Will Humble Prevention, Professional Development, Wills Blog

Action Alert: Phoenix Considers Outlawing ‘Phoenix Street Medicine’ Tomorrow

A proposal from City of Phoenix Parks and Recreation Director Cynthia Aguilar would make it a crime to provide basic medical screenings to people experiencing homelessness in city parks unless her department gives special permission — permission that is unlikely to be granted.

Proposed Phoenix ban may end medical aid to homeless in parks

If approved by the Phoenix City Council tomorrow (Thursday December 17 at 2:30pm at the Phoenix City Council Chambers, 200 W. Jefferson St., Phoenix, AZ), the measure would basically outlaw the Phoenix Street Medicine program and put volunteer health workers at risk of arrest by Phoenix Police and prosecution for a Class 1 misdemeanor by the County Attorney with punishments of 6 months in jail and $2,500 in fines if they continue to do this important work.

Request to Speak Virtually Against the Motion (Item 46)

Sign the Petition · Oppose Phoenix Park Ordinance Prohibiting Medical Care and Harm Reduction

Aguilar’s target is clear: Street Medicine Phoenix, a volunteer health program organized by the University of Arizona, which provides care to people who otherwise have little or no access to the health system.

Street Medicine Phoenix | Zuckerman College of Public Health

Street Medicine Phoenix began in 2017, founded by University of Arizona medical students who wanted to bring health care directly to people living on the streets, in encampments, and in public spaces. One of the co-founders is AZPHA Board Member Jeffery Hanna.

The Street Medicine Phoenix mission is simple and evidence based: meet people where they are, rather than expecting them to navigate a system that often shuts them out.

The program hosts about 12 outreach events each month, mostly at Margaret T. Hance Park in downtown Phoenix and in areas once known as “The Zone”. The services they provide are wide-ranging and practical, including:

  • Blood pressure, blood sugar, cholesterol, and A1c screening
  • Physical exams, wound care, foot care, and other urgent needs
  • Flu, COVID-19, and Hepatitis A vaccines
  • Mental health screening and education
  • Narcan distribution to prevent overdose deaths
  • Vision screening and prescription glasses
  • Help with medications, daily living needs, and referrals to clinics and community resources

This care is free, voluntary, and evidence based. No one is forced to take part. No one is charged.

People experiencing homelessness face much higher rates of chronic disease, mental illness, and early death. In the summer they are at a 500 times higher risk of dying from excessive heat.

Many avoid hospitals or clinics because of cost, fear, transportation barriers, or past trauma. Street Medicine Phoenix and similar programs have been shown to improve health outcomes, reduce emergency room visits, and build trust between vulnerable people and the health system.

Street Medicine Phoenix is doing exactly what public health should do, prevent illness, reduce suffering, and connect people to care before small problems become emergencies.

Sadly, someone on the council or the leadership of Phoenix Parks and Recreation wants to end the program and even criminalize their humanitarian aid.

The compassionate and logical response from city staff would be to support, partner with, or expand the program, not criminalize it.

There’s another major benefit to this program that the proposal would trash. Street Medicine Phoenix provides important early-career training for students and professionals from the UA College of Public Health and College of Medicine, along with partners from ASU, NAU, Midwestern University, and Creighton University.

Future doctors, nurses and public health professionals gain real-world experience working with vulnerable populations. They learn empathy, cultural humility, and how social conditions shape health. The experience comes at an important early-career time… valuable experience which will carry through to the rest of their career.

By the way… the proposal wasn’t vetted through City Council subcommittees or village planning committees, which is the normal process for major policy changes proposed by city department leaders or a council member.

It’s been radio-silence from Aguilar and the elected council members about their motivation. Nobody has yet explained why blood pressure checks, wound care, or vaccines and referral to services in a park should be a crime punishable by jail time.

In my opinion, Aguilar’s proposal to criminalize volunteer medical care isn’t how you “build healthy communities” (straight from the Parks and Rec website).

The Phoenix City Council should reject the proposal and instead stand with Street Medicine Phoenix, a program that reflects the best of public health, compassion, and common sense. We urge AZPHA members to contact their city Council members and urge them to shoot down this cruel policy and if possible, attend the meeting and ask to speak to the Council.

