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Dynamic Chiropractic – February 26, 2008, Vol. 26, Issue 05

Chiropractic "Adjusting" to National Public Health Week

Building the Bridge for the Future of Public Health One Person at a Time

By Julie Johnson, DC and Lisa Zaynab Killinger, DC

Since 1995, National Public Health Week (NPHW) has been the first full week of April, by presidential proclamation.

Public health issues concern us all.

For those in the pubic health community, this week serves as an opportunity to tackle current issues and educate policy-makers. This all trickles down to the rest of us, in addition to the general public and their practitioners of varying disciplines.

Now is the time to move forward and plan your chiropractic involvement in the 2008 NPHW events. Chiropractic is as important to public health as any other profession. The American Public Health Association's (APHA) Chiropractic Health Care Section offers examples of how chiropractors can host events in their own communities as tie-ins. NPHW events mobilize people to work together to improve the nation's health. For years, members of the APHA Chiropractic Health Care Section have been organizing National Public Health Week events in their local communities. As an established leader in this realm, the APHA assumes the responsibility of coordinating this tremendous effort with the help of its 55,000 members and organizational partners, including those in the chiropractic community. Individual chiropractors all around the nation, and/or chiropractic organizations and colleges, can host NPHW activities in their own communities.

In 2008, NPHW will be held April 7-13 with the theme "Climate Change: Our Health in the Balance." A different theme is chosen each year, and the APHA offers materials to assist providers and organizations to get out the word about an issue impacting our nation's health. Previous themes include: Tobacco Use Cessation; Overweight and Obesity; Healthy Aging; and Healthy Kids. As you can see, these are simple, relevant themes, important to anyone who cares about health. Last year, all activities were based around the theme of "Preparedness and Public Health Threats: Addressing the Unique Needs of the Nation's Vulnerable Populations." Each year, guidelines and suggested activities are offered in one central location, but each community can create and implement activities relevant to their local area.

For the past five years, the Palmer Chiropractic Clinics have chosen to be actively involved in this national event. Particularly in the past three years, students have participated in these programs via the S.P.E.A.K. (Student Patient Education Awareness and Knowledge) Clinic Marketing Program. It has been a process that has grown, from limited efforts in the 2003 campaign to encourage the cessation of tobacco use, to a groundbreaking 2005 collaboration with a local hospital system in the entire Quad Cities area.

So, why should chiropractors care about National Public Health Week? It's true that many in our profession don't even know what it is. Well, now is the time to jump on this bandwagon! The work of Pulitzer Prize-winning journalist Laurie Garrett comes to mind from her 2001 book, Betrayal of Trust: The Collapse of Global Public Health. She challenges the premise that as a nation, we have the luxury to rely solely upon our government to protect our health. It doesn't matter whether you're a part of a chiropractic institution that trains the future leaders of the profession or you're an individual practitioner in the field. Anyone involved in health care ultimately plays a role in global health by affecting those in their immediate community. Perhaps the larger question is, "If not us, then who?"

Participating in National Public Health Week offers an endless number of opportunities. When planning for our college's participation this past three years in particular, three factors have been the driving force behind all planning: community education, student education and patient recruitment. This could easily translate for the individual practitioner as well.

In order to promote the increasing number of those in our profession who choose to join us each year in this process, a step-by-step progression has been chosen as the most logical vehicle of explanation. You can follow this process to create an event or series of events on a small- or large-scale basis. This outline will be helpful whether you choose to hold something in-house or take part in a combined effort with multiple partners. It's a matter of public relations and public education wrapped in one package with passion, enthusiasm, creativity, professionalism and never-ending energy. That's the magic ingredient in the recipe - the energy! Don't let our approach intimidate you because these steps can be scaled down easily to the solo practitioner's own office setting.

Step One: Assemble Your Team

Each December, the APHA releases the theme for the coming year. Identifying the overall theme needs to happen before you consider who will make the best team players in this effort. This team could be a joint effort of those within your institution or private practice, or it could include several community partners. Don't be afraid of leadership in this process. It is true - no matter how clichéd - that one person can make the difference. This is the time to start pulling together your initial framework. Make the decision now as to whether this will be a small project or a large one. It is possible to create an opportunity for students to get involved, if you teach. The APHA has consistently done a thorough job of offering a multitude of resources that explain their choice of the most prevalent public health crisis. There is a multitude of resources available on the APHA Web site at to help promote your activity.

