Many Hispanic immigrants forgoing care due to fear, language barriers

Immigrant woman sitting in an exam room with a provider taking her pulse

Important note: Malheur County Health Department proudly serves Spanish speaking clients and offers interpreting services for any language available on the interpreting assistance line. Immigrant status should not be a barrier to care and all are welcome. Services are available at reduced cost or free for many programs. Call 541-889-7279 to schedule a confidential appointment.

To get a better handle on the health care access barriers Hispanic immigrants in the U.S. often face, researchers from the University of Kansas Medical Center surveyed Hispanic immigrants about their experiences with the health care system.

“The Affordable Care Act has helped many Latinos, but it has systematically excluded the undocumented,” said Mariana Ramírez, a bilingual research counselor at the Kansas medical center who spoke on “Emerging Issues in Refugee and Immigrant Health” at the American Public Health Association 2019 Annual Meeting and Expo in Philadelphia.

Even those who have ACA plans sometimes struggle with high deductibles and premiums and limited coverage. Ramírez and her fellow researchers found that many times, people would change plans every year, which can make coverage inconsistent and confusing.

Researchers found that while a majority of people surveyed were employed, only 11% had employee-sponsored health insurance. In comparison, about two-thirds of adults in the region overall had insurance through their employer.

And it’s not a simple problem of access to insurance or paying for coverage. There’s a real fear in the Hispanic community that trying to get medical care could have negative consequences, Ramírez reported. For example, a vast majority of those surveyed — 86% — were worried that either they, a family member or a close friend could be deported. And about 60% said they were concerned that health care practitioners would share their information with immigration officials or were worried that using publicly funded health care services would negatively impact their immigration status.

The problems didn’t stop there. Even if an Hispanic immigrant is able to access needed health care, significant challenges such as language barriers can persist. And, unfortunately, translation services are often inconsistent and insufficient. Indeed, study participants reported lower quality of care because they were unable to effectively communicate with health care providers.

“(When) everything is in English, you just kind of have to hope that everything goes well and cross your fingers,” Ramírez said.

As a result, some Hispanic immigrants end up calling a doctor back in their home countries for consults or ask family or friends to bring them medications from abroad. They may even turn to self-medication, home remedies or unlicensed practitioners — such as someone who studied dentistry in another country and now operates in the U.S. without a license.

Article adapted from Public Health Newswire

Wash Your Hands in the Kitchen and the Bathroom

The most dangerous antibiotic-resistant strains of E. coli are transmitted not through food but through contact with human feces.

While it’s important to wash your hands carefully after handling raw chicken, it may be even more important to wash them after going to the bathroom. The most dangerous antibiotic-resistant strains of E. coli, called ESBLs, are transmitted not through food, according to new research, but through contact of human feces with human mouths.

British researchers examined many strains of ESBL-E. coli in human blood and feces, sewage, farm slurry, live animals, and raw meat, fruits and vegetables.

They found that one multidrug-resistant strain, ST131, responsible for a mortality rate as high as 35 percent in humans, was found in more than 60 percent of human bloodstream infections, but was extremely rare in live animals and nonexistent in foods.

The study, in Lancet Infectious Diseases, concludes that many of the E. coli strains that make people seriously ill come from other humans, not food or animals (though foods can also contain dangerous strains).

The senior author, David M. Livermore, a professor of microbiology at the University of East Anglia, explained that there are some strains of are E. coli that are harmless and just live in your gut. Others cause mild food poisoning. And finally there are the E. coli that are antibiotic resistant and often lead to serious illness and death.

“Good kitchen hygiene remains important,” he said, “but with these antibiotic-resistant E. coli, toilet hygiene becomes vitally important.” For many of the strains that are causing major disease, “food is not the source. It’s humans.”

But how best to protect yourself from E coli? Wash your hands properly. “When you wash your hands with soap, what the soap does is to detach the microbes from your hands, but the microbes remain alive,” says Prof Sally Bloomfield of the London School of Hygiene and Tropical Medicine. “The important part of washing your hands is rinsing them. That’s what takes the microbes off your hands.”