Request to Speak Virtually Against the Motion (Item 46)

Sign the Petition · Oppose Phoenix Park Ordinance Prohibiting Medical Care & Harm Reduction
Thursday December 17 at 2:30pm
Phoenix City Council Chambers, 200 W. Jefferson St., Phoenix, AZ
Contact Your Councilperson

Mayor Kate Gallego

District 1 – Vice Mayor Ann O’Brien

  • Email: council.district.1@phoenix.gov
  • Phone: 602-262-7444

District 2 – Jim Waring

  • Email: council.district.2@phoenix.gov
  • Phone: 602-262-7445

District 3 – Debra Stark

  • Email: council.district.3@phoenix.gov
  • Phone: 602-262-7441

District 4 – Laura Pastor

District 5 – Betty Guardado

District 6 – Kevin Robinson

  • Email: council.district.6@phoenix.gov
  • Phone: 602-262-7491

District 7 – Anna Hernandez

  • Email: council.district.7@phoenix.gov
  • Phone: 602-262-7492

District 8 – Kesha Hodge Washington

  • Email: council.district.8@phoenix.gov
  • Phone: 602-262-7493
Will Humble State Legislature, Wills Blog

Legislative Session Begins January 12: Our Advocacy Approach

January 12 marks the beginning of the 2024 legislative session. The kickoff will be the Governor’s address to the legislature where she’ll outline what she sees as priorities.

Our Advocacy Approach

AzPHA will follow the session closely and express our support or opposition to bills based on a simple core principle…  we support bills that will have a positive impact on public health especially when they are evidence-based or evidence-informed.  We oppose bills that are likely to have a negative impact on public health. 

Our support or opposition to bills is located on the https://www.azleg.gov/ site under RTS Current Bill Positions. We have a host of Resolutions that also guide our advocacy which are posted on our website.

The fact that we have Resolutions on so many core public health priorities make it easy for us to be swift with our support or opposition. Our Resolutions go all the way back to the 1930s. They are started by either the Board or our members and all resolutions have been voted on and approved by our members.

Our Public Health Policy Committee has a discussion board on Basecamp and that’s also where we post information, research and documents related to public health policy.  Let me know if you’d like to sign up for that Basecamp site at willhumble@azpha.org.

Our policy committee also has conference calls every Friday at 2pm starting on January 9 and usually lasting through the last Friday in February. The calendar in the policy committee basecamp has the URL for the zoom meetings.

More details as the session actually approaches – but those are the basics.

PS: So far we’ve signed up against bills that would ban community water fluoridation, make ivermectin over the counter, and we signed up for a bill that would limit the speed limit for e-bikes (the kinds that don’t require a license – the ones the kids use) to 15mph.

Will Humble Disease Control, Prevention, Wills Blog

Arizona State Fair E-coli Outbreak: Petting Zoos Need Basic Safety Rules

Petting zoos can be a lot of fun for kids. They’re a teaching tool as well, helping kids have experiential learning opportunities about farm animals & agricultural life.

But they also come with real risks. Germs like E. coli, which live in the gut of many farm animals, can spread easily in these settings. These infections can cause severe stomach illness, kidney damage, long hospital stays, and in some cases can even be deadly.

CDC has written many reports over the years showing outbreaks linked to petting zoos.

Enteric Disease Outbreaks Associated with Animal Contact — Animal Contact Outbreak Surveillance System, United States, 2009–2021 | MMWR
Outbreaks of Escherichia coli O157:H7 Associated with Petting Zoos — North Carolina and Florida, 2004 and 2005

When I worked at the ADHS in jobs ranging from disease control epidemiologist to agency director we took this risk seriously. For years, we made it standard practice to send our vector-control staff to the State Fair before opening day. Our goal was simple: make sure the petting zoo area had the basic protections needed to keep kids safe.

We didn’t license petting zoos, and we didn’t have enforcement power. But the State Fair always welcomed our help, and they followed our recommendations. Those steps were not complicated. They included:

  • Barriers to guide visitors in and out safely.
  • Limits on how many kids could be inside the animal area at one time.
  • Hand-washing sinks with running water, soap, and paper towels at both the entrance and exit.
  • A staff monitor on-site to watch behavior and make sure kids wash their hands on the way out.

These simple steps helped prevent outbreaks. Unfortunately, the department appears to have dropped this best practice. This year Arizona kids paid the price.

During the 2025 Arizona State Fair, a major E. coli outbreak occurred among children who visited the petting zoo. According to news reports there have been many cases linked to the exhibit, and several kids were hospitalized with serious complications. Some were diagnosed with hemolytic uremic syndrome, a kind of kidney injury that can be life-threatening.

