3 Medical Conditions Move to Hearing

August 28th, 2013 by Will Humble 11 comments »

Three of the petitions to add debilitating conditions to the medical marijuana program that we received last month will be moving forward to a public hearing, which will be on Tuesday, October 29 from 9 am to noon in our State Lab conference room.  We’ll also broadcast the hearing via Livestream. 

The petitions are for PTSD, Migraines, Depression.  All these conditions have already been through the review process in previous petitions- but we’ve asked the UA College of Public Health to look for any new literature that has been published on these topics since the previous review.  This will be the first set of hearings since the first round back in 2012.

Native American Trauma Report

August 27th, 2013 by Will Humble No comments »

One of the things you’ll see in our upcoming State Health Assessment is the fact that traumatic injury disproportionately impacts the American Indian population in Arizona.  To dive into the issue deeper and to help us design more effective interventions, our Bureau of Emergency Medical Services and Trauma System published our first Arizona American Indian Trauma Report last week.  

The report was prepared from data contained in the Arizona State Trauma Registry for 2011. American Indians in Arizona have a trauma injury rate of 871 per 100,000 which is almost double the rates of other race/ethnicity groups in AZ. American Indians in Arizona also have a lower rate for reaching a trauma center within one hour after injury, a lower proportion of safety restraint use, and suffer significantly more injuries from motor vehicle traffic, struck by or against, falls, cuts or puncture, and other transportation and a greater proportion of injuries involving drugs or alcohol. 

The Report was prepared in collaboration with a 21 member Work Group comprised of ADHS, Tribal, Tribal 638, ITCA, and IHS personnel. We’ll be using data from the report to assist in the development of trauma prevention programs that will reduce these health disparities statistics over time. A special thank you to the Work Group including Bureau staff Terry Mullins, Rogelio Martinez, Maureen Brophy, and Vatsal Chikani for preparing the report- along with Michael Allison, our Native American Liaison.

Licensing Collaborative Established as an Evidence-Based Best Practice

August 26th, 2013 by Will Humble No comments »

Our Licensing team routinely analyzes the most frequent and important deficiencies that we observe when we conduct inspections at our licensed facilities.  We use the data to help educate the folks that we license… and to identify topics for provider training and technical assistance (public health interventions). For example, our medical facilities licensing team has found that infection control had become increasingly troublesome among some dialysis providers.  

That info led our medical facilities licensing team to join with our Office of Infectious Disease Services and our Healthcare Associated Infections Advisory Committee to conduct a day-long collaboration for our licensed dialysis providers and public health professionals. We conducted the collaborative a few months ago- providing tools for dialysis providers to improve their infection control performance by building relationships with public health, renal associations, federal partners and other stakeholders.  The event was very well attended; participants spent the day sharing best practices, identifying new ways to promote infection control, and developing a strategic plan for future activities. Best of all- we’ve seen a decrease in deficient practices since the event.  

Our ADVICE Collaborative has been identified by the federal government as a Best Practice Pilot and will be featured at the upcoming Roadmap to Eliminate HAI: 2013 Action Plan Conference. Kathy McCanna, our branch chief of Healthcare Institution Licensing will be presenting at the conference about our collaborative.  You’ll find more about the collaborative by visiting our website. This is just one of our many examples of how we’re leveraging licensing to improve public health outcomes.

Coming Attraction: AZ’s 1st State Health Assessment

August 23rd, 2013 by Will Humble 1 comment »

Publication of Arizona’s very first State Health Assessment is just around the corner  The 2013 Arizona State Health Assessment will use AZ quantitative and qualitative data to assess the public health status of the state.  The end product will be a comprehensive summary of the 15 leading health issues that have the greatest impact in Arizona. 

Over 10,000 community members participated across the state in helping provide valuable input.  Our county health departments did the heavy lifting and engaged the public and their local partners to develop county level community health assessments. Primary data was collected through local community participation in surveys, focus groups and strategy meetings to establish local priorities and really capture the community’s concerns.  Secondary data from public data banks such as hospital discharge data, Behavioral Risk Factor Surveillance System, and the disease registries was also part of the analysis. 

The State Health Assessment uses a combination of the Community Health Status Indicator Project and the Healthy People 2020 Mobilize, Assess, Plan, Implement, Track Models. The 15 leading health issues identified in the Assessment were compiled from county and state priority rankings. Each indicator is summarized for its significance and scope, trending over the past few years, and comparative analysis against national data.  

The 15 priority health issues that’ll be identified in the Report are (in no particular order): obesity, tobacco use, substance abuse, healthcare associated infections, suicides, teen pregnancy, creating healthy communities, behavioral health services, diabetes, heart disease, other chronic diseases (cancer, respiratory disease, asthma), accidents and injuries, oral health, access to well care, and access to health insurance. 

The State Health Assessment will provide the starting point for our first ever State Health Improvement Plan in 2014… which will outline actionable and specific strategies, tactics and interventions for improving population health.  The Improvement Plan will provide a roadmap for Arizona policy makers at the state, county and local level as well as our partners in the private sector to take serious concrete steps to improve population health outcomes while reducing health care costs in AZ.

