Transcription of Julie Alfred Sullivan for the show Harvest #2
Dr. Lisa: Our featured guest today is Julie Sullivan the Public Health Director for the city of Portland. Today we’re talking … for our theme we’re talking about harvest and about reaping what you sow. That has multiple connotations, which we’ve discussed in our earlier introduction. I’m sitting here with Genevieve Morgan Wellness Editor for Maine Magazine. Good morning Gen, hello.
Julie Sullivan: Good morning everybody.
Dr. Lisa: I’m going to tell you a little bit about Julie and then we’re going to get started. Julie is a dear friend of mine; I’ve known her for a while. She is the Public Health Director for the City of Portland overseeing a nearly $6 million budget with more than 100 staff and five program areas. Under her leadership, the health department doubled grant revenues while decreasing general fund reliance by 15%. Previously Julie was the Health Promotion Program Manager and started the city’s first minority health and community health outreach worker initiatives.
Before moving to Maine, Ms. Sullivan served as Project Director for a $3.3 million department of justice, demonstration grant for children exposed to violence at the Chicago Department Of Public Health. Ms. Sullivan earned MBA and MPH degrees from the University of Illinois at Chicago and a BA in History from Northwestern University. I’m impressed.
Genevieve: So am I.
Dr. Lisa: Lots of things that you’ve done in your life, lots of degrees that you have. You know that I have a Master’s in Public Health myself so this is very dear to my heart. I know that Gen is wondering and the rest of us as well, what is public health? What does this have to do with wellness? What does it have to do with medicine? What’s the intersection? Tell us Julie.
Julie Sullivan: Public health I think is something that’s very hard for people to define. I think most often people think of public health as perhaps healthcare for poor folks, maybe immunizations, a flu shot is something that’s often connected with public health. The field, what’s always been interesting to me about it, the field of public health is so broad. We look at the health of a population and what makes people healthy, what keeps people healthy.
We look at income and education and jobs and community supports and there are so many things that go into the making and keeping people healthy and public health looks at all of those things. Whereas medicine is very focused on individuals and the needs that they present to an individual practitioner in an individual moment in time. We look at the prevention factors and the assets that are in place in communities to making keep people healthy.
Dr. Lisa: We are talking about wellness on a much bigger scope. We’re talking about the wellness of the family, the wellness of the community and really the wellness of the country and the world honestly. If you look at the world Health Organization, that’s public health on a global scale.
Julie Sullivan: Absolutely.
Dr. Lisa: I know that one of your projects recently has been Portland Defending Childhood, and I’d like you to speak a little bit more about that.
Julie Sullivan: It’s a new award from the Department of Justice and looking at the impact of children’s exposure to violence. It’s something that most people really aren’t aware of especially when you look at very young children maybe ages zero to five who might be witnessing some domestic violence in the home. Many folks might assume that a baby is too young to really get it, to really have any sort of negative impact from that. Or that a toddler or a pre-schooler is sleeping and didn’t hear it.
Unfortunately what we find most often is that, especially with domestic violence which is most often chronic and not just a onetime thing, that there is a pretty severe impact or there can be on a developing brain. That often when these children come to school, it’s the first time anybody is noticing that there might some challenges for that kid. They have a hard time sitting still and paying attention in school and things begin to snowball from there.
We want folks to know that there is an impact when children are witnessing violence. That there are signs to look for when a kid is struggling and that there are supports in the community available to children and families to seek services when they need them.
Dr. Lisa: What are those signs if I am a teacher or a social worker or a community member or even a parent? Perhaps a co-parent in a situation where I don’t have my child full-time what signs am I looking for?
Julie Sullivan: With little kids it’s a short list of symptoms because they only have limited ways of expressing themselves. Often it’s regression in toilet training, problem sleeping and maybe odd complaints about a headache or a stomachache. There are nonspecific signs but it’s certainly violence in the home or violence in the community is one thing to look for.
