Rural Spotlight

With Just a Click, Determine Your Risk

Do you know if you are at risk for high blood pressure? The Heart Disease and Stroke Prevention Program, in partnership with the American Heart Association, is offering a free online risk assessment calculator.

The calculator uses your height, weight, blood pressure and other factors to determine your risk of heart attack, stroke, heart failure and kidney disease. The risk calculator also estimates how lifestyle changes such as reducing your sodium and daily exercise can lower blood pressure and other health risks.

After taking the test, the risk assessment calculator generates a report that you can take to your next doctor’s appointment. The risk assessment only takes a few minutes. Click here to find it.

Highlighting Positive Results

Health and Human Services’ Secretary Kathleen Sebelius recently released the first in a series of health care “success story” reports that document innovative programs and initiatives that can serve as models for a reformed American health care system. The inaugural report highlights the Michigan Keystone ICU Project, a joint partnership between the Michigan Health & Hospital Association and the Johns Hopkins University. The Michigan Keystone ICU Project helped dramatically reduce the number of health care - associated infections in Michigan, saving over 1,500 lives and $200 million. The goal of the Michigan Keystone ICU Project, which was initially funded by AHRQ, was to make patient care safer in over 100 ICUs in the state of Michigan by reducing catheter-related bloodstream infections. To help reduce these infections, clinicians were asked to implement a safety protocol that included a simple checklist. Select to read the HHS press release.

Barnes-Jewish Named One of Nation's Best

U.S. News and World Report has come out with their annual list of the country's best hospitals. Coming in at number nine is Barnes-Jewish in St. Louis.  Read this article for more on what the Missouri hospital is being recognized for.

F as in Fat: How Obesity Policies are Failing in America 2009

According to a new report by the Trust for America's Health (TFAH) and the Roert Wood Johnson Foundation (RWJF), adult obesity rates increased in 23 states and did not decrease in a single state in the past year. In addition, the percentage of children who are obese or overweight is 30 percent or higher in 30 states.

Mississippi had the highest rate of adult obesity at 32.5 percent, marking the fifth year in a row that the state topped the list. Four states now have adult obesity rates above 30 percent, including Mississippi, West Virginia (31.2 percent), Alabama (31.1 percent) and Tennessee (30.2 percent). Adult obesity rates now exceed 25 percent in 31 states. Colorado (18.9 percent) remains the only state where fewer than 20 percent of adults are obese. The F as in Fat report contains rankings of state obesity rates and a review of federal and state government policies aimed at preventing or reducing obesity. The report also offers recommendations for addressing obesity as part of health reform. Some key recommendations include:

• ensuring every adult and child has access to coverage for preventive medical services, including nutrition and obesity counseling and screening for obesity-related diseases such as type 2 diabetes;
• increasing the number of programs available in communities, schools and child-care settings that help make nutritious foods more affordable and accessible and provide safe places for people to engage in physical activity; and
• reducing Medicare expenditures by promoting proven programs that improve nutrition and increase physical activity among adults ages 55 to 64. 
  The report also calls for a National Strategy to Combat Obesity that would define roles and responsibilities for federal, state and local governments and promote collaboration among businesses, communities, schools and families. It would seek to advance policies that:
• provide healthy foods and beverages to students at schools;
• increase the availability of affordable healthy foods in all communities;
• increase the frequency, intensity, and duration of physical activity at school;
• improve access to safe and healthy places to live, work, learn, and play;
• limit screen time; and
• encourage employers to provide workplace wellness programs.

Read more here.

Read the executive summary and full report here.

 

State Response to H1N1 Outbreak

The Missouri Department of Health and Senior Services (DHSS), in coordination and collaboration with the Centers for Disease Control and Prevention (CDC) and local public health agencies (LPHA) worked quickly throughout the state to move Missouri from being prepared to responding to a possible widespread outbreak of a new H1N1 infl uenza virus.

The DHSS’ Department Situation Room (DSR) operated 24 hours a day, seven days a week and served as a command center for DHSS staff, DSR and Strategic National Stockpile team members to coordinate response efforts. The below information highlights some of those efforts:

SURVEILLANCE AND REPORTING

• Gathered and analyzed data on emergency room visits due to infl uenza-like illness.
• Developed updated surveillance strategies based on the developing situation.
• Responded to numerous questions from the LPHAs and healthcare providers and provided technical consultation on local public health case investigations.

STRATEGIC NATIONAL STOCKPILE (SNS) PROGRAM
As concern grew that a fl u pandemic was forming, the federal government activated the national SNS plan, sending pre-staged medication and supplies to states to further public distribution using state SNS plans. Missouri’s SNS plan was successfully activated and included the following activities:

• Distributed more than 600,000 adult antiviral medication courses and over 27,000 pediatric antiviral medication courses to local public health agencies.
• Provided technical support and guidance to LPHAs regarding the SNS activation.

NURSE HOTLINE
To assist medical providers seeking detailed consultation on a wide variety of related issues, a nurse hotline was activated. These consultations determined whether potential H1N1 fl u cases met the criteria to be tested through DHSS’ Public Health Laboratory, as well as addressed a myriad of questions, comments and concerns posed by medical professionals from across the state.

