Posts Tagged ‘obesity’

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Block Grants Improve Arizona’s Quality of Life

June 17th, 2013

You might have read something I wrote called, “Title This, Title That” where I wrote about Title V, Title XIX and Title XXI… three programs you hear quite a bit about because they provide funding to help us do our work.  The Title V program is the one that helps the work we do with maternal and child health prevention programs.  “Title V” is the shortcut way of talking about maternal and child health because it’s Title V of the Social Security Act.  Our Bureau of Women’s & Children’s Health and our Office of Children with Special Health Care Needs execute the Title V program in Arizona. 

Title V programs are a little different than the other funding.  We get the money through Block Grants.  Each state decides its own priorities based on the needs of that state.  In Arizona we choose our priorities by asking you what we need to improve in the next 5 years.  Not too long ago, we completed the process and set the priorities for maternal and child health including reducing teen pregnancy, reducing the rate of injuries in our state and reducing obesity.  You can read the whole list online, but there are many that overlap with our strategic map.  Setting priorities for the block grant is an ongoing process and we are working on the next block grant application right now.  We’d love to hear your comments.

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To Decolonize, or Not to Decolonize

June 5th, 2013

…  that is the question- at least when it comes to whether to take standard measures to decolonize intensive care patients with antibiotic ointments in their nose to remove Staphylococcus bugs.  Hospital associated infections are a critical public health and healthcare cost problem.  While we’re losing ground in our fight against obesity- we’re making progress toward reducing healthcare associated infections both here in AZ and across the country. 

A study published in the New England Journal of Medicine this week found that that “universal decolonization” of intensive care patients can reduce MRSA infections by up to 37% and other  bloodstream infections by 44%.  This was a big study (about 74,000 patients in 43 hospitals), meaning that these results carry a fair amount of statistical weight.  This study will provide additional information to the infectious disease practitioners in AZ as they craft and implement hospital infection control plans. 

We’re making it a priority to prevent hospital associated infections by maintaining our HAI Program and by licensing and inspecting healthcare facilities across the state.  We also facilitate a multidisciplinary HAI Advisory Committee that identifies and addresses priority areas for Arizona.  This dedicated group of partners has collaborated continuously since 2009 to coordinate prevention efforts across the state. The partnerships and open dialogue help us improve surveillance, report and prevent hospital associated infections, which support our Strategic Map goal of reducing healthcare associated infections and re-admissions.

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Data Shows Progress… but Obesity is Still Rising

March 19th, 2013

Here’s some good news about the battle against the obesity epidemic: national data shows the average intake of calories has decreased for boys and girls over the last 12 years.  While the news is encouraging, our work to promote nutrition and physical activity to reduce obesity remains important. Reducing obesity is a Winnable Battle both nationally and in Arizona. 

There are lots of resources to help you and your family eat healthier meals and become more active. Check out the Arizona Nutrition Network’s Champions for Change for simple ways to eat better. Find more ideas for healthy eating and active living at ChooseMyPlate.gov, where you can sign up for healthy recipes that are emailed every week.

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The Health Care/Public Health Continuum

March 13th, 2013

In the world of health care- the clinician works with patients individually. They examine various indicators of health for their patient including direct observations and laboratory or other diagnostic tests and implement interventions to help their patient improve their health. Providers also encourage their patients to live healthy lifestyles and take safety precautions- and help patients with preventative care by providing vaccinations and the like. Over time, the health care provider follows the patient and measures how they’re doing with patient centered criteria. 

In the world of public health, the practitioner works with communities… in other words the community is the patient. Public health folks look at outcome indicators to determine the health of the community so they can take action and implement interventions at the wholesale level to improve population health. In other words- public health uses community indicators like infant mortality, communicable disease rates, obesity and diabetes to assess the patient (the community). Of course, public health relies on health care providers in the health care world to carry out public health objectives and interventions. 

So you can see that there is a strong interface between health care and public health- but the distinction is that in health care the patient is the patient while in public health the community is the patient- the interventions are community based, and community indicators are the primary assessment tool. By the way, reports suggest that behavior accounts for roughly 50% of health outcomes, genetics about 20%, the environmental about 20%, with medical care about 10%… 96% of our national health expenditures are focused on medical care with about 4% dedicated to prevention. Does prevention sound like a good investment?