As you know we have a growing number of refugees who have been through unbelievable trauma in their country of origin and so they are coming here. Those kids have seen things and witnessed things and been directly affected by things that we can’t, that thankfully we can’t even really understand. We’re building capacity as well to deal with that kind of trauma too.
Dr. Lisa: I read the percentage is 15% of our city’s population is a minority?
Julie Sullivan: Yes, Maine is still of course, one of the widest states in the country but Portland is not at the same rate as the state at all. We have increasing numbers certainly from all sorts of different countries in Africa. Also from Afghanistan and Iran and very large families that have been through very serious trauma coming here.
Dr. Lisa: We’ve been talking about the negative aspects of violence whether it’s violence coming from a different country, violence in the home if you’re from the United States, and that’s all about reaping what you sow. Something happens early on and then later on you see an impact. Tell me about the things that the city has to offer that actually can change things for the better. We’re talking about harvest and abundance and I know that you spent so much money right now to try to get people healthier. Tell me what types of things you’re doing.
Julie Sullivan: I would start with our maternal-child health nurse home visitors which is part of the Maine Families Program. Home visiting, a series of home visits are offered to every first-time parent in the State of Maine and our nurses visit families in Portland. They’re able to help new parents adjust to having a new baby and anyone who’s had a new baby knows that there is little that can really prepare you for that. There’s lots of assistance in that transition and also in breastfeeding and making sure the baby is developing appropriately.
We also do some parenting support groups and infant and toddler playgroups which are a great ways for parents to get support from one another as well as from our nurses. For the kids to play together which is always a good thing. We also have six school-based health centers. We’re in most of the schools in Portland, all three high schools and King Middle and across some of elementary schools as well.
That’s a great way to provide additional medical services for kids who need them in the school. Some of the assistance is managing chronic disease but also with the older kids there’s reproductive support and mental health and dental services.
Dr. Lisa: You do work with immunizations? Tell me about the immunizations.
Julie Sullivan: We do. Our India Street clinic provides every immunization you need at a very low cost or no cost. We also connect with our school-based partners to be providing flu clinics for kids as well to make that as accessible as possible. We allow younger siblings to come into the school and get their shots as well when we do our flu clinics.
Dr. Lisa: You told me there is a travel clinic as well?
Julie Sullivan: There is a travel clinic. We want to support people being healthy no matter where they go. We know that getting the required shots to travel different parts of the world can be prohibitively expensive. We are able to provide I believe everything that is needed at a much more reasonable cost. That helps us to be able to provide services for those who can’t pay as well.
(Music)
Dr. Lisa: We’ve talked about immunization, we’ve talked about school-based health and preventing violence in the home. I know that eating and food choices have been pretty important. There was a recent campaign that you did we regard to sugar beverages. Is that right?
Julie Sullivan: Yes, we just did a campaign that’s wrapping up to raise people’s awareness on exactly how much sugar there is in soda, in these sports drinks, some of the vitamin drinks that are marketed as being very healthy are loaded with sugar. Some can have 16, 20 packets of sugar in them. Some surveys show that two thirds of high school kids are drinking at least one of these beverages a day. They’re empty calories; they don’t fill people up so therefore, they’re not adjusting how much they eat otherwise. The pounds just pack on. Folks aren’t even aware of that happening.
We’ve been really pleasantly surprised by the reaction to that campaign. In fact in the rotunda of City Hall we have an exhibit with a liter of soda and the amount of sugar in it so that people can actually see. There’s other sort of different bottles showing how much sugar is usually in these drinks. I’m always amazed, every time I walk by there is somebody in there fondling the drinks and looking pretty disgusted by what they see. It’s been great to see that awareness.
Genevieve: Lisa and Julie, my son came home yesterday from lunch and said that he’s had a chocolate milk. He goes to King Middle School, but he said there was high fructose corn syrup in the milk. Have you heard of that?
Julie Sullivan: No, I will certainly share that-
Dr. Lisa: That’s something we need to work on now, isn’t it?
