HEALTH S O U T H W E S T U TA H P U B L I C H E A L T H F O U N D AT I O N | FA L L 2 016 CANCER
Understanding Basics
FOOD PRESERVATION pg.10
A Lost Art
pg.22
ZIKA
An Emerging Disease
pg.12
LET TER FROM THE HEALTH O F F IC ER Local health departments are charged with the responsibility of preventing disease, promoting wellness and protecting the health of the population. Answering to a Board of Health comprised of county commissioners and appointed citizens, the Southwest Utah Public Health Department employs 54 staff and offers over 80 programs to serve the 210,000 residents of the five counties in southwestern Utah. These services make the most impact at the local level and our health department will continue to do our best to offer science-based, effective programs to our communities. Much of what we do is preventive and goes unnoticed. Yet in reality, the difference between a third world country and a developed nation is a good public health system. We hope the articles in this magazine will motivate you to protect and improve health where it matters most; with yourself, family, and community. Sincerely,
David W. Blodgett, MD, MPH SWUPHD Health Officer & Director
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THE PARAMOUNT IMPORTANCE
of public health By David N. Sundwall, MD
PUBLIC HEALTH
SOUTHWEST UTA
O u r m i s s i o n i s t o P R OT E C T t h e c o m m u n i t y ' s h e a l
past & present By David Heaton
10 CANCER
the basics By David Blodgett, MD, MPH
OUR 5 COUNTIES
12 ZIKA
the new west nile virus? By Kari Abeyta, RN, BSN
Beaver
PROMOTE
14 AN EPIDEMIC of fear By Anna Almendrala
Iron Panguitch
16 TIPS FOR EATING HEALTHY as a family By Erin Stewart
18
Washington
Kane
WALKING through the ages By David Heaton
20 THIS IS WHAT HAPPENS when you drink soda By Lindsay Maxfield
MAGAZINE BOARD
PROTECT
22 FOOD PRESERVATION a lost art By Al Cooper
26 THINK
like a survivor By Paulette Valentine
28 PRESCRIPTION drug safety By Amber M. Rich
30 FLU SHOOTOUT
EDITOR
PUBLISHER
David Heaton
Jeff Shumway
DEPUT Y DIRECTOR
Chris White
HEALTH OFFICER
David Blodgett, MD
DESIGN Kindal Ridd
calendar
ON THE COVER HEALTH S O U T H W E S T U TA H P U B L I C H E A L T H F O U N D AT I O N | FA L L 2 016
Special thanks to Andy, Emily, Avery, Maggie and Cole Heaton for modeling and growing such a beautiful Cedar City garden.
duck foot
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The entire contents of this publication are Copyright ©2016 HEALTH (the magazine of the Southwest Utah Public Health Foundation) with all rights reserved and shall not be reproduced or transmitted in any manner, either in whole or in part, without prior written permission of the publisher. Health magazine hereby disclaims all liability and is not responsible for any damage suffered as the result of claims or representations made in this publication. Printed by Hudson Printing Company / Salt Lake City, Utah / hudsonprinting.com
AH PUBLIC HEALTH DEPT.
l t h t h ro u g h t h e P R O M O T I O N o f w e l l n e s s a n d t h e P R E V E N T I O N o f d i s e a s e .
B E AV E R
IRON
75 West 1175 North 260 East DL Sargent Dr. Beaver, Ut. 84713 Cedar City, Ut. 84721 (435)438-2482 (435)586-2437
WAS H I N G TO N
KANE
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T H E PA R A M O U N T
OF PUBLIC HEALTH By David N. Sundwall, MD Guest Columnist
I
t has been said that “public health” – the collective efforts of our public health programs and policies at all levels (local, state and national) – does more to improve the quality of our lives and our longevity than all the doctors and hospitals put together. Seems like a bold statement, but it is true. The work done by public health programs to monitor threats from infectious diseases, assure the cleanliness of the water we drink, the safety of the drugs we take, the purity of the air we breathe, the quality of the food we eat, and the prevention of disease by immunizations, does far more to protect our personal health and that of our communities - than does medical care. Of course we all want and need access to the best, scientifically sound medical care when we need it to treat
disease and injury and to relieve suffering. However, techniques to prevent disease are often overlooked, and the importance of our public health efforts are frequently taken for granted and not valued to the extent they should be.
six years, from 2005 through 2010, and had the tough job of having to help develop our agency’s annual budget, get the governor’s approval, and present it to the Legislature for its authorization and appropriation of funds. This was always a daunting and difficult task, inasmuch as It is well known that the this one agency’s budget apUnited States spends an ex- proximates $2 billion (most traordinary amount of mon- of which funds the state’s ey on health-related care share of our Medicaid proand services – approximate- gram, which pays for health ly $3 trillion a year – yet, it care services for the poor, is estimated that only 3 per- disabled, and long-term care cent of this is spent on our for the poor elderly). Since public health enterprise (lo- each state agency competes cal health departments, and for a share of the state budstate and federal agencies). get, I needed to make the Still, although our invest- case for such a large amount ment in “health” could and of taxpayer dollars going to should be better balanced, the UDOH compelling and we get a lot of benefit from comprehensible. To explain what we do invest in public the value of public health, I health programs. simplified my message, tell ing our policy makers that I served as the executive public health does the foldirector of the Utah Depart- lowing “5 P’s”: ment of Health (UDOH) for
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PROTECTS the public by conducting careful disease and environmental surveillance. PREVENTS disease and injury with immunizations and making the public aware of threats. PROMOTES healthy behavior and awareness of risks through public education programs. PROVIDES care to those most in need on the state level through Medicaid, and by providing primary and preventive care through state-funded clinics. PREPARES for emergency responses to disasters, be they natural or man-made calamities. This oversimplified view does not begin to describe the range of activities that comprise our public health programs, but it seemed to help those responsible for supporting public health in our state to appreciate that these efforts are essential to the well-being of all of us. While most of the funding for specific public health programs comes from the federal government, our state and local governments are responsible for sustaining the infrastructure of the UDOH and our 13 local health departments. Between 1986-88 I was the administrator of the federal Health Resources and Services Administration (HRSA), and in that capacity I was also an assistant to the renowned Dr. C. Everett Koop, the 13th Surgeon General of the United States under President Ronald Reagan. He was a remarkable leader and for a time he succeeded in putting public health at the forefront of our national health concerns. I think this simple quote from Dr. Koop helps us all appreciate just how important public health is: “Health matters to all of us some of the time, public health matters to all of us all of the time.� I encourage everyone to be more aware of the critical role of public health principles and practices in our lives, not just when a threat to our health captures our attention. Dr. Sundwall is a Professor of Family and Preventive Medicine at the University of Utah. He served as director of the Utah Department of Health (UDOH) from 2005-2010. The original version of this article appeared in ILLUMINATIONS, the Magazine of the School of Medicine Alumni Association - University of Utah (Summer 2015). Used with permission.