How to wash your hands properly

Use plenty of soap and be vigorous. “Rub them for at least 15 seconds, making sure that you rub them properly, from palm to palm, as well as rubbing the back of your hands. Interlace your fingers and rub them together. Rub around the backs of each of your fingers and thumbs,” Bloomfield says. “That’s the way to mechanically detach all of the organisms from your hands.”

After rinsing, dry your hands thoroughly to remove any microbes left lurking behind. (Be sure to change your hand towels regularly – every few days, or every day if you have children – on a hot wash of 60C or more to kill bacteria.)

If you’re not able to wash your hands using soap and running water, Bloomfield recommends using antibacterial hand gel to kill any microbes on your hands. Keep one in your bag and use it when you’re not able to get to a bathroom.

Article adapted from The New York Times and The Guardian.

Halloween the Healthy Way

Halloween image with the wording Creatures of Habit
Make choices to stay healthy and strong!

Have a safe and healthy Halloween

Make Halloween festivities fun, safe, and healthy for trick-or-treaters and party guests.

Take steps to prevent the flu and other illness

It’s Halloween and the flu season is here! Keeping hands clean by washing them with soap and water is one of the best ways to prevent the spread of germs. Everyone 6 months and older should get a flu vaccine each year for the best protection against influenza throughout flu season.

Keep your bite healthy

Brush with fluoride toothpaste. Floss every day. Don’t go batty for sugary treats.

Sleep tight

Don’t look a fright this Halloween! Insufficient sleep is associated with a number of long-lasting diseases and conditions. Adults should get 7 to 8 hours of sleep each night.

Treat yourself to fruits and veggies

Don’t fill up on junk this Halloween. Treat yourself to yummy fruits and vegetables. They make a great healthy snack to serve for Halloween parties.

Be a smoke-free creature of habit

Smoking harms nearly every organ of the body. Make your Halloween activities smoke- and tobacco-free events. Eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from secondhand smoke exposure.

Prevent injuries

Make sure costumes fit well to avoid blocked vision, trips, and falls. Check out a fun coloring book. Color Me Safe! from CDC tells the rhyming story of the “Safe Family,” who take steps to protect themselves from injury at home, on the road, and at play.

Article from the CDC.

It’s Flu Shot Week!

  • Tuesday, October 22, 2019: Come to TVCC to get your flu shot!
  • TVCC Cafeteria/Weese 110
  • 9:00 a.m. to 4:00 p.m.
  • 650 College Blvd, Ontario, OR 97914
  • Wednesday – Friday, October 23-25, 2019: Come to the Malheur County Health Department Walk – In Clinic to get your flu shot!
  • Extended Hours: 8:30 a.m. – 7 p.m. (not closed during lunch)
  • 1108 SW 4th Street, Ontario, OR 97914
  • Please bring insurance card, if available
  • No cost vaccine available for those without health insurance
  • For more information, call 541-889-7279

Temporary ban on flavored vaping products

Effective October 15, 2019 through April 11, 2020, the sale of flavored vaping products is prohibited​ in the state of Oregon for 180 days.

  • No retailer may sell a flavored vaping product to a consumer in Oregon.
  • Online sales of flavored vaping products to people in Oregon are also prohibited during the ban.
  • The temporary ban applies to THC and non-THC vaping products.

Governor Kate Brown’s Executive Order 19-09 to enact a temporary ban on the sale or display of flavored vaping products is an evidence-based strategy to prevent youth, as well as adults attracted to flavors, from becoming exposed to the health risks from vaping products and from becoming addicted to nicotine. These recommendations from the Governor, taken together, will help us protect the health of all Oregonians. The Oregon Health Authority urges all Oregonians who use vaping products to stop vaping immediately.

OHA continues to work with health care providers in Oregon to identify cases of vaping-related illnesses and to partner with federal officials to investigate the causes ​of vaping-related lung injuries and deaths.

The Oregon Health Authority will work closely with the Oregon Liquor Control Commission, the Oregon Department of Justice and other agencies to implement the Governor’s Executive Order, including launching a statewide public education effort to warn Oregonians about the risks e-cigarette use or vaping products pose to youth and adults. Nearly 90 percent of Oregon high school students who exclusively use e-cigarettes use flavored products.

