Posts Tagged ‘heart disease’

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Promotoras Make Connections

March 11th, 2013

What’s a Promotora?  In simple terms, a Promotora is a community health worker who’s a trusted member of the community and serves as a link between people and services to promote the overall health of family, friends and neighbors. Creating effective linkages between vulnerable populations and the health care system can be challenging in Arizona. Like many other agencies in Arizona, we’ve called on Promotoras to bridge the gap between community members and health care service providers. 

We have a long history of working with Promotoras.  In 1994 our Health Start Program was established and began utilizing them to link women, children, and families to services to reduce low birth weights and the number of children affected by childhood diseases. There are now 45 Promotoras in the Health Start Program who reflect the ethnic culture of their communities and receive extensive training on pregnancy, child growth and development, and community resources. Eligible families receive home visits by Promotoras during their pregnancy and after the birth of their children up to two years of age. 

Our Heart Disease and Stroke Prevention Program uses Promotoras to help manage services for high blood pressure in Yuma and Maricopa Counties.  We partner with the U of A to train Promatoras on identification, treatment and management of high blood pressure and the risk factors related to cardiovascular disease. In Yuma County, more than 1,400 patients are currently enrolled in this hypertension management program. The Maricopa County Hypertension Project is now underway at Wesley Community Health Center and is demonstrating a 100% compliance rate that patients get follow up services if needed. Any behavioral health patients seen at Wesley are referred to the Hypertension Project if they meet the requirements.  

As we look to the future, Promotoras will probably have an increasingly essential role in outreach, reducing health care disparities and emergency room costs within the changing healthcare environment. We’ve partnered with the U of A to call upon nationally respected experts to create the best strategy for Arizona to move forward in building a sustainable Promotora program.  To learn more about this exciting program contact Sara Rumann at sara.rumann@azdhs.gov or David Heath at david.heath@azdhs.gov.

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Mission of Mercy

December 7th, 2012

Oral health is more than a nice smile.  Having good oral health improves a person’s ability to speak, smile, smell, taste, touch, chew, and eat.  Plus, tooth decay and gum disease have been linked with other health problems like heart disease, stroke and diabetes, as well as premature births.  Given the link between oral diseases and other systemic health problems, it’s critical to maintain good oral health. 

To help folks who desperately need dental care, the Central Arizona Dental Society Foundation will host its first AZ Mission of Mercy event at the Arizona Fairgrounds December 7-8 using portable dental equipment and 1,000 volunteers.   Dental screenings and services will be provided on a first-come, first-served basis at no charge.  About $1M in free care is expected to be delivered to 2,000 patients (both adults and kids).  They’ll focus on basic dental care such as fillings, extractions and cleanings.  More than 70 Mission of Mercy dental programs have been conducted since 2000- providing free dental care to local residents who otherwise couldn’t get care. We’re supporting the event through Title V funds and providing health information and resources. 

Thanks go out to the following folks from Team ADHS that have volunteered to help out at this important event: Anna Alonzo, Amber Asbury, Stacy Beauregard, Brian Beebe, Elena Beeman, Anita Betancourt, Karen Boswell, Jennifer Botsford, Tracy Chisler, Omar Contreras, Juanita Dailey, Ali De La Trinidad, Willie Dennis, Erica Ferguson, John Fiorentino, Jan Ford, Amanda Gainey, Tiana Galindo, Ann Gardner, Cecilia Gaytan-Newberry, Margaret Hensell, Victoria Mieth, Kimberly Oneill, Elie Partida, Nicholas Pigg, Carmen Ramirez, David Ramirez, Deborah Reardon, Matthew Roach, Crystal Rodriguez, Ruthann Smejkal, Nicole Thurlow, Tina Wagner, Julia Wacloff, Virginia Warren, and Chelley Weber.  Also, thanks go out to Maricopa County Public Health for organizing the vaccine clinic that’ll be there too.

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AZ’s Trauma System: Moving to the Next Level

December 3rd, 2012

Injuries are the leading cause of death for Arizonans from age 1 to 44.  That means for the majority of the young and the middle-aged injury is more lethal than cancer, heart disease, hypertension and influenza combined.  The effectiveness of a State’s pre-hospital and Trauma System makes the difference when it comes to saving lives (and quality of life) from injuries.  That’s why we invited the American College of Surgeons to assess AZ’s Trauma System back in 2007…  to evaluate the effectiveness of our trauma system and to make recommendations.  