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PA ST A N D P R E S E N T By David Heaton Managing Editor / SWUPHD Public Information Officer
that helped him narrow his search to a specific area surIn 1831, England was hit rounding a water pump on for the first time by a wave Broad Street. Dr. Snow wrote: of cholera, one of the most dreaded diseases of the time. A "On proceeding to the spot, I bacterial infection of the intes- found that nearly all the deaths tines, cholera causes profuse had taken place within a short diarrhea and vomiting and distance of the pump. There has up to a 60% mortality rate were only ten deaths in housif left untreated, sometimes es situated decidedly nearer to causing death within hours af- another street pump. In five of ter symptoms begin. Cholera these cases the families of the killed millions of people in the deceased persons informed 1800s as it spread from India me that they always sent to to Russia, Europe, and North the pump in Broad-street, as America. they preferred the water to that of the pumps which were Most medical practitioners at nearer. In three other cases the the time believed that diseas- deceased were children who es like cholera spread through went to school near the pump a poisonous mist in the air in Broad-street. Two of them called "miasma". John Snow, were known to drink the waa British physician, was skep- ter, and the parents of the third tical of this theory and chal- think it probable that it did lenged it in an 1849 essay. A so‌ few years later, London was in the grip of another series of With regard to the deaths occholera outbreaks. On August curring in the locality belong31, 1854 the worst outbreak ing to the pump, there were 61 hit the Soho district, causing instances in which I was inmost residents to flee and kill- formed that the deceased pering over 600 people over the sons used to drink the pump course of a few weeks. With water from Broad-street, eithe aid of a local reverend, ther constantly or occasionalDr. Snow took to the streets ly‌ of Soho as the outbreak raged in an effort to track down the The result of this inquiry, source. Going door to door then, is, that there has been no to identify where the victims particular outbreak or prevlived and what they had in alence of cholera in this part common, he created a map
THE POISON PUMP
of London except among the lation level. A new element of persons who were in the hab- public health had emerged. it of drinking the water of the above-mentioned pump-well. PROTECTING THE I had an interview with the Board of Guardians of St. James's parish, on the evening of the 7th (of September), and represented the above circumstances to them. In consequence of what I said, the handle of the pump was removed on the following day." Source: Snow, John. Med. Times and Gazette, n. s. vol. 9, Sept. 23, 1854, pp. 321-322.
Dr. John Snow's detective work helped end what he later called "the most terrible outbreak of cholera which ever occurred in the United Kingdom". He was able to show that contaminated water, not air, was responsible for the spread of cholera, and he traced the source of disease to nearby cesspools and sewage-polluted water from the Thames river, which was being piped directly to the pumps. Dr. Snow's use of statistics and investigation along with the simple removal of a pump handle marked the founding of epidemiology, or the science of studying patterns of health and disease at the popu-
PUBLIC
Renowned bacteriologist C.E.A. Winslow defined public health as "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations...communities and individuals." Public health has been practiced in various ways throughout history. The Chinese employed an early form of immunization against smallpox 3,000 years ago. In the Roman era, measures were taken to divert human waste in cities. Quarantine was used in medieval times to fight the spread of contagious illnesses. The 19th century saw the development of sewers, garbage collection, and landfills in industrialized countries where higher populations in urban areas increased the risk of disease. By the arrival of the 20th century, germ theory had been accepted and vaccines were being developed. World War I became the first major conflict where disease caused fewer casualties than combat.
HEALTH Science was making amazing strides against smallpox, diphtheria, yellow fever, syphilis, typhoid , and bubonic plague. Tetanus and meningitis were largely conquered with antitoxins. Feared diseases that once took a high toll from the population were being subdued in the United States and other developed nations. In the 1950s, Jonas Salk and Albert Sabin introduced vaccines for polio, which has now been eradicated throughout most of the world. Smallpox, which once destroyed entire civilizations and killed millions annually until just a few decades ago, became the first disease to be completely eradicated as of 1979. Advances in public health reduced infant mortality and have increased life expectancy to over 78 years for Americans. Traditional public health has usually included clean water, immunization, safe food, rule enforcement, passive surveillance, and some clinical programs. More recently, public health practice has entered new frontiers in technology, emergency preparedness, community involvement, and personal empowerment. Good
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public health practice protects the community's health by promoting wellness and preventing health problems from occurring in the first place.
Today the United States spends about $7000 annually per person on health care, usually for treatment after we become ill. It is estimated that an investment of $790 per person (as recommended by DOING MORE the CDC) for public health WITH LESS activities would actually cut The task of shouldering the what we spend on healthcare responsibility of public health in half. in society has largely fallen to government entities, since the Traditionally, we in Utah have emphasis is on populations funded public health at one of and broad-based solutions. the lowest rates in the nation, The Department of Health and so we're forced to do a lot and Human Services (HHS) with very little. Utah’s 13 lohealth departments get the oversees public health on the cal of their budget from federal level and includes the majority federal grants, which are obSurgeon General, Food and tained and distributed by the Drug Administration (FDA), Utah Department of Health. Centers for Disease Con- Currently, the five counties trol and Prevention (CDC), covered by the Southwest and the National Institutes of Utah Public Health DepartHealth (NIH). The Utah De- ment (SWUPHD) get $28 partment of Health (UDOH) annually per person for pubaddresses public health issues lic health, including $6.05 on the state level, and final- per head from county taxes. ly the work on the ground in Funding public health has Utah is done by independent been a "backburner" issue for local health departments. years, and increasing funding These county-level organi- to prevent future problems is zations are charged with pro- a tough sell for many people, viding direct services to their especially in today's economy. communities, and do so today The profession is also losing with increasing expectations knowledge and wisdom as and decreasing resources. experienced members of the
public health workforce retire. They, and others who leave for different employment, may not replaced due to tightening budgets. Local health departments are charged with the responsibility of preventing disease, promoting wellness and protecting the health of the population. Answering to a Board of Health comprised of county commissioners and appointed citizens, the SWUPHD employs 53 staff and offers over 80 programs to promote and protect the health of the 218,000 residents of southwestern Utah; which includes Washington, Iron, Kane, Beaver, and Garfield counties. “These services make the most impact at the local level and our health department will continue to do our best to offer science-based, effective programs to our communities," states Dr. David Blodgett, SWUPHD Director and Health Officer. "Much of what we do is preventive and unnoticed. Yet in reality, the difference between a third world country and a developed nation is a good public health system."
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By David Blodgett, MD, MPH SWUPHD Director & Health Officer
B
y nature, our cells divide and increase their number through a process called mitosis. Normally, cells divide to replace those lost or to repair injuries, then stop dividing. Cancer occurs when there is an abnormal, continuous multiplying of cells. These cells divide uncontrollably and may grow into adjacent tissue or spread to distant parts of the body. The mass of cancer cells eventually becomes large enough to form lumps or tumors that can be detected. Cancers begin in a single cell and are named after the primary site of origin; such as skin, colon, or breast. For example, when cancer that started in the colon is found in the liver, it is called colon cancer that has metastasized to the liver, not liver cancer.
change the fact that overall, the chances of developing cancer at every age have been going down slightly. From 2003 to 2012, cancer death rates decreased by: • 1.8 % per year among men • 1.4 % per year among women • 2.0 % per year among children ages 0-19 The most common types of cancer in America are (in order): breast cancer, lung and bronchus cancer, prostate cancer, colon and rectal cancer, bladder cancer, melanoma of the skin, non-Hodgkin lymphoma, thyroid cancer, kidney and renal pelvis cancer, leukemia, endometrial cancer, and pancreatic cancer. The occurrence of new cases of cancer each year in the U.S. is 454.8 per 100,000 (or .455%). The occurrence of cancer deaths per year is 171.2 per 100,000 (or .171%). The number of people living beyond a cancer diagnosis reached nearly 14.5 million in 2014 and is expected to rise to almost 19 million by 2024.
