At the opening of the 2011 American Public Health Association (APHA) Conference in Washington, D.C., last week, a collection of very provocative opening presentations challenged all 12,000-plus attendees to work harder for the health of those most in need. To view a few of the presentations, including one from former Senate Majority Leader Tom Daschle, visit APHA's YouTube Page .

During that same opening session, attendees were encouraged to visit the new Martin Luther King, Jr. Memorial. I did that and found the monument very thought-provoking. Below is a quote and picture from the memorial. If you've been there, what did you think?

The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. - Martin Luther King

The APHA Conference featured more than 1,000 scientific presentations, including one based on our work with the Foundation for a Healthy Kentucky on the Kentucky Health Issues Poll (KHIP). Take a quick look at our slides:

This presentation reviewed how the addition of surveys with the cell phone-only population can affect the results of traditional landline surveys, and considered the costs and benefits of adding this hard-to-reach, but growing, population of telephone users.

KHIP is a random-digit-dialing telephone health opinion survey of more than 1,500 adults that has been conducted annually since 2008. Landline-only samples fell short of U.S. Census estimates of young and non-white people living in Kentucky. Therefore, a sample of more than 200 cell phone-only households was included in the 2009 and 2010 KHIP. In both years, the unweighted cell phone-only sample was significantly more likely than the unweighted landline sample to be non-white and to be younger than 35 years old.

Combining landline-only and cell phone-only surveys resulted in improved sample coverage, but did this improved coverage affect results? The answer is yes. The cell-phone sample included considerably more uninsured Kentuckians than would have otherwise been possible with a landline-only sample.

This week has been a real test of the Health Foundation's belief in sharing openly all of the public opinion polling data collected by our Health Issues Polls . I have received many calls from people on both sides of the issue, but especially calls from the smoking and liquor lobby thanking me for my groundbreaking work. They are also asking for more specifics about our poll that shows that Ohioans want the smoking ban in bars lifted.

First, let me set the record straight: our data show that Ohioans are split on support for the ban on smoking in bars. There is no great call to arms to repeal the ban based on our findings: 51% said they want to repeal the ban, 47% said they wanted to keep it in place. But the calls I've gotten from the public give me serious pause: How can I, a staff member of The Health Foundation of Greater Cincinnati, an organization that has given over $14 million in grants to reduce alcohol, tobacco, and other drug use in our region, be providing data to groups who want to encourage increased consumption of cigarettes?

My answer is transparency and reliability. The Health Foundation believes that we must provide high-quality, reliable, local public opinion data so people can make data-driven decisions. We know we cannot control public opinion, but understanding what people think is critical to the work that we do.

In order for the Health Foundation to be a legitimate source of high-quality, reliable data, we cannot just release the data we like best. This means that when we ask tough public opinion questions, we are not always going to get the answers that we hope for. But it is our responsibility to provide the data to the community.

One very important distinction that was not made in the media is the difference between public opinion data and research data. We used good polling techniques to obtain the opinions regarding smoking in bars, but that doesn't change the research data that shows that first- and second-hand smoke cause cancer of the lungs, mouth, throat, and other cancers in people who smoke in a bar (or anywhere for that matter) and, because of the prolonged exposure, people who work in bars. The poll data show that the public is divided on whether or not people should be permitted to smoke in bars. The research data show clearly that smoking causes cancer, emphysema, and many other unpleasant or fatal illnesses.

Unfortunately, while the media chose to spin the spilt on support for the smoking ban in bars into a cry for repeal of the law they have missed other stories that I think are much more interesting:

• The majority of smokers support continued ban on smoking in restaurants and workplaces
• A third of Kentuckians are uninsured
• Most Ohioans and Kentuckians support mental health and substance abuse treatment over incarceration for non-violent offenders
• Most of Ohioans and Kentuckians support healthcare reform

Increasing access to health care has been a strategic focus of the Health Foundation since our inception. In recent weeks, I have been looking back over the Community Primary Care grantmaking and thinking about the challenges ahead. The good news is that over the past 10 years, grantees in our Community Primary Care focus area have added capacity to give 12,000 more people a medical home. Significant planning and implementation went into accomplishing this community benefit. This work is far from finished and the need is growing. It is disconcerting to see that the number of uninsured has increased in all three states in our service area. The biggest challenge is Kentucky: our latest Kentucky Health Issues Poll found the number of uninsured increased from 14% in 1995 to 33% in 2009. Our regional numbers will probably continue to increase over the coming year as more local businesses reduce staff.

The demand for additional healthcare services will increase as healthcare reform is implemented between now and 2014. A continuing challenge is adding enough capacity in medical and dental homes so that the currently uninsured can have a regular and trusted source of primary care when they get insurance. I am hopeful that there may be some state or federal opportunities to partner or collaborate with others to leverage funding.

In looking toward the future, I am reminded of the Carpenters' song "We've Only Just Begun."

Last week I was in Erie, Pennsylvania, presenting at a community forum. One of the speakers reminisced about his youth and how his family doctor practiced in a house in the neighborhood. That doctor was an integral part of the community and the speaker's childhood. In most places, that type of access to a family physician no longer exists. However, 2,000 communities across the nation have access to another provider that also plays an integral part in a community and in the lives of children and families: the school-based health center (SBHC). SBHCs are as local- and community-driven as healthcare can get these days. The school community--school staff, parents, students, supporters, and neighborhood representatives--helps define the SBHC and the services it will provide. One of the identified concerns about healthcare reform is the limited access to primary care services. At this point, it is estimated that once everyone has health insurance and begins seeking regular, on-going primary care services, these services will be hard to get because there won't be enough providers. This is where the SBHCs can play a role. SBHCs are mostly located in communities that have high numbers of uninsured adults, in addition to high numbers of children with Medicaid or no insurance. Structuring the SBHCs to be open to the community--and not just school children--will allow more access points in communities where they will be needed the most. One of the hidden gems in the healthcare reform bill is support for expanding SBHCs. The bill makes $200 million beginning this year available to provide capital improvements, equipment, and other supports for SBHCs. Those funds could be used to remodel existing facilities to make them available to the community while keeping the kids safe and sound in the school building. Doesn't that seem like a great way to bring the local doc back into the community and create an important relationship and childhood memory for today's children?