Public Health in Oregon - Join The Conversation

Investments in safe bike routes (perhaps separate from roads); more parks in neighborhoods that have no park within a half mile (perhaps more “indoor parks” for the winter season, such as community health centers); and investments in “long parks” - a green belt - that can be used by walkers, runners and bike commuters.
Hindu Baby Names

Saw this today…maybe people have ideas that could be supported by this grant (please note the 1/29/10 deadline):

ConAgra Foods Foundation’s 2010 Community Impact Grants (CIG) program is open from January 11 - January 29 for eligible organizations to submit a Letter of Interest (LOI). The CIG program will award grants between $10,000 and $100,000 to impactful, grassroots organizations that leverage innovation and creativity to address childhood hunger and nutrition needs in communities where ConAgra Foods’ employees live and work [that’s OR] or states where 20% or more of children are food insecure. Organizations that demonstrate a strong alignment with the Foundation’s giving strategies (i.e., direct service, capacity building, and advocacy) and core funding priorities have the greatest chance of receiving a grant. The CIG program is a two-step, competitive process that first requires the submission of an LOI and then the subsequent completion of a full application if invited to apply for a grant. For more detailed program information and guidelines please download the Community Impact Grants Program Overview. To begin the LOI process, please complete the eligibility survey in Step 3 above.

(http://www.nourishkidstoday.org/about-us/application-guidelines.jsp )

Personally i find that prevention of obesity and nutrition education are both equally important and fall into the same category in a sense. Obesity is almost directly effected by a lack of proper nutrition education. Generally people are aware of the foods that are good for you and the foods that higher in fat, but along with that people find out that healthier foods are often more expensive. I think the many parts of the public health world need to advocate for more education about how to choose healthier options at popular restaurants.
No only does poor nutrition education effect obesity rates, it is that obesity that compromises the health and generally well being of the obese. Obesity causes so many other health issues such as diabetes, high cholesterol, and physical health. I feel like this current obesity epidemic has become so big that companies are finding new ways to advertise unhealthy products such as diet pills. The general public needs to learn that yes losing weight is hard but it is very very important to your well being.

I think that the adolescence and teen health awareness programs are most important, though all the issues posted are. If you teach young kids to be healthy in all aspects they normally will carry this into adulthood and this can help prevent future problems, many which are listed such as obesity,smoking and drug problems. I believe it is smarter to teach people at a young age to be healthy instead of try to fix there problems later on in life when they are already unhealthy.

I thought that prevntion of obesity was my most important issue. In my howtown we have plenty of resources to help us with the other topics that were mentioned. When i go to the doctor or something i never see as much advertisments posted on the walls warning us that it is important to watch what we eat. Sometimes i see posters here and there, but not as there should be. It has become a huge issue among americans that it is important for us to make sure that we care of our bodies. This can prevent further diseases such as cardiovascular disease which is the number one kill for americans.

I choose prevention of obesity for the reasons that i believe that we have many other programs for the other ones on list. We haven’t been making a better effort in preventing obesity and the statstics show how many more people are being diagnosed with diabetes, cardio vascular disease, and heart diseases. I believe that obesity is an important health priority to help our future generation to live a healthier life style.

It is hard to choose just one of these issues, because in many ways they are all related and can influence one another. I believe that nutrition education and the prevention of obesity are very important, seeing as the lack of either would lead to many more issues such as; higher cancer rates, depression, cardiovascular diseases, an unhealthy population etc.

I think that the prevention of obesity is very very important and it is usually over looked. Not many people think of it as a problem or even notice that it is increasing more and more over the years. Something definitely needs to be done with all of the processed foods and drinks in the US.

Personally, I would absolutely choose the prevention of obesity. So many other diseases and complications with life come with being overweight or obese. It is an epidemic in the United States. I recently read that there are now more obese people in America than there are people of an “average weight.” (Though, I don’t know what they used to determine their “average weight” in these statistics.) Heart disease, stroke, type 2 diabetes, cancers—these are 4 MAJOR interruptions in a person’s life, and someone who is obese is at a drastically higher risk. Also, once someone reaches obesity, they seem to me much less likely to LOSE 50lbs than say, if they were 50lbs lighter, being educated and learning how to avoid gaining those 50lbs in the first place (just an example.) Taxes on high sugar and high fat foods and beverages, just as were placed on cigarettes, could be a great step to reducing the likelihood of people making those purchases. Being a college student, I see people who walk 3-4 miles a day to, from and between classes who are overweight and obese. These people are 18-24 and are already well on their way to some disheartening health complications. Preventing obesity could also be as simple as making easier-to-read food labels, public education. I think the possibilities are endless!

