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Prom Tools for Parents

April 26th, 2013

As spring blooms in AZ, the change in seasons also comes with milestones for our state’s teenagers. In the next few weeks many of them will be attending proms and graduations. While proms and graduations can have positive memories, the experiences can turn tragic when alcohol is part of the mix.  Alcohol impairs judgment…  potentially leading to heart-retching outcomes and regrets like sexual assault, unplanned pregnancies, sexually transmitted diseases and deadly car crashes.  Car crashes are the leading cause of death among teens… and 1/3 of traffic deaths of 15 to 20 year olds are alcohol-related. 

A national survey of more than 1,000 adolescents by the Guttmacher Institute found that 80% of first sexual experiences occurred under the influence of alcohol and about ½  of all nonconsensual sexual experiences involve alcohol use by the perpetrator, the victim or both.  Another recent report called Girls and Drugs found that 1/3 of girls and young women 14 to 21 years old with unplanned pregnancies were drinking when they had sex, and 91% said they hadn’t planned to have sex. 

Despite knowing all the reasons why teens shouldn’t drink, it can be challenging for them to stay clear-headed when all  their friends are drinking. No one likes to feel left out, and teenagers especially feel the need for acceptance by their peers. So what can we do as parents?  

You can help by finding effective ways to say no in a peer pressure situation.  Self-esteem is critically important because it gives kids confidence in themselves and decisions.  Talking to them leading up to the prom and graduation is also important.   Take a look at the website 15 Ways a Teen Can Say No to Alcohol to learn how you can play a role in helping your teen make responsible decisions.  You can also find great tips about talking to teens about alcohol use from the National Institute on Alcohol Abuse and Alcoholism and at Girlshealth.gov.

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Autism & Folic Acid

March 26th, 2013

A new study published in February by the Journal of the American Medical Association shows that taking folic acid may help reduce the number of children diagnosed with Autism Spectrum Disorder. The study followed more than 85,000 children nationwide born between 2002 and 2008 and followed up with them in 2012. According to the study, the number of children born with autism was 40% lower in mom’s who took folic acid during pregnancy. 

The results of the study are encouraging, but they’re not a solution.  However, the benefit of women taking folic acid before and during their pregnancies is well documented.  We know taking folic acid during pregnancy can help prevent birth defects. It can also reduce stress and anxiety, help keep skin clear, and even give women better hair and nails. 

We just launched a new program called Power Me A 2 Z where women between the ages of 18 and 45 can get a free 90 day supply of multivitamins containing folic acid. To order the free vitamins, visit the website and answer a short and simple quiz about your Health IQ. It’s not just beneficial for pregnant women, but for all women. Visit this site today to learn more about the health benefits of folic acid as a part of a healthy lifestyle. 

If your child was diagnosed with autism and you need help, you can contact our Office for Children with Special Health Care Needs or your local school.  You can find information about early intervention and school based services at the Arizona Department of Education website.

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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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Show Your Love

February 14th, 2013

Valentine’s Day isn’t just a day of romance, flowers and candy.  The CDC Preconception Health and Health Care Initiative launched a campaign asking all women of childbearing age to Show Your Love by taking good care of themselves.  It’s a national initiative to educate women and couples on the importance of preconception health. Preconception health refers to a woman’s health during the years she can have a child.  A mother’s health before she gets pregnant can affect the health of her baby.  

Women who’d like to become pregnant are urged to “Show Your Love” to your future baby by adopting healthy behaviors now.   Women who are not planning a pregnancy now are encouraged to “Show Your Love” to themselves so they’ll be healthy and have a fulfilling future.  About half of all pregnancies in our country are unplanned, which increases the chances of having a poor birth outcome such as preterm birth, low birth weight, high birth weight, or stillbirth.  Many women become pregnant when they’re not in the best health or while engaging in behaviors that could harm a pregnant woman or her baby.  It makes sense to be healthy at all stages of life. 

The Show Your Love website includes posters, educational videos, TV PSAs and health checklists for use by health care providers and community partners who want to educate the women and couples they work with about the importance of preconception health.  Preconception health is impacted by a number of health issues addressed by various ADHS programs – chronic disease, oral health, nutrition, physical activity, smoking, STD’s, immunizations and mental health.  The Bureau of Women’s and Children’s Health website includes additional preconception health tools. Also, please feel free to email the Bureau at: preconceptionhealth@azdhs.gov .

