Local Health Departments on the Front Lines of the Opioid Epidemic

According to the National Association of County and City Health Officials, local health departments play a critical role in responding to opioid misuse and overdose within their own communities and are well suited to serve as conveners or supporters of coalitions and partnerships.

According to the Centers for Disease Control and Prevention’s 2018 report, Morbidity and Mortality Weekly Report, 47,600 Americans died because of opioid-related overdoses in 2017—far outpacing the mortalities associated with car crashes in 2017 and those of the peak years of the AIDS epidemic. While success has been made in recent years to curb the severity of the epidemic, these recent numbers are a stark reminder of the continued suffering of individuals, families, and communities across the country.

On the “front line” of the epidemic, LHDs are well suited to serve as conveners or supporters of coalitions and partnerships. This is critical, given that collaboration at the local level is essential to address the multifaceted nature of the opioid epidemic. The coordination of federal, state, and local partners, along with the engagement of community agencies and organizations, is imperative in implementing strategies to prevent and respond to opioid misuse and overdose.

Activities located within a local health department are beneficial because opioid use looks different across jurisdictions. To support individuals living with Opiod Use Disorder (OUD), local health departments can help their communities build out treatment options, including medication-assisted treatment, and can improve community linkages to care for OUD treatment, as well as for other physical and mental health services related to opioid use. They are also well-suited to support active drug use communities and to develop and enhance support systems for individuals engaging in treatment.

The opioid epidemic skyrocketed to public consciousness on the back of the immense suffering addiction has inflicted on American communities. There will always be another crisis, and the lessons learned from a variety of domestic drug use epidemics tell us that when we fail to prepare, we fail far too many. Instead of reactionary responses to each new public health emergency, local health departments have a unique opportunity to harness the national conversation around opioids to push for structural improvements in our official response to drug use of all kinds.

Article by Evans, Higgins, and Stanford. Adapted from Journal of Public Health Management & Practice.

10 Ways to Lower the Cancer Risk of Grilling

If you plan to grill often experts suggest taking some small steps to make a big difference in lowering your exposure to compounds that are tied to cancer.

Many people would be surprised to hear that grilling carries potential cancer risks. But each year, the American Institute for Cancer Research publishes guidance for “cancer-safe grilling,” cautioning consumers to avoid two types of compounds that have been tied to cancer. These compounds, called polycyclic aromatic hydrocarbons and heterocyclic amines, get generated when food, especially meat, is cooked on a grill. They have not been proven to cause cancer in people, but lab studies have shown they alter DNA in a way that could lead to cancer.

“Polycyclic aromatic hydrocarbons are formed when any kind of organic matter,” primarily fat that drips off meat and down into the grill grates, “gets burned, because the carbon inside is being combusted in the flames, and those hydrocarbons get carried up in the smoke,” said Rashmi Sinha, senior investigator in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute. The resulting smoke can envelop the meat and coat it in the potentially carcinogenic compounds.

The black char we’ve all seen on grill grates and grilled food? That’s the heterocyclic amines, or HCAs, which occur when high temperatures meet muscle meat, which includes red meat (pork, beef, lamb, goat), poultry (turkey, chicken) and fish. “Grilling — or even pan-frying — at these high temps causes amino acids found in the meat to react with another substance found in meat called creatine,” said Colleen Doyle, managing director of nutrition and physical activity at the American Cancer Society and a registered dietitian. Creatine is found only in muscle meat.

“It’s the reaction of those amino acids and the creatine that form the HCAs, which is why we don’t see HCAs formed when grilling asparagus, squash, peppers and other vegetables.”

As with most lifestyle choices related to dialing up or down one’s cancer risk, the dose makes the poison. Which means if you’re grilling once or twice a year, don’t sweat it. But if you plan to grill often — once or twice a week throughout the summer, say — experts suggest taking some small steps to make a big difference in lowering your exposure to these compounds.

Grill fish, seafood, poultry or plant-based foods rather than red meat and especially processed meats like hot dogs; the World Health Organization considers processed meats a carcinogen and red meat a probable carcinogen. While HCAs are still formed while grilling fish and seafood, Ms. Doyle pointed out that you typically don’t have to cook seafood as long as beef and chicken, which reduces the accumulation of the compounds.