If I had to choose just one of the myriad of community health issues that exist today, I would choose the elimination or at least reduction of chemically enhanced drinks that offer extra energy as their base for consumption.  There are many substances that advertise increased energy, and are sold in powder, pill, and liquid form, and most of these can be found in places where everyday consumers go to shop. Although vitamin stores and online outlets are known to sell energy drinks, convenient stores and supermarkets also have energy drinks readily available. For example, there is a drink that is touted as the world’s most powerful energy drink. The company advertises its product as a potent herbal blend of Guarana, Ginkgo, Ginseng and Milk Thistle. The drink is supposed to provide an incredible energy boost for those who lead active and exhausting lifestyles, from athletes to rock stars. Although the recommended serving size is 8 oz, the drink is sold in 8.4 oz, 16 oz, and 24 oz cans. It only takes a trip to the local supermarket to realize that energy drinks occupy a quarter of the drink isle. My purpose here is not to criticize any energy drink in particular, but it is to raise consciousness of the meteoric rise of such products. High stress and low energy status is growing within the population, and it is a rising concern for many of those in the health field that are paying attention. We should be looking at health behaviors upstream to find out why people think they need these energy drinks to begin with.

In my current job, I serve the 43 federally recognized Tribes of the Northwest and I’ve done project work w/ a few Tribes w/ regard to Drug and Alcohol Abuse. In some of the reservations they’re lucky to have one treatment center, if any, and the nearest Treatment Center is NARA (Native American Rehabilitation Center) located in Portland. The need for a (if one) drug/alcohol treatment center is expressed in many tribal communities because many community members don’t have the transportation, money, or access to a drug/alcohol treatment center which in turn only increases their use of drugs and/or alcohol if they can’t travel or access a treatment center. On the other hand, if there were funds to bring a treatment center to these communities, would there be enough counselors and/or trained staff to run such a clinic? In Indian Country the need for trained, experienced staff, intervention specialists and counselors is also lacking in Hospitals and health clinics, not just in the NW but in the entire U.S. Why? There is simply not enough funds to do this.
I am only relaying the information which was presented to me by Tribal Council Members, Health Directors and A&D Counselors. In one community the need for trained and skilled staff was reported first before the need of a drug/alcohol treatment center because the closest treatment center was only 20 minutes away.

I am an older adult fitness educator and instructor. I would love to have the funds to start a program that educates and facilitates education and fitness programs for older adults so that we can erradicate the impending need for medication and other expensive and otherwise preventable treatments. If people could have the knowledge to realize how much prevention can enhance our physical and psycho-social well being for a longer, healthier life, they would have a chance to lessen the burden of medical expenses in the future. I could go on and on, but I hope you get my idea for now.
Thanks for giving us a place to give ideas.

It is my opinion two of the most pressing public health issues we face as Oregonians are the rapid increase of obesity, as well as the lack of effective drug and alcohol treatment programs available.

Only in recent years has addiction been looked at in its true form, a public health issue, and this somehow still evokes controversy.  An addict is a sick person, and this sickness is spread to those around them.  Depression rates not only tend higher among those addicted to drugs and alcohol, but also those close to the afflicted.  Every time we allow an addict who is ready for change to continue on the same desperate path we miss the opportunity to offer treatment for a treatable condition.  We allow an illness to persist.  This issue seems not completely lost on the average person, as a growing number of publicly funded programs have in recent years become available.  Much like the battle with diabetes, this is a continuous problem that will not go away, but we as a society have a responsibility to treat it.  This critical issue deserves more attention and funding than it currently receives.

Now I must speak to an epidemic.  Obesity is obviously one of our nations most serious issues; the evidence is all around us (literally and figuratively).  While I am no expert on nutrition, it seems to me that the sweetener high fructose corn syrup has greatly contributed to our national problem.  It’s in everything; I have to hunt for bread baked without it!  At least some of its popularity can be attributed to the low price of corn, making it an attractive material for business.  At least domestically, corn’s price is kept artificially low by subsidies from the U.S. government.  Are we helping to propel this epidemic?  We must address whatever is making our country so fat, as this issue is siphoning so much from our public coffers, contributing to decreased life span, increased rates of heart disease, childhood diabetes, etc…

I could elaborate on these issues for pages, but as this is a blog posting I’ll leave you with this.  I was very pleased to see how low the banning of outdoor smoking ranked in this poll.

