerful stories of individuals taking responsibility for their actions and contributing to the betterment of their communities, one person at a time. And that’s the message of Youth Violence Prevention Week – that we all can play a role in reducing and PREVENTING violence in our communities.

Youth Violence Prevention Week ends tomorrow, but our prevention work and that of our partners will continue until homicide ceases to be the leading cause of death for young people age 15-24 in Baltimore City.

2011 Baltimorphosis Award Winners Announced

As part of National Youth Violence Prevention Week, we wanted to take an opportunity to recognize the accomplishments of some of our city’s residents who are Standing Up and Speaking Out against youth violence. That is why yesterday afternoon at City Hall, I had the pleasure of honoring the winners of the 2011 Baltimorphosis awards. 

The Health Department created this award as our way of recognizing those who join us in the fight against youth violence. On the evening news, all too often we see reports about people who have made poor choices. Faced with a choice, they chose to embrace a culture of violence.
Rarely do we get to hear about people who make the right choice. Rarely do we hear about people who are teaching kids nonviolent ways to resolve their problems. Rarely do we hear about young adults who have made a conscious decision to spurn violence and work instead to better their community, neighborhood or school.

With the Baltimorphosis awards, we hope to raise the profile of individuals who do make these right choices. Today, we recognized the following four Baltimoreans who are fighting against youth violence:

  • Anita Foster, who was nominated by two individuals – Ashley Moore and Ericka McRae was nominated for her passion for getting youth back in school and off the violent streets of Baltimore City.
  • Tard Carter, who was nominated by Daniel Webster, for his work as an outreach worker with the Safe Streets East program.
  • Michael Williams, who was nominated by Linda Wicklein, for is dedication to making a profound difference in the lives of Baltimore City youth, by teaching kids about the effects of violence through his own story. 
  • Robert Madden, who was nominated by Regina Lansinger for his work in forming Helping Boys Understand, an after-school program that targets at-risk young males.

We also honored 3 Baltimore youths:

  • William Murphy, who was nominated by Jay Gillen, for his efforts as a member of the Baltimore Algebra Project  leading his peers to renounce violence by focusing on education, positive youth employment, ending the school-to-prison pipeline, and turning away from gangs and drugs.
  • Tavon Smith, who was nominated by Hansberry Moore, for showing younger children in the neighborhood that they can change the direction that their life is heading, just as he was able to positively affect the direction of his life, through a strong desire and hard work to change his ways.
  • Molly Phillips, who was nominated by Stanley Smith for starting an started an “Anti-Bullying Campaign” at Northwestern High School. 

Thank you all for being part of the solution and for contributing to help to make Baltimore achieve its potential.

Wednesday, March 23, 2011

Getting the Facts: The Affordable Care Act and You

This afternoon I joined Congressman Elijah Cummings and Maryland’s Health Secretary Dr. Joshua Sharfstein in attending “Getting the Facts: The Affordable Care Act (ACA) and You” – a Baltimore HealthCare Access event coinciding with the one year anniversary of the ACA. It’s important we celebrate this landmark legislation because it stands to transform the lives of millions of people.

This landmark legislation is important for several reasons:

•    The Affordable Care Act is a real opportunity to significantly strengthen the role of disease prevention and health promotion in tackling the chronic diseases that are causing medical costs to spiral. Diabetes and heart disease are the number one killers of Baltimoreans and others throughout the US. They are illnesses that are relatively inexpensive to prevent or control. But when people living without insurance become sick, they become dramatically expensive to treat.

•    It helps us move away from a system that revolves around sickness to one that focuses on well-being.

•    Thousands of people who are currently uninsured will receive health coverage. I look forward to the day when the majority of the 96,000 uninsured residents in Baltimore City will have health insurance. No longer will they have to worry about whether they should buy insulin syringes for their diabetes or pay their rent.

The federal government’s investment in health care reform will result in healthier, more productive citizens. It also will save Maryland and Baltimore City money by enabling us to prevent disease, detect it early, and manage conditions before they become severe. The ACA will reduce medical costs, driving down long-term health care spending.