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Folic Acid Awareness Week

January 11th, 2013

Taking a daily multivitamin can save babies lives by preventing birth defects.   Folic acid is a B vitamin can prevent up to 70% of neural tube defects (including spina bifida and anencephaly).   An average of 52 babies are born with neural tube defects in Arizona each year. 

The easiest way for women of childbearing age to get the needed 400 micrograms (mcg) of folic acid each day is to take a multivitamin with folic acid.  While folic acid is found in foods like green, leafy vegetables, beans, and cereals, many people don’t eat enough of those foods to get all the folic acid needed to protect against birth defects.  It’s especially important that all women of childbearing-age take folic acid before getting pregnant.  Neural tube defects occur very early on in pregnancy, often before a woman is even knows she’s pregnant.  Given that about half of pregnancies are unplanned, taking a multivitamin with folic acid is an easy solution to reducing the risk of birth defects. 

This is National Folic Acid Awareness Week and it’s a great time to share the message about the importance of folic acid in preventing birth defects.  For educational materials and a Fact Sheet about spina bifida, please contact Tim Flood, MD at the ADHS, Arizona Birth Defects Monitoring Program.  You can also find more information about folic acid on our ADHS Folic Acid Education Program site.   

Next month we’ll be launching a new initiative to get more young women to take multivitamins with folic acid. Watch for lots of new and exciting ways to encourage young women to take their multivitamin with folic acid every day.

 

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Informed Consent Website Up & Running

November 26th, 2012

Last legislative session the Governor signed HB 2036- which amends state law regarding abortions. Some parts of the law are pending legal challenges, but the parts requiring us to develop a website were unaffected- and our new informed consent site just went up.  The website lists agencies and services that are available to assist women throughout their pregnancy, including information about adoption.  The information is listed to make it easy for women to find local resources.  Many of our public health programs are listed, like WIC, breastfeeding support, and home visiting programs.  The website also includes information describing fetal development and info describing various abortion methods and medical risks associated with the procedures. 

It’s important that providers are aware of the website because the law requires AZ health care providers to give a woman considering an abortion the opportunity to review the information. A “Potential Resources Submission Form” is posted in case agencies are interested in listing additional resources on the site.

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Prematurity Report Card

November 13th, 2012

The March of Dimes just released its annual report card marking how well states are doing in the battle to lower the percentage of babies born prematurely.  Being born too soon can cause long-term disabilities in children including cerebral palsy, developmental delay, respiratory problems and vision and hearing problems.  Sadly, prematurity is also the leading cause of infant death in Arizona.  In 2011, 199 Arizona infants died from being born too soon.

This year we launched a Healthy Babies initiative and pledged to reduce prematurity 8% by 2014.  We’ve been working hard with our partners, especially the March of Dimes Arizona Chapter and the Arizona Perinatal Trust to implement strategies, like reducing elective deliveries before 39 weeks.  We now know how important those last weeks of pregnancy are to a developing baby.  A baby’s brain at 35 weeks weighs only two thirds of what it will weigh at 39-40 weeks. 

The report card shows Arizona’s prematurity rate declined from 12.7% in 2009 to 12.1% in 2011.  This is a 4.7% reduction, meaning we are a little over half way there to meeting our goal of an 8% reduction.  The progress is good, but there’s more work to do.

One of our main leverage points in the battle to reduce prematurity is the multi-agency system of home visiting programs for pregnant women and families with young children.  The system – known as Strong Families Arizona – offers many home visiting programs that can help a pregnant woman learn about her pregnancy and her baby.  The home visitor can also teach a family about safe sleep for baby.  Click on this link to see if you are eligible for home visiting and if it is available in your neighborhood. 

Preterm birth can happen to anyone and most women who have a premature birth have no known risk factors.  We do know about half of premature births are as a result of preterm labor.  There are things that women can do to help their health and lower the risk of having a premature baby such as quit smoking and avoid alcohol or drugs; see your health care provider for a medical checkup before pregnancy; maintain a healthy weight; work with your health care provider to control diseases such as high blood pressure or diabetes; get prenatal care early, as soon as you think you may be pregnant, and discuss concerns during pregnancy with your health care provider.

