Goodwin, a 57-year-old nursing care consultant for the state Department of Social and Health Services, works in an office where a majority of nurses are nearing retirement and in a field where a shortage of nurses will mean less comprehensive care for the agency’s low-income clients.
“The nursing force is aging,” Goodwin said. “We have trouble recruiting nurses because they can make more money in the private sector. They can earn overtime. … It’s just difficult to recruit nurses away from those higher paying jobs into what we do.”
To address the problem, the state has negotiated a targeted wage increase for its nurses. However, those pay increases for nurses and other state workers still require approval from the Legislature, which is working on a compromise on the 2017-19 budget.
Although the governor’s and the House Democrats’ budgets include all of the state worker wage increases negotiated last summer, the Senate Republicans’ budget funds only a few of the proposed increases and does not include the pay increase for many state nurses.
Gov. Jay Inslee will meet with state agency directors Wednesday to discuss efforts to increase the percentage of Washingtonians with a personal health care provider.
The meeting will include representatives from the state Health Care Authority, Department of Health and other agencies, as well as representatives from the Washington Academy of Family Physicians, Amerigroup Washington and the University of Washington. For more details, please see the agenda.
Increasing the number of Washingtonians who have a personal doctor or other health care provider is one of nearly 200 metrics being tracked by Inslee’s Results Washington initiative, launched in 2013. Inslee meets monthly with agency directors to review data, progress and improvement strategies.
Having a personal health care provider helps manage chronic conditions, increases the likelihood of getting appropriate health care services and preventive care, and helps decrease the likelihood of unnecessary hospitalizations and emergency room visits.
Results Washington tracks progress in education, the economy, the environment, health, safety and government effectiveness. More than half those measures are on track to meet or beat targets.
TVW plans to live-stream the meeting at https://www.tvw.org/watch/?
|Investigators from the University of Alabama at Birmingham have developed a new conceptual framework highlighting how unique dimensions of individual-level HIV-related stigma might affect the health of those living with HIV. According to the paper’s authors, little is known about the mechanisms through which stigma leads to worse health behaviors or outcomes.
The framework, published in the American Journal of Public Health, looks at perceived community stigma, experienced stigma, internalized stigma and anticipated stigma as barriers to both HIV prevention and engagement in care. An intersectional framework looks at how multiple social statuses intersect at an individual level, such as HIV status, race, gender or sexual orientation, and a broader level, such as structural stigmas in society including racism, sexism, HIV-related stigma and classism, to produce health inequalities.
The conceptual framework suggests that individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources and biological stress pathways.
“Those living with HIV often fight fear and experiences of HIV-related stigma, affecting their quality of life and mental health, as well as engaging poorly in their HIV care and treatment,” said Janet Turan, Ph.D., professor in the UAB School of Public Health Department of Health Care Organization and Policy. “Our proposed conceptual framework for individual-level dimensions of stigma and potential individual and interpersonal mechanisms explains how stigma affects each individual’s HIV-related health.”
HIV-infected individuals may be judged by others to be in marginalized social groups, causing social stress because of their minority social position, which could lead to important implications for their health.
“People living with HIV may be stigmatized by their partner, family members and members of the community,” said Bulent Turan, assistant professor in the UAB College of Arts and Sciences Department of Psychology. “Those who are close to the individual and who place them in a minority status may cause more harm to their overall mental and physical health. In fact, health care workers who stigmatize people living with HIV can be detrimental to treatment outcomes.”
People living with HIV may have a lack of physician trust, poor adherence to care and lower quality of life if stigmatized by those involved in their care. They may experience social stress in various ways, including externally by discrimination of others, anticipation of discrimination by others, internalizing negative attitudes from those around them and/or hiding their sexual orientation. Each of these can adversely affect health behaviors, physical health, and outcomes such as depression, adherence to care and HIV health outcomes.
According to the study, stigma can worsen HIV-related health both directly through physiology and indirectly through engagement in care behaviors. The framework suggests that stigma at a structural level may also affect individuals living with HIV directly or through individualized-level dimensions, such as internalized stigma, and individual-level mechanisms, such as depression.