Read the Governor’s press release.​ 

The Oregon Health Authority is urging Oregonians to stop using all vaping products until federal and state officials have determined the cause of serious lung injuries and deaths linked to the use of both cannabis and nicotine vaping products. State health officials will continue to work closely with the federal Centers for Disease Control and Prevention and the Food and Drug Administration to determine the cause of deaths and illnesses in Oregon and across the nation.

No vaping products should be considered safe. Until health experts can identify why people who have used these products have become seriously ill, and in some cases died, no vaping product should be used.

People who experience symptoms of the illness after using vaping products, such as shortness of breath, cough or chest pain, should immediately seek medical attention.

Get Help Quitting

Oregon Quit Line

The Oregon Quit Line is a free, telephone and web-based program that helps youth and adults quit vaping ​cannabis and nicotine. It offers free confidential, evidence-based counseling and materials. Callers 18 years and older can receive Nicotine Replacement Therapy in the form of patches or gum.

The Quit Line is open 24 hours a day, seven days a week.


This is Quitting

This is Quitting powered by truth® is a free, confidential, 24-7 texting program for young people who vape. 


Oregon’s Drug and Alcohol Helpline​

The Alcohol and Drug Helpline serves anyone in Oregon who needs information, support or access to resources and treatment for alcohol or drug use. If you or someone you know needs help, the Alcohol and Drug Helpline is free, confidential, and available 24-7, 365 days a year.

  • Call 800-923-4357 or Text RecoveryNow to 839863.

SAMHSA’s National Helpline

SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families who need support quitting substances other than nicotine. 

  • ​Call 1-800-662-HELP (4357).

For more information, visit the Oregon Health Authority page on Vaping and Your Health

LGBTQIA+ Welcome

The Malheur County Health Department (MCHD) provides compassionate, high quality care for all people in Malheur County, including LGBTQIA+ individuals. We are proud to offer many services for the health and well-being of our community, including:

  • Rapid HIV testing, referral, and case coordination
  • Sexually Transmitted Infections testing and treatment
  • Communicable disease testing and case coordination, including tuberculosis and hepatitis
  • Wide range of birth control options
  • Immunizations, including HPV for all genders ages 9-26
  • Home Visiting programs for parents with children age 5 and under
  • Pregnancy testing and counseling
  • Tobacco prevention and education
  • Birth and death certificates, available within 6 months of event
  • WIC nutrition program for qualifying families with children age 5 and under

We are a community of all sexual orientations and gender identities and have a variety of health needs. MCHD serves all people regardless of ability to pay, with a few low-cost exceptions. No one will be denied services based on immigration status, sex, gender identity, sexual orientation, race, nationality, or religious affiliation. MCHD also accepts Medicare, Medicaid, and most private health insurance. If you do not have insurance, we have staff who can help you sign up for the Oregon Health Plan or determine your eligibility for other assistance programs.

All services are confidential and open to all ages. Call 541-889-7279 to make an appointment. Walk ins welcome. Se habla Español.

Crisis Resources and Support

Resources for LGBT Youth and Friends/Supporters

Some LGBT youth are more likely than their heterosexual peers to experience negative health and life outcomes. It is important that at-risk LGBT youth have access to resources and support to deal with the questions and challenges they may face as they mature.

Resources for Educators and School Administrators

Because some LGBT youth are more likely than their heterosexual peers to experience bullying or other aggression in school, it is important that educators, counselors, and school administrators have access to resources and support to create a safe, healthy learning environment for all students.

Resources for Parents, Guardians, and Family Members

Some LGBT youth are more likely than their heterosexual peers to experience negative health and life outcomes, so it is critical for the parents, guardians, and other family members of LGBT youth to have access to the resources they need to ensure their LGBT children are protected and supported.

Resources from the Centers for Disease Control and Prevention (CDC) LGBT Youth Resources

Pregnant Women Should Get Flu and Whooping Cough Shots

If pregnant women don’t get vaccinated, they may be endangering their babies as well as themselves.

Call the Malheur County Health Department at 541-889-7279 to schedule your flu and Tdap vaccines locally.