Research suggests that marinating for at least 30 minutes can reduce the formation of HCAs on meat, poultry and fish. The reason for this is not entirely clear to researchers, but one possibility is a kind of shield effect. “If you put a barrier of basically sugar and oil between the meat and the heat, then that is what becomes seared instead of the meat,” said Nigel Brockton, vice president of research at the American Institute for Cancer Research. It also makes your meat more flavorful.

Many kinds of fruits and vegetables are actually protective as far as cancer risk, and they don’t form HCAs when grilled. Several experts recommend using meat as a condiment. Think of alternating cubes of chicken with peppers and onions or peaches and pineapple on a skewer, for instance. This trick, which also works when pan frying, reduces the surface area of meat exposed to the hot surface, Dr. Brockton explained, since the meat is also touching other ingredients throughout the cooking process.

According to Dr. Brockton, cooking your meat with herbs, spices, tea, chili peppers and the like — ingredients with phenolic compounds — can be a helpful approach because “it seems they quench the formation of the potentially carcinogenic compounds because of the antioxidant properties of those ingredients.”

Try to minimize how much smoke you’re breathing in, the Harvard T.H. Chan School of Public Health recommends as part of a helpful resource on healthy summer picnic practices.

The black, crispy crust that you often see on the bony edges of ribs or steak is more likely to contain a higher concentration of potentially carcinogenic compounds. Ms. Doyle also recommends cleaning the grill grates ahead of time, to remove any previously generated char.

“The longer you cook something, the longer the chemical reaction is happening, the higher the amount of HCAs are formed,” Dr. Brockton said. If you partially precook your meat, such as by baking or cooking in the microwave, the layer of HCAs that gets formed won’t be as thick. The same goes for meat cut into smaller pieces, such as with kabobs, because it cooks faster. Grilling in foil can also help protect the food from smoke and speed up the cooking time, according to the Harvard resource on healthy picnics.

“Types of wood can influence HCA formation,” Ms. Doyle said. “Hardwoods, such as hickory and maple, and charcoal all burn at lower temperatures than soft woods, such as pine. Cooking with wood that burns at a lower temperature is desirable.”

To minimize your exposure to polycyclic aromatic hydrocarbons, experts recommend selecting leaner cuts of meat or trimming any visible fat, which can lower the amount that drips down through the grates and comes back up in the smoke. To minimize dripping, Ms. Doyle suggests not piercing your meats while they’re on the grill.

According to guidance from the National Cancer Institute, fewer HCAs are formed if you turn meat over frequently while cooking it on high heat.

Article by Sophie Egan. Adapted from The New York Times.

West Nile virus detected in Canyon County mosquitoes

Because of Malheur County’s proximity to Canyon County, Idaho, we will share health advisories from neighboring areas to alert people to local concerns. Thanks to the Idaho Department of Health and Welfare for the important information.

Mosquitoes infected with West Nile virus (WNV) were detected in Canyon County on June 14, 2019, prompting public health officials to remind people to take precautions to “Fight the Bite.” The positive mosquitoes, which are the first detected in the state this year, were collected by the Canyon County Mosquito Abatement District. The positive lab results were confirmed Tuesday.

Last year, one death was reported because of WNV complications, and 11 counties across Idaho reported finding mosquito pools that tested positive for West Nile virus. Sixteen people and five horses were infected. This first detection of 2019 occurred in western Idaho, an area where positive mosquitoes have been found almost every year since West Nile virus was first detected in Idaho in 2004.

West Nile virus is contracted from the bite of an infected mosquito; it is not spread from person-to-person through casual contact. Symptoms often include fever, headache, body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash. In some cases, the virus can cause severe illness, especially in people over the age of 50, and may require hospitalization. On rare occasion, it can lead to death. 

“This is the time of year we expect West Nile virus-positive mosquitos to be found in Idaho,” says Dr. Christine Hahn, Idaho Division of Public Health Medical Director. “Avoiding mosquito bites is the best protection against infection with the virus.”