The conceptual framework encompasses recent advances in stigma science that can inform future research and interventions aiming to address stigma as a driver of HIV-related health.
Known for its innovative and interdisciplinary approach to education at both the graduate and undergraduate levels, the University of Alabama at Birmingham is an internationally renowned research university and academic medical center and the state of Alabama’s largest employer, with some 23,000 employees and an economic impact exceeding $5 billion annually on the state. The five pillars of UAB’s mission deliver knowledge that will change your world: the education of students, who are exposed to multidisciplinary learning and a new world of diversity; research, the creation of new knowledge; patient care, the outcome of ‘bench-to-bedside’ translational knowledge; service to the community at home and around the globe, from free clinics in local neighborhoods to the transformational experience of the arts; and the economic development of Birmingham and Alabama. Learn more at www.uab.edu.
Experience the interactive Multimedia News Release here: https://www.multivu.com/
Listeria can affect all races and ethnic groups, but pregnant women are 10 times more likely than other healthy adults to get listeriosis due to hormonal changes that affect the immune system during pregnancy. Pregnant Hispanic women are about 24 times more likely than the general population to get listeriosis. A pregnant mother may pass Listeria onto her unborn baby without even knowing it because she doesn’t feel sick at all, yet the disease can lead to miscarriage, stillbirth, premature labor, the delivery of a low birthweight infant, a wide range of health problems for a newborn, or even infant death.
The FDA has developed a Community Educator’s Guide in English and Spanish, which includes a variety of printable and customizable materials, to help educate communities on this serious foodborne risk.
Learn more and download the guide at:
What Is Listeriosis?
Listeriosis is a foodborne illness caused by eating food contaminated with Listeria bacteria, which are commonly found in soil, water, decaying vegetation, and the intestinal tract of animals such as milk cows. Listeria can also be found in soft cheeses or other products made from unpasteurized milk and processed foods that have become contaminated — such as deli meats. Unlike many other foodborne bacteria, Listeria grows at refrigerator temperatures. However, cooking and commercial processes like pasteurization destroy Listeria.
Pregnant Hispanic Women are at Greater Risk
Pregnant Hispanic women can be at particular risk for listeriosis because of certain cultural dietary choices. In many Latin American cultures, it is common to eat soft cheeses like Queso Fresco, which are often made from “raw” (unpasteurized) milk. Many women are simply unaware that cheese made with unpasteurized milk can contain potentially deadly bacteria.
In some Hispanic communities in the U.S., people have been known to purchase raw milk and use it to make cheese, and then sell it door-to-door. Unlicensed vendors also sell it from carts. This cheese can sometimes also be found in small neighborhood stores.
Symptom of Listeriosis
Listeriosis can cause fever, chills, muscle aches, nausea and diarrhea, or upset stomach. If infection spreads to the nervous system, it can lead to headaches, stiff neck, confusion, loss of balance, or convulsions. In extreme cases, death can occur.
Preventing Listeriosis in Pregnant Women
The FDA advises all pregnant women not to eat soft cheeses unless they are made with pasteurized milk and to follow these additional tips to avoid the illness:
Do NOT eat:
- Soft cheeses (such as Feta, Brie, Camembert, Blue-veined cheeses, Queso Blanco, Queso Fresco, Asadero, and Penela) – unless they’re made with pasteurized milk
- Hot dogs and luncheon meats unless they’re reheated until steaming
- Refrigerated pâtés or meat spreads
- Refrigerated smoked seafood-unless it’s in a cooked dish, such as a casserole
Hospitals Encouraged to Nominate Patients for Nationally-Renowned Training Program for Women Living with Heart Disease
WomenHeart: The National Coalition for Women with Heart Disease has announced that applications are now being accepted for the Fall 2017 WomenHeart Science & Leadership Symposium. The Symposium is taking place October 6-October 9, 2017 at Mayo Clinic in Rochester, MN. The application deadline is July 31, 2017.
The four-day Symposium brings together dedicated female heart patients and provides a rigorous training for them to be WomenHeart Champions — patient volunteers who work in their local communities to lead support network meetings with heart disease survivors and/or participate in other WomenHeart education and advocacy activities.
