Give Women the Gift of Good Health

By Mysheika W. Roberts, MD, MPH, Health Commissioner, Columbus Public Health

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As we celebrate all the women in our lives for Mother’s Day and National Women’s Health Month, we are reminded that despite the advances women have made in many areas, great disparities still exist when it comes to their health. 

Women make the majority of health care decisions for their families and are powerful partners by advocating and modeling healthy lifestyles and behaviors for their children, colleagues and friends. But when it comes to their own health, they are often left behind.

For years, medical studies were conducted just on men and the results were applied to women assuming the same outcome, even though symptoms like a heart attack and the presentation of disease can show up differently for women than men. Women age 55+ also have higher cholesterol levels than men, putting them at higher risk of developing heart disease.

According to the World Health Organization, gender bias also occurs in the treatment of psychological disorders. Doctors are more likely to diagnose depression in women compared with men, even when they have similar scores on standardized measures of depression or present with identical symptoms. Female gender also is a significant predictor of being prescribed mood altering psychotropic drugs.

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While the causes can be many, women suffer from gender specific risk factors for common mental disorders that disproportionately affect them. These factors include violence, socioeconomic disadvantage, low income and income inequality, low or subordinate social status and rank, and responsibility for the care of others.

Many women also do not have access to healthy foods that can help prevent and control chronic diseases, which account for over 60 percent of all deaths to women in Franklin County (home to the City of Columbus), Ohio.[1] In fact, over 40 percent of women in the county do not eat fruit on a daily basis, and more than one in five women (20 percent) do not eat vegetables every day. [2]

This trend is of particular concern considering that four out of the top five leading causes of death are due to chronic conditions, and cancer and heart disease account for over 40 percent of all deaths to women in Franklin County. [3]

In addition to healthy and affordable foods and lifestyle factors, the social determinants of health greatly impact women’s health outcomes in not only Columbus, but also communities across the country. Neighborhoods and housing, employment, education, transportation, and access to health care all play an important role and must be addressed at their root causes.

Columbus Public Health is working to address the social determinants of health so that all women can live the healthy and safe lives they deserve. Learn more about our work with the Community Health Assessment and Community Health Improvement Plan.

The bottom line is that women play a major role in the health of the community. If we improve the overall health of women, this effect will trickle down to positively impact the health of their families and the community as a whole.

Over the last 100 years, we have opened doors and shattered glass ceilings to give women more opportunities than ever before, and now is the time to give all women the opportunities and choices they need for good health.

We have a lot of work to do to protect and empower future generations of women and it will only happen if we all work together at the local, state and federal levels to improve health. At Columbus Public Health, we are committed to this effort – and I encourage you to join us.

Working to protect the health and improve the lives of all women will be the best Mother’s Day gift we can give to our grandmothers, mothers, aunts, sisters, daughters, granddaughters and nieces.

 

[1] Ohio Department of Health, Vital Statistics, 2014-2016, Analysis by Columbus Public Health.

[2] Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2015.  Analysis by Office of Epidemiology, Columbus Public Health

[3] Ohio Department of Health, Vital Statistics, 2014-2016, Analysis by Columbus Public Health.

Multnomah County’s Community Powered Change

After years of unacceptable disparities data, we knew we had to do something different.  In the summer of 2015, Multnomah County Health Department (MCHD), set out to create a community health improvement plan (CHIP) centered on things that are largely outside of the control of the individual. In response, MCHD released a request for proposals (RFP) for the coordination of a CHIP that was created in partnership with communities of color. Oregon Health Equity Alliance (OHEA) was selected as the contractor to lead the development and implementation process for the CHIP.

Throughout 2016 OHEA, with the support of MCHD’s Health Equity Initiative (HEI), intensive community engagement and outreach (forums and interviews) were conducted to gather input from a variety of communities including: African-American, Asian, Immigrant/Refugee, Latino, Native American, Pacific Islanders, and youth and elders of color. The outreach and engagement was followed by a tremendous amount of planning, analyzing and prioritizing areas over the next year. Through these engagement efforts, a framework was developed outlining 23 goals and over 150 strategies.

Sexually Transmitted Diseases (STDs) are Making a Comeback – Recognizing April as STD Awareness Month, We Highlight BCHC Activities to Address Vast Increases in (STDs)

STD Awareness Month is an opportunity to focus on raising awareness of a problem that affects millions of Americans every year. STDs in the United States are at record highs, despite years of dropping rates, with the latest CDC data showing chlamydia, gonorrhea, and syphilis infections rising to exceed 2 million reported cases nationwide.  The increases are dramatic - 4.7% for chlamydia, 17.6% for syphilis, and a whopping 18.5% for gonorrhea. In short, we’ve lost ground in this fight. Left undiagnosed or untreated, STDs can cause serious long-term problems. Importantly, they are largely preventable and treatable.