The state of Maryland and Baltimore City are poised to benefit greatly from these structural and funding shifts. States will compete for more than $15 billion (over 10 years) under a new Prevention and Public Health Fund. Through new initiatives sponsored by the health department, we will be able to grow services and reach more people, tackling health disparities, improving health outcomes preventing premature deaths in the process.

The Mayor and I speak regularly about health reform and we agree that the task ahead is to ensure Baltimore City is well positioned to take full advantage of these opportunities, to work with our partners in health care to improve their readiness, and to communicate these changes to the public.

Today’s public forum was an opportunity for the community to get answers to their questions about health reform. Do you have questions about the legislation? What concerns do you have?


Tuesday, March 22, 2011

Health Department Receives Two Mayor's Innovation Fund Awards

This morning, I was pleased to join Mayor Stephanie Rawlings-Blake as she announced three winning proposals for Baltimore City Government’s first Innovation Fund. Mayor Rawlings-Blake created the $1 million fund this year to provide seed money for City agency program investments that will lead to long-term improved results and/or reduced operating costs but that require a “start-up” investment.  The three proposals will cost a total of roughly $700,000, will save over $250,000 each year in operating costs, and could generate as much as $1.4 million annually in new revenue.

Two of the three proposals selected originated from the Health Department. The first grant for $128,000 will bring our Environmental Health inspection program into the computer age by equipping our sanitarians with handheld computer devices so they can fill out electronic inspection reports in the field. The second proposal for $174,000 will be used to upgrade the information systems at the BDC Laboratory, enabling us to expand to serve outside clients. A third winning proposal for the Department of Housing also was announced.
These awards are well deserved and will set the bar for future innovations. They exemplify the department’s goal of using technology and innovation to increase efforts in improving the City’s health. I look forward to seeing these projects come to fruition.

Here's a more detailed description of our two winning proposals:

Environmental Health – Quality Management System

We conduct over 11,500 federal, state, and city-mandated inspections annually, which includes more than 5,000 food facilities, 339 daycare and family day care centers, 325 schools, 52 recreation centers, 140 swimming pools, 180 tattoo operations, and over 3,800 complaint and disease outbreak investigations annually. In addition, we issue and collect over $2.1 million in annual licenses and inspection fees.

I recently accompanied one of our sanitarians on a visit and saw for myself the paper intensive nature of an inspection.  Moving to an electronic system will allow sanitarians to move away from paper and pen inspections, manual inputting and extraction of data, paper files, and inefficient record keeping. 
The grant award will pay for purchasing hand-held devices that capture all investigations and inspections conducted. Sanitarians will complete their inspection reports electronically in the field and later upload them into a database. Business owners will receive an email with inspection results on the same day! 

Additional benefits include creating a web tool for allowing business owners to apply online for a new business or operating license or renew an existing license. Businesses will also be able to schedule plan review inspections online. Inspection reports for all licensed facilities captured through the QMS will be accessible through OpenBaltimore.

We anticipate that the city should recoup its investment within two years due to the estimated revenue generated and costs savings realized.  In addition, we project that at least 30 minutes will be saved from standard inspections.  This means that we’ll be able to spend more time helping businesses remain in compliance by focusing on quality control and education – the core of our business as a public health entity.
The system is expected to be fully operational by March 2012.

Baltimore Disease Control Laboratory – Information Systems Improvement

The BDC Laboratory has supported the Department’s communicable disease control efforts for more than 20 years. CLIA-88 Highly Complex Laboratory is accredited by the Commission on Laboratory Accreditation (COLA) and fully licensed by the federal and state governments. The BDC Laboratory has continually improved its efficiency by constantly employing increasingly more sensitive and more efficient testing platforms.

However, much of the lab’s efficiency is attributable to its use of novel software system that was developed in 1992. The software is too antiquated to be upgraded and is vulnerable to virus attacks. If the computers fail, it would require four full-time data entry clerks to manually enter and print results, a function the computerized system performs.