“Education, advocacy and support are at the core of the fight against heart disease in women. WomenHeart Champions trained at this prestigious program are equipped to improve awareness, increase action and lead peer support efforts in their local communities,” said Mary McGowan, CEO of WomenHeart.
McGowan referenced research that underscores the impact of peer support in helping women improve their heart disease outcomes.
“So many women experience feelings of fear, anxiety and isolation following a heart disease diagnosis. However, women who regularly attend a support group led by a trained peer leader are more engaged in their health care and experience lower levels of stress, anxiety and depression,” she said. “This is just one example of the real impact made by participating in the WomenHeart Science & Leadership Symposium, and we’re so proud to see the difference it makes in each WomenHeart Champion‘s local community.”
Members of WomenHeart’s National Hospital Alliance are encouraged to nominate patients that they believe would be would be best suited for this leadership opportunity. The organization is also seeking nominations from hospitals not currently affiliated with the National Hospital Alliance, as well as directly from women living with heart disease. Patients are asked to complete a short survey to begin the application process.
WomenHeart was founded in 1999 and the Science & Leadership Symposium at Mayo Clinic was founded as an integral part of WomenHeart in 2002. WomenHeart currently boasts more than 800 WomenHeart Champions and 97 WomenHeart Support Networks that reach more than 10,000 women heart patients nationwide every year.
WomenHeart National Hospital Alliance
The WomenHeart National Hospital Alliance is currently comprised of 40 member hospitals. It is a unique partnership between WomenHeart and member hospitals throughout the country who are dedicated to advancing women’s heart health in their community. The National Hospital Alliance was developed by WomenHeart to ensure that women heart disease patients in every community have access to information, education and patient support services.
WomenHeart: The National Coalition for Women with Heart Disease
WomenHeart: The National Coalition for Women with Heart Disease is the nation’s only patient centered organization serving the almost 48 million American women living with or at risk for heart disease – the leading cause of death for women. WomenHeart is devoted to advancing women’s heart health through advocacy, community education, and the nation’s only patient support network solely for women living with heart disease. WomenHeart is both a coalition and a community of thousands of members nationwide, including women heart patients and their families, healthcare professionals, and health advocates, all committed to helping women live longer, healthier lives. To join or donate, visit www.womenheart.org.
Effort aims to help communities profiled by the tobacco industry
Where you live, who you love, your race, your mental health and financial status play an important role in how hard tobacco companies come after you. For decades, African Americans, low-income neighborhoods, LGBTQ communities and those with mental illness have been disproportionally targeted with advertising and promotional efforts. The “truth x CVS Health Foundation” tobacco-free campus initiative follows the launch of the latest campaign by truth®, #STOPPROFILING, that underscores the fact that tobacco use is more than a public health issue, it’s a social justice issue.
Despite lower youth and young adult smoking rates overall, smoking on college campuses remains a problem in the U.S. Of the 102 federally recognized HBCUs in the country, less than half have smoke-free and/or tobacco-free campus policies. Of the 1,108 community colleges in the U.S., only 360 have 100 percent smoke-free policies in place1.
“With 99 percent of smokers starting before age 27, college campuses are critical to preventing young adults from starting tobacco use, aiding current smokers in quitting and reducing exposure to secondhand smoke for all,” said Robin Koval, CEO and President of Truth Initiative, the national public health organization that directs and funds the truth campaign. “Our partnership aims to counteract the decades of profiling of African Americans and low income communities by Big Tobacco. We are thrilled to be working with the CVS Health Foundation to make smoking and tobacco use a thing of the past on HBCU and community college campuses.”
Since the launch of their tobacco-free college program in 2015, Truth Initiative has awarded funding to 135 colleges. To date, 50 colleges have gone smoke- or tobacco-free (40 community colleges and 10 HBCU’s).
The “truth x CVS Health Foundation” tobacco-free campus initiative is part of CVS Health’s Be The First campaign, the company’s five year, $50 million commitment to helping deliver the nation’s first tobacco-free generation. CVS Health and the CVS Health Foundation have set actionable and measurable goals for Be The First, including a doubling of the number of tobacco-free educational institutions in the United States.