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Guide to Community Prevention Services

October 3rd, 2012

Every so often- you run into a resource guide that stands above the rest.  I discovered one of those a couple of weeks ago when I was at a conference with the people in my job from around the country.  It’s called the Guide to Community Preventive Services – and it’s a free resource to help you choose programs and policies to improve health and prevent disease in communities.  The easy to read resource guide answers questions like: 1) Which program and policy interventions have been proven effective; 2) Are there effective interventions that are right for my community; and 3) What might effective interventions cost and what’s the return on investment? 

There are modules on different public health topics- and the evidence-based information is printed in colorful, easy-to-read formats.  Subjects include much of our core strategic plan activities in health and wellness including: Adolescent Health; Alcohol; Asthma; Birth Defects; Cancer; Cardiovascular Disease; Diabetes; Emergency Preparedness; Health Communication; Health Equity; HIV/AIDS,STD’s, Pregnancy; Mental Health; Motor Vehicle Injury; Nutrition; Obesity; Oral Health; Physical Activity; Social Environment; Tobacco Use; Vaccines; Violence; and Worksites.  Learn more about The Community Guide, collaborators involved in its development and dissemination, and methods used to conduct the systematic reviews.

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Women’s Services Expansion Kick In

September 20th, 2012

Several prevention-related health services will be covered without cost sharing in new health plans as of a couple of weeks ago as a result of the Affordable Care Act.  The changes are designed to help lower costs and outcomes for a variety of preventative women’s services.  Previously, some insurance companies didn’t cover some of the new preventive services, while some women had to pay deductibles or co-pays.  The new rules in the health care law requiring coverage of these services take effect at the next renewal date. 

Some of the new services include: 1) Well-woman visits; 2) Gestational diabetes screening for pregnant women; 3) Domestic violence screening and counseling; 3) Breastfeeding support, supplies, and counseling; and 4) Sexually transmitted infections and HIV counseling for sexually-active women.  The list of required services are based on recommendations from the Institute of Medicine, which relied on independent physicians, nurses, scientists, and other experts as well as evidence-based research to develop its recommendations. These preventive services will be offered without cost sharing beginning today in all new health plans.  Group health plans and issuers that have maintained grandfathered status and certain nonprofit religious organizations (like churches and schools) aren’t required to cover the new services.

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Public Health Budget

May 9th, 2012
 The Governor signed the budget this week – here’s a look at how some of it affects public health:

Behavioral Health Services for folks that don’t Qualify for Medicaid

The budget that was just signed includes about $39M in new funding for services for folks with a serious mental illness that don’t qualify for Medicaid.  With it, we’ll be able to provide some services like supported employment and housing, peer and family support, living skills training, and health promotion to help folks along their Recovery journey.  We’ll also be expanding the list of medications for the folks with a serious mental illness so it matches the list for folks that qualify for Medicaid.  Our behavioral health team has already begun working closely with the RBHAs, providers, and members/families to plan for the most effective use of this funding.

Newborn Screening

Our newborn screening program has been running in the red for the last couple of years- despite the fact that we’ve squeezed just about every efficiency out of the program and are collecting more than 95% of our service fees.  The current screening fee is $30 for the 1st (hospital) screen and $40 for the 2nd (which happens in the pediatric office a couple of weeks after birth).  These fees haven’t been raised in several years- meanwhile the instruments and reagents we use have become increasingly expensive.  We’ve been supplementing the program with Title V funds that really should be used for other more effective purposes. The budget that was just signed allows us to set new fees for the 2nd screen in Rule…  and we’ll be starting that process shortly.

County Contribution toward Hospital Patients and Residents

The “Budget Reconciliation Bill” or BRBs included specific instructions regarding how much counties are obligated to pay (50%) for the patients and residents at the Hospital and ACPTC (the sexually violent person’s unit).

ASH Administration building

Hospital Operating Fund

Despite all our efforts to reduce overtime, cut shift overlap, streamline services and other efficiency measures- our hospital operating fund was headed for big trouble next fiscal year- partly because the Hospital Fund (which had provided funds to operate the Hospital) went dry. The state budget that was just signed rescued us from needing to cut our staffing ratio’s to below Licensing standards (which would have put us in jeopardy of losing Medicare and Medicaid funds).  Whew.

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