Julie Sullivan: Yeah, yeah. We’ve had a great partnership with the Portland Public schools and Ron Adams who is charge of the foods service there has been a terrific partner in bringing local Maine foods into the schools and increasing how much healthy food is available. We’ve used a large federal grant that we go in obesity prevention to buy salad bar equipment for each school. The schools are doing much better than they ever have before. I will share that with our guys.
Dr. Lisa: How do you network with the entire state as far as public health is concerned? I know that in the last few years we’ve now become a CDC, a Center for Disease Control. We’ve been linked in nationally. How does that the City of Portland link actually link in with what’s going on in the State of Maine?
Julie Sullivan: I’d say the largest source of our funding is through state contracts. We are accountable to the state through … Let’s see, we’ve probably got about 50 different funding sources or 50 different contracts. At least a third and probably close to a half are those from the state. We work very closely in implementing often mutually agreed objectives to further their work.
Dr. Lisa: Can you give me some example of projects that people might be familiar with?
Julie Sullivan: Oh sure. Our school-based health centers are a state grant. The reason why I paused is that so many of the state grants are federal pass-through. The state of Maine does not allocate, the legislature has not – at least in my tenure – does not allocate very much money to public health at all. Most of the money that is available to us through contracts from the state is via the Fund for Healthy Maine. Which is tobacco settlement money, which is going to be once again severely at risk going into the state legislative session – It’s been cut back.
If that continues to be cut back, that will affect immunizations. That will affect maternal-child home visiting. These were things that were on the block last year but survived, but the governor is intending to cut at that fund again. I certainly want to point that Maine is one of the lowest states in the country along with Arkansas and Mississippi in state funding provided for public health.
Dr. Lisa: Most of the money is coming through-
Julie Sullivan: It’s Federal pass-through.
Dr. Lisa: That’s the United States government.
Julie Sullivan: Yes.
Dr. Lisa: The tobacco funding, just address that briefly.
Julie Sullivan: That is the tobacco settlement from a number of years ago in which, oh gosh, 20 to 30 attorneys general from around the country sued all the major tobacco companies. As part of that settlement the companies have to give billions into this national fund, which is then allocated out with some formula to the states. Again that’s really the source of funding for public health in Maine. It does support home visiting, school-based healthcare I believe, certainly immunizations.
We do a lot of work around substance abuse prevention as well. It comes from the office of substance abuse. A big topic right now of course is bath salts. We’re trying to get some education out there for folks on bath salts.
Dr. Lisa: Wait, bath salts is a big topic and yet I have not heard of this. We just have a few more minutes left, just briefly bath salts.
Julie Sullivan: Bath salts is some odd name for a new drug that’s out there that is a chemical synthetic drug that reminds me of what I used to hear about PCP or Angel Dust. It has horrible effects on people. What we’re seeing we’ve seen unfortunately in a case or two our own clinics. We know the ER, the Poison Control Center are seeing significant cases Bangor has had a huge number of cases. Folks are violent and paranoid. They are very harmful to self, dangerous to others. They’re very delusional, they have no idea what’s going on.
They’re ripping their clothes off. They’ve found a naked woman in a pipe somewhere, in a drainage pipe. We had someone come in out of his tree, out of his tree. The police have to take them down to the ER. It’s a dangerous situation, so it’s really something that we want people to be aware of. There’s more and more information coming out.
Dr. Lisa: How can we access this information? What’s the best way to get information on all these programmes you’ve just described?
Julie Sullivan: Well, most of it is available on our website which is portlandmaine.gov all spelt out in one word-
Dr. Lisa: We’ll have that also on the Dr. Lisa website for people who would like it. I know that you’ve done so much work. I have to say that the people who do public health work and wellness are perhaps the least recognized. It’s a very difficult job. Along with social workers I’m just going to make a shout-out to the social workers and the teachers of the world.
Julie we so appreciate your coming in and talking to us about what you’re doing with public health. It’s an amazing resource available to the city of Portland, to the State of Maine and we wish you all the best.
Julie Sullivan: Thank you very much.