In addition to supporting Truth Initiative to expand technical assistance to support 42 HBCUs and 64 community colleges advance their campus policy effort, the CVS Health Foundation is also working with the American Cancer Society to help 125 colleges advocate for, adopt and implement 100 percent smoke- and tobacco-free campuses. Students, faculty and staff at the schools are charged with developing a campus task force, assessing tobacco use on their campus and developing public-education campaigns to support comprehensive tobacco- and smoke-free polices on the campus.
“Today’s young people are a generation with an unyielding commitment to diversity, inclusivity and equality, and that includes making sure health benefits are equally distributed across ethnic and socioeconomic classes,” said David Casey, Chief Diversity Officer at CVS Health. “We’re proud that the CVS Health Foundation is working with Truth Initiative to help HBCUs and community colleges adopt tobacco-free campus policies. Helping more colleges and universities go tobacco-free is an important step in achieving our shared goal of helping to deliver the first tobacco-free generation.”
The tobacco industry has long profiled minority communities, particularly African Americans, with intense advertising and promotional efforts. For example, in major cities like Washington D.C., there are up to ten times more tobacco advertisements in African American neighborhoods than in other neighborhoods. There is a disproportionate health burden of tobacco-related morbidity and mortality among African Americans. Each year, approximately 47,000 African Americans die from smoking-related disease. Research has also shown a clear pattern of targeted marketing in socioeconomically disadvantaged neighborhoods. People living below the poverty level in the U.S. are nearly twice as likely to smoke, compared to those at or above the poverty level.
Additional stats on smoking
- Teen smoking of traditional cigarettes in the U.S. reached a historic low of six percent in 2016, but tobacco still remains the leading preventable cause of death in the United States.
- Cigarettes cause over 480,000 deaths annually in the U.S.
- Tobacco kills up to half of its users.
- LGBTQ young adults, ages 18-24, are nearly twice as likely to smoke as their straight peers.
- Individuals with mental illness account for up to 46 percent of cigarettes sold in the U.S.
- People living below the poverty level in the U.S. are nearly twice as likely to smoke, compared to those at, or above, the poverty level.
About Truth Initiative
Truth Initiative is a national public health organization that is inspiring tobacco-free lives and building a culture where all youth and young adults reject tobacco. The truth about tobacco and the tobacco industry are at the heart of our proven-effective and nationally recognized truth® public education campaign, our rigorous and scientific research and policy studies, and our innovative community and youth engagement programs supporting populations at high risk of using tobacco. The Washington D.C.-based organization, formerly known as Legacy, was established and funded through the 1998 Master Settlement Agreement between attorneys general from 46 states, five U.S. territories and the tobacco industry. To learn more about our work speaking, seeking and spreading the truth about tobacco, visit truthinitiative.org.
Air pollution remains a major threat to our health, according to a new report from Environment Washington Research & Policy Center, Our Health at Risk: Why Are Millions of Americans Still Breathing Unhealthy Air? In 2015, people here in the Seattle-Tacoma-Bellevue metropolitan area experienced 137 days with elevated particulate matter pollution, increasing the risk of premature death, asthma attacks and other adverse health impacts.
“Even one day with unhealthy air is too many,” said Bruce Speight, Environment Washington Executive Director. “Burning dirty fuels like coal, oil and gas threatens our health. It’s time to shift to 100 percent clean, renewable energy.”
“We could achieve enormous and immediate health co-benefits from burning less fossil fuels,” said Dr. Kenneth Lans, MD, MBA, Vice President of Washington Physicians for Social Responsibility. “The same fossil fuel combustion that is responsible for the dangerously rising levels of CO2 is also responsible for most of our other air pollutants: particulate matter, sulfur dioxide, and nitrogen dioxide. We have years of evidence and clinical experience showing that burning fossil fuels has had significant, direct, and harmful impacts on heart disease, lung disease and other health problems.”
The report comes on the heels of National Public Health Week, a celebration of efforts to tackle the underlying causes of disease – like air pollution – and ensure that all people have a chance to live long and healthy lives.