Approximately 39.6% of men and women will be diagnosed with cancer at some point during their lifetimes (based RESEARCHERS [HAVE] HIGHLIGHTED THE SUBSTANTIAL on 2010-2012 data). Cancer is not a single PREVENTABILITY OF CANCER BY CHANGING ONE'S LIFESTYLE. About 25% of us will disease, but includes die from cancer. In many related diseases 2014, an estimated from different sources, which is partly why 15,780 children and adolescents ages 0 to 19 were diagnosed with cancer and the war against cancer is so difficult. It is likely 1,960 died of the disease. Spending for cancer care in the United States totaled that the ultimate cure will be a combination of nearly $125 billion in 2010 and could reach $156 billion by 2020. preventive factors which decrease the number of people who get cancer, and an array of As the overall cancer death rate has declined, the number of cancer survivors therapies to treat specific cancers once they has increased. These trends show that progress is being made against the disease, but much work remains. Although rates of smoking - a major cause of develop. cancer - have declined, the U.S. population is aging and cancer rates increase Encouragingly, you are less likely to die of with age. Obesity, another risk factor for cancer, is also increasing. cancer than at any time in recent history. However, because the population is aging, the Many factors increase the risk of developing cancer. However, not all people overall number of people dying from cancer who are exposed to these risk factors will get cancer. is on the rise. This may seem paradoxical, but • Family history and genetic factors: Some genetic combinations have a sigthe older a person is, the chance of getting nificantly higher risk of developing certain cancers. cancer gets higher. The total number of cancer • Age: Most cancers are more common in adults, particularly in older people. cases also increases as the percentage of elderIn the United States, more than 60% of cancers occur in people older than 65. ly in the population increases. That does not The increased cancer rate is probably due to a combination of increased and
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prolonged exposure to carcinogens and weakening of the body’s immune system. • Environmental factors: Numerous environmental factors increase the risk of developing cancer. Tobacco smoke, pollutants in the air or water, certain chemicals, carcinogens, radiation, ultraviolet exposure from sunlight, X-rays, radon, and other sources contribute to the total lifetime risk of cancer. • Diet: A diet high in unsaturated fat - and obesity by itself - has been linked to an increased risk of colon, breast, and possibly prostate cancer. Alcohol and smoked and pickled foods have also been linked with cancer. • Drugs and medical treatments and some Infections and inflammatory disorders may increase the risk of developing cancer. So, what can be done to reduce the risk of cancer? As early as 1981, researchers first highlighted the substantial preventability of cancer by changing one's lifestyle. Most authorities remain convinced that 30 to 60% of cancers could be prevented by avoiding tobacco, eating a healthy diet, routine physical activity, and controlling weight. If you’ve read our previous articles in this series, you’ll remember that the percentage of Americans who do all four of these behaviors is about 6%. How are you doing? There have been several nationwide initiatives aimed at cancer prevention that could help lower the risk of cancer in the population, including: • Reducing alcohol use. • Reducing indoor tanning among minors. Most skin cancers arise from ultraviolet exposure before the age of 18. • Reducing radon in homes. This topic was covered in our last issue (Radon on the Radar). • Quitting smoking or vaping. If you haven’t started, don’t. Tobacco use is the single most preventable cause of disease, disability, and death in the United States. Nearly half a million Americans die from tobacco use each year, and more than 16 million suffer from a disease caused by smoking. Despite these risks, about 42 million U.S. adults still smoke. As a result, 20% of all cancers are related to the use of tobacco products. Cancer remains more common than it should be; too many people have their lives disrupted or shortened by the terrible effects of this disease. Fortunately, improvements in our understanding of what causes cancer has given us better tools to lower the chance that we will get cancer during our lifetimes. Cancer screenings remain a critical component in the overall battle to prevent cancer when they are used appropriately, and these will be covered in a future issue. In the meantime, it is my hope that this information will help you be successful in creating a healthier lifestyle.
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THE NEW WEST NILE VIRUS? By Kari Abeyta, RN, BSN SWUPHD Public Health Nurse
W
hile I was in nursing school at California State University, Long Beach, I had the amazing opportunity to work as a student-intern at Orange County Vector Control District (OCVCD) in Garden Grove, California. I was surrounded by fascinating scientists who taught me the value and importance of public health practices. My experience began with a simple data entry project. I loved listening to the interesting conversations and discussions that took place there, and Dr. James P. Webb, the Technical Director, took notice of my curiosity and appreciation. He gave me permission to do some surveillance work in the field; collecting and identifying mosquitoes. I also helped with the collection of blood samples from wild birds and sentinel chickens. After some time, I was finally allowed into the lab, although I started out by washing dishes. I then was given the responsibility of feeding and maintaining tissue cultures (monkey kidney cells). Dr. Martine Jozan, an independent researcher work-
ing at OCVCD, took me under her wing and she opened up my eyes to the wonders of virology. It was during this time (1999) that we began to hear reports of an emerging infectious disease in New York called West Nile virus (WNV).
“science nerds” may not have found this very exciting, I sure did.
Just as Dr. Webb predicted, WNV did indeed spread across the country. Three years later, during the summer of 2002, the number of WNV cases in North America was I clearly remember one unprecedented and the disease meeting we had at OCVCD had spread from coast to coast. that was led by Dr. Webb. During the meeting he stat- Presently, we are hearing a ed with firm confidence lot about an emerging, mosthat West Nile virus would quito-borne virus; Zika. Will spread across the U.S. and it spread throughout North would soon be in our own America like West Nile virus backyard in Orange County. did? Why? Because the type of mosquito that transmits the There are a few interesting virus and the wild birds that similarities between West Nile carry the virus are present and Zika viruses: throughout the U.S. • Both are of the Flaviviridae We knew that WNV would family make it to Orange County • Both are spread by the bite and we needed a way to test of an infected mosquito for it. Dr. Jozan began a new • Both were first identified in project and I was allowed Uganda (WNV in 1937 and to assist her. We obtained Zika in 1947) blood spot samples from • Both have recently “emerged” New York and fine-tuned an into new territories (WNV in enzyme-linked immunosorNorth America and Zika in bent assay test (ELISA) that the Pacific Islands, South and was able to detect WNV in Central America) bird serum. Although non-
HEALTH • Both typically cause very mild illness (but can cause serious problems in rare cases. Zika has been linked to birth defects from infected mothers) The most significant difference between the two diseases is that West Nile virus is spread by Culex mosquitoes (found throughout the United States), while Zika is transmitted by the Aedes aegypti or Aedes albopictus mosquitoes. These mosquitoes are usually more abundant in tropical regions, although they have been found in the lower and eastern halves of the U.S. Interestingly, Zika also appears to be the only mosquito-borne disease that can be spread by sexual contact. Dr. Jim Webb was certain WNV would spread due to the presence of Culex mosquitoes and birds throughout the nation. The same elements are not in place for Zika. As of the writing of this article there are mosquito-spread cases now confirmed in the Miami, Florida area, but although we cannot predict with certainty - the chances of seeing it in Utah are slim.
