Racial and economic disproportionality

On February 2008 The Seattle Times published on their editorial page a guest piece on Equity and social justice. The election of Senator Barack Obama to the Presidency of the United States should increase the momentum to significantly erode racial and economic disproportionality. This will be particularly important as this nation’s racial make-up continues to undergo rapid change.

Is this of local concern? African Americans, Native Americans, Latinos and some Asian nationalities are aggregately worse off now than they were in 1970. Even updated census data would tell us the income inequality has seen rapid growth in our community. We need to be aware that the history of this country has taught us that communities with social unrest eventually see the erosion of their quality of life. Businesses relocate elsewhere and talented people find more suitable environments for work, play and to raise their children.

Bill Block who is leading the effort to end homelessness in King County sent me an email link to a New York Times article that discussed income in equality in five metropolitan areas, including King County. Researchers were from the University of Texas Inequality Project. The article reports ”According to Mr. Galbraith and Mr. Hale, much of the increase in income inequality in the late 1990’s resulted from large income changes in just a handful of locations around the country — precisely those areas that were heavily involved in the information technology boom.” The report shows that income inequality was the result of high technology investments in our area.

The 21st Century economy will be a technologically robust era. We are going to continue to invest in the expansion and enhancement of our tech industries. Does that mean we will also continue to be ravaged by poverty and race?

The point of the University of Texas research is not to discourage technological growth. It is to call our attention to its affect. But, we also know that out of the box solutions are being undertaken, explored, and researched in this community. We are the one community with all the tools and resources to reduce the impact of poverty. It will be done if we make considerably more strategic investments in early childhood education both locally and nationally. We also need to continue to rethink and retool our K-!2 schools. Most importantly, our efforts must focus on our poorest zip codes. In those zip codes lay the seeds that may fruitfully undermine our long-term quality of life.

Early Childhood investments are absolutely critical. There is cutting edge research being conducted at the UW Institute of Learning and Brain Sciences. They and other researchers would attest that before birth, an infant learns the “melody” of its mother’s voice. A newborn’s brain is only about one-quarter the size of an adult’s. It grows to about 80 percent of adult size by three years of age and 90 percent by age five. Some of the first circuits the brain builds are those that govern the emotions. The first two emotions are opposites: feeling calm and relaxed and feeling distress. Beginning around two months of age, these start to evolve into more complex feelings. During the first six years, its brain will set up the circuitry needed to understand and reproduce complex language. A six-month-old can recognize the vowel sounds that are the basic building blocks of speech.

Early Learning unquestionably makes a significant difference in the lifetime of an individual. Much of who we are is established between 0-5. Learning literally grows the brain. So, reading to and teaching children to read is an absolute must. But, the exposure to art, music, play, neighborhood, and outdoors activities are also powerful learning tools.

As a state and local priority we must reach every family with children between the ages of 0-5. If necessary, we should pair families in need of help with volunteers who can provide reading and artistic resources. We must do the same for children are under the care of unlicensed childcare providers. We must provide substantial funding for this effort with private and public sources.

In addition, the educational system must work for children in poverty. A Harvard retrained African American, Geoffrey Canada whose book “Whatever It Takes: Geoffrey Canada’s Quest to Change Harlem and America’ makes an incredibly strong case for reducing the impacts of poverty on the educational outcomes of children. It requires major system reform, parental training, and community accountability. We should attempt to uniformly replicate his efforts in the schools where we have significant participation in our free breakfast and lunch programs.

I have often heard, the poor shall be with us always. The context of the phrase denoted our indifference, thus our acceptance of poverty. Yet, we have come to believe we can change the world with technology. We have already changed our community by using the wealth generated by technology. Now is also the time to believe that we can eventually bring poverty in our community to its end.

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The dictionary defines the word convergence as “To come together from different directions; meet.” This past week there were two disparate articles that raise both our hope and our concern about pandemic diseases. Each, standing alone, was not particularly significant. But, when read together they are disconcerting.

The first article was one of hope. This article, “Deep in the Rainforest Stalking the Next Pandemic” was written about Nathan Wolfe, a 38-year-old visiting professor of epidemiology at Stanford. Dr. Wolfe states, “Before, the best thing you could do was develop a vaccine, but now people are recognizing that’s not going to be enough.”