This was a hard decision for me seeing all those issues are very important. After looking at the result, it became clear to me which one was the priority. I chose improving air quality. I guess this is one of the issue that some people just don’t pay attention to but to me it’s important seeing how there was no vote in the improving air quality. Improving air quality would not only benefit the earth but it would benefit us as well by living in the healthier environment. For this reason, people decide to go green which in my opinion is a very good thing to do to contribute to the earth.

My community health priority for additional funding is mental health.  There are so many people with incredible needs stemming from mental health issues, many of which could be helped with adequate help from counselors and medical professionals.  Proper medications, diets, and advocates are necessary and many cannot afford any of them.  Even people with insurance get limited assistance, but for the many who are without health insurance the cost is prohibitive.  The community at large needs to be educated regarding mental health issues and treatments.  All this comes at a price - but the cost being borne by our communities without more funding is much higher.

I chose the reduced use of pesticides, herbicides, and other toxic chemicals.  While it is possible to educate oneself about many health issues and to change ones own lifestyle, it is impossible to avoid the toxic pollution in our collective environment.  There is much that needs to be changed in the production of food and NOT towards more technology.

Health is a basic human right. Everyone in my community needs access to healthcare. Oregon and Washington can work together to make that a reality for our part of the world. We do not need to wait for change at the national level where most of the health dialogue is dominated by the pharmaceutical and insurance companies. Primary health care can happen here on a human scale. I take inspiration from the Canadian health system. I work as a doctor in safety net primary care and our country’s health system is a terrible mess.
I know that a split exists between what is considered “public health” vs. “direct services” but that divide is artificial.

This was a great list, but I still choose other.  I have spent the last 10 years working with survivors of domestic and sexual violence and many of the health issues listed impact their ability to achieve security and self-sufficiency.  We have seen major decreases in affordable housing, health care, basic food support and other safety nets that were once in place to help those in need.  Domestic and sexual violence is not a new phenomenon and it so greatly impacts a persons emotional, physical and mental health.

I am involved in many NGO’s concerned with peace and justice issues, homeless, health care advocates. 

I join with other members of Oregon Physicians for Social Responsibility in supporting an Environmental Health Conference at OHSU.

During these challenging times in our economy, we cannot let go of thinking more long term, i.e. prevention.  The only way to reverse the downward spiral we are facing in health care, is to redirect and increase resources towards community prevention.  And the partners it will take to accomplish this are not just in public health; they are in planning, schools, private business, development and medical care.

I agree that directing resources into smart urban design can have profound impacts on community health.  Investments in safe bike routes (perhaps separate from roads); more parks in neighborhoods that have no park within a half mile (perhaps more “indoor parks” for the winter season, such as community health centers); and investments in “long parks” - a green belt - that can be used by walkers, runners and bike commuters. Making exercise practical, accessible, and cheap on a large scale can be achieved by investing in strategic urban design.

Oregon ranks 49th in the nation in school nurse- to-student ratios.  Educators and health professionals affirm the interrelationship between health and academic success.  School nurses provide the connection between health and education.  This state needs to prioritize health resources for Oregon’s youth as one of the most valuable investments it could make for the short and long term quality of life for everyone.

Community health priority - the maldistribution of wealth.

I chose the ‘other’ box, with a lens toward a more systemic approach to address community understanding in the relationship of public health and social change. 

My organization focuses on environmental injustices and the issues of overburdened and “ignored communities” impacted by many of the concerns mentioned in the poll. And I was pleased to read some of the responses around social capital and the need for building relationships with communities. I feel this step is missed in the different service-based and upstream approaches towards public health.

An involved, active, knowledgeable and participating community must be prioritized first to address each one of the issues above—and I think we must take a look at the individuals and organizations leading this approach and process. Are the organizations and individuals working to identify with the community? Is the community involved and active in the role of the organizations? Are we taking time to listen and build relationships, or is the focus on timelines, project outputs and workplans?

Given the difficult economic times ahead of us, now more than ever is the time to, as a community, deliberate about our shared health priorities.

A story: ‘Bob’, a 35 year old man who lacks medical/dental insurance and a living wage searches for dental resources to address his painful tooth. The limited dental resources in our community are so overrun by clients in need that they prioritize those individuals who require tooth extractions. Due to the many many other individuals needing immediate dental care, Bob’s needs are not addressed for another two months when his tooth, at that point, must be extracted.