chronic joint pain that lasts for months. Similar to West Nile and Zika, chikungunya has recently shown an emerging pattern and has made its way into the Caribbean and Western hemisphere. The bottom line is: a mosquito bite is not only annoying but can also be dangerous to your health! So what can we do to protect ourselves, our families, and our neighbors? Personal Protection: • Cover up with loose-fitting, long-sleeved shirts and pants • Consider wearing insect repellant. DEET is effective, 20-35% is sufficient • Permethrin-treated clothes are another effective way to prevent mosquito bites Protection around the home: • Use screens on your windows • Eliminate mosquito breeding sites. Mosquitoes can reproduce in just a few days! • Clean bird baths twice a week • Clean out rain gutters so water will drain • Empty collection pans for potted plants twice a week • Dump or cover items on your property that can collect rainwater • Maintain pools
Our climate is too dry and cold for the Aedes mosquitoes to thrive. A few years ago, the Southwest Mosquito Abatement and Control District did find a small number of Aedes mosquitoes in Washington County, but they Protection of our community: were proactively eliminat- • Share what you have ed along with their breeding learned with family and sources. Regular surveillance friends hasn’t found any Aedes since. • Report abandoned pools or other areas where mosquiAedes mosquitoes are able toes are breeding to spread other diseases like • Support local public health dengue and chikungunya, and mosquito abatement which tend to be more seriefforts ous. Dengue, also known as “break-bone fever”, is very painful as the nickname sug- For more information and upgests. Chikungunya can cause dates, visit cdc.gov/zika. SWUHEALTH.ORG
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AN EPIDEMIC OF
THE RESURGENCE OF DEBUNKED VACCINE CLAIMS By Anna Almendrala Guest Columnist
A
ndrew Wakefield is back in the news, thanks to a new, controversial documentary which was set to premiere at the Tribeca Film Festival in New York earlier this year. The screening was cancelled by Robert De Niro, the festival’s co-founder, who stated “we do not believe it contributes to or furthers the discussion I had hoped for.” The film, directed by Wakefield himself, claims that the U.S. Centers for Disease Control and Prevention orchestrated a conspiracy to cover up the “true” reason for America’s rising autism diagnosis rates: vaccines. This is a widely and soundly discredited assertion. Studies from the independent, non-profit Institute of Medicine, the World Health Organization, and the CDC have all found that there is no link between receiving vaccines and developing autism spectrum disorder. Instead, what these studies demonstrate is that vaccines are overwhelmingly safe, with very rare cases of side effects, and that they protect children from dangerous and preventable diseases. But for people who happen to stumble upon the film’s trailer and feel briefly scared and disoriented — dramatic music, sinister cartoons and emotional clips of children with autism will do that to you — we’ve put together a handy guide to remind everyone what Wakefield did, and why he doesn’t deserve anybody’s trust now.
Parents for eight out of the 12 children said this developmental regression began after they got the measles, mumps and rubella vaccination, known as MMR. The study said the onset of symptoms started between one and 14 days after the shot, and also claimed that nine of the children were diagnosed with autism. Wakefield hypothesized that these children could be suffering from a syndrome that combined gastrointestinal problems with autism, and that it could be linked to the MMR vaccine. And in talking about his findings with the press, Wakefield said that he could no longer support giving children the MMR vaccine.
HOW DID PEOPLE REAndrew Wakefield is a disgraced former doctor who be- ACT TO WAKEFIELD’S lieves that standard childhood vaccinations can cause au- STUDY? WHO IS ANDREW WAKEFIELD?
of controversy over whether or not vaccines can cause autism, and potentially influenced thousands of parents to not vaccinate their children against deadly, preventable diseases for fear of triggering autistic symptoms. In a 2010 article, Time magazine noted that vaccination rates in some parts of the U.K. fell from over 90 percent in the mid 1990s to below 70 percent by 2003. Unsurprisingly, the drop in vaccinations coincided with a sharp increase in measles. In the U.S., Wakefield’s legacy of vaccine suspicion continues. Traces can be seen in the 2015 multistate measles outbreak and the whooping cough resurgence in 2012, which are both linked to vaccine refusal. While the vast majority of Americans do vaccinate their children, it only takes a few people to incubate an infection and spread it to others who either refuse to get the shot or who can’t receive the shot for medical reasons.
tism, despite a slew of large, well-designed and authoritative The study was tiny, there studies that prove there’s no evidence for the link. was no control group, and Wakefield acknowledged in WHY DOES HE THINK THIS? his paper that he could not Wakefield published his first research paper on the supposed prove a causal link between relationship between vaccinations and autism in 1998. It vaccines and autism, despite WHEN DID PEOPLE documented changes in 12 children who were said to have using more decisive lan- START TO QUESTION previously been normal but lost acquired skills, like lan- guage when speaking about guage. They had also begun experiencing diarrhea and ab- the issue outside of the study. THE STUDY? dominal pain. But the paper ignited a storm No credible studies have
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ever replicated Wakefield’s 1998 results. That’s probably because there turned out to be a lot of problems with Wakefield’s original data, little though there was. After mounting controversy over the study, the Lancet, the prestigious British medical journal that published it, began investigating allegations of financial conflicts of interest and unethical research practices against Wakefield in 2004, prompting him to abandon his practice there. Among the allegations proven to be true are the fact that some children in the study were also participants in a lawsuit that claimed they were harmed by vaccines, and also that Wakefield was paid by the attorneys pursuing the lawsuit. In the end, ten of the study’s 13 original authors — but not Wakefield — signed a formal retraction that year, which means that they renounced its conclusions. Brian Deer, an investigative journalist, looked into the cases of each of Wakefield’s 12 study participants He helped uncover Wakefield’s falsehoods in an investigation for the Sunday Times of London that lasted more than seven years, concluding that “no case was free of misreporting or alterations.” For instance, Deer’s review of the children’s medical records and interviews with their parents revealed that not all of the children were “previously normal” before their vaccines; in fact, five had shown signs of developmental delays before receiving any shot. Three children who were reported to have autism were never actually diagnosed with the condition at all. Most damning of all, Deer found, is that Wakefield had actually filed patents for his own, “safer” version of the measles vaccine.
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In January of 2010, the U.K.’s General Medical Council, which sets medical standards in the country and decides which doctors are qualified to work there, concluded their own two-and-a-half-year investigation into Wakefield’s original study. They found that he acted unethically and with “callous disregard” for the distress and pain the children might suffer (one example they cited was that Wakefield paid children at his son’s birthday party for blood samples). They also found that he should have disclosed his financial ties to lawyers trying to file a suit against vaccine manufacturers. The next month, 12 years after they published Wakefield’s paper, the Lancet completely retracted his findings.
WHAT HAPPENED TO WAKEFIELD AFTER THAT?
The GMC stripped Wakefield of his medical license over his unethical behavior, and he is no longer allowed to practice in the U.K. But by then, he had already been in the U.S. for six years. In 2004, he founded a treatment center for children with autism in Texas, but resigned in 2010 after the GMC announced the results of their investigation. He is now, apparently, a documentary filmmaker hell-bent on protecting his legacy of disseminating misleading and harmful information about the link between vaccines and autism. Anna Almendrala is a Senior Healthy Living Editor with the Huffington Post The original version of this article was published on HuffingtonPost. com on March 25, 2016. Used with permission.
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TIPS FOR
HEALTHY AS A FAMILY By Erin Stewart Guest Columnist
W
e try to eat healthy as a family, but there are often derailments where we lose sight and consider fruit snacks and Frosted Mini-Wheats as legitimate food groups. It can be extra difficult to make mindful food choices with the “eat me” vibes coming from a pantry full of cookies, candy, and other treats. But now that the enemy has been destroyed (and by destroyed, I mean eaten —even the backup boxes and “gifts for friends” pile), I am trying to refocus on healthy eating in our house. I am particularly determined to reduce the amount of sugar our kids are inhaling through processed foods after watching the documentary “Fed Up”. I went through every item in my pantry and was mortified at how much added sugar was in the foods I thought were decently healthy for my kids. We are not hardcore healthy food people at our house, nor do we follow any particular regimen of shakes or diets. But we have found that nixing as much processed food as possible makes a huge difference in our energy levels and our cravings for junk. We’ve also found a few tried-and-true measures that help us stay on track. First, we have to prep or we’re sunk from day one. The biggest factor in whether we can eat healthy each week is if we cut up fruits and veggies to start the week. If the fridge is stocked with healthy alternatives in prepared containers, it’s easier to pick up one of them and not a processed snack. If it’s not, we opt for the convenience every time. Second, we cook from scratch as often as possible. Before we had kids, we ate a ton of processed meals because it was easier and we were young and invincible. Now, we try to limit
our eating out and processed foods that are loaded with salts and hidden sugars. We make homemade refried beans instead of using ones from a can. We make sure we can pronounce the ingredients we are using. We look for recipes calling for food that actually looks like food. One website I use often is 100daysofrealfood.com. Real ingredients. Real food. Then, we involve our kids. We let them help us chop, cook, and pick healthy snacks. We talk about the food while we’re eating dinner; going around the table so each kid can name an ingredient we used. Finally, we just don’t buy the tempting foods. The unfortunate truth is that I will eat it if it’s in the house. Those late night munchies will find me, and I know myself well enough to know the outcome of a choice between a pear and a Thin Mint at 10 p.m. But if I don’t put the junk food in the cart, the temptation is gone. Sure, I’ll still root around in the pantry for 30 minutes complaining about how we don’t have anything “good,” but in the end, I can’t eat junk that’s not there. We’re definitely not perfect about our healthy eating. I have a pretty raging sweet tooth, and I love eating out. But we keep trying. We do it because we feel better when we do, and because we want to create good eating habits in our children while they are young. And really, that’s the goal: to teach our children to care about what goes into their bodies — because they’re the only ones they get. Erin Stewart is a regular blogger for the Deseret News. Originally published on DeseretNews.com (April 19, 2016), used with permission.