Parents reported long delays in learning about exposures, and public warnings went out only after many children were already sick.

coli outbreak at Arizona State Fair may have started with pig
coli cases tied to Arizona State Fair didn’t trigger public warning

This outbreak was preventable. Nothing about it was new or surprising. CDC research, state outbreak investigations from around the country, and decades of experience all say the same thing: petting zoos need basic controls in place to reduce risk — especially when little kids (and pigs) are involved.

The 2025 outbreak demonstrates that Arizona can’t rely on safety practices that disappear when health department leadership changes. The State Fair runs for weeks and attracts hundreds of thousands of visitors. Any high-contact animal exhibit of that size should meet a minimum set of health and safety rules.

It’s time for Arizona to put simple, proven standards into law for long-standing exhibits like those at the state fair. Kids deserve protection, parents deserve transparency, and vendors deserve clear expectations.

I did a bit of research about what other states have in place and wrote a short model law (with some help from Chat GPT) and sent it to a state senator for consideration this session.

Perhaps you’ll hear about the bill in an upcoming policy update during the legislative session.

State Laws Requiring Hand Sanitation Stations at Animal Contact Exhibits—United States, March–April 2016 | MMWR
Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2009 – National Association of State Public Health Veterinarians

____________________

TITLE 36. PUBLIC HEALTH AND SAFETY
CHAPTER 6. ANIMAL CONTACT EXHIBITS
ARTICLE 16. LONG-TERM PETTING ZOOS

36-799. Definitions

  1. “Long-term petting zoo” means any animal-contact exhibit or activity open to the public for a continuous period of more than seven (7) days.
  2. “Operator” means any person, partnership, corporation, fair, or other entity that owns or manages a long-term petting zoo.
  3. “Animal-contact area” means any enclosure, pen, stall, walkway, or other space where the public may touch or otherwise have direct contact with live animals.

36-799.01. Minimum sanitation and safety requirements

  1. No operator shall open or maintain a long-term petting zoo for public use in this state unless the following minimum conditions are continuously maintained while the exhibit is open:
  2. Controlled access and egress: sturdy barriers or fencing shall be installed to create a unidirectional visitor flow with one entrance and one exit to the animal-contact area.
  3. Occupancy limit: the operator shall limit the number of children (persons under eighteen years of age) inside the animal-contact area at any one time to a maximum number determined by the operator in writing and posted at the entrance; in no case shall more than twenty (20) children occupy the area simultaneously, unless a lower limit is posted.
  4. Hand-washing facilities: hand-washing stations with potable running water, liquid soap, and single-use disposable towels shall be provided at both the entrance and the exit of the animal-contact area. These stations must be maintained in functional, sanitary conditions throughout operating hours.
  5. On-site monitoring: at least one staff monitor per twenty (20) children (or fraction thereof) shall be present in or adjacent to the animal-contact area during all hours of public access; the monitor’s duties shall include enforcing proper handwashing of all visitors upon exit and supervising animal-contact behavior to prevent unsanitary or unsafe conduct.
  6. The operator shall keep a written record of the posted occupancy limit and of the dates and times during which each monitor is on duty; such records shall be retained for a period of at least twelve (12) months and made available for inspection by authorized personnel upon request.

36-799.02. Enforcement and penalty

  1. The Arizona Department of Health Services Director shall have authority and responsibility to inspect long-term petting zoos for compliance with this article.
    B. Any operator found to be in violation of one or more provisions of this Article shall be subject to a civil penalty of up to five hundred dollars ($500) per day per exhibit until the violation is corrected.
    C. The Director may adopt rules necessary to implement and enforce this article, consistent with the minimum requirements set forth here.
Will Humble Public Health Law, Wills Blog

AZPHA Annual Business Meeting Summary

AZPHA held our annual members meeting last Friday afternoon. We covered a host of AZPHA business like finances, governance, professional development activities, membership update and a summary of our advocacy approach and actions over the last year. We also thanked our outgoing board members and welcomed our new Board members and those who moved to new positions.

Elena Burr, Director of Communications & Outreach at AllThrive 365, will serve as Director of Communications. She is recognized for her community-centric storytelling, relationship-building, and visionary leadership in healthy aging and public health. Elena serves as the Chair of the Arizona Health Equity Conference Planning Committee and holds a Master of Public Health from the University of Arizona.

