APHA International Health Section Advocacy Request Form

Question Title

1. What is your First and Last Name? (Required.)

Question Title

2. What is your email address? (Required.)

Question Title

3. What is the best phone number to contact you? (Required.)

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4. Briefly describe the issue you are hoping to advocate for in plain language. (Required.)

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5. Please review the 4 main themes described below and select one that most closely represents your issue. (Required.)

Strengthening Public-Sector Health Systems
A health system can be thought of as the set of resources and activities that work together to improve the health of communities. Health systems include "building blocks" such as a health workforce, health facilities where services are delivered, and the financing needed to fund and manage the whole system.

This theme targets advocacy efforts that may include supporting the establishment of, or the maintenance of systems that protect and ensure universal access to healthcare.

Macroeconomic Justice for Health Communities
Macroeconomic policies are the actions and adjustments by governments - either on the local or the international level - to influence the economic health and stability of an entire country. Today, macroeconomic policies imposed as part of loan conditions constrain many developing countries and have a direct impact on people's health.

This theme targets advocacy efforts that may include supporting treaties, agreements, or policies that maintain a system of fair and equal access to public health.

Using Public Health Solutions to End War
War causes injury and death directly; by some estimates, armed conflict resulted in 1 million to 1.5 million deaths per year in the 20th century. The health costs of war are not only limited to treatment needed for victims and veterans of war. Armed conflict destroys hospitals, water and sanitation systems and drives health workers away from combat zones. Countries emerging from conflict are often faced with rebuilding an entire health system, with few resources at a time of great need.

This theme targets advocacy efforts that may include the support of coalitions, campaigns, policies, or movements promoting peace, peaceful resolutions to conflict, or post-conflict rebuilding efforts.

Movement Building for Social, Racial, and Health Justice
This theme targets advocacy efforts that may include support of coalition efforts in community organizing for race and class equality. Additionally, this may include local efforts to support refugee and immigrant mental health, trade and health justice, and equitable health care for all.

Other (please specify)

Question Title

6. Which of the 17 UN Sustainable Development Goals (SDGs) does your issue address? (You may select up to 3.) (Required.)

GOAL 1: No Poverty

GOAL 2: Zero Hunger

GOAL 3: Good Health and Well-being

GOAL 4: Quality Education

GOAL 5: Gender Equality

GOAL 6: Clean Water & Sanitation

GOAL 7: Affordable & Clean Energy

GOAL 8: Decent Work & Economic Growth

GOAL 9: Industry, Innovation & Infrastructure

GOAL 10: Reduced Inequality

GOAL 11: Sustainable Cities & Communities

GOAL 12: Responsible Consumption & Production

GOAL 13: Climate Action

GOAL 14: Life Below Water

GOAL 15: Life on Land

GOAL 16: Peace, Justice & Strong Institutions

GOAL 17: Partnerships for the Goals

Question Title

7. Is the target audience APHA or an outside organization? (Required.)

APHA

Outside organization

Neither/Unsure

Question Title

8. What policy statements have already been approved by the Governing Council of APHA that we can cite and use to support our effort? Refer to APHA's Policy Statement Database (https://bit.ly/2Og0GRH). (Required.)

Question Title

9. Which advocacy format do you prefer? More than one format may be applicable. (Required.)

Supporting an existing campaign

Writing a letter from APHA

Op-ed

Action Alert or Call to Action

Meeting with and educating a member of Congress

Something else (please specify)

APHA International Health Section Advocacy Request Form

Question Title

1. What is your First and Last Name? (Required.)

Question Title

2. What is your email address? (Required.)

Question Title

3. What is the best phone number to contact you? (Required.)

Question Title

4. Briefly describe the issue you are hoping to advocate for in plain language. (Required.)

Question Title

5. Please review the 4 main themes described below and select one that most closely represents your issue. (Required.)

Question Title

6. Which of the 17 UN Sustainable Development Goals (SDGs) does your issue address? (You may select up to 3.) (Required.)

Question Title

7. Is the target audience APHA or an outside organization? (Required.)

Question Title

8. What policy statements have already been approved by the Governing Council of APHA that we can cite and use to support our effort? Refer to APHA's Policy Statement Database (https://bit.ly/2Og0GRH). (Required.)

Question Title

9. Which advocacy format do you prefer? More than one format may be applicable. (Required.)

Question Title

10. What would make your advocacy effort successful in the short-term? (Required.)

Question Title

11. What would make your advocacy effort successful in the long-term? (Required.)

APHA International Health Section Advocacy Request Form

Question Title

* 1. What is your First and Last Name? (Required.)

Question Title

* 2. What is your email address? (Required.)

Question Title

* 3. What is the best phone number to contact you? (Required.)

Question Title

* 4. Briefly describe the issue you are hoping to advocate for in plain language. (Required.)

Question Title

* 5. Please review the 4 main themes described below and select one that most closely represents your issue. (Required.)

Question Title

* 6. Which of the 17 UN Sustainable Development Goals (SDGs) does your issue address? (You may select up to 3.) (Required.)

Question Title

* 7. Is the target audience APHA or an outside organization? (Required.)

Question Title

* 8. What policy statements have already been approved by the Governing Council of APHA that we can cite and use to support our effort? Refer to APHA's Policy Statement Database (https://bit.ly/2Og0GRH). (Required.)

Question Title

* 9. Which advocacy format do you prefer? More than one format may be applicable. (Required.)

Question Title

* 10. What would make your advocacy effort successful in the short-term? (Required.)

Question Title

* 11. What would make your advocacy effort successful in the long-term? (Required.)

1. What is your First and Last Name? (Required.)

2. What is your email address? (Required.)

3. What is the best phone number to contact you? (Required.)

4. Briefly describe the issue you are hoping to advocate for in plain language. (Required.)

5. Please review the 4 main themes described below and select one that most closely represents your issue. (Required.)

6. Which of the 17 UN Sustainable Development Goals (SDGs) does your issue address? (You may select up to 3.) (Required.)

7. Is the target audience APHA or an outside organization? (Required.)

8. What policy statements have already been approved by the Governing Council of APHA that we can cite and use to support our effort? Refer to APHA's Policy Statement Database (https://bit.ly/2Og0GRH). (Required.)

9. Which advocacy format do you prefer? More than one format may be applicable. (Required.)

10. What would make your advocacy effort successful in the short-term? (Required.)

11. What would make your advocacy effort successful in the long-term? (Required.)