Step Two: Pay Attention to Local Needs

Step two involves paying serious attention to the needs of your local community. Regionally, we're all different, yet in some ways we deal with many of the same health-related issues. That's one of the reasons NPHW can be translated into a project any of us can do. One of the most important things to consider is what will make the greatest impact in your community.

Step Three: Initiate Momentum

Step three begins with creating momentum. Review the chosen sub-theme for each day of the week on the NPHW Web site. This will help stimulate ideas for activities. At that point, it is up to you to decide whether you want to have multiple events throughout the week or just on one day. Plan your activities with respect to the audience you're trying to reach. A geriatric audience is less likely to come to an event in the evening, (as our experience has shown), while weekday events may preclude families from attending together, especially with respect to school kids.

Step Four: Bringing It All Together

Ideally, you should already be at this step by the end of January, so if you're reading this and haven't started the process, there's no time to waste. Things need to begin to take shape at this time to keep you on schedule. You've got to consider several things at this point:

  • What are potential events that you could host?
  • Who will take the lead for organizing and executing events?
  • Who are potential community partners in your community?
  • Are they a local or a national group?
  • What kind of reputation do they have and for what do they stand?

These are all important things to consider as you join forces to show those in your community that not only can health care providers come together for the greater good, but also that the chiropractic profession is going to be at the forefront. In 2005, we got the crazy idea to partner with a local hospital system as a co-sponsor for our NPHW event. The theme that year was "Healthy Aging." Admittedly, it was initially a little daunting. However, planning NPHW events is one of the best times to consider what may seem to some as unlikely partnerships. We talk a great deal about integration, cooperation and commitment to the patient as the ultimate benefactor. What better time than National Public Health Week to create that atmosphere? In our case, it started with a simple phone call. Throughout the years, that relationship has grown to be mutually beneficial. It is often hard to truly know how something might work until you ask.

Now you can begin to consider the depth of the event, the budget and how expenses might be shared. You also should explore free promotion by working with the local media. Refreshments are an expense, but they often draw people to events. You also must decide whether you will have any items to give away and how much can be placed into an advertising budget. You must create a plan to promote your event, no matter how large or small. This is essential.

Step Five: Collaboration and Discovery

The past five years have been both an education about public health and about the numerous organizations that exist in our local community. We've participated in numerous events and met a great number of people. I won't lie and tell you that this won't be creating more meetings to attend. However, the benefits of partnership cannot be denied in this instance and the sky is the limit on what can be created.

Steps Six and Seven: Marketing, Marketing and More Marketing

The sixth and seventh steps involve marketing and yes, more marketing. Many may term at least a portion of this "social marketing," due to the application of marketing principles to health education and promotion.

Although the APHA provides many materials that can be used to promote your event, this is the time to use those with particular PR skills to create press releases, fliers, posters and other materials to connect with your audience. Since this is a not-for-profit event, community health organizations and local media may be delighted to make information available about your event(s). There are free opportunities in the form of public service announcements on most local television and radio stations. It never hurts to ask. Written coverage is also a possibility, either before or after the event. Make sure that the local community news reporters are aware of what is being done for NPHW. There are many resources that describe how to successfully create a powerful media kit. Prominently placed posters and fliers are helpful, but may not be effective without other promotion.

This is a crucial opportunity to think about human nature. Understand the consumer and think as if you were trying to capture the attention of someone amidst the myriad of daily life and the numerous distractions and activities that are a part of our culture. Any marketing resource will tell you that in order to elicit changes in behavior the basic motivation has got to be an emotional trigger. Sustainability comes through intensity and connection. People want something of value to them. What can you say, teach or provide that will motivate them to give you their attention? Where is the emotional punch to your message?

Step Eight: Write It All Out

Step eight involves "putting it all down on paper." Set your agenda in a detailed, organized fashion. Make a contact list of your volunteers, co-sponsors, community partners and local media contacts. Try to think of what it requires to make every detail happen. This is a significant learning opportunity, especially for students at an institutional level. It allows for critical thinking and teaches how to achieve the implementation of NPHW activities as leaders in their own communities, wherever they may land. If you are a private practitioner, this can be a great way to lead a team of people who might not otherwise have the opportunity to come together. They may discover leadership, organizational and other personal/professional attributes they didn't know they had, thus making them a more empowered team player. This is a vital skill that helps to solidify the concept of partnership in practice.

Step Nine: Stepping It Up a Notch

As NPHW nears, the ninth step involves becoming more vocal about your event(s). Consider appearing on local news shows within a week of the activities you've planned. Step up your final efforts to reach as many people as possible in your target audience.