Charity Moparthy, graduate student at the University of Arizona, will serve as Student Representative. She is pursuing a Master of Public Health with a focus on Health Policy and Management from the University of Arizona and brings hands-on experience in research coordination, student engagement, and community outreach, with a deep commitment to health equity and amplifying youth voices.

Lora Timmons, DHPE, MPH, Dean for Nursing and Healthcare at GateWay Community College, will serve as Director of Professional Development & Academic Relations. With a Doctorate in Health Professions Education and a Master of Public Health, Dr. Timmons has a proven track record in increasing student success, developing new academic programs, and fostering industry partnerships. She is a certified experiential educator and has served on many advisory boards and committees dedicated to advancing public health education.

Felicia Trembath, PhD, MPH, Assistant Professor at Midwestern University, will serve as Vice President. Dr. Felicia Trembath is a respected public health scholar and educator. She holds a PhD in Epidemiology and Master of Public Health, and her research and leadership have focused on infectious disease prevention, health promotion, and academic excellence. She is a recipient of the prestigious Health System Integration Program Fellowship with the Centers for Disease Control and Prevention.

Helena Whitney, from the Arizona Hospital and Healthcare Association, will serve as Director at Large. With over two decades of experience in Medicaid and healthcare policy, government relations, and public health consulting, Helena has held senior roles in legislative affairs, led statewide health assessments, and developed innovative programs to improve health equity and behavioral health outcomes.

Annual Members Meeting Financial Review

The 98th Annual Members Meeting was held, with President Sean Clendaniel opening the meeting and highlighting the upcoming centennial celebration in two years.

Dr. Christine Girard presented the Treasurer’s Report detailing financial accountability and the financial landscape of the organization. She explained the fiscal year operations, including consulting with NPO Accountants and preparing financial statements following GAAP.

She presented a bar graph showing the total net assets from fiscal year 2016 through 2025, noting a significant increase in revenue over the last 7 years. She emphasized the need to further diversify revenue streams and mentioned the recent completion of strategic planning work.

APHA Governance and Advocacy Update

Rebecca Nevedale (our Affiliate Representative on the Governing Council) provided an update on her role as the representative to APHA’s Governing Council, explaining its functions and her involvement in policymaking and advocacy at a broader scale. She highlighted APHA’s involvement in six lawsuits to protect public health and introduced the Campaign for the Public’s Health, a new initiative led by Dr. Benjamin.

APHA Strategic Initiatives and Advocacy

Rebecca discussed APHA’s initiatives, including the formation of a “war room” for strategic policy planning and a new campaign to combat adverse policies. She highlighted the modernization of the policy brief process and a revised nominations process aimed at improving geographic representation. Rebecca also mentioned APHA’s advocacy priorities, financial challenges, and the adoption of a policy on hate-motivated behavior, while emphasizing the importance of supporting the organization financially. She concluded by encouraging participation in APHA activities, particularly for those involved in sections or caucuses, to enhance collaboration at the state level.

AZPHA Policy Updates and Advocacy

AZPHA provided updates on their activities in 2025, including delivering over 50 public health policy updates and action alerts. They discussed their decision-making process, which involves weekly policy meetings and considering factors such as mission alignment and community impact. AZPHA plans to monitor upcoming bills, including one on over-the-counter ivermectin and another related to children’s bicycles, and will meet virtually on Fridays at 2 in January and February.

Will Humble explained the process of reviewing and taking positions on bills in policy committee meetings, emphasizing the importance of resolutions passed by AZPHA members since the 1930s to guide their advocacy. He highlighted their unique ability to quickly take positions on bills due to these resolutions, which helps raise their profile with lawmakers and journalists.

Penny Allee-Taylor mentioned their work with the Arizona Corporation Commission, noting that while their advocacy efforts have been challenging in recent years, they plan to continue engaging with the commission. Felicia Trembath, chair of the Professional Development and Academic Relations Committee, discussed their recent conference on modernizing public health practice and ongoing member webinars, which will continue into the next year.

AZPHA 2026 Initiatives and Growth

Felicia and Will discussed upcoming events and initiatives for AZPHA in 2026, including a heat prevention presentation and a behavioral health conference. They highlighted the success of recent networking events and a National Public Health Week panel.

Dr. DeShawn Taylor presented a membership report, noting a significant increase in members over the years, particularly due to organizational memberships. The survey results revealed that most members heard about AZPHA through word of mouth, and the majority were satisfied with the organization. The association plans to use this feedback to refine its programming and activities in the coming years.