Millions of pregnant women in the United States are not getting two vital vaccines that protect not only their health, but their babies, the Centers for Disease Control and Prevention said October 8th, 2019.

The vaccines — against flu and whooping cough — are strongly recommended during every pregnancy. But only about 35 percent of pregnant women in the country are receiving both vaccines, according to a new CDC report, and just over half receive one.

The consequences of missing vaccines for flu and whooping cough, also called pertussis, can be dire.

“Influenza and pertussis, or whooping cough, are serious infections that can be deadly for babies, especially for those who are too young to be vaccinated directly,” said Dr. Anne Schuchat, principal deputy director of the CDC in a briefing. “We are stressing the importance of two safe and effective vaccines for pregnant women and the risks to both women and their babies when these vaccines are not given during pregnancy.”

Whooping cough can be fatal, especially for babies, who cannot get their first vaccine against it until they are two months old. The CDC report said that about 70 percent of people who died from whooping cough in recent years were infants younger than two months.

“When infants get whooping cough they are usually very sick and have difficulty breathing, eating, drinking or sleeping,” Dr. Schuchat said. “Parents may see their baby gasping for air and even turning blue from lack of oxygen.”

When a woman receives the whooping cough vaccine during pregnancy, antibodies are transmitted to the fetus. Those antibodies protect babies when they are born until they can build up their own immunity from a series of five immunizations against the disease. The report said that if women receive the vaccination early in the third trimester of pregnancy, it gives their newborns optimal protection and will prevent nearly 80 percent of whooping cough cases in babies under two months old.

Flu can be particularly risky for pregnant women and can cause complications like premature birth. The report found that pregnant women account for about a quarter to a third of women of reproductive age who are hospitalized for influenza — even though only about 9 percent of women in that age group are pregnant in any given year.

Babies younger than six months — the age at which they can receive their first flu vaccine — are hospitalized from flu much more often than older children and are at greater risk of dying from it. Dr. Schuchat said infants with flu can develop problems like pneumonia, dehydration and swelling of the brain.

“Maternal immunization rates have been steadfastly stuck at about 50 percent,” said Dr. Denise Jamieson, chairwoman of the department of gynecology and obstetrics at Emory University School of Medicine, who was not involved in the new report. “We really haven’t moved the needle at all.”

The new report analyzed data on hospitalization and death from flu and whooping cough between 2010 and 2018. The researchers also conducted an online survey this past spring of about 2,600 women who reported being pregnant any time since August 2018. It asked whether the women’s health care providers recommended the vaccines, either by offering to provide them or referring the patients to someone who could, and whether the women agreed to get vaccinated.

About three-quarters of the women surveyed said that during pregnancy their providers recommended the flu vaccine and the Tdap vaccine, which protects against whooping cough, tetanus and diphtheria. But even among those women, about a third did not get vaccinated, the report said.

The most common reason the women gave for not getting the flu vaccine was a belief it was not effective. The reason they gave most often for not getting the Tdap vaccine was not knowing it is necessary during each pregnancy. For both vaccines, the second most common reason women refused it was concern about whether it was safe for their babies, the report said.

Dr. Jamieson, a former CDC official who now practices obstetrics and gynecology at Grady Memorial Hospital, said that pregnant patients in her practice who declined to get the flu vaccine often said, “they heard bad things about the vaccine, misconceptions that it makes you sick or wasn’t safe,” she said. Some didn’t think they were at risk for flu she said.

Dr. Jamieson said women were generally more likely to accept the Tdap vaccine, possibly because it is newer so there are fewer misconceptions about it. The flu vaccine has been recommended in pregnancy since 1960, Dr. Jamieson said, but the Tdap has only been recommended for pregnant women since 2012.

Vaccines for flu and whooping cough are the only two immunizations recommended for all pregnant women, according to the American College of Obstetricians and Gynecologists, which posts a list of vaccines that are considered unsafe in pregnancy and others that can be given under certain circumstances.

Article adapted from the New York Times by Pam Belluck.