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Workin’ Out

February 11th, 2013

Student participation in PE and sports has lots of benefits like improved social skills, confidence, general health, well-being and healthier weight.  According to the CDC rates for obesity among students with disabilities are 38% higher than for students without disabilities.  Students who have intellectual disabilities, learning disabilities and mobility limitations have the highest obesity rates. Ensuring that students with disabilities are afforded their right to participate in physical education and sports can be an effective strategy in making progress toward achieving our winnable battles.  

Last week, in a letter to school districts, the US Department of Education provided sample scenarios and guidance for increasing participation of students with disabilities in PE and extracurricular activities, including sports. The guidance includes examples of reasonable modifications which may help schools in providing physical activities for all students.  Under section 504, of the Rehabilitation Act of 1973, students with disabilities are ensured access to educational and extracurricular activities available to other students; however sports opportunities have been limited.  For more information you may contact our Office for Children with Special Health Care Needs.

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Mealtime

February 7th, 2013

Does when you eat make a difference in how much you weigh? A new study in the International Journal of Obesity indicates eating late may make it less likely you will lose weight as quickly. The five-month study was done in Spain and included 420 people in a weight loss program using the Mediterranean Diet. People in the study were grouped into early-eaters and late-eaters (lunch before/after 3pm). The late-lunch eaters lost less weight even though their calorie intake and other factors (like amount of sleep) were similar in the two groups. 

Does this mean you should eat your big meal earlier in the day? Maybe and maybe not.  Remember, the people in the study were in a supervised weight loss program and eating a diet rich in good-for-you fats (like olive oil) and with lots of fruits and vegetables. For you, a good place to start is taking a look at how much and when you eat along with how much physical activity you get each day. Try out the Choose MyPlateSupertracker. It’s a great tool to use to track your progress on eating healthy and moving more. You can switch up the size and timing of when you eat and see if being an “early-eater” makes a difference for you.

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Posted in General, Prevention

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Selling Food

January 16th, 2013

Food marketing to children and teens is a major public health concern. Earlier this year, the Walt Disney Company announced it will no longer accept advertisements for junk food on its child-directed television, radio, and online sites.  Disney also updated its nutrition standards for foods that can be advertised to children.

The food and beverage industry spends $2 billion per year advertising food to children.  Kids aged 2-11 years old see an average of 13 food ads a day, mainly promoting unhealthy foods. This contributes to our country’s obesity epidemic; one in every three children is overweight or obese. To see some of the best and the worst examples of advertising food to children, check out the Rudd Center for Food Policy & Obesity — Food Marketing Practices. 

Food marketing can make the job for parents harder or it can be used to promote healthy eating. In a recent study by Cornell University, children chose apples over cookies when Elmo stickers were placed on the apples. (The Elmo sticker increased the consumption of apples, though, did not have an effect when placed on the cookies.) 

Our nutrition education programs like the Arizona Nutrition Network and WIC do a good job of promoting healthy foods but are small compared to industry efforts. The Food Marketing Workgroup (FMW) is made up of partners like the Association of State and Territorial Health Officials (ASTHO), the American Heart Association, the National PTA, and other organizations. They are working together to eliminate harmful food marketing, particularly marketing aimed at people most vulnerable to obesity. The FMW is now urging Nickelodeon to stop marketing junk food to kids. To find out how you can be part of this action, visit the FMW website.

 

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Integrated Care Responses On Deck

January 8th, 2013

We all need to take care of both our physical and behavioral health needs in order to be healthy. The mind and body aren’t separated- and neither should the health-care delivery system- especially for folks with a serious mental illness. Folks with a serious mental illness die more than 25 years earlier than the general population… an unacceptable health disparity in anybody’s book. The increased mortality is largely from treatable medical conditions caused by modifiable risk factors like smoking, obesity, substance abuse, and not accessing primary and acute medical care. Population health issues. 

We recognized the need to address this unacceptable health disparity when we put together our Strategic Map and Plan that includes integrating behavioral and acute healthcare. It’s been a long haul and a lot of work- and we passed a major milestone today when folks submitted their bids on our Request For Proposal (otherwise known as RFP) for the delivery of behavioral health services in Maricopa County.  We received bids from: 1) Magellan Complete Care of Arizona, Inc.; 2) Cenpatico of Arizona LLC; 3) Arizona Physicians IPA, Inc. (APIPA), d/b/a UnitedHealthcare Community Plan, operating as UnitedHealthcare Whole Health; 4) Mercy Maricopa Integrated Care; and 5) Partners in Integrated Health, LLC. 

