Public Health Community Trends
Josie Henderson = Program Manager at Oregon Public Health Association.
"The big effort here is around healthy environments, because these are seen to impact a multitude of factors from obesity to safe food and water supply to workplace health."
1. The role of Public Health in Coordinated Care Organizations:
She explained to me that this one of their biggest "trends"/projects going on. Health care has become increasingly unaffordable to individuals, businesses, and state and local governments for Oregon. So, they're trying to transform Oregon's health care system by creating a local network of all health care providers to provide optimal delivery of care to Oregon Health Plan clients. With this transformation, they're trying to eliminate unnecessary costs (due to over treatment, failure due to lack of coordination, excessive administrative spending, excessive pricing, fraud and abuse) and bring more coordination between physical, mental, dental, and other care. If there is no coordination between them, the costly outcomes go up. She said that for all that they spend, the health outcomes are not what they should be (an estimated 80% of health care dollars go to 20% of patients mostly for chronic care).
They want to change the way health care is delivered to:
- Focus on and improve health
- Reduce waste
- Create local accountability
- Align financial incentives
- Fiscial sustainability
2. Obesity:
Oregon is the 35th most obese state in the country. Not too bad; however, it's still an important issue to the Oregon Public Health Association. Trends in food consumption are not surprisingly low in fruits and veggies and high in flour and cereal products. Over the years, the trends in energy expenditure at work are decreasing for both men a women. As for transportation to work, we see less walking more driving (showing an average of .13 kg/m increase in BMI for those who drive to work). We see that in places with more fast food and convenience stores per square mile, the average BMI is .02 kg/m higher. Conversely, places with more grocery stores and farm stands per show the average BMI is.08 kg/m lower. These aren't just trends going in just Oregon itself but certainly all around the nation.
3. Fluoridation:
Josie noted how Portland isn't fluoridated and that their making a huge effort to change that. One third of Oregon's children suffer from untreated dental decay and it accounts for more than 30% of all healthcare costs for them. This in turn causes them pain, an undermining of their education and impacts them in the long run of employability, productivity, and their overall health status. Because of this dental crisis, money from taxpayers, businesses, and families are wasted. Although everyone is affected by this, people of lower income communities and communities of color suffer the most (sometimes with two or three times more dental decay than other Oregonians.) This is why fluoridation has been such a big deal. By fluoridating their drinking water, dental decay will be reduced by at least 25%. "The difference between good dental health and bad dental health is fluoride."
4. Built Environments:
Something that the Oregon Public Health Association has been working on is keeping neighborhoods healthy and safe. They do this by creating a "built environment." This includes building center houses for community activities and providing the means of transportation. The affects of the built environment have a definite impact on our health (obesity, CVD, hypertention...etc) What OPHA has been doing to support the built environment is creating more parks and recreational facilities for people of all ages, helping to create safer environments and allow for more physical activity.
The built environment affects:
- Active transportation, physical activity levels and recreation
- Public transit
- Accessibility of resources
- Affordable housing
- Access to food/healthy diet
- Water and air quality
- Noise
- Traffic safety and pedestrian/bicyclist safety
- Exposure to environmental hazards
5. Worksite Wellness:
Something that Oregon has been working towards is safer worksite environments. They have 4 steps toward worksite wellness: Inspire, Engage, Inquire and Act. In August of 2010, the Public Health Leadership Division approved a Public Health Wellness Policy which also established a Healthy Public Health Division Committee. They have developed a 5 year wellness plan which in their mission is to improve the health of their employees through systems and policy change, health promotion, communication, and evaluation. They want to create a "Culture of Health" to support the workplace, benefit employees, and allow for personal responsibility.
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