On Earth Day: Local efforts are making a difference on climate change

The world-wide scientific consensus is clear: climate change is real, it is being driven by human causes, and we must act now to avoid its worst effects. However, it also clear that leadership in the fight against climate change will not come from Washington, D.C. anytime soon. The EPA is being targeted for huge budget cuts, and the U.S. withdrew from the Paris Climate Accord. In a heartening trend, businesses, community organizations, non-profits, states, counties and cities are stepping up to fill this leadership vacuum. Within this growing coalition there is one player that is often overlooked: local Health Departments. We have a unique perspective and the community connections to play a significant role in helping our communities adapt to the effects of climate change while also fighting against its causes.

Making Public Health Visible

By Narintohn Luangrath, Special Assistant to the  Baltimore City Health Commissioner and
Dr. Leana S. Wen, MD, MSc, FAAEM, Baltimore City Health Commissioner

At a commencement ceremony several years ago, Dr. Linda Rae Murray, then-president of the American Public Health Association, recounted a famous saying: “When public health works, we’re invisible.” She followed that by urging the graduates to “refuse to be invisible, because […] we need to lend our strength and our science to broad social movements whose goal is to make things better.”

When public health is invisible, we only end up talking about it when things go wrong; people tend to think about public health agencies as entities that respond to infectious disease outbreaks or shut down a restaurant due to health code violations. We frequently think about health as healthcare, but what determines how long and how well we live is less about what happens in the doctor’s office and more about where we live, the air we breathe, and the availability of other resources in our communities. At the Baltimore City Health Department (BCHD), we believe that all issues – education, housing, employment, public safety, and beyond – can and should be tied back to health. We are committed to making the progress earned through public health visible, and to make the case for incorporating health-in-all policies across the City.

Wanted: Leaders for a TB-Free United States

By Joseph Iser, MD, DrPH, MSc, Chief Health Officer, Southern Nevada Health District

This blog originally appeared in County Line Magazine

 

Every year on March 24 the health care community commemorates World TB Day to bring attention to a preventable disease that still impacts many people in the United States and around the world. This year’s theme is “Wanted: Leaders for a TB-Free United States. We can make history. End TB.” It is a call for health care partners to work together on a local, national, and international scale to eliminate the disease.

Health care providers are instrumental in this process. For many patients, TB can present as a bad cold or respiratory infection that won’t go away. Physicians should always consider the possibility of TB when examining a patient with an ongoing respiratory infection, especially if it is accompanied by a persistent cough, night sweats, loss of appetite, and fatigue.

Seattle's Food Safety Rating System is One Year Old

In 2017, King County launched our new food safety rating system with the goal of making it the best rating system in the country. With a year under our belt, Public Health – Seattle & King County’s food safety team is proud to say that the new system has achieved measurable success.

  • Over 75 percent of all restaurants in King County now have easy to understand food safety rating signs in their front windows. This has greatly improved the ability for consumers to quickly assess the food safety practices at each restaurant.
  • Anecdotally, our food safety investigators report an increased interest from restaurant owners in improving their food safety practices, which means that the placards are motivating restaurants to do better. The number of perfect scores from all restaurants across King County increased 3 percent in 2017 from 52 percent to 55 percent.
  • The ratings provide a more complete picture of food safety than any other rating system across the country. Ratings reflect the trend of critical food safety practices over time in each restaurant and take inspector differences into account to make sure the playing field is level.
     

The 90 Days of the White House Opioid State of Emergency are up, and communities have little to show for it

By Chrissie Juliano, Director of The Big Cities Health Coalition

Today marks 90 days since the President declared the opioids crisis a public health emergency, and the White House announced last week that it would extend the declaration for another 90 days. To date, little has changed in the federal approach to the epidemic, and unfortunately, the emergency declaration has amounted to little more than administratively nibbling around the edges of a major national public health crisis.  Simply extending the emergency declaration does little to address the epidemic. What is needed is funding and leadership at the federal level.

Measles: An Ongoing Challenge to Prevent and Control Reintroduction Outbreaks

By authors including Jeffrey Gunzenhauser, MD, MPH, Interim Health Officer and Medical Director
and Franklin D. Pratt, MD, MPHTM, Immunization Program, Los Angeles County Department of Public Health

Since measles was eliminated from the United States in 2000, efforts to control reintroduction outbreaks have faced a variety of challenges. An outbreak in California was largely isolated to Los Angeles County and primarily affected a single social group in which anti-vaccination beliefs and behaviors prevailed. The outbreak resulted from a single individual who acquired infection from an unknown source, developed rash on Dec. 2, 2016, and subsequently exposed siblings and other contacts. This produced a clear chain of transmission. In total, 24 cases resulted from this outbreak, with 18 occurring in Los Angeles County and six occurring in nearby jurisdictions.

What a Long Strange Year 2017 has been in Public Health: Historic Storms, “Banned Words,” and Deep Funding Cuts – Just to List a Few

By Chrissie Juliano, Director of the Big Cities Health Coalition

In 2017, governmental public health shined in our country. In the face of historic natural disasters in Texas, Florida, Puerto Rico, and California, public health staff on the front lines dedicated to serving the American people – no matter what – did their work and delivered. Many stayed behind when others fled, or travelled from their safe, dry homes to help those in danger, save lives, or clean up.