Although our air is less polluted than it was 30 years ago, dirty air is still a major health problem. Despite that fact, President Trump is taking an axe to important programs that could help clean up our air. In just the last month, the Trump Administration has:
- Instructed the EPA to rewrite the Clean Power Plan, the largest step the United States has ever taken to cut dangerous global warming pollution;
- Proposed to cut the budget of the Environmental Protection Agency by 31 percent, a “get out of jail free card” for polluters;
- Instructed the Environmental Protection Agency to roll back federal clean cars standards that were supposed to prevent 6 billion metric tons of global warming pollution; and
- Told the Department of Interior to rewrite air pollution regulations for oil and gas drilling.
These actions will have significant health impacts. Blocking the Clean Power Plan alone will slow progress in cleaning our air – leading to 3,600 additional premature deaths, 90,000 more asthma attacks in children, and 300,000 more missed work and school days by 2030.
“Going backwards on clean air is reckless and wrong,” said Speight. “We should be doing more to clean up pollution and develop clean energy, not less.
Our Health at Risk reviews EPA records of air pollution levels across the country, focusing on smog and soot – dangerous pollutants that come from burning dirty fuels like coal, oil and natural gas. Key findings include:
- People in Seattle-Tacoma-Bellevue metropolitan area experienced 43 days with elevated smog pollution and 137 days with elevated soot pollution in 2015.
- Across Washington, three cities had unhealthy levels of air pollution on at least six days during 2015, including three unhealthy air pollution days in the Seattle-Tacoma-Bellevue metropolitan area, and two in the Vancouver-Portland, OR-WA metro area.
- In Washington, wildfires, already increasing in intensity and frequency due to drought and higher temperatures, create particulate matter and other air pollution that can travel for hundreds of miles. One of the report findings is that the counties that experienced the most frequent particulate pollution often were downwind from major wildfires.
Many Washingtonians may be exposed to air pollution even more severe than described here because they live in local pollution “hotspots,” such as near freeways, airports and industrial facilities – facing greater health impacts. For example, people who live near highly traveled roads are at increased risk of developing lung cancer, and at greater risk of death from stroke, lung disease and heart disease.
“There’s no safe level of exposure to smog and particulate pollution,” said Elizabeth Ridlington, “Policy Analyst with Frontier Group and co-author of the report. “Elevated levels of air pollution – even levels the federal government says are safe for most people – hurt our health.”
“And it’s not just soot and smog,” said Speight. “We also have to worry about global warming pollution. Warming is extending the smog season across more of the year, and driving up smog levels on hot days. Along with drought, warming is also making wildfires more frequent and intense – causing additional pollution that can travel hundreds of miles.”
Speight urged Washington’s elected leaders to stand up to attempts to weaken the Clean Air Act, to maintain the strength of the nation’s Clean Car Standards, and to accelerate our transition to clean energy.
“In the face of reckless and dangerous actions from the Trump Administration on clean air, we look forward to working with Senators Cantwell and Murray as we work to stand up for our health,” said Speight. “We urge our senators to defend clean air safeguards and clean cars standards so that dirty air days can become a thing of the past.”
A leading consumer group, WashPIRG, released the ninth in a series of reports that review complaints to the Consumer Financial Protection Bureau (CFPB). The latest report explores consumer complaints about medical debt, a major source of problems for consumers, since medical debt items on credit reports are often wrong or about the wrong consumer. The report also demonstrates the need to defend the CFPB from partisan and special interest attacks.
Medical debt collectors often employ aggressive tactics and attempt to collect debt from the wrong customers – putting consumers’ credit records at risk. Medical debt accounts for more than half of all collection items that appear on consumer credit reports. Recognizing medical debt is both often mistaken and not a good indicator of future creditworthiness, leading credit score companies have begun to remove it from credit scores, but it still appears in credit reports.
“The CFPB is working tirelessly to stop unfair medical debt collection practices that harm innocent consumers, so why are some on Capitol Hill backing efforts to kill or weaken the CFPB?” asked Bruce Speight, Executive Director of WashPIRG. “This report provides strong, concrete evidence that CFPB Director Richard Cordray and the CFPB’s oversight are effective in protecting consumers. Both the director and the bureau must be defended.”