The main 2007 recommendations were to improve trauma care in the rural parts of the state by recruiting Level IV trauma centers in rural AZ, strengthen the State’s trauma registry, and to assess our system and make necessary updates to our state trauma plan.  We have.  

Over the last 3 ½ years, our EMS and Trauma System team has been able to recruit 17 rural hospitals (up from 0) into our trauma system.  For the first time, Arizona’s rural trauma patients have timely access to good trauma care.  Our State Trauma Registry has been strengthened by undergoing validation checks and audits and is now one of the best in the country, allowing us to conduct all kinds of research to improve care across the state.  Arizona’s trauma system today bears little resemblance to our system 4 years ago, and like any system, it’s important to re-assess how we’re doing and set new priorities to maximize our effectiveness.  

That’s why we invited the American College of Surgeons back last week…  to evaluate our system- to take a look at the progress we have made over the last several years and give us feedback on the best way to move forward- both in rural and urban Arizona.  The ACS met with our team and our EMS and hospital trauma Stakeholders- and we had great participation. 

The ACS had about a dozen nuts and bolts recommendations and 3 larger recommendations regarding AZ’s Trauma System in their report-out presentation. Their written report (in about 6 weeks) will recommend (among other things):

  1. A moratorium on new trauma center designations in the Valley and Tucson and at the same time recommending that the Department explore the statutory authority to have a “needs based” system for designation.
  2. During the moratorium (if we have one)- they recommend that we put together a destination protocol for the Valley for ambulance providers.
  3. Their report will recommend that we explore more effective ways to use the Prop 202 money that currently only goes to Level I Centers. 

We’ve just begun to explore the who, what, when, where, and how their initial recommendations. Once the actual written report comes in 5 or 6 weeks we’ll be in a better position to evaluate the recommendations. 

Finally…  three cheers for Dan Didier, Noreen Adlin, Donna Meyer, and Betty Yunick for preparing for this week’s evaluation.  To get ready, they had to respond to a detailed trauma system pre-review questionnaire; identify, copy and scan approximately 400 pages of trauma system reports developed over the past 5 years; and coordinate hotel and meeting room space for approximately 80 participants. Thanks!

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AZ’s Mission of Mercy

November 28th, 2012

Oral health is more than a nice smile.  Having good oral health improves a person’s ability to speak, smile, smell, taste, touch, chew, and eat.  Plus, tooth decay and gum disease have been linked with other health problems like heart disease, stroke and diabetes, as well as premature births.  Given the potential link between oral diseases and other systemic health problems, it is critical to maintain good oral health.   A startling 42% of Arizona adults over 65 years have lost 6 or more teeth due to decay or gum disease.  We know that nationally about half of people don’t have dental insurance and pay for dental care out-of-pocket.    

To help those who desperately need dental care, the Central Arizona Dental Society Foundation will host its first Mission of Mercy event at the Arizona Fairgrounds December 7-8 using portable dental equipment and 1,000 volunteers.   Dental screenings and services will be provided on a first-come, first-served basis, at no charge to those who attend.  Approximately $1M in free care is expected to be delivered to 2,000 patients (both adults and kids).  They’ll focus on basic dental care such as fillings, extractions and cleanings.  More than 70 Mission of Mercy dental programs have been conducted since 2000- providing free dental care to local residents who otherwise couldn’t get care. 

The Arizona event will focus on: 

  • providing free access to dental care while placing a high priority on     patients suffering from dental infections or pain;
  • raising public awareness of the increasing difficulty low-income adults and children face in accessing critical dental care; and
  • creating health care advocates via the hundreds of volunteers participating in the event. 

ADHS is supporting the event through Title V funds and providing health information and resources at the event.  To volunteer at the event, or to find out more information to refer potential patients, see http://azmom.org/.   

 

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Worksite Wellness- a Critical Public Health Lever

September 21st, 2012

Chronic diseases like heart disease, cancer, stroke, and diabetes cause 70% of deaths in the US these days… absorbing 75% of the $2.5T spent on annual medical care costs.  When it comes to employee healthcare expenses- the indirect costs of poor health like absenteeism, disability, and reduced work output can be several times higher than direct medical costs.  In fact, productivity losses from health problems cost employers $1,685 per employee per year! 