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THIS IS WHAT HAPPENS WHEN YOU DRINK
By Lindsay Maxfield Guest Columnist
I
t’s no news flash that soda — diet or otherwise — is bad for health; even those who happily indulge in a can-aday (or more) habit can rattle off at least two or three negative effects of soda consumption. But when it comes to the effects of soft drink consumption on the human body, the total picture is downright scary. With high levels of sugar, acids, preservatives, and other harmful ingredients, soda causes more damage to the body than just expanding the waistline. From stroke to kidney stones to dementia, here’s a look at what can happen to the body long-term for those who regularly drink soda.
BRAIN
A 2002 UCLA study found that consuming excessive amounts of sugar reduces the production of the brain chemical called brain-derived neurotrophic factor, or BDNF. According to Forbes Magazine (David DiSalvo, 2012), “Without BDNF, our brains can’t form new memories and we can’t learn (or remember) much of anything.” Another study from the University of Copenhagen found that low BDNF levels are linked to depression and dementia. What’s more, when BDNF levels are reduced, the body begins to become
resistant to insulin, which kicks off a cascade of other health problems. But there’s a more immediate problem from consuming too many sweets. According to a 2010 study from the University of Minnesota, chronic sugar consumption dulls the brain’s mechanism for knowing when to stop eating.
TEETH
Sugar is not the only harmful substance in soda that affects dental health. A 2006 study published in the Academy of General Dentistry journal found that drinking soda is nearly as harmful for your teeth as drinking battery acid. That’s because soda actually contains acid (most commonly citric and/or phosphoric), which corrodes tooth enamel. And with a pH of 3.2, diet sodas are even more acidic than regular sodas. According to the Colgate Oral and Dental Health Resource Center, soft drinks are among the most significant dietary sources of tooth decay. “Acids and acidic sugar byproducts in soft drinks soften tooth enamel, contributing to the formation of cavities. In extreme cases, softer enamel combined with improper brushing, grinding of the teeth or other conditions can lead to tooth loss.”
HEART
Recent research has shown a correlation between soda consumption and heart disease. Most recently, a 2012 Harvard study found that one daily 12-ounce serving of regular soda “was linked to a 19 percent increase in the relative risk of cardiovascular disease,” according to the New York Times. Some researchers say the blame can be placed on high fructose corn syrup, which has been linked to an increased risk of metabolic syndrome, a condition associated with an elevated heart disease risk. However, others say diet sodas with artificial sweeteners are much worse on the heart. A study from the University of Miami found that those with a daily diet soda habit had a 61 percent increased risk of a “cardiovascular event,” including heart attack and stroke, than those who drank no soda — even when factors such as smoking, physical activity, alcohol consumption and diet were controlled.
LUNGS
A recent study by the University of Adelaide found that drinking too much soda can increase the risk for develop-
HEALTH ing asthma or chronic obstructive pulmonary disorder, or COPD. The more soda a person consumes, the greater the risk of developing those diseases. Other studies suggest sodium benzoate, a preservative in soda, may directly affect the lungs: It increases the amount of sodium in the body while reducing the availability of potassium, causing asthma as well as eczema.
BONES
Soda consumption has been linked in several studies to osteoporosis and bone density loss. While many suggest that those who regularly consume soft drinks — especially in large amounts — are not leaving enough room in their diets for healthier drinks, like milk and fortified juice, other studies say phosphoric acid may be to blame. “Phosphorus itself is an important bone mineral,” writes Gina Shaw for WebMD, citing a study from Tufts University. “But if you're getting a disproportionate amount of phosphorus compared to the amount of calcium you're getting, that could lead to bone loss.” Caffeine may also be the culprit, as it is known to interfere with calcium absorption.
KIDNEYS
The high levels of phosphoric acid in colas have been linked to kidney stones and other renal problems, but diet cola is most likely to have a negative effect on kidney function. In fact, diet cola is associated with a two-fold increased risk. According to a Harvard study, kidney function in 3,000 women subjects started declining when they drank more than two sodas a day.
DIGESTIVE SYSTEM
For those who have digestive issues to begin with, consuming soda will only add to their troubles. The carbonation in soft drinks can irritate the digestive system, particularly in those who have irritable bowel syndrome (IBS). Carbonation can cause a buildup of excess gas in the abdominal area, leading to bloating, cramping, and pain. The caffeine in soda can also increase stomach acid production, worsen episodes of diarrhea, and contribute to constipation. In addition, the sweeteners used in soft drinks can worsen IBS symptoms due to their laxative effects.
WEIGHT
Drinking just one soda a day equates to consuming 39 pounds of sugar per year, which is one of the main reasons that soda consumption is strongly linked to obesity. A recent Harvard study found that sugar-sweetened beverages are linked to more than 180,000 obesity-related deaths each year, which means that about one in every 100 deaths from obesity-related diseases is caused by drinking sugary beverages. An additional Harvard study concluded that regularly consuming drinks high in sugar interacts with the genes that affect weight, dramatically increasing a person’s risk for obesity.
HOW TO KICK THE HABIT
Ready to kick soda to the curb for good? While breaking the habit isn't always pleasant, it's easier than you think. Here's how I quit my Coke-a-day habit:
• GO COLD TURKEY. Weaning off soda will only drag out the inevitable, or worse, weaken or even change your resolve. Once you've decided to quit, keep moving forward and never look back.
• PREPARE FOR A MENTAL BATTLE. Chances are, your body is addicted to soda on some level.
Know that you're going to go through withdrawals and quite a bit of mental agony. But also know that this will only last a few days. Remembering that there will soon be an end will help you stay strong. • FIND A SUBSTITUTE. To distract you from the battle and satisfy your craving in a healthier way, find a suitable substitute, like fruit juice or herbal tea with honey. You'll satisfy your sweet tooth and be less likely to relapse. • GET SOME TLC. If your beverage of choice was caffeinated, be aware that you will likely get withdrawal headaches. • REWARD YOURSELF. It's OK to accept a bribe (or two) if it motivates you to cross the finish line. Set a goal, like no soda for a week or month. When you've met it, treat yourself to something non-food related, like a new DVD, pair of shoes, or a night out.
Lindsay Maxfield is a freelance editor, writer, and blogger who often contributes to Deseret Media Companies. Original version published on KSL.com (March 28, 2013), used with permission.