Behavioral Health Conference Planning

Will discussed the upcoming May 1st conference focusing on behavioral health, including topics like court-ordered treatment, homelessness, and maternal mental health. He mentioned the need to balance conference planning with legislative session work and other responsibilities.

Will also touched on the organization’s 98-year history and plans for its 100th anniversary in 2028. Finally, he reviewed the recent board-driven strategic planning process, which included a SWOT analysis and development of a draft strategic work plan for the board to review in January.

Board Member Transition Recognition

The meeting focused on recognizing outgoing board members for their contributions, while welcoming newly elected members including Charity Moparthy as student representative, Laura Timmons for professional development, and Helena Whitney as member at large.

Sean Clendaniel highlighted the competitive election process and praised the incoming board members, while expressing gratitude to the current board and members for their dedication to public health. The conversation ended with a warm introduction of Lauriane as the new president, acknowledging her leadership qualities and enthusiasm.

2026 Public Health Conference Planning

The board discussed plans for the 2026 public health conference, noting strong interest in AZPHA events and a high number of board applications, including many students. They agreed to focus on providing more engagement pathways for the public health workforce and to support Will, their sole paid staff, by handling non-essential tasks while allowing him to focus on policy and advocacy.

Will outlined the conference planning process, including a January call for proposals, review committees, and free attendance for selected presenters, while Dr. DeShawn Taylor emphasized the importance of securing sponsorships from for-profit organizations to keep conference costs low.

View the PowerPoint used at the Annual Members Meeting
View the Annual Member Meeting Recording:
Passcode: e=2KS%o=
Will Humble Public Health Law, Wills Blog

2026 Arizona Legislative Session: What We’re Hearing So Far

The 2026 Arizona Legislative Session kicks off in just seven short weeks, and early conversations at the Capitol are already pointing to a crowded policy agenda.

As always, which ideas ultimately become bills—and which of those receive hearings, amendments, or traction—will come down to committee chairs, caucus priorities, fiscal constraints, and the political dynamics of an election year. But based on what we’re hearing, here’s a preview of the major themes likely to shape the session.

Healthcare Financing, Coverage, and System Oversight

Legislators are expected to revisit several complex issues related to healthcare costs and coverage. Concerns about uncompensated care and cost-shifting to employers continue to drive interest in reforms to the insurance marketplace.

Proposals may appear around health insurance company regulation, improving navigation support for health coverage, and policies aimed at addressing fraud, waste, and abuse across the health sector.

A significant focus will likely be on safeguarding Arizona’s ability to use provider taxes to draw down federal matching funds for AHCCCS, a key financing tool for maintaining Medicaid stability.

Lawmakers are also expected to consider measures to preserve coverage gains in Medicaid, CHIP, and ACA marketplace enrollment, while some may advance proposals promoting a more explicitly free-market model of healthcare.

Behavioral health access—including workforce, licensing, and reimbursement challenges are also expected to feature prominently.

Early Childhood and Child Development

Several legislators are signaling renewed attention to early childhood, including all-day kindergarten funding options, strengthening the early childhood system, and investments in child development supports. Expect ongoing debate about funding models and the long-term return on early learning investments (but little or no progress).

Housing, Homelessness, and Community Development

Housing will again be one of the biggest policy arenas of the session.

Anticipated proposals include:

  • Arizona Department of Housing reauthorization
  • Investments in the AZ Housing Trust Fund and making its annual appropriation permanent
  • Updates to the Low-Income Housing Tax Credit program
  • “Yes in God’s Backyard (YIGBY)” strategies to encourage faith-based organizations to develop housing
  • A continued push for attainable workforce housing
  • Support for new facilities and services to mitigate homelessness
  • Efforts to reduce zoning barriers and community opposition to affordable housing and shelters

Workforce housing is also expected to appear in the broader set of healthcare workforce policies, including graduate medical education, recruitment and retention, and transportation-related supports.

Civic Health and Voting Access

Measures affecting civic participation will likely surface again, probably as a ballot referral by the legislature (Hobbs can’t veto those). We expect opposition to proposals that would limit early voting or otherwise create inequitable barriers to voter access.