Bob’s story is an analogy for our community’s health. As the abiliity to access upstream interventions decline (i.e. primary care, wellness exams, preventive education, dental screenings), the need for downstream interventions increase exponentially (i.e. emergency room visits, immediate dental care such as extractions). We require a balanced system in our community; one that is designed with intention.

I urge individuals to continue to share their stories, thoughts, and suggestions in this forum. I’m thankful for the opportunity to share mine.

Our children are suffering the physical, mental, emotional impacts of a health care crisis. School-based health centers are a recognized solution to this crisis. More than 20,000 students came to a center during the 2006-07 school year, receiving 69,000 service encounters!

Thousands more children are in need of care and we can and must help create opportunities for them to receive the care they need, when they need it.

I echo the call for policy makers to do the tough work of making accessible, quality health care available!

Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery

In the best of times it is hard to balance the priorities of public health - much less priorities between public health and direct services.  It seems like we are often victims of the economic cycles - when times are good, we just get going at the more preventive, public health work and then the economy goes down hill and pressure to fund direct services takes precedence.  Because of our scarcity thinking and survival mode reactions, we often tend to take sides - “Public Health is more important” - “Direct Services are more important”. Despite years of effort and thought, we have made very little progress and have actually moved backwards in some ways.

I appreciate this website and the opportunity to get more voices involved.  I urge policy makers and opinion leaders to really challenge their assumptions - what makes academic sense does not always work in reality.  I recommend we all look to what is actually working in communities and that we commit to balancing our short term crisis with our long term needs for systemic change.

By investing in school-based health centers we can take on multiple issues on this list—preventing obesity, mental health and depression, smoking prevention and not just screening for diseases but well child visits and the primary care that so many children miss out on in Oregon.

I think what is interesting about this list of health priorities is that it is all about deconstructing health into tidy discrete boxes. This process of deconstruction may be good for health care redesign but it should not be confused with community health priorities.  Deconstruction means that we can “value” some diseases more or less relative to cost savings on the system or which diseased evokes more fear among the public. Strokes cost the medical system a whole bunch more money (and is scarier) than childhood asthma so if that was the priority choice we should be allocating limited resources to prevent strokes and let vulnerable kids struggle to manage asthma.

Our true community health priorities should be wrapped around the concepts of social capital and connectedness.  If we truly had a sense of community and were connected to each other it would radically change the shape and nature of our social fabric.  In a connected community our priorities would be about promoting such things as living wages; investing in the commons (eg., public transportation, open spaces and libraries);  promoting community gardens and other access to local foods;  teaching community members conflict resolution, parenting and primary health prevention.  Learning, daycare, food cooperatives would become the norm and not the exception. If we were truly connected as a community, it would not be an option for children to arrive at school hungry or be without health care.

So I would suggest that prioritizing the disease of the day list can be useful but engaging in a deeper conversation about root causes might be even more fruitful

I chose housing because I am growing in my awareness that “homelessness” is a growing problem that belongs to all of us.
Research has shown the homeless have higher rates of hypertension, arthritis, mental illness, victimization, tuberculosis and substance abuse. Despite the higher rates of health problems, the homeless are less likely to have a regular source of health care, health insurance, a steady income or social support. The homeless are less likely to obtain preventive medical services.
Everyone deserves a safe place to call home.

It is difficult to choose just one priority. However, what I witness each day as a community health advocate are the ramifications from an unhealthy diet. So I chose nutrition education. Couple this with slanted advertising campaigns, lack of public transportation, barriers to accessing fresh produce, increasing food costs, the rising epidemic of childhood obesity, these all add up to a recipe for an unhealthy community. One of the initiatives working in our rural community is the Seven Oak Middle School vegetable garden, “Planting Seeds of Change”. Kids plant, tend, harvest and eat the produce which is incorporated into the school lunch program. The garden serves as their “classroom without walls”. The kids have embraced the “edible educational endeavor” and are engaged garden stewards while increasing their interest and knowledge of the importance of healthy foods in their diet. Our community partners are working together to create a healthier generation of kids by way of the vegetable garden. One row at a time, one school at a time.

The list represents a “Sophie’s Choice”. My community needs them all,and plenty of others so essential. They are all so interrelated.  We’re in such a crisis, and some people more affected than others.  CB’s response (#11) came closest to my heart.  I know that a medical calamity can put so many of us on the other side of our philosophies on what it takes to be healthy, maintaining our wellness, spirit, and hopes for a better, more sustainable future.