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THROUGH THE AGES By David Heaton Managing Editor / SWUPHD Public Information Officer
B
abies get lots of atten- said, "Walking is a big part themselves on having sub- day walking up and down tion when they take of my life. If you walk vig- dued the horse to the uses his garden. Jane Austen took their first steps, which orously, it's just as good for of man. But I doubt whether part in frequent walks with are celebrated with applause, you as running." Author Re- we have not lost more than company, a custom often cheers, and Facebook posts. becca Solnit adds, "Walking we have gained by the use of portrayed in her novels. VicThe skill of walking is an articulates both physical and this animal (replace 'horse' tor Hugo chose the beach for important one and humans mental freedom." with 'motor vehicle' for our his daily two-hour walks. For have employed it out of inday)." Jefferson also wrote, years, Charles Dickens had stinct and necessity through- The virtues of walking have "I repeat my advice to take a three-hour walks through out history to get from one been known since ancient great deal of exercise, and on London or the countryside. point to anothDarwin beat Dicker, whether it's ens by half-anWHY NOT FOLLOW IN THE FOOTSTEPS OF THE across the room or hour in his schedacross a continent. ule. Tchaikovsky GREAT MINDS OF THE PAST AND ADD A DAILY WALK We walk around walked for thirty without a second minutes in the TO YOUR SCHEDULE? thought, it's automorning, then matic. But when is two hours later the last time you walked "on times. Hippocrates pro- foot. Health is the first requi- in the day. Louisa May Alpurpose"? claimed, "Walking is man's site after morality." cott walked with her family, best medicine." Diogenes who were ahead of their time Walking for good health coined the Latin phrase Many great authors, art- in advocating healthy lifeis currently highly recom- solvitur ambulando - "it is ists, musicians, and thinkers styles. mended; it's low-impact, solved by walking". A Bul- made walking part of their free, and beneficial for the garian proverb reads, "From routines. Mason Curry, in Who knows what you will heart, lungs, joints, and walking-something, from his book Daily Ritual, found contribute to the world? Why mind. You're exposed to na- sitting-nothing." It turns out many examples in his re- not follow in the footsteps of ture, fresh air, and sunshine. sitting is worse than nothing, search. Beethoven took two- the great minds of the past and Depression and anxiety are it's actually linked to early hour long vigorous walks add a daily walk to your schedreduced, healthy weight is death, especially for those with pencil and music paper ule? Thomas Jefferson encourachieved and maintained, with sitting jobs. stuffed in his pocket in case ages, "No one knows till he (or and sleep is improved. inspiration struck. Sigmund she) tries how easily the habit Done with family, friends, Thomas Jefferson, who took Freud took daily one-hour of walking is acquired." How and pets, walking can even daily long walks through- walks around Vienna at easy? Just follow the advice strengthen relationships. out his life, was concerned "terrific speed". John Mil- of this Chinese proverb: "One Fitness guru Jack LaLanne that "the Europeans value ton spent up to four hours a step at a time is good walking."
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THE LOST ART OF FOOD
By Al Cooper Guest Columnist
CAPTURING SUMMER IN A JAR Some of my earliest and most pleasant boyhood memories had their genesis in one particular corner of the cellar which ran under the hundred-and-fifty-yearold home place. My father had built a storage area made up of glass-fronted shelves salvaged from some previous location, and it was behind those hinged doors that my mother stored the bounty of woods, orchards, and gardens – the provender which would grace our table during the cold weather months of winter. One of my great pleasures was to make my way to that corner, and count the jars of “canned” tomatoes, corn, beans, beets, fruit, pickles, and relishes my mother had carefully lined up there. Some of my favorites were the tall quart jars of wild blackberries, blueberries, raspberries,
and huckleberries I had helped he carried in his back pocket for to pick myself – each jar just the “sampling” good things from the right size to make one of Mom’s garden as we picked. prized pies. In our extended family today, Behind the bounty stored in every the rich chili sauce my mothone of those bail-lidded Ball jars er taught me to make is every was a story: the green tree snake bit as much an annual mainstay I met up with picking huckleber- as it was in the household over ries in a Jersey swamp; the sheer whose kitchen she presided sevlabor of turning the crank on the enty-five years ago. food chopper from which poured the minced ingredients of Mom’s The ethic of “home canning” famous pepper relish, and the which is so much an American arm itch I always suffered from institution, actually had its birth picking green beans and their on the other side of the Atlantic. yellow-wax cousins; the surprise During the Napoleonic wars, rain storm which caught us when France experienced widespread harvesting blueberries in the pine food shortages, especially during barrens, and my father’s devo- the winter months when even tion to Stone tomatoes, Coun- the traditional grains and other try Gentleman sweet corn, and dry staples the world had long Early Wakefield cabbage. And depended on became scarce. In then there was the salt shaker 1791 the French government of-
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fered a prize of 1200 francs to anyone who could come up with a method of preserving otherwise perishable foods from season to season. Around 1809 an inventive citizen by the name of Nicholas Appert discovered that by heating fresh garden vegetables and fruit to various high temperatures before sealing them tightly in suitable containers, spoilage could be greatly delayed or halted. His experiments caught the attention of Peter Durant who patented the process in England in 1810. Neither Appert nor Durant had any idea why this method worked; it remained for Louis Pasteur to discover what was first called “the germ theory”, finally identifying bacteria, yeast, and mold organisms as the culprits which for tens of thousands of years had limited the possibilities of intra-seasonal food preservation. At first the search for the “suitable container” led down several paths: earthenware crocks and jugs sealed with paper and wax; small-mouth bottles capped by hard-tofind corks of various sizes, or tin cans with lids soldered into place. In fact it was a 26-year-old New Jersey tinsmith named John Landis Mason who came up with the idea of a threaded glass container, to which a metal cap with matching threads could be screwed down over a rubber gasket, making an airtight seal. Here at last was a viable commercial procedure which could be duplicated in the home kitchen. Patented in 1858, the famous “Mason Jar” would revolutionize the science and practice of food preservation and lead to a succession of improvements and challengers. Mason’s main competition came in 1882 from Henry W. Putnam’s “Lightning Jar”, which featured a wire bail securing a glass cap over a rubber ring, a system which allowed the jar to exhaust air during the heating process and yet be firmly tightened by depressing the loosened bail immediately afterward. In 1885, the Ball brothers began manufacturing their line of canning jars, destined to become one of the two most well-known and long-lasting brand houses, turning out first bail lid jars and then Mason types. In 1903, with nothing behind him but one hundred dollars of borrowed capital and a deep religious faith, Alexander H. Kerr established his glass company in Sand Springs, Oklahoma, introducing a whole new concept with his two-piece cap and lid sealing system on the traditional Mason jar foundation. Despite the fact that over the years there have been more than 400 jar manufacturers serving America’s army of home canners, Ball and Kerr (now owned by a single corporation) remain the dominant names in a field which claims a one hundred year history and has seen an estimated 150 billion jars produced. The popularity of home canning received a big boost with the advent of World War I, and a gigantic impact from the Great Depression years of the 20s and 30s, reaching an all-time high with Pearl Harbor and the food rationing spawned by the Second World War. During the 1940s, it is believed that up to 60% of America’s fresh and preserved perishable food came from home gardens and canning kitchens.
