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National Report Ranks Georgia 43rd in Protecting Kids From Tobacco

Wednesday, December 18th, 2013

Fifteen years after the 1998 state tobacco settlement, Georgia ranks 43rd in the nation in funding programs to prevent kids from smoking and help smokers quit, according to a national report released today by a coalition of public health organizations.

Georgia currently spends $2.2 million a year on tobacco prevention and cessation programs, which is 1.9 percent of the $116.5 million recommended by the Centers for Disease Control and Prevention (CDC). Other key findings for Georgia include:

• Georgia this year will collect $346.8 million in revenue from the 1998 tobacco settlement and tobacco taxes, but will spend just 0.6 percent of it on tobacco prevention programs. This means Georgia is spending less than a penny of every dollar in tobacco revenue to fight tobacco use.

• The tobacco companies spend $316.9 million a year to market their products in Georgia. This is 142 times what the state spends on tobacco prevention.

The annual report on states’ funding of tobacco prevention programs, titled “A Broken Promise to Our Children: The 1998 State Tobacco Settlement 15 Years Later,” was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association, the Robert Wood Johnson Foundation and Americans for Nonsmokers’ Rights.

The report assesses whether the states have kept their promise to use a significant portion of their settlement funds – estimated to total $246 billion over the first 25 years — to fight tobacco use. The states also collect billions more each year from tobacco taxes.

In addition to its lack of funding for tobacco prevention programs, Georgia’s cigarette tax is only 37 cents per pack, which is 48th in the nation and well below the state average of $1.53 per pack.

“Georgia again is one of the most disappointing states when it comes to protecting kids from tobacco,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “Georgia should raise its tobacco tax and increase funding for tobacco prevention programs that are proven to protect kids, save lives and save money by reducing tobacco-related health care costs. States are being truly penny-wise and pound-foolish when they shortchange tobacco prevention programs.”

In Georgia, 17 percent of high school students smoke, and 7,200 more kids become regular smokers each year. Tobacco annually claims 10,500 lives and costs the state $2.25 billion in health care bills.

Nationally, the report finds that most states are failing to adequately fund tobacco prevention and cessation programs. Key national findings of the report include:

• The states this year will collect $25 billion from the tobacco settlement and tobacco taxes, but will spend just 1.9 percent of it — $481.2 million — on tobacco prevention programs. This means the states are spending less than two cents of every dollar in tobacco revenue to fight tobacco use.

• States are falling woefully short of the CDC’s recommended funding levels for tobacco prevention programs. Altogether, the states have budgeted just 13 percent of the $3.7 billion the CDC recommends.

• Only two states — Alaska and North Dakota — currently fund tobacco prevention programs at the CDC-recommended level.

There is more evidence than ever before that tobacco prevention and cessation programs work to reduce smoking, save lives and save money. Florida, which has a well-funded, sustained tobacco prevention program, reduced its high school smoking rate to just 8.6 percent in 2013, far below the national rate. One study found that during the first 10 years of its tobacco prevention program, Washington state saved more than $5 in tobacco-related hospitalization costs for every $1 spent on the program.

Tobacco use is the number one cause of preventable death in the U.S., killing more than 400,000 people and costing $96 billion in health care bills each year. Nationally, about 18 percent of adults and 18.1 percent of high school students smoke.

More information, including the full report and state-specific information, can be obtained at


Navy Lt. Cmdr. Leah Brown Earns Bronze Star for Improving Care for Afghan Women

Monday, November 25th, 2013

By Douglas H Stutz, Naval Hospital Bremerton Public Affairs

The Tarin Kowt district of Afghanistan is mired in poverty, wracked by warfare, and beset by a host of concerns such as lack of available medical care.

Lt. Cmdr. Leah Brown helped to alleviate some of that medical care shortage by providing direct patient-centered care to the local population during her time recently deployed with Combined Joint Special Operations Task Force – Afghanistan.

Brown, an orthopedic doctor at Naval Hospital Bremerton received the Army Bronze Star for her humanitarian efforts when she assigned to the Role 2 hospital in Tarin Kowt Forward Operating Base, located in southeast Uruzgan province from Oct. 2012 to May 2013.

“I was part of a medical team utilized by special operations and we took on a humanitarian assistance role to visit the local hospital which served the entire province. They had a very large catchment area. It is also one of the poorest regions as well as a very traditional area that really needed dedicated medical support,” said Brown, an Atlanta native who attended Benjamin E. Mays High School and the University of Georgia for her undergraduate work before going to Ohio State University and the Cleveland Clinic Foundation for medical school before her 10 years of Navy service.

Brown noted that as part of the Role 2 hospital’s medical team, she and others were invited by the local hospital equivalent of chief medical director to help them care and offer services to the surrounding population. Brown conducted orthopedic surgeries that the local doctors couldn’t handle as well as provided orthopedic care to many local children and men. She made such a positive impact, she even started treating women.

“Being able to treat Afghan women was a very big deal due to their rigid beliefs rooted in old ways. It was a huge turnaround and a big accomplishment,” Brown said, adding that as part of an all-female team, they really made a strong positive impression in providing health and wellness care.

As a result of their efforts, Brown attests that the all-female medical team really helped to win over hearts and minds and facilitate relationships.