Not only will we be rejuvenating the information system, but we’ll be expanding to offer services to outside clients such as clinics, federally qualified health centers, and community based organizations.  This will will generate additional revenue to support the laboratory and help these partner control their costs. 
By realizing certain process efficiencies, a new system is expected to save the city more than $136,000 annually, in addition to the additional revenue that will be generated.

These are but two of the innovative ideas generated by the health department that were funded through the Mayor’s innovation fund.  Our team at the Health Department is constantly pushing itself to do more, so I anticipate that we’ll be reporting on additional innovations in the near future.

Monday, March 21, 2011

Baltimore City Kicks Off Youth Violence Prevention Week

This afternoon, I joined Mayor Stephanie Rawlings-Blake, City Council President Bernard C. “Jack” Young, Minister Cleo Walker, and many of our community partners in kicking off Baltimore’s celebration of Youth Violence Prevention Week. From March 21 – 27, 2011, activities and events will be held nationwide to spotlight the issue of youth violence, to identify strategies to combat this epidemic, and to promote the positive role youth may have in making their communities and schools safer. 

Youth violence is no stranger to Baltimore. While homicide was only the 15th leading cause of death nationwide in 2009, it was the 4th leading cause of death among Baltimore residents and the leading cause among Baltimore City residents aged 15-24 years. A report released in 2009 by the Health Department documented the trajectory of youth violence in Baltimore by looking at both victims of violence and perpetrators of violence. The study showed that 99 percent of the youth victims and perpetrators of violence interacted with one or more child-serving administrative agency in the time period preceding the violent episode. It concluded that greater agency cooperation is critical to formulating early interventions capable of effectively reducing youth violence.  

In a review of Baltimore juvenile non-fatal shootings that occurred between January 1, 2001 and March 12, 2007, 7%, or 22 of 319 victims, were either murdered or shot again non-fatally within 18 months of their initial shooting. In an effort to address this issue, the City’s Safety Protocol for Juvenile Non-fatal Shooting Victims was developed approximately three years ago. This protocol was created in an effort to prevent shooting victims from being re-victimized and /or from retaliating by assessing their safety and developing and implementing safety plans. Partners involved in this collaborative effort are the Mayor’s Office on Criminal Justice (MOCJ), the Baltimore City Health Department (BCHD), Department of Juvenile Services (DJS), the Baltimore City Police Department (BPD), and the State’s Attorney’s Office (SAO).  

Recognizing violence as an important public health issue, the Health Department created the Office of Youth Violence Prevention (OYVP) in 2002. OYVP is dedicated to combating the epidemic of violence affecting our city’s young people through innovative public health programming and policy initiatives. The Office works closely with community stakeholders, state and local agencies, and public health experts on programming and citywide anti-violence initiatives to prevent youth from becoming victims or perpetrators of violence.  

The Baltimore City Health Department’s Office of Youth Violence Prevention, in collaboration with city agencies and community-based organizations, is using this week to kick-off a series of events, workshops and open houses to spotlight this issue, the work being done here in Baltimore, and encourage everyone to Stand Up and Speak Out against and provide our youth with the tools they need to be successful. There are more than 70 events planned for this year’s YVP Week, including an airing of the documentary, “Concrete Steel and Paint” on Wednesday, a recognition ceremony for adults and youth making efforts to end violence in their communities, the 3rd Annual Playing for Peace Basketball tournament on Friday and a production of the play “Where Y’all At?” on Saturday.

For more information, contact the Office of Youth Violence Prevention at or (443) 984-3566. You can also like us on Facebook at

Wednesday, March 9, 2011

Baltimore City's Code Blue Program Offers Relief from the Cold

While Baltimoreans enjoyed a brief reprieve from the bitter recently, anyone who has stepped outside this morning feels how brisk our city gets at this time of year.

The plummeting temperatures and wind chill present a serious danger, and that is why Mayor Stephanie Rawlings-Blake, the Office of Emergency Management, and the Department of Human Services joined with the Health Department to announce the start of the Code Blue winter weather program.  This program establishes a coordinated approach to providing relief from extreme cold weather to vulnerable populations in Baltimore City during the winter season.

