Posts Tagged ‘diabetes’

Arizona’s First Ever State Health Assessment

February 13th, 2014

Today we published Arizona’s first ever comprehensive State Health Assessment. The objective of the State Health Assessment is to give Arizona’s public health and health care systems a clear tool to help drive future decision-making and resource allocation as we collectively design and implement evidence-based interventions to improve health and wellness outcomes across Arizona.  

The Assessment uses Arizona-specific data to assess the state of the public’s health in Arizona and has been a collaborative effort among all of the health departments in each AZ county as well as the ADHS.  The 15 priority health issues in the Report are 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. 

Each public health indicator is summarized for its significance and scope, trending, and comparative analysis against national data.  The report also provides in-depth analysis for a number of indicators in each of Arizona’s 126 Community Health Analysis Areas. 

Please take time to look at the State Health Assessment and the county level community health assessments.  After you’re done, we’d appreciate hearing from you through the survey monkey as we take the next giant step to create Arizona’s first State Health Improvement Plan.

Community Paramedicine Workshops Scheduled

February 12th, 2014

On previous Blogs I’ve shared information about Community Integrated Paramedicine.  One of the most promising opportunities for Community Paramedicine is in working with hospitals to prevent readmission of patients with diseases like diabetes, asthma or congestive heart failure.  It’s also a great opportunity for EMS providers to provide some coaching on other prevention initiatives including childhood immunizations, smoking prevention and chronic disease prevention.  

Our Bureau of EMS and Trauma System hosted the first meeting of the workgroup a few weeks ago.  Membership was solicited from each of the four EMS regions representing various components of emergency medical care.  The participants have an aggressive agenda to research a number of topic areas, and then provide updates on these to the full workgroup.  

The deliverable from this workgroup will be a report that includes a survey of what Community Paramedicine initiatives look like and recommendations for what type of guidelines may need to be developed to move this promising practice forward.  The next meeting of the workgroup is February 20th.  Leveraging our state’s EMS system to improve health outcomes via Community Paramedicine is one of my top priorities this year…  and our EMS team will be investing a fair amount of their time on it this year.

50th Anniversary Surgeon General Report on Smoking

January 29th, 2014

The new Surgeon General’s report on smoking called The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General adds diabetes, colorectal and liver cancer, rheumatoid arthritis, erectile dysfunction, age-related macular degeneration, and other conditions to the list of diseases that cigarette smoking causes.  The report (released this week) concludes that secondhand smoke exposure is now known to cause strokes even in nonsmokers.

The new report also says 5.6 million American children alive today will die prematurely from smoking-related diseases unless current smoking rates drop. The report concludes that smoking kills nearly half a million Americans a year, with an additional 16 million suffering from smoking-related conditions. It puts the price tag of smoking in the U.S. at more than $289 billion a year in direct medical care and other economic costs.

Arizona “Mission of Mercy” Starts Tomorrow

December 12th, 2013

Seems like anytime you hear a 100+ year old person being interviewed about the secret to long life they say “take care of your teeth and feet and drink cod liver oil”.  For good reason.  Good oral health is critical to a person’s overall health. Tooth decay and gum disease are linked with heart disease, stroke and diabetes, and premature births. Many people in our community can’t afford dental care, so they suffer from poor oral health that affects their ability to speak, smile, smell, taste, touch and eat. That’s why the Arizona Dental Mission of Mercy is such an important event for Arizona.  

The event provides free dental services to people in need. Last year about 2,000 people were able to get services. This year’s Mission of Mercy takes place December 13 and 14 at the Arizona Fairgrounds. There’ll be about 100 portable dental units and 1,500 volunteers that will provide more than $1M in free care to children and adults. 

We’re supporting the event through Title V funds and several of our staff volunteered to provide health information about our programs and services to the patients. Thanks to Sheila Sjolander, Wayne Tormala, Jennifer Botsford, Tiana Galindo, Mary Luc, Cristina Ochoa, Margaret Lindsay, Anita Betancourt, Kimberly O’Neill, Mohammed Khan, Sharon Jaycox, Karen Sell, America Coles, Mary Ellen Cunningham, Belen Herner, Matthew Roach, Brandy McMahon, Blanca Caballero, Michael Abbott, Julia Wacloff, and Chris Minnick for volunteering for the event. 