To reduce the likelihood of infection, take steps to avoid mosquitoes, particularly between dusk and dawn when they are most active. In addition, you should:

  • Cover up exposed skin when outdoors and apply DEET or other U.S. Environmental Protection Agency-approved insect repellent to exposed skin and clothing. DEET may be used on adults, children, and infants older than 2 months of age. Carefully follow instructions on the product label, especially for children. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant or breastfeeding women.
  • Insect-proof your home by repairing or replacing screens.
  • Reduce standing water on your property; check and drain toys, trays, or pots outdoors that may hold water and harbor mosquito eggs.
  • Change bird baths and static decorative ponds weekly as they may also provide a suitable mosquito habitat.

WNV does not usually affect domestic animals such as dogs and cats, but it can cause severe illness in horses and certain species of birds. Although there is no vaccine available for people, there are several vaccines available for horses. People are advised to have their horses vaccinated annually.

For the latest information, visit www.westnile.idaho.gov. Article adapted from the DHW blog.

Tanning industry uses promos, cheap prices to lure adolescents and young adults, study finds

Everyone knows cigarette smoking causes cancer and as a result, prices and advertising are closely regulated to discourage youth from starting. But another cancer risk, indoor tanning, which has been shown to cause melanoma, lags in regulation. Researchers at the Colorado School of Public Health have found that the tanning industry uses marketing strategies that appeal to adolescents and young adults, including unlimited tanning packages, discounts, and even offering free tanning when paired with other services like an apartment rental or gym membership.

“This study highlights the fact that a lot of businesses out there are providing this service at a low cost which removes a barrier to adolescents and young adults,” said Nancy Asdigian, lead author of the study and a Research Associate in the Department of Community and Behavioral Health at the Colorado School of Public Health. “Young people who want to tan do so when they can afford it and don’t when they can’t. The industry capitalizes on this with the strategies they use to price and promote this risk behavior.”

The study was published June 17, 2019 in the Journal of Public Health Policy.

According to the Global Burden of Disease Study, about 352,000 people worldwide were diagnosed with potentially deadly melanoma in 2015. That includes 81,000 cases in the U.S.

High profile public health and policy efforts along with state age restrictions have helped decrease the prevalence of indoor tanning among youth, but the study said levels remain ‘unacceptably high.’

Source: University of Colorado Anschutz Medical Campus. Adapted from an article in ScienceDaily.

Ready. Set. Quit Smoking.

Curious about what happens when you contact the Quit Line?

  1. You can get help to stop smoking—free, with no judgment.
  2. Quit coaches help create a plan that can work for you.
  3. Quit coaches can help you get quit-smoking medications.
  4. You can get helpful tips by email, chat with a Quit Coach, Text2Quit, Quit Now website, and by calling 1-800-QUIT-NOW.

Using proven techniques tested over 25 years, the Quit Line program has helped millions of people and it can help you, too. Get started today, and connect with 1-on-1 support to beat urges, manage withdrawal symptoms and switch up your habits so you can enjoy life tobacco-free.

Sun Safety

You can reduce your risk of skin damage and skin cancer by seeking shade under an umbrella, tree, or other shelter before you need relief from the sun.

The sun’s ultraviolet (UV) rays can damage your skin in as little as 15 minutes. Follow these recommendations to help protect yourself and your family.

Shade

You can reduce your risk of skin damage and skin cancer by seeking shade under an umbrella, tree, or other shelter before you need relief from the sun. Your best bet to protect your skin is to use sunscreen or wear protective clothing when you’re outside—even when you’re in the shade.

Clothing

When possible, long-sleeved shirts and long pants and skirts can provide protection from UV rays. Clothes made from tightly woven fabric offer the best protection. A wet T-shirt offers much less UV protection than a dry one, and darker colors may offer more protection than lighter colors. Some clothing certified under international standards comes with information on its ultraviolet protection factor.

If wearing this type of clothing isn’t practical, at least try to wear a T-shirt or a beach cover-up. Keep in mind that a typical T-shirt has an SPF rating lower than 15, so use other types of protection as well.

Hat

For the most protection, wear a hat with a brim all the way around that shades your face, ears, and the back of your neck. A tightly woven fabric, such as canvas, works best to protect your skin from UV rays. Avoid straw hats with holes that let sunlight through. A darker hat may offer more UV protection.

If you wear a baseball cap, you should also protect your ears and the back of your neck by wearing clothing that covers those areas, using a broad spectrum sunscreen with at least SPF 15, or by staying in the shade.