One of the provisions in the Affordable Care Act includes incentives for employers to implement worksite wellness programs to help them keep their workforce healthier.  When done well (using evidence-based and best practices) worksite health programs have a 3:1 payoff.  Like the odds? 

The Affordable Care Act contains some elements that will make worksite wellness programs more common and robust over the next couple of years.  There are basically 2 kinds of worksite wellness programs.  I’ll call them Wellness and Wellness Lite.  A “Wellness Lite” program doesn’t require a participant to meet any standard related to health status to receive a reward.  For example…  a wellness program could include a gym membership or tobacco cessation program but doesn’t require participants to actually lose weight or quit smoking.  

A Wellness program requires people to meet a health status standard to get a reward.  For example- an employer could ask employees to certify that they haven’t smoked during the previous year.  Enrollees who don’t could be assessed an annual surcharge of  20% of cost of the employee’s health insurance coverage.  Rewards may be in the form of premium discounts or rebates, lower cost-sharing requirements, waiving a surcharge, etc. Under the Affordable Care Act, wellness program rewards can be as high as 30% of the cost of the employee health plan- potentially going to 50% in the future.  

Our AZ Healthy Worksites web page provides businesses with information and tools to help them develop and implement an effective worksite wellness program.  For example, the Program Design page lists the eight steps for developing, implementing, and evaluating a comprehensive worksite program.  We’ve also contracted with the Arizona Small Business Association &  Viridian Health Management to develop a new toolkit for AZ businesses.  Viridian and the Arizona Small Business Association will teach businesses how to do effective wellness programs, understand their own particular issues/data, and develop effective strategies.  In all, our contract tasks the team to train 500 AZ employers.   Finally- the CDC is jumping into the fray with a variety of resources, which you can see at their worksite wellness hub website.  

 

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Lower the Pressure

September 14th, 2012

About 1/3 of American adults have high blood pressure and more than half of them don’t have it under control.   The majority of people with high blood pressure are being treated with medicine and have seen a doctor at least twice in the past year…  but their pressure still isn’t under control, according to a new Vital Signs report from the CDC this week. 

High blood pressure means blood pressure greater than or equal to 140/90 mm- Hg…  and its direct health care cost is almost $131B per year.  To learn more about blood pressure, visit www.cdc.gov/bloodpressure/.   For more information on heart disease and stroke, visit http://www.cdc.gov/heartdisease/.  Controlling high blood pressure is also a key component of the Million Hearts initiative to prevent a million heart attacks and strokes by 2017.

 

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Arizona’s New Chronic Disease Strategic Plan

September 10th, 2012

I’m happy to share our new Arizona Chronic Disease Strategic Plan.  This past year, our team from the Bureau of Tobacco & Chronic Disease worked with community partners from across the state on a new guiding document for chronic disease prevention and health promotion.  This strategic plan will be used by ADHS, county health departments, and community partners to advance chronic disease policies, systems and environmental change in the areas of where we work, live, learn, and get care.  At the same time, this plan will also help align activities around the CDC’s Chronic Disease Prevention and Health Promotion Four Domains.  

Funded through the CDC Coordinated Chronic Disease Program- the new plan identifies ways in which our partners can maximize the impact in the areas of heart disease, cancer, diabetes, obesity and tobacco.  The strategic plan includes a matrix of evidence-based strategies which can be used by the public health community..  and it provides clear direction for advancing nationally recognized recommended or promising evidence-based practices.  Congratulations and thank you to the many community partners and health department staff who contributed to the development of new plan.

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September: Childhood Obesity Awareness Month

September 5th, 2012

Protecting the health and wellbeing of our children is critical to the future of Arizona. September is National Childhood Obesity Awareness Month. Arizona ranks 15th in the nation in childhood obesity with almost 18% of Arizona children (10 to 17) being obese. Obesity puts our children at early risk for conditions we normally associate with adulthood – Type 2 diabetes, high blood pressure, heart disease and even stroke.