Also, thanks to Maricopa County Public Health for providing flu vaccinations to participants- and a huge thanks to Kevin Earle, the Executive Director of the Arizona Dental Association for his leadership in setting up this year’s Mission.

Sitting is the new smoking

October 23rd, 2013

Public health embarked on a smoking revolution over the last few decades, kicking it into high gear to provide programs and policies to help Arizonans change their smoking habits. While by no means has the tobacco battle been won, America is currently undergoing another revolution—a walking revolution. Physical activity is not new territory in public health. Public health professionals have been encouraging adults to achieve at least 150 minutes of moderate or vigorous physical activity per week.  Now, though, the public health world is taking a step back and promoting the simplest of physical activities: walking or biking. A recent study from Kansas State University looked at the association between sitting time and chronic diseases. The study found that people who sat for more than four hours per day were significantly more likely to report having a chronic disease such as cancer, diabetes, heart disease and high blood pressure. 

The Surgeon General has started the “Everybody Walk” campaign, releasing a document entitled “A Walking Revolution: The moving making Americans Happier and Healthier,” developing a free App that tracks all aspects of your walk, and hinting at writing a call to action on walking. This call-to-action is being compared to the famous 1964 Surgeon General’s Report on the dangers of smoking, translating that message into the dangers of sitting. 

Here at ADHS we take an innovative approach to promote more walking and less sedentary behavior. Our focus is to create environments where the healthy choice, walking, is the easy choice. Our Empower program establishes policies in child care centers that decrease sedentary time and screen time, and increases physical activity of youngsters. The Arizona Nutrition Network has been infusing traditional nutrition education with physical activity. Community design initiatives have worked to establish environments where walking or riding a bike are the predominant means of transportation in a community, rather than driving a car. With walking being so simple, the question remains: how will you walk or bike today?

 

Guide to Community Prevention Services

October 22nd, 2013

Every so often- you run into a resource guide that stands above the rest.  I discovered one of those awhile back 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.

What’s Community Paramedicine?

September 3rd, 2013

Community paramedicine is a paradigm shift for the use of paramedics in the US.  It’s an emerging model in which paramedics function outside their usual emergency response & transport roles- delving into the world of primary care.  As the health care world increasingly shifts toward prevention and well care- the system will increasingly demand more folks that can function in a community health (primary care and prevention) role.  Community paramedicine is increasingly being recognized as a promising solution to efficiently increase access to care (especially for underserved populations). 

For example- paramedics could shift from a sole focus on emergency response to things like: 1) providing follow-up care for folks recently discharged from the hospital to prevent unnecessary readmissions; 2) providing community-based support for people with diabetes, asthma, congestive heart failure, or multiple chronic conditions; and/or 3) partnering with community health workers and primary care providers in underserved areas to provide preventive care. 

The UC Davis Institute for Population Health Improvement released a new report this week called ”Community Paramedicine: A Promising Model for Integrating Emergency and Primary Care”.  The report is the one I know about that explores this new and evolving model of healthcare.  The report concludes that expanding the role of paramedics is a promising solution to efficiently increasing access to care, particularly for underserved populations…  and it recommends the development of pilot projects to further refine and evaluate the role of community paramedicine. 

One Valley fire department is exploring its own concept – the Mesa Fire and Medical Department is using a grant from the Centers for Medicare and Medicaid Services to staff mental health and nurse practitioners according to the Arizona Republic last weekend. 

I’ve asked Dr. Bobrow and Terry Mullins to open up dialogue about community paramedicine in Arizona and how it could improve outcomes in a measurable way- and to examine the current scope of practice for EMTs and Paramedics relative to the practice of community paramedicine.  We’ll be asking for interested volunteers from our EMS Council to lead a workgroup of individuals to begin answering the Who, What, Where, When and Why of community paramedicine in Arizona.  Stay tuned.

Coming Attraction: AZ’s 1st State Health Assessment

August 23rd, 2013

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.

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?

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.