New AZ Cancer Report

August 22nd, 2013 by Will Humble No comments »

Surveillance is a cornerstone of public health practice because it gives us the tools we need to identify priorities and craft effective interventions to improve outcomes.  Cancer surveillance is no exception.  Our Arizona Cancer Registry tracks and monitors the number and types of cancer cases in the state and publishes reports periodically.  Our new report shows that we’re continuing to have lower cancer rates than the rest of the country overall.  Prostate cancer is the most common diagnosed among men and breast cancer is the most common diagnosed among women.  

Lung cancer continues to be the deadliest cancer for all Arizonans, with 1,479 men and 1,185 women dying from lung cancer every year.  Folks can reduce their chances of dying from lung cancer if you smoke by stopping – visit ASHLine.org or call 800-55-66-222 to find free help.

AZ’s Trauma System Makes the News Again

August 21st, 2013 by Will Humble No comments »

Four years ago- AZ’s Trauma System was really in its infancy.   We had 7 Level I (high-end) Trauma Centers…  but that’s it.  After 4 years and a full court press- we now have a functional statewide trauma system to help folks who get injured outside the metropolitan areas that includes 31 trauma centers including 16 of the Level IV Centers in rural Arizona.  Over the past few years I’ve blogged about the progress we’ve made.  There was a pretty detailed newspaper article in the Republic this week as well.  

Our system growth puts us at a pivotal point…  which is why we asked the American College of Surgeons to come out and review our system and make recommendations earlier this year.  Normally we’d ask the American College of Surgeons to conduct an analysis of our Trauma System every 10 years- but we asked them to conduct a review of our system a few years early because of the remarkable expansion and progress we’ve made over the last 4 years.  So, what’s in the report?  For one, traumatic injury in rural AZ still has room for improvement.  Trauma care in the urban areas of Phoenix and Tucson is solid…  and we want to make sure that we keep it that way and improve even further where we can.  

We don’t have the statutory authority to implement a designation moratorium for additional Level I Trauma Centers as the report recommends- but we do recognize the importance of having sufficient patient volume to support the necessary resources and provider expertise required by the highest level Trauma Centers. We have a few top-tier trauma system priorities right now:  1) redoubling our efforts on preventing injury from happening in the first place (prevention is always the best cure); 2) helping our Level III and IV trauma centers implement performance improvement practices in their facilities to ensure that trauma patients get high quality and timely care in the field- whether rural or urban; 3) identifying 3 hospitals to become Level III trauma centers in rural AZ; and 4) updating our trauma plan- which will contain a three-year package of objectives that we can work on with all of our trauma system stakeholders.  

Why the continued focus on rural AZ?  It’s pretty simple…  our injury surveillance data clearly shows that the biggest improvements in outcomes from traumatic injury will come from improving care in the first hour after the injury- and because of the geographic distribution of our injury and response times- that means continuing to focus our energy on both the quantity and quality of care when folks are injured outside of the main urban areas.  We put together a set of frequently asked questions that shed some light on where we plan on going from here.  I’m excited to think about what additional progress we’ve made, and how we continue to move the needle on trauma in Arizona- contributing to ”Health and Wellness for all Arizonans”.


How do we age successfully?

August 20th, 2013 by Will Humble No comments »

Guest Post Written by Melanie Mitros, PhD, Director of the Arizona Living Well Institute:

Make regular deposits in your health account while minimizing the withdrawals!

Invest in your health by exercising regularly, eating a nutritious diet, managing stress and chronic conditions, and engaging with family and community as well as volunteering.

As the vision of healthy aging in AZ began to emerge with the first evidence-based programs grant to the State in 2007, many partnerships have developed to make this vision a reality. One such partnership between ADHS/BTCD, DES-DAAS, St. Luke’s Health Initiatives, and Virginia G. Piper Charitable Trust, resulted in the launch of the Arizona Living Well Institute (AZLWI) in April 2010.

The Arizona Living Well Institute is a public-private partnership encompassing all sectors of the healthcare community including area agencies on aging, local health departments, veterans’ services, hospitals and providers, community and faith-based organizations, insurance plans, and community health centers. The mission of AZLWI is to advance evidence-based programs for Arizona communities through structured communication, multi-level coordination and systematic coaching.  Supporting the dissemination of self-management programs throughout Arizona occurs by providing quality assurance, technical assistance, training and mentoring to individuals and organizations who are interested in evidence-based programs like Healthy Living. As part of the health education and wellness programs at Empowerment Systems, Inc., AZLWI is committed to developing partnerships with like-minded organizations to contribute to the overall wellbeing of individuals, families and communities across Arizona.

Healthy Living is a 6-week chronic disease self-management program (CDSMP) developed by Dr. Kate Lorig and colleagues at Stanford University. With over 20 years of research including multiple controlled trials and a recent National Study, the benefits of Healthy Living are well established.  Participants report increased physical activity, improved general health, better psychological well-being, increased energy/reduced fatigue, decreased ER visits and days in the hospital, and enhanced partnerships with their health care team.  The Healthy Living workshops are available in-person, online and in Spanish.  These programs include: Tomando Control de su Salud (Spanish CDSMP), Healthy Living with Arthritis, Healthy Living with Diabetes, Programa de Manejo Personal de la Diabetes (Spanish Diabetes), and Better Choices, Better Health® (online CDSMP) which are all evidence-based self-management programs developed by Stanford University.