“If you find diseases before they’ve really emerged,” he continued, “you can control them early on, before you get a major epidemic.” The article continues, “With the goal of identifying more of these “little sources” — new disease-causing pathogens — and choking them off, Dr. Wolfe started the Global Viral Forecasting Initiative this year. If new disease strains could be culled before they had a chance to take hold in humans, he reasoned, health organizations would have to spend less money and energy on developing expensive vaccines and treatment drugs.”

The second article was a report from Lloyd’s of London. Their Emerging Risks Team issued a new report on the threat posed by a global pandemic.

The report, “Pandemic – Potential Insurance Impacts” focuses on the threat to the global business community and, in particular, the insurance markets of a global pandemic.

The report concludes that a pandemic is inevitable; explaining that with historic recurrence rates of 30-50 years it is prudent to assume that a pandemic will occur sometime in the future.

Trevor Maynard, Manager, Emerging Risks, at Lloyd’s and the report’s author says: “The significant message is that society should not optimize to one particular scenario as a worst case. Much has been said of the 1918 Spanish Flu epidemic, which is said to have killed up to 100 million people worldwide. While Avian Flu is seen as the most likely next pandemic, we have to ensure we are prepared for other types of pandemics that may require different responses and pose different challenges —some of which may well have higher rates of mortality than flu.”

Maynard goes on to say, “The threat of pandemic to the global economy cannot be underestimated.” He explains. “If you look at the example of a recent limited pandemic, such as SARS, the regional economic impact was severe and a repeat of the 1918 Spanish Flu outbreak, even without the current economic conditions, would be expected to reduce global GDP by between 1% and 10%.”

These two articles of warning and prevention are a reminder that pandemics remain a constant and extraordinary threat. The world population in 1918 during the Spanish flu pandemic was 1.8 billion people. Today, according to the Population Reference Bureau, in 2008 the world population is 6.7 billion: 1.2 billion people live in regions classified as more developed by the United Nations; 5.5 billion people reside in less developed regions. “We will likely see the 7 billion mark passed within four years,” said Carl Haub, PRB senior demographer and co-author of this year’s Data Sheet. “And by 2050, global population is projected to rise to 9.3 billion. Between now and mid-century, these diverging growth patterns will boost the population share living in today’s less developed countries from 82 percent to 86 percent.” Over half live in urban environments. Never in human history has the available supply of fuel for a pandemic illness been greater.

According to USA Today, the threat posed by infectious diseases is of growing and immediate concern to infectious disease experts. A soon-to-be released report by the non-profit Trust for America’s Health asserts, “infectious diseases from the developing world are anything but “a back-burner concern.”

The report, “Germs Go Global: Why Emerging Infectious Diseases Are a Threat to America,” cites National Intelligence Estimates that conclude outbreaks of new and resurgent infectious diseases, many of which “originate overseas,” kill more than 170,000 people in the USA each year.

The death toll would climb much higher in the event of a new global pandemic or bioterrorism attack. Infectious diseases, the report concludes, have become “a matter of national security.”

In his brilliant Pulitzer Prize winning book, Guns, Germs, and Steel, Jared Diamond “seeks the root answers to why European societies (and their American offspring) became the dominant powers on Earth in terms of wealth and power. He traces the proximate causes–the development of deadlier weapons technologies, immunity to germs, superior metal working, and writing systems–to the ultimate cause of the way food production varied in human societies and then looks at geographic variations and impediments that affected food production and the spread of technological innovation in all regions of the world.”

Dr. Irwin Sherman, a professor emeritus of biology at the University of California Riverside, in his book, Twelve Diseases That Changed Our World, also describes how bacteria, parasites, and viruses have swept through cities and devastated populations, felled great leaders and thinkers, and in their wake transformed politics, public health, and economies.

The US Center for Disease Control, The World Health Organization, and King County’s Department of Public Health have undertaken surveillance and preventive measures to protect the public from pandemic illnesses. Those investments must remain an international, national, and local priority. All of these agencies face the daunting challenge of developing measures to identify and prevent the spread from numerous germs that have the capacity to change human history. In an age of limited resources, the agencies must remain a key priority. We must commit to the robust funding of early warning systems. We must continue to remain vigilant about the microscopic life forms that with great swiftness and determination can change our world. If we don’t do these things, we are at peril.

A fool too late bewares when all the peril is past.
-Elizabeth I

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Every gun that is made

“Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed. This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children…This is not a way of life at all, in any true sense. Under the cloud of threatening war, it is humanity hanging from a cross of iron.”