Complaints submitted to the CFPB suggest that many consumers contacted about medical debt should not have been contacted in the first place, and that many contacts involve aggressive or inappropriate tactics. Key findings of the report “Medical Debt Malpractice,” by the WashPIRG Foundation and the Frontier Group include:
- Nearly two-thirds (63%) of 17,701 complaints about medical debt collection reviewed in the report assert either that the debt was never owed in the first place, it was already paid or discharged in bankruptcy, or it was not verified as the consumer’s debt.
- Many complaints document inappropriate and aggressive tactics including frequent or repeated calls, calls harassing friends and family, threats of legal action, or the use of abusive language.
- Although impacts on credit reports are not categorized by the CFPB, they appear to be a significant source of complaints: 1,810 complaint narratives, or 35 percent of all medical complaint narratives submitted, contain the text “credit report.”
“Medical debt collection is a system run amok,” said Gideon Weissman of Frontier Group, report co-author. “Our analysis of CFPB complaint data suggests that many of the consumers facing harassment and damaged credit due to medical debt never owed any money in the first place.”
The group noted powerful special-interests continue to spend many billions — $2 billion on lobbying and campaign donations in 2015-2016 alone, according to the PIRG-backed Americans for Financial Reform, to weaken the CFPB and all of the Wall Street reforms enacted in 2010.
The report’s key recommendations included the following:
- Stop debt collectors and buyers from collecting debts without proper information and documentation about the debt and records of prior communications with the consumer.
- Stop debt collectors from bringing robo-signed cases in court.
- Crack-down on widespread use of threats, harassment and embarrassment in debt collection, and make it easier for the consumer to demand a stop to unwanted communications.
- Protect servicemembers by strictly limiting contact with their commanders to verifications of address.
“Consumers deserve protection from unfair, aggressive, and illegal medical debt collection. Fortunately, they have a powerful resource in the CFPB, which has already taken multiple actions against collection companies that break the law while collecting medical debt,” Speight concluded. “Not only that, they need to preserve a strong CFPB because it’s the one agency working to make financial markets fair for consumers.”
Your Local Public Health Departments
Can Play a Vital Part in Building Community, Building Hope
Millions of children and adolescents are exposed to violence and experience child abuse and neglect early in life. Exposure to violence, abuse and neglect is a significant problem, as it can cause serious physical, mental, and emotional health problems and lead to injuries and death.
The National Association of County and City Health Officials (NACCHO), representing nearly 3,000 local health departments across the nation, supports leadership and capacity-building in local communities to prevent and reduce children’s abuse and neglect. Local health departments play an important role in local systems that serve children to reduce rates of abuse and neglect, both as direct service providers and as coordinating agencies.
April is National Child Abuse Prevention Month. This month and throughout the year, NACCHO encourages local health departments to observe National Child Abuse Prevention Month by implementing policies, programs, and strategies that help prevent child maltreatment and exposure to violence, and provide for children’s physical, emotional, and developmental needs. Every young person deserves the right to grow up safe, healthy, and free from violence.
“Local health departments provide critical services and programs that support families and promote safe, stable, and nurturing environments for children,” said William M. Barnes, PhD, MBA, NACCHO’s Acting Executive Director and Chief Program Officer.
“Children can be safeguarded through home visitation programs such as Nurse Family Partnership and Healthy Families America; therapeutic interventions, including cognitive behavioral therapy and strengthening families; and evidenced-based parenting education programs such as the Triple P – Positive Parenting Program. Creating an environment that supports children and families is effective in reducing child abuse and neglect.”
Research shows that protective factors are present in healthy families. Promoting these factors is among the most effective ways to reduce the risk of child abuse and neglect. They are:
- Nurturing and attachment
- Knowledge of parenting and of child and youth development
- Parental resilience
- Social connections
- Concrete supports for parents
- Social and emotional competence of children
In support of these efforts, the Centers for Disease Control and Prevention (CDC) has developed Preventing Child Abuse and Neglect: A Technical Package for Policy, Norm, and Programmatic Activities (2016). This resource presents a select group of strategies based on the best available evidence to help prevent child abuse and neglect.