Sunglasses

Sunglasses protect your eyes from UV rays and reduce the risk of cataracts. They also protect the tender skin around your eyes from sun exposure.

Sunglasses that block both UVA and UVB rays offer the best protection. Most sunglasses sold in the United States, regardless of cost, meet this standard. Wrap-around sunglasses work best because they block UV rays from sneaking in from the side.

Photo of a woman putting sunscreen to her young daughter.

Put on broad spectrum sunscreen with at least SPF 15 before you go outside, even on slightly cloudy or cool days. Don’t forget to put a thick layer on all parts of exposed skin. Get help for hard-to-reach places like your back. And remember, sunscreen works best when combined with other options to prevent UV damage.

For more information, check out the Sun Safety Tips for Families fact sheet. Article adapted from the CDC.

Tips to Prevent Poisonings

Drugs and Medicines

  • Only take prescription medications that are prescribed to you by a healthcare professional. Misusing or abusing prescription or over-the-counter medications is not a “safe” alternative to illicit substance abuse.
  • Never take larger or more frequent doses of your medications, particularly prescription pain medications, to try to get faster or more powerful effects.
  • Never share or sell your prescription drugs. Keep all prescription medicines (especially prescription painkillers, such as those containing methadone, hydrocodone, or oxycodone), over-the-counter medicines (including pain or fever relievers and cough and cold medicines), vitamins and herbals in a safe place that can only be reached by people who take or give them.
  • Follow directions on the label when you give or take medicines. Read all warning labels. Some medicines cannot be taken safely when you take other medicines or drink alcohol.
  • Turn on a light when you give or take medicines at night so that you know you have the correct amount of the right medicine.
  • Keep medicines in their original bottles or containers.
  • Monitor the use of medicines prescribed for children and teenagers, such as medicines for attention deficit hyperactivity disorder, or ADHD.
  • Dispose of unused, unneeded, or expired prescription drugs. Follow federal guidelines for how to do this (FDA 2011).
  • Participate in National Drug Take Back days recognized by the Drug Enforcement Administration or local take back programs in your community.

Household Chemicals and Carbon Monoxide

  • Always read the label before using a product that may be poisonous.
  • Keep chemical products in their original bottles or containers. Do not use food containers such as cups, bottles, or jars to store chemical products such as cleaning solutions or beauty products.
  • Never mix household products together. For example, mixing bleach and ammonia can result in toxic gases.
  • Wear protective clothing (gloves, long sleeves, long pants, socks, shoes) if you spray pesticides or other chemicals.
  • Turn on the fan and open windows when using chemical products such as household cleaners.

Keep Young Children Safe from Poisoning

Be Prepared

  • Put the poison help number, 1-800-222-1222, on or near every home telephone and save it on your cell phone. The line is open 24 hours a day, 7 days a week.

Be Smart about Storage

  • Store all medicines and household products up and away and out of sight in a cabinet where a child cannot reach them.
  • When you are taking or giving medicines or are using household products:
    • Do not put your next dose on the counter or table where children can reach them—it only takes seconds for a child to get them.
    • If you have to do something else while taking medicine, such as answer the phone, take any young children with you.
    • Secure the child safety cap completely every time you use a medicine.
    • After using them, do not leave medicines or household products out. As soon as you are done with them, put them away and out of sight in a cabinet where a child cannot reach them.
    • Be aware of any legal or illegal drugs that guests may bring into your home. Ask guests to store drugs where children cannot find them. Children can easily get into pillboxes, purses, backpacks, or coat pockets.

Proper Disposal

For more information on proper disposal, please see the FDA’s web site, Disposal of Unused Medicines: What You Should Know.

What To Do If A Poisoning Occurs

  • Remain calm.
  • Call 911 if you have a poison emergency and the victim has collapsed or is not breathing. If the victim is awake and alert, dial 1-800-222-1222. Try to have this information ready:
    • the victim’s age and weight
    • the container or bottle of the poison if available
    • the time of the poison exposure
    • the address where the poisoning occurred
  • Stay on the phone and follow the instructions from the emergency operator or poison control center.

The Safety tips above were adapted from the American Association of Poison Control Centers. Find more information on Home and Recreational Safety from the CDC HERE.