“We started to see women on a regular basis at the Role 2. But at the start, we never saw any. Then we started to see young girls, then older women and then mid-adult age women. This symbolized that we had advanced in our relationship and were trusted. We visited the hospital and coordinated getting the patients to the base to the Role 2 facility which was one of the reasons it was such a big deal. It also helped to have an advanced female medical team made up of an orthopedic doctor, anesthesiologist, critical care nurse, hospital corpsman and translator. We pulled from every level of care we had to comprise our team,” said Brown.

The all-female team became high profile in the area, primarily all Navy with three Air Force personnel. They utilized all the resources at their disposal and devoted extra time and effort helping the local populace. Brown and her team shared what they could, donating underutilized supplies such as gauze and a few instruments. All this helped to show that they were willing to assist the locals. Still, they were in the midst of a very volatile region of the country. They were always very careful in going to the hospital to provide medical care. Hospital visits were always carefully coordinated with safety and security being of paramount importance.

The local hospital itself had seen better days. Three decades of war had depleted skilled medical workers, what supplies were to be had, and there was a limited infrastructure, not only in the hospital but throughout the region.

“The hospital staff was limited due to the constant danger and there were simply not a lot of resources. It was also frustrating to see so much poverty and what the prolonged war had done to the country. In conversation with our translators, they would share on how it used to be. It’s sad,” Brown said.

Due to local tradition, the Tarin Kowt hospital was segregated along gender line. There was an entire separate area in the hospital for women, which lacked many of the amenities found on the other side of the hospital.

“It was vastly different. We even provided a lot of health items for women. Their female medical director, really an equivalent to a midwife, was aggressive in pushing the agenda for women’s health care. We did mid-wife training for a group of 14-15 year old girls, who were essentially the only providers available for women there. The main concern for medical attention for women was it was just mainly required during the birthing process,” related Brown.

Along with being smack in a war zone and trying to deliver medical care to a populace in need, there were constant logistical, location and logical issues to handle and try to comprehend on a daily basis. Those dilemmas were part of the legacy of constant warfare, pain, and suffering for overlapping generations over the past 30 years.

“Dealing with the Afghan people in such a different environment to ours, and trying to understand the psychology of them living in nearly impossible situations was so difficult,” Brown shared, adding that the cultural divide would always lessened when a local hospital provider would contact them to see a specific patient.

“There were many cases I remember such as when we were asked to care for a local child with a femur fracture that had been that way for a week, and the provider added an ‘oh by the way can I send another I’m caring for.’ The other kid, around 10 to 12 years old, had wounds sustained from live ordnance – with a finger already amputated, an upper extremity open wound and a serious tibia fracture. We took care of him and essentially saved his leg,” said Brown.

Local children finding improvised explosive devices and unexploded ordnance were a constant theme. Another local child found ordnance and the resulting blast caused a huge skull defect.

“The child’s father had cared for him but we took him in and immediately provided emergency care. With treatment and therapy the young child went from being bed ridden to using a walker to zooming around our area,” remembered Brown, adding that they then got to send him to the Role 3 multinational medical unit at Kandahar Air Field and then on to Landstuhl Regional Medical Center in Germany for neurological help. “It was case by case consideration, but that’s an example of doing all we can.”

“It was a hard deployment but our entire base embraced what we did at the hospital. Everyone got involved, from helping with a blood transfusion to bearing a litter. There was a definite ‘what can we do to help?’ feeling at the FOB. From the gate to operating table to recovery, a local was never alone. The morale of our forces always got a boost from helping a local who received medical care. It gave us all an improved outlook,” Brown said.

The deployment also had traumatic moments. Special Warfare Operator 1st Class Kevin Ebbert, a hospital corpsman with 18-Delta combat medical training, was killed in action on November 24, 2012 while supporting stability operations in Uruzgan Province.

“I was able to work with a great team. We made due with the resources we had. There was no ‘Gucci medicine’ practiced here. We were all a little proud to do a lot without all the extras that are normal at our military treatment facilities. We got used to that. I wish people knew more on what we did,” stated Brown.

Brown’s efforts did get noticed internally with the Army Bronze Star. Her advice for those following?

“Practice medicine with the total altruistic reason that got you into the field in the first place. You get what you get and you provide what you can, even if it’s just a band-aid or pair of crutches with a smile,” shared Brown.

Note: Role 2 is a Battalion Aid Station providing emergency surgical care, stabilizing hemodynamic status in order to send the patient to the Role 3. It is also where the wounded are linked up with a nurse and physician in the chain of evacuation. A Role 1 refers to emergency medical care in the field, historically handled by independent duty corpsmen. The Role 3 multinational medical unit at Kandahar Air Field has the highest level of care available in theater, with additional capabilities such as specialist diagnostic resources, specialist surgical and medical capabilities, and preventive medicine. Landstuhl Regional Medical Center, Germany, is the largest American hospital outside the United States and an example of a Role 4 facility. Role 5 sites are stateside rehabilitation facilities.


Georgia Department of Community Health

Wednesday, October 15th, 2008

The vision of Georgia’s Department of Community Health is: provide health care benefits to over two million citizens under the Medicaid and PeachCare for Kids programs and the State Health Benefit Plan for our employees; pursue and correct fraud and abuse through our DCH Program Integrity unit; develop health policy through our Health Strategies Council; approve the development and expansion of health care services and facilities through the Certificate of Need program; and administer all of our health care programs for Georgia’s citizens by using public resources wisely.


Georgia Division of Public Health

Wednesday, October 15th, 2008

The Division of Public Health (DPH) is the lead agency entrusted by the people of the State of Georgia with the ultimate responsibility for the health of communities and the entire population.



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