-President Dwight Eisenhower

The public assumes that the US withdrawal from Iraq would reduce defense spending. The New York Times reported that the proposed US Defense Department 2009 budget “when adjusted for inflation, will have reached its highest level since World War II.” Although the Federal Government committed over $700 billion  to stabilize the financial markets, it will also spend $711 billion  on defense. Is it likely that we’ll see significant reductions in military spending? Probably not. The war in Iraq and Afghanistan has taken its toll on military equipment and it needs to be replaced. Those who serve in the military need better pay and health care. The development of new and advanced weapons systems will require significant investments. We will need to develop a full spectrum military. We will also see military spending continue to rapidly increase in most countries. The world is still too dangerous.

The next President of the United States will have to make either unpopular reductions in defense department spending or continue the explosive growth of the federal deficit. How will he fund Medicare which is expected to go broke in 2018? How will the federal government, which owes foreign investors over ten trillion dollars, reduce our indebtedness?

The President must also meet the demands of reducing poverty, disease, and hunger. He must recommit to making substantial investments to address our domestic needs. He must also maintain sustainable funding for our military needs. Will the next administration want the US to continue to be a military, financial, and cultural superpower? Do we want to? Can we afford it?

As a superpower nation, we are clearly being reminded of the moral requirement to look beyond our military needs.

  • Each year, more than 8 million people around the world die because they are too poor to stay alive.
  • Over 1 billion people—1 in 6 people around the world—live in extreme poverty, defined as living on less than $1 a day.
  • More than 800 million go hungry each day.
  • Over 100 million primary school-age children cannot go to school.

Based on definitions established by the World Bank, nearly 3 billion people-half of the world’s population-are considered poor. In his recent address at the United Nations Food and Agriculture Organization, Pope Benedict XVI blamed food shortages on “feverish speculation” that drives up prices, along with “corruption in public life or growing investments in weapons and sophisticated military technologies to the detriment of people’s primary needs.”

“Of all the enemies to public liberty war is, perhaps, the most to be dreaded because it comprises and develops the germ of every other. War is the parent of armies; from these proceed debts and taxes … known instruments for bringing the many under the domination of the few. No nation could preserve its freedom in the midst of continual warfare.”

-James Madison, Political Observations, 1795

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The spider to the fly

The US Treasury and Federal Reserve are giving over a trillion dollars to financial institutions. They also intend to invest and assume partial ownership in them as well. Yet, the only thing being promised the American taxpayer is easier credit. Is that a good thing?

Everyone, including my son, who happens to be a junior in college and unemployed, is being inundated by offers for credit cards. Most of my household mail consists of mailers from numerous financial institutions offering me credit cards. They promise low interest rates yet the fine print says that if you make one late payment, they can charge you a usurious 25-30 percent. Credit cards have become so easy to get, but so expensive to manage. The allure of credit cards is appropriately captured by this stanza from the poem Spider to the Fly by Mary Howitt, Will you walk into my parlour?” said the Spider to the Fly, ‘Tis the prettiest little parlour that ever you did spy.

Should we be concerned? In the New York Times article Some Debt Trends Are Good. This Isn’t One of Them, they reported AMERICAN credit card debt is growing at the fastest rate in years, a fact that may signal coming trouble for the banks that issue them. This week the Federal Reserve reported that the amount of revolving consumer credit that is outstanding hit $937.5 billion in November, when seasonally adjusted, up 7.4 percent from a year earlier.” Market Watch in their news piece, Another shoe to drop, says Credit-card debt is on the brink of imploding and will be the next storm to hit the fragile finance industry, an investment research firm predicted this week. The Washington DC think tank, Center for American Progress, believes so. In their report, House of Card, they state, As borrowing in the mortgage market slows, credit card borrowing is accelerating-a dangerous trend because borrowers still face weak income growth. That means the credit card market could eventually run into the same problems that now afflict the subprime mortgage market.

The Center for Responsible Lending, a nonprofit, nonpartisan research and policy organization dedicated to protecting homeownership and family wealth, in its report Pushing the Limit states, During the past few years, the United States has experienced an unprecedented boom in household debt. Although most household debt is in the form of mortgages and home equity lines, credit card debt deserves particular attention. The reason: credit card debt tends to carry high interest rates, large fees and a number of hidden costs, all of which weigh disproportionately on lower income families. They are also concerned about the mortgage refinancing of credit card date. In their report, Risking Homes to Pay Off Credit Cards, The fear of overwhelming credit card debt is driving many Americans to hand their equity back to mortgage lenders in the form of “cash-out”

What are the solutions? The Council on American Progress succinctly summarizes a variety of solutions: implement a credit card safety rating system that can give consumers better information about their credit cards and thus help them make better decisions; and Congress should mandate a higher level of fairness in credit card terms by adopting the Credit Cardholders’ Bill of Rights Act that also bans several of the most abusive credit card practices.