Infrastructure, Economic Development, and Workforce Training

Infrastructure needs are still a perennial topic, especially as the state continues to attract large-scale business and population growth. Anticipated areas of focus include:

  • Water, wastewater, transportation, and power infrastructure
  • Investments in training and workforce development
  • Licensing reforms aimed at creating a system that is both safe and predictable
  • Financing tools—like Tax Allocation Districts—to help local governments stay competitive in business attraction and retention

The Legislature is also expected to revisit Prop 123 / State Land Trust Permanent Fund issues and once again debate the Aggregate Expenditure Limit (AEL), which continues to affect K–12 operations and school district flexibility.

Will Humble Early Childhood, Wills Blog

What the 2025 Child Fatality Review Report Tells Us (Including Policy Recommendations)

Every year since the 1990s the Arizona Child Fatality Review Program looks at every child death in our state — from birth through age 17 — to see which ones might have been prevented. Their goal is simple but vital: to use what we learn to save lives.

The 2025 report (the 32nd annual edition) shows that communities across Arizona — including all tribal nations and local review teams — completed reviews for 100% of child deaths in the year.

That thorough work helps point out trends, risks, and possible solutions so that parents, lawmakers, and communities can do better.

2025 Child Fatality Review Report

What Are the Main Problems

The report breaks child deaths into different types — accidental injuries, homicides, suicides, natural (medical) causes, and more.

Some of the biggest issues include:

Premature births and sudden infant deaths — For babies under one year, prematurity and sudden unexpected infant death (SUID) remain major challenges.

  • Drowning deaths — Children sometimes die in water-related accidents.
  • Firearm-related deaths — Gun injuries remain a serious cause of child fatalities.
  • Car crashes and motor vehicle accidents — Crashes continue to put young lives at risk.
  • Infectious disease deaths — The report notes that deaths from infectious illness rose, and a significant portion may have been preventable.

While some deaths are unavoidable, many fall into categories labeled “preventable” — meaning that safety rules, education, health care access, or better supervision could be effective.

What the Report Recommends

Based on its findings, the CFRP proposes several key steps for families, communities, and lawmakers to help reduce child deaths.

  • Require proper storage of all firearms by making adult owners legally civilly & criminally responsible for keeping the firearm unloaded and locked in a safe with the ammunition stored separately.
  • Families should store firearms securely, keeping guns unloaded and locked, with ammunition stored separately. Arizona should implement a child access prevention law to reinforce the importance of safe gun storage.
  • Parents and caregivers should use age-appropriate car seats and seat belts — and enforce rear-seat travel for children under 13. Enforcement of existing requirements would help
  • Communities should expand home-visiting and support programs (especially for expectant mothers), and encourage healthy behaviors during pregnancy to reduce premature birth deaths
  • Parents must know safe-sleep guidelines for babies and avoid using items not designed for infant sleep or recalled products.
  • Access to health care and preventive measures — including vaccinations and timely medical care — should be improved, especially to address disease-related deaths.

Some recommendations need new laws; others can be acted on by state agencies, community groups, or families right away.

Firearm Violence in Arizona: Data to Support Prevention Policies

You can see the numerous graphs and policy recommendations in the full report (142 pages): 2025 Child Fatality Review Report

Will Humble Early Childhood, Vaccination, Wills Blog

Kennedy’s ACIP Votes to Weaken the Birth-Dose Hepatitis B Vaccine Recommendation

Last week the Advisory Committee on Immunization Practices voted to change a policy that has protected newborns for 30 years. ACIP is the group that advises the CDC on vaccines, and its decisions shape what shots are covered by the Vaccines for Children program, Medicaid, and private insurance… so they have a hardwire into vaccine policy and reimbursement.

Arizona reacts to RFK Jr. panel’s decision on Hep B vaccine

The new recommendation says that parents of babies born to mothers who test negative for hepatitis B should talk with their doctor about whether to delay the first dose of the hepatitis B vaccine. If they choose to delay, ACIP says the baby should wait until at least 2 months of age to start the vaccine series.

This is a big shift in policy (which wasn’t supported by evidence). The birth dose has helped cut hepatitis B infections in babies by more than 90% over the last few decades.

At least the committee recommended that if a mom hasn’t been tested for Hep B (or if she tests positive for hepatitis B) the old rules stay in place… that the babies should still get the vaccine within 12 hours of birth, plus hepatitis B immune globulin.

Because of the way ACIP wrote the new recommendation, coverage rules don’t change. VFC and private plans must still cover the birth dose.