HEALTH DRYING: RE-EMPLOYING AN ANCIENT FORM OF FOOD PRESERVATION
Perhaps the earliest form of human-centered food preservation comes down to the art of removing or reducing the water content of fruit, vegetable or animal products, thereby eliminating the environment in which various bacteria can survive and grow. Since moisture represents as much as 95% of some fresh produce, dehydration reduces the weight and volume dramatically. For instance, 20 pounds of newly-dug onions becomes 3 pounds of dehydrated product with a shelf life of several years, all in a small package. In the 13th century, Genghis Khan conquered three-fourths of the known world with his Mongol armies, establishing an empire embracing more than four million square miles of Europe and Asia. His ability to move an army of 200,000 superbly-able warriors quickly across vast distances with a minimum of supply transport was an example of epic logistical genius. Archaeological and human evidence convinces me that his secret weapon was the health-giving power of a tuberous vegetable we call the sweet potato, which when combined with rice supports a very nutritious diet. I believe they carried eminently mobile dehydrated sweet potatoes, enabling each fighting man to easily carry a week’s supply on himself. Today I cut one pound of skinned sweet potatoes into ¼ inch rounds and placed them on a rack in my electric dryer at 130 degrees. In less than three hours they are tender-dry and weigh only 3 ounces. In our household we annually dry figs (from a close neighbor’s tree), apples, peaches, apricots, pineapple, and Roma-type tomatoes. The fruit we dip in an ascorbic acid (Vitamin C) solution to protect from browning and the tomatoes we blanch, peel, and slice. We began years ago drying several quarts of dried corn kernels from which to grind our own corn meal flour throughout the cold-weather months. By blanching freshly-picked sweet corn in boiling water for a few minutes, then plunging the ears in a cold water bath to halt ripening, we have a product which, once dried in our electric dryer, has all the original germ intact. The germ is not present in regular commercial cornmeal. We store the quart jars of magnificently full-flavored kernels in our freezer, sometimes for years. They can be quickly ground into either meal or soft flour in minutes in a kitchen blender, or reconstituted in milk to produce a flavorful “creamed” corn dish. As with the soft-dried tomatoes, the intensity of the concentrated flavor is almost better than that of the unprocessed fresh crop! We have also sun-dried most of these crops and this year will be experimenting with our new portable solar dryer. Al Cooper is a local author, blogger, radio personality, and preparedness expert.
Home-dried sweet corn can be milled into either meal or a fine flour in a kitchen blender. Sun-dried or machine-dried tomatoes add a new dimension of intense flavor to cooking and salads.
Preserving food by canning, drying, or freezing is easier than you think! Visit the Utah State University Extension Service online for instructions on how to safely preserve tomatoes (including spaghetti sauce and salsa), squash, zucchini, apples, peaches, berries, apricots, corn, beans, and more!
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THINK LIKE A
By Paulette Valentine SWUPHD Emergency Preparedness & Response Director
M
ost of us live in places where we are at risk, at some point, of experiencing natural or manmade disasters. The most likely - and potentially destructive such events for southwest Utah are flooding, wildland fires, earthquakes, and pandemic disease.
few minutes after a disaster’s impact, reacted in a way that made all the difference.
The questions the survivors had asked themselves and were able to answer in the affirmative immediately following the event included, “Am I going to survive this? Have I done It is human nature to proceed with our daily routine without the things I needed to do to prepare for an emergency such giving much thought to the unpleasant “what-ifs”; those as this? Do I have the right items to help me survive along rare but possible events that have the potential to disrupt with the knowledge to use them?” life with unexpected chaos and danger. A higher confidence level comes from how we handle the At any time, some of us may have to react to an unpredict- preparedness phase, before the emergency and response able emergency. What will it feel like? Have we experi- need occurs. My friends who are first responders, such enced something like this before? How prepared are we? as police officers, firemen, and medical personnel, seem to Will we be heroes or victims? have this confidence level because of the knowledge they have gained through training and real-life experiences with In her book The Unthinkable, Amanda Ripley looks at emergencies and response actions. There are also ways that the human response to some of history’s biggest disasters, any of us can gain similar knowledge and confidence, inrevealing characteristics of those who survive and even cluding: thrive in the face of adversity. In interviews with survivors along with reports gathered from scientists, trauma spe- HAVE A FAMILY PLAN cialists, and other disaster experts, Ripley strives to gain Have your family help in creating the family emergency a deeper understanding of mental strength and resilience, plan. Teach your children how to properly respond to many whether in Holocaust survivors or a master gunfighter who different scenarios through discussion and practice. You’ll learned to overcome the effects of extreme fear. find some great resources onlline at SWUHEALTH.ORG, under the Emergency Preparedness tab. Why do some people survive while others in the same circumstances do not? The primary common asset possessed by Ripley’s interview subjects, those who survived past BUILD AN EMERGENCY KIT the initial impact, was confidence. These people knew Take the time to create an emergency kit that would meet they were going to make it and, especially in those first your basic needs for at least 72 hours (or more). Many
HEALTH
people make their kits portable in case of sudden evacuation. It should be tailored to your (and your family’s) individual needs, but there are some basics that most people should include, such as water, food, essential medications, flashlight, change of clothes, etc. (see “Plan 9” under the website referenced above for details). It takes only a few minutes to put together a simple kit using items already on hand and a few added purchases. We recommend similar kits for your office and vehicles as well.
FOOD AND WATER STORAGE
Some emergencies have a longer recovery period, so store enough food and water to sustain your family for more than a few days (from one week to three months). Some families have lived off their food storage during times of lost employment. You might also want to share extra supplies with others during a widespread emergency. Take it slow and build your storage week by week, using a variety of food your family is used to eating. Rotate it often so it won’t go to waste. Get advice from others on how they manage their emergency food supply. Some far-sighted people even plan for an extended period of need, gathering up to a year’s (or more) worth of long-lasting basic food items that would keep them alive, such as wheat, rice, and beans. Some of these foods can last 30 years or more when properly packaged and stored in a cool, dry place. It’s advisable to learn how to prepare these foods and rotate them into your three-month supply.
DO YOU NEED A “PREPAREDNESS BUDDY”?
A Preparedness Buddy is someone who will check on you when a disaster occurs. This person should know where you keep your emergency kit and emergency medical supplies in case of evacuation; and be familiar with your health issues and medications, your next of kin and their contact information, your medical provider, and pet care issues. The buddy concept is valuable for elderly or disabled people, or those who live alone. It’s not a bad idea to check on any of your neighbors during an emergency.
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JOIN AN EMERGENCY RESPONSE GROUP
• SOUTHWEST MEDICAL RESERVE CORPS (MRC). MRC volunteers are
trained on a regular basis to support and strengthen public health efforts, emergency response, and community resiliency. The MRC is made up of both medical and non-medical volunteers. To register, visit WWW.UTAHRESPONDS.ORG and select Southwest Utah as your partner agency.
• CITIZEN EMERGENCY RESPONSE TEAM (CERT). Classes are offered pe-
riodically through county emergency management, along with many cities and towns in our region. CERT training offers skills to assist in responding to local emergencies, from basic first aid to incident command procedures. You can be trained as a group of neighbors or friends if there is enough interest, or you can join the next CERT training. Contact your county Emergency Manager for more information or visit CITIZENCORPS.UTAH.GOV and click the CERT tab.
Planning, preparing, and training as individuals, families, and communities will increase our confidence in handling adversity, no matter what disaster or emergency may come our way. Another vital survival skill is the willingness to cooperate and share with those. Communities that work together recover much faster and end up with even stronger relationships. We are fortunate to live in southern Utah, where we enjoy a culture of looking out for neighbors and cooperating for the common good. Being prepared, starting at the family level, brings a peace of mind that is priceless. Then when the wind blows, the flood waters rise, the earth shakes, or the lights go out; we can rise to the occasion as an asset instead of a liability. The SWUPHD Emergency Preparedness and Response Division offers a number of resources and trainings. To schedule a presentation or for more information, call Paulette at 435-986-2579.