USA Today reports in its article a proposal would limit increases in credit card fees, and rates. The Federal Reserve, the Office of Thrift Supervision, and the National Credit Union Administration are recommending a proposal that would:

  • Bar issuers from raising interest rates on existing debt, except under certain conditions, such as when a promotional rate expires or when a borrower pays 30 days or more late.
  • Prohibit issuers from calculating one month of finance charges based on two months’ worth of activity, a punitive practice called double-cycle billing.
  • Require card issuers to apply monthly payments that exceed the required minimum at least partly to higher-rate card debt. Borrowers often face varying interest rates on credit card debt, for cash advances, balances transferred and purchases.
  • Bar financial institutions from charging checking-account customers a fee for paying an overdraft – unless the customer has had the chance to opt out of this payment.
  • Bar financial institutions from charging checking-account customers a fee for paying an overdraft – unless the customer has had the chance to opt out of this payment.

“Do not accustom yourself to consider debt only as an inconvenience; you will find it a calamity.”

– Samuel Johnson

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The earth is not flat

In this age of global warming, many have directed our attention to the use of cap and trade tools to reduce carbon emissions. According to the U.S. Environmental Protection Agency:

Cap and Trade is a market-based policy tool for protecting human health and the environment. A cap and trade program first sets an aggressive cap, or maximum limit, on emissions. Sources covered by the program then receive authorizations to emit in the form of emissions allowances, with the total amount of allowances limited by the cap. Each source can design its own compliance strategy to meet the overall reduction requirement, including sale or purchase of allowances, installation of pollution controls, implementation of efficiency measures, among other options. Individual control requirements are not specified under a cap and trade program, but each emissions source must surrender allowances equal to its actual emissions in order to comply. Sources must also completely and accurately measure and report all emissions in a timely manner to guarantee that the overall cap is achieved.

Denis Hayes, one of the world’s foremost environmentalists, would seem to be an unequivocal supporter of cap and trade schemes to reduce global warming. Many others from across the political spectrum support them. Yet, in a thoughtful, provocative, and visionary article he effectively challenges our belief in the cap and trade system. He is reminiscent of those who said the earth is neither the center of the universe nor flat. He insightfully argues:

The backbone of any comprehensive policy to limit greenhouse gas emissions must cap carbon at the places — coal mines, oil fields, pipelines, ports — where it enters the economy. Instead, at the behest of corporate behemoths and their green enablers, our political leaders are focusing most of their attention on smokestacks, and when that is obviously impossible (e.g. with gasoline or propane) on refiners or distributors. They want to cap CO2 where it enters the atmosphere — an approach that is guaranteed to fail because there are far too many point sources.

Regarding Europe’s cap and trade schemes he states, “Europe has already attempted a cap-and-trade program, and it belly-flopped.” According to Denis, their failure taught us:

  • The most important part of cap-and-trade is the “cap.” Any successful law must place an impermeable lid on the amount of carbon that enters the atmosphere. To whatever extent additional trees or windmills are used to “offset” additional carbon-based fuels, the exercise is self-defeating.
  • In contrast to regulating a sea of smokestacks, the best course is to require carbon permits at the 2,000 sources where carbon enters the economy. It would be simple, straightforward, and impossible to “game.” It is vastly more effective than trying to police carbon dioxide wherever carbon is burned. In setting the number of carbon permits issued — and thus determining how much coal, oil, and gas can enter the economy — the government would be setting an absolute, easily-enforced cap on emissions.
  • All carbon permits should be auctioned — not given away. In Europe, permits were given away to large carbon users to ease their transition to the new regime. Major polluters made cheap improvements, lowered their emissions, and sold their unneeded permits. This gave windfalls to the worst polluters, penalized companies that had already invested in efficient new factories and renewable energy, and helped guarantee that Europe would miss its Kyoto targets.
  • Auctioning 100 percent of all carbon permits is fair and transparent; it eliminates backroom special-interest pleadings. By reducing the number of permits auctioned each year, the government can guarantee that its emissions targets are met.