Public Health Warning: People should stop vaping immediately

oha logo
Second vaping-related death in state confirmed; people who vape are at risk, officials say

The Oregon Health Authority is issuing a public health warning urging people to immediately stop using all vaping products. On September 26, 2019, the agency confirmed a second vaping-related death in the state.

This is the second death among the five previously reported cases. Oregon’s first fatality was announced on Sept. 3. All five cases are part of a national outbreak of severe lung injury linked to vaping and e-cigarette use.

“People should stop vaping immediately,” said Dean Sidelinger, MD, state health officer. “If you vape, whether it’s cannabis, nicotine or other products, please quit. These are addictive substances, and we encourage people to take advantage of free resources to help them quit.”

He added: “If you haven’t started vaping, don’t start.”

OHA officials say the most recent death was an individual who had been hospitalized with respiratory symptoms after vaping cannabis products. Nationally, there have been more than 800 cases, primarily among youths and young adults, in 46 states and one U.S. territory. A total of 12 additional deaths, including Oregon’s first fatality, have been reported in 10 states.

Those who have fallen ill in Oregon have been hospitalized after experiencing worsening symptoms, including shortness of breath, cough or chest pain. CDC and the FDA have not identified a cause, but all cases have reported e-cigarette use or vaping.

OHA investigators and local public health authorities continue to urge clinicians to be on alert for signs of severe respiratory illness among patients and report any cases.

Before the new illness reports, OHA was already concerned about the health risks of vaping products. A recent report by the agency details the health risks for the products including nicotine addiction, exposure to toxic chemicals known to cause cancer and increases in blood pressure.

Individuals who have recently vaped and are having difficulty breathing should seek medical attention immediately.

If you or someone you know smokes or vapes, we urge you to quit now. Free help is available from the following resources:

Switching to cigarettes or other combustible products is not a safer option.

Public Health Warning: Stop using vaping products

Public health officials have now linked a second Oregon death to the use of vaping products. The Oregon Health Authority urges Oregonians to stop using all vaping products until federal and state officials have determined the cause of serious lung injuries and deaths linked to the use of both cannabis and nicotine vaping products. No vaping products should be considered safe. Until health experts can identify why people who have used these products have become seriously ill, and in some cases died, no vaping product should be used. State health officials will continue to work closely with the federal Centers for Disease Control and Prevention and the Food and Drug Administration to determine the cause of deaths and illnesses in Oregon and across the nation

Oregon Health Authority Media contact: Jonathan Modie, 971-246-9139, phd.communications@dhsoha.state.or.us

GET THE FACTS ABOUT FLU SHOTS

Call 541-889-7279 to schedule an appointment for your FREE flu shot at the Malheur County Health Department before the end of October.

Flu season is nearly here. To help you decide when, where, and how to get vaccinated, we compiled answers to some of the most common questions we see regarding flu vaccinations.

Who should get a flu shot?

Everyone over 6 months of age should receive a flu vaccine yearly, unless a doctor has advised otherwise.

But I’m healthy and getting the flu doesn’t seem like a big deal. Why do I need a flu shot?

No one wants to miss out on their vacation or be two weeks behind at work because of a preventable illness. So while you may be able to get through the flu, why take the risk?

During the 2017-2018 flu season, influenza vaccination prevented approximately 7 million flu illnesses, 109,000 flu hospitalizations, and 8,000 flu deaths.

Even if you’re young and healthy, the flu can lead to serious complications that require hospitalization. Getting vaccinated not only helps prevent you from getting ill, it also decreases the severity of illness if you do get the flu and helps protect those around you who cannot receive the shot because of their age or underlying conditions, such as your grandma or your neighbor’s new baby.

Can I get the flu from the flu shot?

No, flu shots do not cause the flu. This is a common concern but, thankfully, not something that happens.

Flu vaccines given via a needle are made with inactivated (killed) viruses that are not infectious or with just certain proteins from flu viruses, so they cannot cause the flu. And, the nasal spray flu vaccine is made with live viruses that are significantly weakened, so they can give protection but not cause illness.

While vaccinations cannot cause the flu, some people do experience mild side effects, including aches and a low-grade fever. However, when these side effects occur, they are generally mild and tend to last only a day or two.