I chose “other” because of my fervent desire that everyone—EVERYONE—receive great preventive medical care…but now I think that, in fact, the lack of a living wage has perhaps the most immediate impact on my community’s health. Our family no longer earns a living wage, and, frankly, many of the values & lifestyles I held so dear back when we were solvent (healthy air, walking/going car-less, organic food, elite and fabulous childcare, etc) are simply, totally irrelevant. It (hopefully only metaphorically!) kills me to eat crappy cheap food (I’ve been obese), drive around looking for work, etc., but my immediate concern is earning enough to pay for housing/utilities/medical care/etc.

I chose housing because without housing, so many other services aren’t effective - it is nearly impossible to manage physical or mental health care, healthy eating,preventative practices if one is homeless.  We have a growing number of working families with children who are calling our centralized waiting list for emergency shelter - certainly they are “unsafe” as long as they are without housing.

Like others, I had trouble choosing just one area, but I went with obesity prevention because it impacts so many lives (children and adults) in so many ways. Close behind were dental and oral health care and mental health. All three of these issues are deeply felt in rural areas.

I chose increasing awareness of young people as a top priority.  When education about the cons of smoking increases, the rate of new smokers decreases.  So, hopefully, the same would be true if young people have enough education about the impact of obesity and drug use.  We can also influence culture and lifestyle if we have safe parks and ample sidewalks and walking paths.  A European immigrant once said to me, “Americans are fat because they don’t have to run to catch the bus.”  Public transportation may have benefits in addition to improving air quality.

I chose “other” because I believe every community needs universal access to primary health care.  As long as millions of people are outside the system, we won’t achieve cost control or better health outcomes. Communities need leadership on the national level for things to really change.

Our communities must peel back the layers and address the causes of obesity.  In order to prevent and treat obesity we have to rethink how we design our infrastructure and how we allocate resources.  This means transportation, land use, economic development, education, health care, public health, and other interests must collaborate for long-term solutions.  All citizens should have easy access to healthy choices that will help prevent and treat obesity and the burden it places on individuals, families, and communities.

While Bend is making progress, other Central Oregon towns lack sidewalks in many areas. The weather is good for walking, but many streets are unsafe. Art and/or other projects (landscaping, plants, etc.) that make walking interesting would encourage people to exercise.

Communities that endorse active transportation (walking, biking, public transportation) would have a long term impact on the health of our residents.  Using the principles of smart growth for changing our communities is necessary.

There are many important issues on this list that public health needs to address. For me, I feel like a top priority should be prevention of childhood obesity, as obese children are more likely to turn into obese adults. Obesity rates in the United States are increasing dramatically. In the past 20 years, the CDC reports that rates have doubled among children aged 6-11, and tripled among adolescents aged 12-19. Obesity puts individuals at risk for a number of physical and psychological problems, including heart disease, diabetes, certain types of cancer, social stigmatization, and low self esteem.  Treatment and management of these obesity-caused conditions require extensive use of public health funding and other resources.

The obesity epidemic is a very large problem with many contributing factors to consider. One I would like to highlight relates to the previous comment. When there is a lack of availability of sustainable, healthy, affordable food choices, individuals are forced to turn to cheap, high-fat, high-calorie options. This, in turn, can lead to obesity. It is important to make healthy options more affordable and easier to obtain. If we want to begin to fix this problem, the healthy choice has to be easier than the unhealthy choice.

http://www.cdc.gov/healthyyouth/obesity/index.htm

Food insecurity and hunger are important public health issues in Oregon that were not represented by the above list. Oregon has the highest rate of food insecurity with hunger in the nation.  So much time and energy is spent improving schools and education programs but the fact that the children who attend those schools are hungry and unable to take full advantage of the services can be easily overlooked.  Hungry children are more likely to have behavioral issues including irritability, aggression and anxiety.  Hungry children also have problems learning and retaining information.  This problem is not limited to families who are unemployed or living in rural areas.  Food insecurity and hunger are occurring more and more in urban families with at least one working parent.  I would urge the public health community to increase efforts in improving food availability, especially for children.

It was hard to choose from this list.  Some of these are priorities because of the great need, others rise to the top because of the great opportunity we have in making strides toward something “better.”

But I chose “depression and mental health programs” today because, for me, this area seems to suffer from a gross lack of understanding and dis-investment at all levels of our society—even more so than the others.  Also, because the systems to promote mental health are so underfunded and stretched (and in some cases, in disarray), it is imperative that we approach this topic through a preventive and community-wide perspective.