Obesity has other consequences that can hinder these kids academically and socially. This September we have an opportunity to build awareness about the issue across several Arizona cities, communities and organizations.  Our strategic plan identifies “Promoting Nutrition and Physical Activity to Reduce Obesity” as one a winnable battle.  We have started several programs to help achieve that – things like integrating physical activity into our everyday lives, making healthy foods available everywhere, activating employers and healthcare providers, strengthening schools and preschools as the heart of health, and marketing what matters for a healthy life.  

Adults have an opportunity to help young people get a healthy start in life.  We work hard to protect our children from danger – if we think of obesity as a threat like a drug dealer, we can easily imagine our reaction. We have the power to change the future – we can remove the threat  by removing obstacles to healthy living and creating more opportunities to be healthy.  My counterpart at the Department of Economic Security, Director Clarence Carter, speaks about the mission we need to take on to change the course for our children in his blog.  

We have to work together to change the course of obesity in our state.  Our future depends on it.

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2011 AZ Diabetes Burden Report

May 17th, 2012

Our Tobacco and Chronic Disease team released the 2011 Diabetes Burden Report this week.   And you guessed it- a primary cause is a lack of physical activity and poor nutrition (I know I sound like a broken record).  Diabetes is linked to heart disease, stroke, high blood pressure, blindness, kidney failure, neuropathy and even amputations.  Sadly, AZ and the nation are on the wrong track when it comes to diabetes- and the number of folks living with diabetes has gone from about 7% to 9% in the last 5 years.    

Diabetes is largely preventable and manageable… and folks with well-managed diabetes do much better.   The cornerstone for prevention is better nutrition and more physical activity.  The cornerstone for treatment is self-management, education and training.  Our 2011 Diabetes Burden Report is a work in progress, as our staff will be updating it on a yearly basis in consort with our partners and other stakeholders across the state.  It’s a valuable resource for improving our collective efforts to fight the alarming trends of diabetes through prevention, early detection, and effectively disease management.

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Do Yourself A Favor in 2012

January 4th, 2012

Life is a precious gift.  None of us knows long our gift will last, so it’s important to make the most of every day.  That means doing everything you can to stay healthy by eating well and exercising regularly.  A lot of folks will say – I’m stuck with my health because of my genes, or my doctor can’t do anything to help me.   The truth is, half your health depends upon your choices.  Only 20 percent of health is hereditary, 20 percent comes from your environment, and 10 percent is dependent on your doctor.  The bottom line – your health is largely in your own hands. 

Meet Matt Gainey. Matt works at the Department of Health Services.  About 3 years ago, he was tired of how he felt and looked.  He started walking at lunch, added more fruits and vegetables to his diet.  He didn’t notice a change immediately, but he kept going.  He wanted to feel better. 

As his energy increased, Matt added more to his routine – sit ups at night. He cut out soda and reduced the processed food he ate, like cookies and chips.  He started paying attention to what he ate, what he did and what he weighed – things he’d never really noticed before, even though diabetes and heart disease run in his family. 

Pretty soon Matt was taking longer walks – he changed from walking to running. He added push-ups and free weights to his evening activities.  Even when it’s hot, I see Matt running wind sprints on top of the parking garage. 

The changes paid off; Matt lost 160 pounds.  He has more energy and sleeps better.  Of course, he did have to buy new pants – the old ones were 9 sizes too big! 

As you can see with Matt’s story – you can change your bad habits.  It doesn’t take a miracle or a fortune – and you don’t have to do it alone. 

If you want to change your diet and activities, eatwellbewell.org can help you choose healthier foods. For example, switching to whole grain foods and adding fruits and vegetables will increase your fiber, give you more vitamins and let you eat less to feel full.  

For ideas to helping you increase activity and for healthy recipes on the website go to eatwellbewell.org. You can even have them emailed to you each week.  Myplate.gov helps you decide the right balance of foods to eat. 

There’s a worksite wellness website (azhealthyworksites.com), if you want to corral your coworkers into getting healthy in 2012. 

The Arizona Smokers’ Helpline will help you stop smoking.  Online (ashline.org) or by phone (800-55-66-222), ASHLine provides medication, tips and coaching to help you get through the urges – all for free.  There’s also an iPhone and Facebook app. 

So when you wake up tomorrow in the New Year – know that you have the power to make a change.  You have the power to choose how healthy you will be for the rest of your life.  Go for it!

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