Recently, we’ve witnessed historic volatility on Wall Street and world markets as worries of a worldwide recession begin to overtake us. Yet, there remains one bullish market. In a Washington Post article entitled, There’s a Gold Mine In Environmental Guilt, it reported, This is strange territory. The Dow is down. Wall Street needs a bailout. But in the Washington area and across the country, there is still a bull market in environmental guilt. But, are we likely to witness an historic collapse of the market that was established to save the planet?

The New York Times in a counterpoint response to the Post article, A Bull Market on Offsets, but What Are They Really Worth? states, “Writing last year at the online journal Nature Reports Climate Change, a Web site of Nature Publishing Group, an assembly of five scientists and climate experts called the fuzzy notion of additionality the ‘most vexing’ challenge facing the offsets trade — particularly in voluntary markets like those in the United States.”

The blog’s closing paragraph states:

Developing market-wide standards for drawing lines, as well as creating mechanisms for government oversight, the authors of The Nature article say, is a first step. As it is, a wide array of competing industry standards are being developed, the experts lament, which might well undermine the whole enterprise: “Although the consequences are difficult to predict,” the authors write, “the confusion produced by a host of independent ’standards’ operating in a regulatory vacuum has the potential to discredit market-based environmental policies.

The European Community, the United States, and those nations that have committed to reduce human impacts on the climate must heed the words of Denis Hayes and the authors of Nature Reports Climate Change. If we ignore them, we will fail to save the planet.

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Hardly noticed, and buried deep in the hundred pages of bailout legislation, is a provision that would raise the statutory ceiling on the national debt to an eye-popping $11.315 trillion dollars. In part, it includes the $700 billion bailout money, the $85 billion the U.S. government is lending to save the insurance company AIG, and the $200 billion it put up for mortgage giants Fannie Mae and Freddie Mac.

It will even affect the iconic National Debt Clock in New York that now sits above the entrance of an Internal Revenue Service office in midtown Manhattan. It will need to be reprogrammed to handle the extra digit!

Why do I care? Why should you? Well, I have three children and promised their life would be better than my own. We should not hand my kids or yours a debt payment that is the greatest in the history of the world. With each year, government spending rises and the budget deficit gets bigger. As Steve Chapman, a columnist and editorial writer for the Chicago Tribune writes “As the Baby Boom generation retires, the gap will grow. Given current trends, federal outlays stand to double between now and 2050, while revenues remain roughly stable.”

He continues to write, “By then, two programs — Medicare and Medicaid — will cost as much as the entire federal budget does today. Which means that, essentially, we’ll be financing two federal governments. If you dislike carrying a defensive end on your back, wait till his twin climbs aboard.”

Wikipedia concisely states, “The Government Accountability Office (GAO), Office of Management and Budget (OMB) and the U.S. Treasury Department have warned that debt levels will increase dramatically relative to historical levels, due primarily to mandatory expenditures for programs such as Medicare, Medicaid, Social Security and interest. Mandatory expenditures are projected to exceed federal tax revenues sometime between 2030 and 2040 if reforms are not undertaken. Further, benefits under entitlement programs will exceed government income by more than $40 trillion over the next 75 years. The severity of the measures necessary to address this challenge increases the longer such changes are delayed. These organizations have stated that the government’s current fiscal path is “unsustainable”.”

In Congressional testimony, Peter Orszag, Director of the Congressional Budget Office said that “substantial increases in revenues,” perhaps even in tax increases, will be necessary in the short term to cover the initial infusion of hundreds of billions in borrowed dollars into the private sector, especially given the already record budget deficits and federal debt levels the government is currently running.”

He also said “that the combination of high budget deficits and record expenditures on bailouts — including the proposal now before Congress — has significantly hampered the government’s ability to respond further to any economic crises.”

On his blog site Orszag states, “How Would Rising Budget Deficits Affect the Economy? Sustained and rising budget deficits would affect the economy by absorbing funds from the nation’s pool of savings and reducing investment in the domestic capital stock and in foreign assets. As capital investment dwindled, the growth of workers’ productivity and of real (inflation-adjusted) wages would gradually slow and begin to stagnate. As capital became scarce relative to labor, real interest rates would rise. In the near term, foreign investors would probably increase their financing of investment in the United States, but such borrowing would involve costs over time, as foreign investors would claim larger and larger shares of the nation’s output and fewer resources would be available for domestic consumption.”