But here’s the concerning part: ACIP didn’t present new safety or effectiveness issues to support this change. Instead, committee members said they revisited the policy because:

  • Some parents have concerns about the birth dose
  • Some European countries wait a few months to start the vaccine
  • It has been a long time since ACIP last reviewed this topic

Those reasons may sound reasonable at first glance, but they ignore real-world risks in the U.S. health system. All pregnant women should be tested for hepatitis B, but testing does not always happen.

Even when it does, about 2% of results are false negatives. And some women become infected later in pregnancy, after they’ve already been tested. The birth dose is the safety net that protects babies in these situations.

A new modeling study (not yet peer-reviewed) estimates that delaying the vaccine until 2 months could lead to:

  • 1,400 more babies becoming chronically infected in the first year
  • 304 future liver cancer cases
  • 482 deaths related to hepatitis B

Hepatitis B in infants is extremely serious. About 90% of babies infected at birth become chronically infected, and about one-quarter of those children will die early from liver disease.

An Odd Second Recommendation

ACIP also advised that parents who choose to vaccinate their kid for Hep B ask for a blood test after the first dose to see if more doses are needed. This suggestion wasn’t backed by evidence either. It’s also impractical and won’t be covered by VFC or insurance because it’s not a vaccine—it’s a lab test.

The Bigger Picture

Last week’s changes won’t cause sweeping harm right away because they apply only to infants whose moms known to be negative for hepatitis B. But the signal is clear.

I think this these decisions are just the lowest hanging fruit and the start of what will be a years-long effort by CDC leadership and Kennedy to make wholesale changes to the kids and adult vaccine schedules. Basically, that last week’s “small” changes are warm-up for much larger steps in 2026, 2027 and 2028.

In a nutshell:

  • The decisions at ACIP are now mainly driven by politics & ideology rather than hard evidence, undermining trust in public-health guidance.
  • This politicization decreases vaccination uptake, risking preventable disease outbreaks and long-term public health harm.
  • That greatly weakened institutional expertise at the CDC and their consent to the ACIP recommendations harms both domestic and global health infrastructure — which historically relied on robust, evidence-based vaccine programs out of the ACIP & CDC.

Since last week’s changes weren’t driven by evidence – the future changes probably won’t be either.

Will Humble Professional Development, Wills Blog

Public Health Journalism this Week

Arizona lawmaker proposes making ivermectin available over-the-counter

Arizona flu rising E. coli linked to state fair sparks concerns – Arizona PBS

Copa Health to operate new housing for Arizonans with mental illness

RFK Jr.’s ACIP panel recommends delay in newborn hepatitis B vaccination | STAT

RFK Jr.’s CDC spreads false facts about vaccines, autism, critics say

Arizona reacts to RFK Jr. panel’s decision on Hep B vaccine

Will Humble Oral Health, Wills Blog

New NIH-Backed Study: Fluoridated Water During Childhood Linked to Better Academic Performance — Contrary to What Kennedy Claims

A landmark NIH-funded study published this week offers evidence supporting the benefits and safety of community water fluoridation, The study directly refutes the false claims Secretary Kennedy has made about community water fluoridation.

Drawing on data from nearly 27,000 individuals across more than 1,000 U.S. high schools the research finds that children raised with recommended levels of fluoride in their drinking water tend to perform better on standardized tests in math, reading, and vocabulary, compared to peers in non-fluoridated communities.

The study reported no negative cognitive effects among older adults (around age 60) exposed to the same fluoride levels during their youth (despite what Kennedy says).

Childhood fluoride exposure and cognition across the life course | Science Advances

Key Findings

  • Improved High School Test Scores
    • The study used the “High School and Beyond” cohort, a nationally representative sample of students followed from 1980 into the 2020s.
    • Adolescents who drank optimal fluoride (around 0.7 mg/L, the U.S. public health recommendation) scored modestly but consistently higher in mathematics, reading comprehension, and vocabulary.
    • The cognitive advantage was small (about 7% of a standard deviation), but statistically clear.
  • No Evidence of Harm Later in Life
    • When researchers followed up with participants around age 60, they found no statistically significant link between childhood fluoride in drinking water and cognitive function (memory, fluency, attention) in older adulthood.
  • Robustness & Quality
    • The study controlled for a wide range of confounders (e.g., socioeconomic status, residential moves) and ran sensitivity analyses to rule out alternative explanations.
    • By focusing on fluoride exposures typical of U.S. water systems, it avoids the critiques of earlier studies that examined much higher levels found overseas.