Step Ten: Implementation of the Event(s)

It's up to the event leaders to shine now and rally the troops. It's hard to completely determine how many people will actually show up. At times, the turnout hasn't been ideal. However, it's about the effort and the relationships, and ultimately about establishing not only the individuals involved, but the chiropractic profession as a reliable, consistent source of relevant information that cares and champions the health of our nation.

After years of experience with this, the idea that "everything will take care of itself" ends up appearing more ludicrous than ever. It is up to us. The health of the world, just like the health of a nation, is determined by the health of the individual. We have the opportunity to effect change in a great way. Mother Theresa said, "We cannot all do great things, but we can do small things with great love." If you still wonder, "What's in it for me," think about the impact of a healthier community, the burden of disease or the brunt of the economic forces of public health crises.

What Next?

The NPHW Web site states, "There is a direct connection between climate change and the health of our nation today. Yet few Americans are aware of the very real consequences of climate change on the health of our communities, our families and our children." We can tell you that the relationships we have been built over the past five years have enriched our college, our community, our profession and the patients we all serve.

There are no words to encourage you strongly enough to take your next step in the effort to promote public health, whether you are a private practitioner, part of an integrated group of professionals or associated a major institution like Palmer College of Chiropractic. There may already be others who are planning NPHW events in your community - you could join them. Another idea would be to consider what actions your community, office or college could take to reduce contribution to climate change to add to a healthier lifestyle for us all. Are there any community actions already in place to focus on your region's weather, rainfall changes or impact from extreme temperatures, especially on the elderly, sick and young? How is climate change impacting the patients you serve? Once you begin asking some very basic questions, ideas for potential event(s) begin to flow quickly.

In the January/February 2007 issue of Foreign Affairs, Laurie Garrett submitted an article titled, "The Challenge of Global Health." In it she states, "In recent years, the generosity of individuals, corporations and foundations in the United States has grown by staggering proportions. As of August 2006, in its six years of existence, the Bill and Melinda Gates Foundation had given away $6.6 billion for global health programs. Of that total, nearly $2 billion had been spent on programs aimed at TB, HIV/AIDS and other sexually transmitted diseases. Between 1995 and 2005, total giving by all US charitable foundations tripled, and the portion of money dedicated to international projects soared 80 percent, with global health representing more than a third of that sum. Independent of their government, Americans donated $7.4 billion for disaster relief in 2005 and $22.4 billion for domestic and foreign health programs and research." These are not small figures. When the cost of lost productivity and the quality of life for all are considered, it's hard to put a final price tag on the concepts being discussed.

Hosting a National Public Health Week event is a way to build relationships with other organizations in your community and serve the health and educational needs of your patients, their families and potential patients. DCs should also consider joining the American Public Health Association, the nation's oldest, largest, and most influential and diverse public health organization. This organization truly keeps the health of individuals and society as its top priority. As two APHA members ourselves, we've realized that the APHA helps us to keep our fingers firmly on the pulse of the nation's health and stay abreast of changes in our ever-evolving health care system.

It's as simple as visiting and clicking on the link for National Public Health Week. You can do it and APHA can help. The level of participation can vary from a full-scale association or college activity, to the individual DC putting up a few announcements and posters in their office to let patients know that chiropractors and public health go together.

If you are in a solo or group practice, don't hesitate to be a smaller team. Last year, the participation in one office consisted of both the CAs and the DC greeting each and every patient with, "Hello, did you know this is NPHW?" That was one effortless step for that office, but what a great impact and a lot of very favorable comments and questions it generated. Having patients tell their friends, "My DC is interested in public health," doesn't hurt your practice. Start planning your own participation today - April is only a few weeks away!


  1. The Betrayal of Trust: The Collapse of Global Public Health. New York: Hyperion 2001.
  2. Garrett L. The Challenge of Global Health. Foreign Affairs, January/February 2007.
  3. Egan JT. Who needs chiropractors anyway? An invitation to join the APHA. Dynamic Chiropractic, April 23, 2007. Available at
  4. Feise R. The path of professionalism. Dynamic Chiropractic, July1, 2002. Available at
  5. Curtis V. Masters of marketing: bringing private-sector skills to public health partnerships. Am J Public Health, 2007;97:634-41.

Dr. Lisa Zaynab Killinger is past section chair of the APHA's Chiropractic Health Care section and director of diagnosis and radiology at Palmer College of Chiropractic. Contact her with questions and comments at .

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