Our evaluation team will begin their analysis shortly…  and we expect the evaluation process to take 8 weeks or so.  The entity that ends up getting the contract will be responsible for delivering both preventative, acute and primary care along with Recovery-based behavioral health services for folks in the public behavioral health system in Maricopa County beginning on 10/1/13.  

It’s difficult to put into words how much work has gone into this solicitation. I know that many of you put this work on top of all your normal work, had put off other projects, and sacrificed some of your home-life for this product- and I just really want you to know that I appreciate it. It’s going to save lives. Stay tuned.

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New Electronic Birth Certificate ‘Round the Corner

December 26th, 2012

Our Vital Records shop does a lot more than manage the State’s birth and death certificate system (which we’ve been doing since 1885).  We’re also an integral part of the Nation’s Vital Statistics System, which serves as the backbone of national data sharing in public health. The data collected under the National Vital Statistics System works in partnership with the National Center for Health Statistics to produce critical information on public health topics like teenage births and birth rates, prenatal care and birth weight, risk factors for adverse pregnancy outcomes, infant mortality rates, leading causes of death, and life expectancy.  All these data are retrieved from the nation’s network of Vital Records shops like ours. 

There have been two birth certificate standards that the states are currently following – the 1989 and the 2003 standard. We’ve been one of the states that had been following the 1989 standard- but not anymore.  Beginning the first week in January, we’ll be turning the key on the new 2003 Standard.  The new Electronic Birth Registration System that we’ll be using will collect a lot more public health surveillance data.  It’s also an electronic system- which will make things much faster and efficient.  The new system will have impacts all throughout our Strategic Plan.  Here are a couple examples: 

  • A1 – Reduce Obesity – The former 1989 standard had zero data on the mother’s height and weight- meaning we couldn’t calculate the mom’s BMI.  Starting next week, we’ll be able to collect this data- which will give us better surveillance- and in turn, help us identify more targeted public health interventions- helping us to make progress in reducing critical risk factors for poor maternal and child health outcomes.
  • A2 – Reduce Tobacco Use and Substance Abuse –  The old system only captured generic measures about maternal smoking during pregnancy.  The new system will have specific cigarette smoking data before and during pregnancy- providing rich data for prevention activities- helping us to improve birth outcomes. 

Other important data elements include information on breastfeeding, whether mother received food during pregnancy from the WIC program (helping us to better evaluate our WIC program), critical medical data elements like congenital anomalies, and fertility treatments (Assisted Reproductive Technology)…  all of which provide newer opportunities for prevention.  The public health applications that the new system will provide are too long to list in a short blog like this… but they’re substantial- believe me.  We’re even going to be able to incorporate the data we’ll be collecting in the new system into our new Midwife rules. 

From a customer service perspective, the new system has improved security for fraud prevention and will provide speedier transactions for printing birth certificates at the county level.  Thanks to all the IT and vital records team that put in the endless hours to make this new application possible.

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Integrating Physical & Behavioral Health Services to Save Lives

October 11th, 2012

We all need to take care of both our physical and behavioral health needs in order to be healthy. The mind and body aren’t separated- and neither should the health-care delivery system- especially for folks with a serious mental illness. Folks with a serious mental illness die more than 25 years earlier than the general population… an unacceptable health disparity in anybody’s book. The increased mortality is largely from treatable medical conditions caused by modifiable risk factors like smoking, obesity, substance abuse, and not accessing primary and acute medical care. 

We recognized the need to address this unacceptable health disparity when we put together our Strategic Map and Plan. It’s been a long haul and a lot of work- and we passed a major milestone this week when we released our Request For Proposal (otherwise known as RFP) for the delivery of behavioral health services in Maricopa County. The entity that ends up getting the contract will be responsible for delivering both preventative, acute and primary care along with Recovery-based behavioral health services for folks in the public behavioral health system in Maricopa County. The new contract is scheduled to start on 10/1/13. 

It’s difficult to put into words how much work has gone into this solicitation. I know that many of you put this work on top of all your normal work, had put off other projects, and sacrificed some of your home-life for this product- and I just really want you to know that I appreciate it. It’s going to save lives. You can check out the full solicitation on the State’s Procurement website hub- called ProcureAZ.

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Posted in Behavioral Health

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