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DRUG SAFET Y By Amber M. Rich Guest Columnist
T
he health epidemics of the past 100 years included dread diseases like cholera, influenza, polio, and tuberculosis. These infectious agents have been diminished by improvements in living conditions and advancements in pharmacology. Ironically, many of today’s looming calamities are linked to an overabundant lifestyle and the misuse of drugs. The fastest growing and leading cause of accidental death in the U.S. and Utah is prescription overdose, which has proven more lethal than even auto accidents. Utah has been one of the hardest hit states, with a 400 % increase in prescription opioid overdose deaths over the past four years, and has the dubious distinction of being fourth in the nation in deaths per capita from this cause.
FIRST WORLD EPIDEMIC
“First world problems” is a glib phrase used to describe modern-day inconveniences like misplacing your phone when it’s on silent. Prescription drug misuse is a first world epidemic and is a direct reflection of prescribing practices for pain treatment. Moreover, it’s a plague that crosses
lines of income, education, race, religion, and gender. The Centers for Disease Control and Prevention (CDC) reports that sales of opioids in the U.S. have quadrupled in the last 15 years, and deaths from prescription drugs have grown at an identical rate during that period. The most current data from the Utah Department of Health shows that 32% of adults were prescribed an opioid in 2014. Yet, we’re not seeing a significant change in the amount of pain reported by patients overall. There were also nearly 300 prescription overdose deaths that year, mostly linked to pain-killers. Could they have been prevented in some way?
LOCAL IMPACT
Our little corner of the world has not gone unscathed. The 2015 Student Health and Risk Prevention (SHARP) Survey reported that 9.2% of local high school seniors have abused prescription drugs in their lifetime, and 4.6% of seniors report behaviors that would indicate a need for drug treatment. Sadly, prescription opioid abuse draws a direct line to heroin abuse, which is
cheaper and deadlier. In Washington County, heroin arrests have increased 23% from 2014 to 2015, and in the first half of 2016 there have been 136 arrests for heroin, a spike of 38% since 2014.
NO RESPECTER OF PERSONS
In an effort to raise addiction awareness and give hope to others as they battle this monster, one St. George mother tells of the nightmare of watching her teenage son escalate from experimenting with Lortab to a life-threatening heroin addiction. Easily characterized as educated, charitable, physically active, respected professionally, and with strong ties to their community, church, and family, this mother said, “Drug abuse can happen to any family. Addiction does not discriminate.” She did not immediately recognize the signs of drug misuse in her son and assumed he was just “tired.” When he eventually spiraled out of control, she said, “I knew something was wrong, but I didn't know what it was. Eventually, I put the clues together, but at that point it had turned into addiction.”
HEALTH For several years her son battled the vicious cycle of clean living and relapse. “With the help of the drug task force and drug court, my son was able to get the tools to repair himself. After a substantial amount of clean time, he relapsed and we nearly lost him again. His arrest picture could've been the poster child for death. Fortunately, he'd learned the tools to put himself back together.”
Drug with an opium-like compound that affects the nervous system to relieve the perception of pain and can produce a euphoric response.
After living clean for several years, her son attends college, owns a small business, and can see a life full of promise, but she said it would not have been possible without professional help and support.
OxyContin, Percocet, Vicodin, Percodan, Lortab, Demerol, and the generic codeine.
SAFETY FIRST
SIDE EFFECTS UNDER REGULAR USAGE:
The first and easiest defense against prescription opioid misuse is safe use, safe storage, and safe disposal. “It might seem like a good idea to hold on to a few extra pills, or get a refill just in case you might need it,” said Detective Chad Pectol with the Washington County Drug Task Force. “But you have no idea the problems it can bring. Get rid of it. Don’t keep opioids around your house, because it’s just an open invitation for heartache and misery. ” Local law enforcement agencies and Intermountain retail pharmacies have permanent disposal drop boxes, and local Take Back Events are held throughout the year (see sidebar for dates and locations). Statewide efforts to educate physicians about best prescribing practices, as well as legislative action, are part of systemic solutions. In 2014, the Utah Legislature passed the Naloxone Law which made the drug available without prescription to a third party (a caregiver or a potential bystander) to obtain and administer the drug without legal liability. Naloxone, if administered in a timely manner, can reverse the effects of an opioid overdose and prevent death if followed by emergency care. Intermountain pharmacies, most Associated Food Store pharmacies, and Southwest Behavioral Health have two-dose kits available. Amber Rich is the Regional Community Benefit Manager for Intermountain Healthcare.
OPIOID /Ō·PĒ·OID/:
BRAND NAMES:
Diarrhea, nausea, muscle pain, anxiety, and irritability.
HAZARDS OF MISUSE:
Dependency, higher incidence of heroin use, other substance abuse, suicide attempt, worsening mental and physical illness, and death.
ONLINE RESOURCES:
www.southwestprevention.com – upcoming prescription take-back events, local drop-boxes, prevention specialists, education, and referrals www.useonlyasdirected.org – list of disposal drop boxes statewide, and public resources for help www.utahnaloxone.org – list of pharmacies with naloxone availability, education, and referrals for treatment
YOUR LOCAL DROP BOX LOCATION WASHINGTON
St. George City Police Department (265 N. 200 E. St. George) Dixie State University Police (300 S. 800 E. St. George) Washington City Police Department (95 N. Main, Washington) Washington County Sheriff’s Office (750 S. 5300 W. Hurricane) Hurricane City Police Department (90 S. 700 W. Hurricane)
IRON
Cedar City Police Department (10 N. Main Street, Cedar)
GARFIELD
Garfield County Sheriff’s Department (375 N. 700 W. Panguitch)
KANE
Southwest Utah Public Health Department (445 N. Main, Kanab)
SWUHEALTH.ORG
FALL 2016
PROTECT
29
2016 FLU SHOOTOUT DATES Flu season arrives this fall. Be ready and get immunized! Attend your nearest flu shoot-out to get vaccinated. It’s fast, convenient, and inexpensive ($20 cash/check/credit or NO CHARGE with some insurances, proof required*) CEDAR CITY Saturday, Sept. 24 (8am-2pm) Cedar City Hospital Health Fair (all ages) ST. GEORGE Saturday, Sept. 24 (8am-1pm) Dixie Regional Medical Center Health Fair (all ages) Tuesday, Sept. 27 8am-1pm, parking lot DRIVE-THRU (ages 18+) noon-5pm, Center Court (all ages) Red Cliffs Mall BEAVER Wednesday, Sept. 28 (11am-4pm) EMS Shed (all ages) MINERSVILLE Tuesday, Oct. 4 (2-4pm) Location TBA (all ages) KANAB Saturday, Oct. 8 (9am-1pm) Kane County Health Fair Kanab High School (all ages) FREE for all Kane County Residents! PANGUITCH Thursday, Oct. 20 (10am-2pm) Fire Station (all ages)
MARK YO SEPTEMBE
Wear a short-sleeved shirt. Visit swuhealth.org for updates and co and bring with you to save time!)
*No fee or co-pay with proof of the following insurances: Altius, D Medicare (some HMOs), PEHP, SelectHealth, Tall Tree, United He
OUR CALENDAR ER 24, 27
onsent form (print, fill out,
DMBA, Adult Medicaid, ealthcare
P.S. OCTOBER IS AWARENESS MONTH FOR ADULT IMMUNIZATIONS For many adults, vaccinations are a distant childhood memory. Did you know that about 50,000 adults die each year from vaccine-preventable diseases? Vaccines aren't just for kids. Stay current on your vaccinations and keep a personal vaccination record. Talk to your local health department about the vaccines you need. See page 5.
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