Childhood fluoride exposure and cognition across the life course | Science Advances

  • Fluoridation is a Local Decision in Arizona: In Arizona, municipal or county governments decide whether to fluoridate their water systems. This new study provides strong, locally relevant evidence to support continued or renewed fluoridation.
  • Leveraging the Study for Advocacy: AZPHA members can bookmark and reference this study in discussions with city councils, county boards, or public health committees. It’s not just theory — it’s real-world, long-term data from U.S. communities.
  • Countering Misinformation: For years, opponents of fluoridation have claimed U.S.-level fluoride harms IQ or health. This rigorous, NIH-funded research directly refutes those claims at the very levels used in public systems.
  • Dental Health + Broader Health Equity: We know that fluoridation reduces tooth decay by at least 25% in children and adults. With this new cognitive data in hand, AZPHA can make an even stronger public health case — not just for preventing cavities, but for supporting brain development and long-term wellness.

Call to Action 

  • Share the Evidence: Use blog posts, newsletters, and presentations to spread awareness among elected officials, water utility managers, and community stakeholders.
  • Engage the Community: Host forums, webinars, or coffee talks in your jurisdiction to explain the significance of the study in plain language.
  • Policy Letters with Impact: When writing to local decision-makers, include a link to the full study (Science Advances, DOI: 10.1126/sciadv.adz0757) as well as key take-home messages (academic performance, safety, long-term benefits).
  • Align with Other Public Health Messaging: Integrate these findings into broader oral health and local prevention strategies — fluoridation isn’t just about teeth, it’s about lifelong health.

Childhood fluoride exposure and cognition across the life course | Science Advances

Will Humble Public Health, Social Determinants, Wills Blog

New HUD Housing Rules: What They Could Mean for Homelessness & Folks w/ a Serious Mental Illness

The federal housing agency (HUD) just changed the way they intend to issue grants to prevent homelessness. The changes are big, and they’ll affect how Arizona communities are able to prevent homelessness and house people with serious mental illness.

In the past, most HUD housing money was renewed automatically each year using local plans. Under the new rules, only about 30% of the funding will be renewed with the remaining 70% up for competitive awards based on new criteria that HUD is prioritizing (e.g. funds will be preferentially directed to states with criminal penalties for urban camping).

Communities with strict camping bans, written partnerships with police, and programs that require people to take part in treatment will now have a competitive advantage for grant awards over those communities that don’t have those things.

HUD is also setting a limit on how much money can go toward long-lasting housing (permanent supported housing) …  the type of housing that’s important for people with serious mental illness who often need stable housing and supportive services for many years.

The new rules push communities to prioritize their plans to focus on short-term housing with tight rules and required treatment programs.

AHCCCS Housing Programs

Arnold v Sarn Legislative Report 2025

Arizona counties play a role in housing folks with a serious mental illness and they’re now under the gun to come up with plans that match what HUD is looking for or go without the federal funds.

For example, Maricopa County relies heavily on long-term housing. The county’s Continuum of Care includes more than 170 housing programs and more than 15,000 beds. They’ll need to rethink that focus or risk losing up to 70% of their current funding. Many other counties are in the same position.

If HUD funding drops or shifts away from long-term housing (as envisioned by the new HUD rules), Maricopa County could lose up to 1,388 units and about $32M. This would make it much harder for people with serious mental illness to find stable places to live.

Losing long-term housing puts people at great risk. Without a stable home, it’s harder to take medications on time, see doctors, or stay connected to support services. This leads to more mental health crises, more emergency room visits, and more time spent in jail.

Arizona counties and communities now face a stark choice. They can try to match HUD’s new expectations by focusing more on short-term programs, strict rules, and law-enforcement partnerships or roll the dice and risk losing most of their housing funds.

Note: AzPHA Policymaker of the Year awardee Attorney General Kris Mayes (with other Attorneys General) filed a multistate lawsuit accusing the HUD of illegally changing its Continuum of Care housing grant program. The suit argues that HUD is cutting protections for long-term housing by slashing the portion of automatically renewed funding and imposing new conditions like mandatory treatment participation and local anti-camping enforcement—without congressional approval.

The plaintiffs contend these changes will reduce access to permanent housing, destabilize populations with serious mental illness and chronic homelessness, and violate the “Housing First” model. They characterize the policy shift as arbitrary and capricious.

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