When should I get a flu shot?

The CDC recommends everyone over 6 months of age receive a flu shot by the end of October. Flu activity generally picks up in the fall and it’s best to get the shot before the virus starts spreading in your community and workplace.

Children 6 months through 8 years getting vaccinated for the first time, and those who have only previously gotten one dose of vaccine, should get two doses of vaccine this season. All children who have previously gotten two doses of vaccine (at any time) only need one dose of vaccine this season. The first dose should be given as soon as vaccine becomes available.

The flu season usually peaks around February, and can last well into the spring. So, even if you miss the recommended window, it is still worth getting vaccinated later in the season.

What’s the benefit of getting a shot now?

It takes two weeks from the time you receive your flu shot to develop full immunity. The sooner you get the shot, the sooner your body can build that full immunity.

Should I get a flu shot if I’m pregnant?

Yes, flu vaccines are safe for pregnant people. They help to protect both the pregnant individual and their baby from the flu.

During pregnancy, people experience changes in their immune system, heart, and lungs that make them more prone to severe illness from flu. According to the CDC, vaccination reduces this risk of serious, flu-associated respiratory infection and hospitalization in those who are pregnant. In addition, pregnant people who receive the flu vaccine are helping to protect their babies from flu illness for several months after their birth, when they are still too young to be vaccinated themselves. 

What if I’m over 65 years old?

The flu can be particularly serious for people 65 and older because human immune defenses weaken with age. The flu vaccine is the best way to protect against the flu and potentially serious complications.

There are two vaccines that are specifically recommended for people who are 65 years of age or older: the “high dose” vaccine and the “adjuvanted” flu vaccine, Fluad. Both options have been found to be effective at preventing the flu and the CDC does not state a preference for one vaccine over another. The regular flu shot is also a good option if these products are not available.

Where can I get a flu shot?

If you are local to Malheur County, Oregon, come see us at the Malheur County Health Department! Call ahead for an appointment: 541-889-7279. Walk ins are welcome.

You can use the online HealthMap Vaccine Finder or Public Health’s Find an Immunization Clinic page to easily find nearby pharmacy and clinic locations to get your flu shot. Remember to call ahead to ensure that the vaccine you need is currently available, especially if you are interested in the nasal spray flu vaccine or the intradermal flu vaccine.

If you still have questions about flu vaccinations or want to know more, check out our past blog post on flu vaccination effectiveness  or CDC’s FAQ’s about the 2019-2020 flu season.

Article adapted from Public Health Insider post by Lily Alexander. Photos taken by Heather Hazzan as a part of the Self x American Academy of Pediatrics Vaccine Photo Project.

Oregon Health Authority Report on Tobacco Retailer Inspections

The Oregon Health Authority recently released a report highlighting a slight decrease in illegal cigarette sales, but illegal sales of little cigars doubled. For Malheur County, what was most striking was how few stores were inspected, giving us an incomplete snapshot of the scale of illegal sales. Only 8 out of 26 retailers in Malheur County were inspected in 2019.

This incomplete snapshot is particularly concerning given the rise of the vaping epidemic among our youth and the recent fatality in Oregon connected with vaping.

The Oregon Health Authority’s Public Health Division conducts retail inspections in collaboration with Oregon State Police. In 2019, the state inspected 1,100 retailers out of about 3,200 retailers who sell tobacco and e-cigarette products statewide. If a retailer violates the law, a citation is issued to the store’s clerk, manager on duty or owner. The annual inspection report shows which stores passed inspection and which sold illegally to people under age 21.

One of the challenges of our inspection process in the state is that only a few counties in Oregon require a license to sell tobacco – and there’s no state license. This means it is extremely difficult to enforce the minimum legal sales age by holding retailers accountable for illegal sales. A tobacco retail license would make it possible to track who is selling tobacco (and thoroughly inspect each one), educate retailers on how to comply with the law and have meaningful penalties for repeat offenders.

The list of Oregon tobacco retailers that violated the tobacco sales is available on the OHA Public Health Division website here.

For more information about how the tobacco industry markets in Oregon, see the recent Tobacco Retail Assessment Report here.