Fighting Flu in Big Cities: Lots of Germs in that Big Petri Dish

By Chrissie Juliano, Director of the Big Cities Health Coalition

Fighting seasonal influenza (the flu) is serious business. It may sound rather pedestrian compared to headline-grabbing diseases like Ebola or Zika, but fighting flu, and other such “routine” outbreaks, is what local public health departments do every day to protect lives.

In a moderate to severe year, seasonal flu kills more Americans than car accidents. Over the past 30 years, it’s killed anywhere between 3,000 and 49,000 people in single a flu season. It also costs Americans $87 billion in direct costs and lost productivity. In short, there are many reasons to fight flu.

Beyond Thoughts and Prayers

By Dr. Rex Archer, Director of Health, Kansas City, Missouri Health Department

After the trauma of the events surrounding the Las Vegas mass shooting, stories of horror and heroism unfolded from that horrible act.  My compassion and prayers felt somewhat hollow.  I am in a position to move my compassion to actions that make a difference and to save many lives.  That is why I am in public health. Yet, the enormity of the challenge seems daunting.

Acts of Nature are Public Health Emergencies

By Meredith Li-Vollmer, Public Health - Seattle-King County

The news from Hurricane Harvey has been heart wrenching. Among the memorable images that emerged was one of nursing home residents sitting in wheelchairs, waist-deep in flood water as they waited for help to arrive. As reported by the New York Times, among the thousands of posts to volunteer rescue groups were common pleas such as “East Houston, 9:53 p.m.: Needs evacuation, one elderly person in a wheel chair” and “Northeast Houston5:36 a.m.: He’s on bottled oxygen now, and running out. Nausea from lack of oxygen has already started.” As some of the most vulnerable in the community struggled, news also covered the toll that the hurricane has taken on the world-class hospitals in the Houston area who were well prepared with back-up generators but hampered by the extremity of the weather and flooded roadways to evacuate patients and bring in emergency vehicles, food, and supplies. Hurricanes and floods aren’t just acts of nature. They are also public health emergencies.

“Back to School” Season: Backpacks, school supplies and cancer prevention

By Dr. Julie Morita, Commissioner of Health, Chicago Department of Public Health

Flipping my calendar from July to August, always yields a sense of melancholy as I can see the less structured, long, warm days of summer rapidly disappearing and the busy, regimented, new school year entering into sight. While many people overcome the sorrow of the summer ending with “Back to School” shopping for backpacks, new clothes and school supplies, since becoming a pediatrician almost 25 years ago, I have sought consolation in knowing that “Back to School” means that millions of school-aged children throughout the US will be receiving health examinations and vaccines, which prevent serious diseases including measles, mumps, whooping cough, and polio.

How the Senate's Obamacare repeal bill would wallop the urban poor, and especially those who rely on Medicaid and public hospitals

By Dr. Mary T. Bassett and Stanley Brezenoff

If there was any hope that Senate Republicans could bring some sanity into the national discussion around the future of our health care system, such hope completely vanished on Thursday. Like the House's health care bill, the Senate's proposal is nothing less than an all-out attack on public health and our public hospital system, and its consequences will be devastating for New York City and the country.

Showing up for LGBTQ communities

By Jesse Chipps, HIV Planning Council Administrator, Public Health - Seattle & King County

June is National Lesbian, Gay, Bisexual and Transgender (LGBT) Pride Month, and each year at this time hundreds of King County employees, department directors and public officials march together in Seattle’s Pride Parade. Rainbow tinsel laden vehicles, bubble machines, and matching t-shirts pull the group together as One King County.

The Zika Fight of 2017

By Chrissie Juliano, Director of the Big Cities Health Coalition

Last year’s high profile infectious disease outbreak of the Zika virus is still fresh in our minds. While official announcements last week told Americans that the outbreak is waning in the U.S., all of the same conditions that created a Zika emergency last year are still present today. And just like then, the consequences of inaction are very real for those at risk, especially pregnant women and their babies. Unlike last year, we are also dealing with an Administration proposing an absurdly large –$1.2 billion – cut to the U.S. Centers for Disease Control and Prevention’s (CDC) budget in a way that would severely hamper its ability to fight, not to mention prevent, disease.

Combining Disciplines, Reducing Stigma: How Long Beach Incorporates Mental Health into Public Health

By Kelly Colopy, MPP, Director, Long Beach Health Department

May is Mental Health Awareness Month, which brings a heightened awareness and opportunity to support the mental and emotional health of those in our communities experiencing a mental illness.  As individuals and families, as well as communities and organizations, we are learning that we all know someone, often close to us, who has experienced some level of mental illness in their lifetime.  Nearly 1 in 5 adults (43 million) in the United States experiences a mental illness each year.  The impacts of mental illness diagnosis vary widely; some have serious impacts on the ability to perform major life activities.  Access to treatment has improved with the passage of the Mental Health Parity and Addiction Equity Act of 2008 and under the Affordable Care Act in 2010, yet more capacity for treatment is needed.  The conversations are increasing at the systems level as we work to grow healthy supportive environments and increase access to mental health resources in our community.  Yet, at an individual and community level, the conversations continue to be difficult.  The stigma, while lessened, still remains.