Throughout the winter, Code Blue days are declared based on the following criteria:

  • temperatures are expected to be below 25 degrees Fahrenheit with sustained winds of 15 mph or higher;
  • or when temperatures are expected to be less than or equal to 20 degrees Fahrenheit;
  • or when other conditions are severe enough to present a substantial threat to the life or health of vulnerable Baltimore citizens.

On Code Blue days, the Mayor’s Office of Human Services will open the homeless shelter at 210 Guilford Avenue for extended hours. The shelter will provide meals and sleeping quarters and will not turn away patrons. Homeless Services has also funded an overflow shelter to provide 100 additional beds for vulnerable residents. Private homeless shelters will be encouraged to use these same guidelines.

The ultimate goal of the Code Blue program is to reduce the number of deaths from hypothermia. Last year, 8 Baltimore residents died from hypothermia-related illnesses. These were highly preventable deaths. Even with the expansion of services on Code Blue days, it is important for all residents to look out for their neighbors, especially those at risk for hypothermia.  Based on the historical data, we know people in Baltimore City most vulnerable include the elderly, individuals with pre-existing heart conditions, those who abuse alcohol and or drugs and the homeless. Know the signs of hypothermia: people who are hypothermic may be lethargic and confused – they can look like they’re intoxicated, when really they’re sick and need medical attention.

Extreme cold weather presents risks in addition to hypothermia as residents use prohibited alternative heat or power sources, such as a stoves and generators that may cause fire or carbon monoxide poisoning. We especially want to reach out to our seniors and other vulnerable populations who are most at-risk during these events. If one of your neighbors is without heat or power, notify 311 so that city agencies can assist them. Caution must be used even when using an approved heating source; be sure to keep space heaters and candles away from flammable materials, such as curtains, furniture and loose clothing. 

Most importantly, in all seasons, you must have working smoke detectors in your house. Baltimore residents can visit any local fire station, or call 311 to make certain there are working smoke detectors in their homes. If you do not have a smoke alarm, you can get one for free from the Fire Department.

Stay warm, B’more!

Thursday, March 3, 2011

BCHD's Loss of Lead Abatement Funds

By now many of you have learned about the Baltimore City Health Department's recent loss of Department of Housing and Urban Development (HUD) lead abatement dollars.

While loss of these dollars is a troubling setback, it does not mean that lead abatement work will cease in the City.  We will continue to do everything possible to protect the health of families with young children and prevent lead poisoning.  I am pleased to report that Housing Commissioner Paul Graziano and I are working closely together to ensure that these activities continue seamlessly as abatement moves to the Housing Department.  We are sharing all policies and procedures to ensure that their work benefits from the control measures put into place by the health department.  We will continue our work on lead health education and inspections.

During the last four years the department’s lead abatement efforts saw several successes, including the following:

  • Increased the efficiency with which contractors were selected and paid through the City’s procurement system
  • Remediated 697 homes of lead paint risks hazards resulting in a significant increase over the previous two-year period
  • The number of lead poisoned children decreased from 315 in FY08 to 205 in FY10
  • The percentage of Baltimore City children ages 0-35 months who were tested for lead increased 9% from 2007 to 2009
However, it was clear to me during my first weeks on the job that administrative issues impacted the abatement program’s ability to demonstrate effectively the scope of work being done and the quality control measures that had been put in place.  As we work to improve health outcomes in Baltimore City, I expect greater oversight will be achieved through Division Stat, an internal process I instituted for sharing program performance data.

The best way for the health department to maintain the public’s confidence is for us to continue striving for excellence as we do the work of ensuring the health and safety of Baltimoreans on a daily basis.  While recent publicity has been negative, it does not reflect the health department’s level of professionalism and commitment to serving the residents of Baltimore.  I want to thank all health department staff for their hard work, and I remain confident that the department’s sterling reputation will shine through this difficult period.