• The hotline was staffed 24 hours a day, 7 days a week between April 27 - May 11, 2009 and received more than 800 calls.

PREPAREDNESS and RESPONSE

Help limit the spread of the H1N1 flu virus by:

• washing hands often with soap and water, especially after coughing or sneezing. Alcohol-based hand cleaners are also effective.
• covering the nose and mouth with a tissue when coughing or sneezing. Throw the tissue in the trash after using it;
• trying to avoid touching eyes, nose or mouth;
• avoiding close contact with sick people; and
• staying home if you come down with the flu and limiting your contact with others to keep from infecting them.

The H1N1 virus spreads in the same way that regular seasonal infl uenza viruses spread, mainly through the coughs and sneezes of people who are sick with the virus, but it may also be spread by touching infected objects and then touching your nose or mouth. The H1N1 infection has been reported to cause a wide range of flu-like symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. In addition, many people also have reported nausea, vomiting and/or diarrhea.

LOCAL PUBLIC HEALTH / COMMUNITY MANAGEMENT
Missouri’s local public health agencies were on the front lines of the response effort. DHSS worked hard to provide LPHAs with the resources they needed to respond effectively.

• Maintained continual communication to advise LPHAs of numerous issues and protocols for H1N1 activities and developed information for the LPHA Emergency web page to provide secure, critical and up-to-date information such as special instructions and frequently asked questions.

MEDICAL RESPONSE
Any public health emergency requires public health and medical communities to work side by side in a united effort. DHSS works closely with medical clinicians and other healthcare providers to attain and maintain a strong, coordinated response.

• Producing Health Updates and Advisories that provide crucial
  guidance on a variety of issues including virus diagnosis, case
  management and protocol for lab testing.
• Reviewing infl ux of ever-changing medical and epidemiological
  guidelines issued by CDC and sharing with response partners.

STATE PUBLIC HEALTH LABORATORY
From April 27 to May 13, 2009, the State Public Health Laboratory analyzed 439 specimens submitted from across the state to identify H1N1 infl uenza cases.

• Special emergency courier services were set-up in strategic
  locations by collaborating with hospitals.
• Sample kits were pre-positioned by surveying and partnering
  with LPHAs.

To date, H1N1 has sickened more than 55 people in Missouri and 20,000 individuals in all 50 states. The virus emerged in Mexico and the World Health Organization has reported more than 55,000 confirmed cases of H1N1 infection in more than 100 countries and has declared the virus a worldwide pandemic. In the United States, the illness has so far not been severe. People who have contracted the virus generally have reported symptoms in line with the regular seasonal fl u. For additional information, visit the Missouri Department of Health and Senior Services’ H1N1 web site.

Heat & Humidity Make Deadly Summer Duo

The heat and humidity of Missouri summers are a traditional threat to small children, the elderly and the chronically ill, but they can also take their toll on young, healthy people. Among the 10 Missourians who died last year from heat-related causes, only three were age 65 or older. Seven were 25 to 64 years old. 

Missouri's Summer Weather Safety Week is set for June 21 through 27. Director of the Department of Health and Senior Services Margaret Donnelly says,

"High temperatures and humidity can combine to cause illness and even death, often with little warning.”

“We have to protect ourselves and take care of those who are more vulnerable to heat, such as senior adults and young children. Summer Weather Safety Week gives us the ideal opportunity to get people’s attention early, before it gets dangerously hot, and remind them to start taking precautions.”

Between 2000 and 2008, 203 Missourians died from heat-related causes. The elderly and the chronically ill are often more vulnerable because they perspire less and are more likely to be taking medications that can impair the body’s response to heat.

Those medications include antihistamines, heart drugs, over-the-counter sleeping pills, antidepressants, antipsychotics, major tranquilizers and some medications for Parkinson’s disease.  People should check with their doctor or pharmacist to find out if their medications make them more sensitive to heat. 

Seniors on fixed incomes often do not have air conditioning or feel they cannot afford the expense of running it.  Since many senior citizens live alone, Missourians should check on elderly family members and neighbors regularly to be sure they are not suffering from the effects of the heat.

Donnelly urges Missourians to call the state's toll-free abuse and neglect hotline at 1-800-392-0210 to report any senior adults or persons with disabilities suffering from heat and needing assistance.

Children are also sensitive to heat. They need to drink plenty of fluids during hot weather. Infants and young children should never be left unattended in hot environments, especially cars, even if they are running with the air conditioner on.  A car’s interior takes only a few minutes to reach oven-like temperatures, putting anyone left inside at risk of overheating.

Children also should not be allowed to play in or around cars. Small children can quickly be trapped because they are not big enough to open the door or roll down a window to escape.  Older children are also at risk if they fall asleep in a hot vehicle or play or hide in the trunk of a car. Donnelly says,

“Infants and young children rely on adults to regulate their environments and provide adequate liquids,” Donnelly said. “Without adult help and encouragement, small children often do not drink as much liquid as they should and they can become dehydrated very quickly.”

For warning signs for heat-related illness and ways to treat the heat, click here.

Listen to audio clips associated with this information here.