He continued to state, ”According to CBO’s simulations using that model, the rising federal budget deficits under this scenario would cause real gross national product (GNP) per person to stop growing and then to begin to contract in the late 2040s. By 2060, real GNP per person would be about 17 percent below its peak in the late 2040s and would be declining at a rapid pace. Beyond 2060, projected deficits would become so large and unsustainable that the model cannot calculate their effects. Despite the substantial economic costs generated by deficits under this model, such estimates greatly understate the potential loss to economic growth because the effects of rapidly growing debt would probably be much more disorderly and could occur well before the time frame indicated in the scenario.”

The growth of the federal debt is the emergency we face. It is unsustainable and unfairly burdens future generations. We’ve seen the enemy; it is our appetite for spending.

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Save a life

Infections – we all get them, and astoundingly, many people will die from them. But, you’d never think that we’d get them in the hospital while being treated for another illness. Or see the needless loss of life of a newborn baby because of an infection in a nursery.

Some individuals will become infected in an ambulatory care facility. These infections are called health-care-associated infections (HAIs), also referred to as hospital acquired infections.

HAIs are a serious and pervasive issue afflicting our health care system. According to the Centers for Disease Control and Prevention (CDC), HAIs are estimated to be one of the top 10 causes of death in the US, totaling 100,000 per year. That means more patients die of HAIs than from HIV/AIDS (60,000 per year) and automobile accidents (40,000 per year). Specifically, central-line infections occur in 250,000 people a year in the US, and are fatal between 5% and 28% percent of the time.

HAIs are very costly, should be mostly preventable, and everyone – patients, employers, hospitals and even state and federal government (Medicare) – bears the burden of these costs. It is reported that HAIs add as much as $20 billion in additional costs to the health care industry. In 2005, the average payment for a hospitalization in Pennsylvania was over six times higher for patients who contracted a hospital-acquired infection than for patients who did not acquire infections, according to a report by the Pennsylvania Health Care Cost Containment Council. Moreover, a 2007 study of 1.69 million patients who were discharged from 77 hospitals found that the additional cost of treating a patient with an HAI averaged $8,832. This is alarming when data show that Medicare, alone, the federal health insurance program for persons over 65, paid for over one-third of all hospital costs in 2005, according to the American Hospital Association.

Ironically, the Federal Office for Human Research Protections shut down a Michigan HAI project, even as it proved itself to be effective. I think it is time for Congressional action.

Can we reduce HAIs? The leading hospitals in the nation successfully tackling them are Allegheny General Hospital in Pittsburgh, Johns Hopkins in Baltimore, and a consortium of hospitals in Michigan. Allegheny, under Dr. Jerome Granato’s leadership the past five years, and with support from Dr. Peter Perreiah of the Pittsburgh Regional Health Initiative, reduced central-line HAIs by 90% in two years, and sustained a 15 month period in their ICU with no infections.

In this state, the Puget Sound Health Alliance (Alliance), a regional consortium of employers, providers, health plans, unions, and patients aimed at improving the quality of health care in Puget Sound, has made HAIs a priority (www.pugetsoundhealthalliance.org). An Alliance workgroup recommends “highlighting the incidence of hospital acquired infections to lower their occurrence and resulting costs to the system.” The Alliance is currently working with the State Department of Health to make the data more transparent and more consumer-friendly, and will include HAI outcomes data in future reports of its own Community Checkup Report (www.wacommunitycheckup.org). The Alliance is also researching how it can help accelerate current HAI efforts in the Puget Sound region using the proven interventions from Pittsburgh and Johns Hopkins.

Mirroring national efforts, the Washington State Hospital Association (WSHA) and Washington State have been engaged in patient safety efforts. Washington was the first state to get all its hospitals participating in Institute for Healthcare Improvement’s 100,000 Lives Campaign. WSHA is actively engaged in national efforts in addition to its own effort, which includes providing technical assistance to hospitals and disseminating posters and brochures to promote hand washing and staff training. Washington State, in 2007, passed SB1106 to mandate public reporting of certain HAIs beginning in January 2009. A phased-in approach, in July 2008, all hospitals were required to start collecting and reporting all central line-associated infections in ICUs. (When this data will be available to the public has not yet been determined.)

We know what works, as evidenced by efforts in Pittsburgh, Baltimore, and Michigan, and now it’s our turn to implement these best practices here and work with the federal government to break down barriers to efforts that will save patients’ lives. It is imperative that we publicly report the incidence of health care associated infections by facility in King County and the State of Washington, in order to shed light on the problem and save lives.

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