Since 2010, AZLWI and its partners have shared workshops to 3,189 participants in all 15 AZ counties, including work with 6 tribes. In 2011, our services expanded to include behavioral health support where 40 workshops have been hosted with 371 participants and a 76% completion rate.  Behavioral health participants are younger and report higher rates of depression than the general population; however, their outcomes are just as favorable.  And based on preliminary data from the Northern Arizona Regional Behavioral Health Authority, their results may be more favorable than the studies published at the national level. Our behavioral health providers are in a unique position in AZ where Healthy Living workshops are a reimbursable service.

We can make a difference in the lives of those living with an on-going health condition by creating an inclusive, far reaching mission for healthy aging for all ages in all communities.

It’s never too late to start & it’s always too early to quit!

Power Me A2Z: Our New Evidence-Based Preconception Health Intervention

August 19th, 2013 by Will Humble No comments »

We’ll be turning the key on our newest evidence-based preconception health initiative next week.  Look for the rollout of PowerMe A2Z- which is our innovative public health campaign that promotes healthy living among young women in Arizona. The goals are to help young women to take a multivitamin with folic acid, to promote healthy eating, active living, maintaining a healthy weight, and staying away from drugs and alcohol. 

The PowerMe A2Z campaign will promote healthy living across the board, not just for women planning to have a baby. The program takes advantage of modern technology and media that Arizona women interact with on a daily basis, like Facebook and other social media.  One of our tactics will be to distribute 40,000 bottles of multivitamins with folic acid each year to young women across Arizona.  Folic acid helps to prevent serious birth defects, but also acts as a beauty aid to make hair shine, nails grow, and skin glow- a fact that we’ll be using throughout the initiative. We’ve been providing free vitamins with folic acid to prevent birth defects for women throughout the state since 2002.. but PowerMe A2Z will include new strategies in order to reach a larger number of young women.

We’re also partnering with the Arizona Pharmacy Association who is engaging their members to help spread the word about the campaign to young women. Health care providers will also talk directly with young women about healthy living and the benefits of folic acid and direct Arizona women on how they can get a “PowerMeA2Z Pack” with their free vitamins and valuable health information. For more information on how women can power their life and power their health, visit www.PowerMeA2Z.org.

Camelus dromedarius & Our State Public Health Lab

August 16th, 2013 by Will Humble 3 comments »

Last year, a new SARS-like virus called Middle East Respiratory Syndrome coronavirus (MERS-CoV) broke out in Saudi Arabia. Since then, 94 cases of the very lethal disease have been reported by the World Health Organization (50% of the cases have been fatal).  All the cases have been on the Arabian Peninsula.  The virus causes severe respiratory symptoms like fever, cough, and shortness of breath.  The virus has spread person-to-person among family members and close contacts…  but there hasn’t been any sustained transmission.  

Our Arizona State Public Health Laboratory passed all the requirements to test for the new virus under an Emergency Use Authorization from the FDA this week.  We received the CDC-developed assay test kit last week from the Laboratory Response Network…  so now we’re able to test any suspect patient samples in Arizona. 

Interestingly, a study published in The Lancet this week found that the virus is common among dromedary (one hump) camels on the Arabian Peninsula.  CDC, WHO, and other public health organizations are looking into all severe acute respiratory cases, especially those with recent travel to the region to find any new cases and learn more about how it might be spreading. 

Hopefully we won’t see any cases here in Arizona, but if any patients are suspected of having MERS-CoV because of their symptoms and travel history, our State Lab will now be able to verify or rule out the diagnosis quickly so epidemiologists at the state and county can prevent additional cases.  If you’re interested in learning more about MERS-CoV, here’s some up to date information.


Stop the Silent Killer

August 15th, 2013 by Will Humble 2 comments »

Drowning happens quickly and quietly in a matter of minutes.   It happens in all kinds of places – bathtubs, swimming pools, buckets – anything with water.  So far this year in Arizona, 27 people have died including 6 children.  Last year that number was sixty – 20 were children. 

August is Drowning Impact Awareness Month.  For the rest of the country and part of Arizona, pool time is over for the summer, but not in the hot parts of our state.  Nor is it over for small children who see the shimmery water as an invitation no matter what the temperature is.  Drowning is often called a silent killer – because it happens quietly as a person slips under the water and stops breathing.

Fortunately, drowning is preventable by following a few simple safety tips:  actively supervise children whenever they are around any body of water, including pools, spas, bathtubs or open water; assign a designated water watcher who actively supervises the children and is not distracted by texting, reading, drinking alcohol, or socializing; enroll your children in swim lessons; learn CPR; and keep a phone near the water at all times to call 9-1-1 if something happens.

The state’s Drowning Prevention Coalition put together a video so you can hear it from the kids themselves.

The Departments of Economic Security and Health Services are working together to raise awareness of drowning prevention.  I invite you to view a similar blog piece by my agency counterpart, Director Clarence Carter.