Secondhand Smoke

Malheur County Health Department is committed to enforcing Oregon’s Indoor Clean Air Act (ICAA), which prohibits smoking, vaporizing or aerosolizing in most public places and places of employment. Additionally, smoking, vaporizing or aerosolizing is not permitted within ten feet of any entrance, exit, window that opens or air-intake vent. All public places and workplaces affected by the law must post appropriate signs. The ICAA is a complaint-driven law; OHA (along with the health department) may respond to complaints, inspect public places and issue citations and penalties for violating the law. Report an ICAA violation HERE by filling out the online complaint form or call 1-866-621-6107. You can leave your complaint anonymously.

Why do we care so much about the ICAA? Because second hand smoke is dangerous and can harm you and the ones you love. Quitting smoking and ensuring you are not exposed to second hand smoke will benefit you plus help you protect the people in your life.

Dangers of Secondhand Smoke

The main way smoking hurts non-smokers is through secondhand smoke. Secondhand smoke is the combination of smoke that comes from a cigarette and smoke breathed out by a smoker. When a non-smoker is around someone smoking, they breathe in secondhand smoke.

Secondhand smoke is dangerous to anyone who breathes it in. It can stay in the air for several hours after somebody smokes. Breathing secondhand smoke for even a short time can hurt your body.

Take this quiz to see how much you know about the dangers of secondhand smoke.

Health Effects of Secondhand Smoke

Over time, secondhand smoke has been associated with serious health problems in non-smokers: 

  • Lung cancer in people who have never smoked. 
  • More likely that someone will get heart disease‚ have a heart attack‚ and die early. 
  • Breathing problems like coughing‚ extra phlegm‚ wheezing‚ and shortness of breath.

Secondhand smoke is especially dangerous for children, babies, and women who are pregnant: 

  • Mothers who breathe secondhand smoke while pregnant are more likely to have babies with low birth weight. 
  • Babies who breathe secondhand smoke after birth have more lung infections than other babies. 
  • Secondhand smoke causes kids who already have asthma to have more frequent and severe attacks. 
  • Children exposed to secondhand smoke are more likely to develop bronchitis, pneumonia, and ear infections and are at increased risk for sudden infant death syndrome (SIDS). 

The only way to fully protect non-smokers from the dangers of secondhand smoke is to not allow smoking indoors. Separating smokers from non-smokers (like “no smoking” sections in restaurants)‚ cleaning the air‚ and airing out buildings does not get rid of secondhand smoke.

Steps You Can Take to Protect Your Loved Ones

The best thing you can do to protect your family from secondhand smoke is to quit smoking. Right away, you get rid of their exposure to secondhand smoke in your home and car, and reduce it anywhere else you go together.

Make sure your house and car remain smokefree. Kids breathe in secondhand smoke at home more than any other place. The same goes for many adults. Don’t allow anyone to smoke in your home or car. Setting this rule will:

  • Reduce the amount of secondhand smoke your family breathes in.
  • Help you quit smoking and stay smokefree.
  • Lower the chance of your child becoming a smoker.

When you’re on the go, you can still protect your family from secondhand smoke:

  • Make sure caretakers like nannies, babysitters, and day care staff do not smoke.
  • Eat at smokefree restaurants.
  • Avoid indoor public places that allow smoking.
  • Teach your children to stay away from secondhand smoke.

Find out more about secondhand smoke:

May is Mental Health Awareness Month

Millions of Americans face the reality of living with a mental illness every day. During May, the Malheur County Health Department is raising awareness of mental health and the ways we can support those in our communities. It is important that together with many other service organizations, we fight stigma, provide resources, educate the public and advocate for people with mental illness and their families.

Mental Health Awareness Month brings attention to trauma and the impact it can have on the physical, emotional, and mental well-being of children, families, and communities. Mental health is essential for a person’s overall health. Prevention works, treatment is effective, and people can recover from mental disorders and live full and productive lives. For more information on mental health, children and families, visit Youth.gov.

One in six Oregonians live with mental illness. To raise awareness, fight stigma and encourage struggling individuals to seek help, two Oregonians share their stories in this brief video.

The National Alliance on Mental Illness (NAMI) wants to inspire others with the following facts.

Mental Health Facts

  • 1 in 5 (46.6 million) adults in the United States experience a mental health condition in a given year.
  • 1 in 25 (11.2 million) adults in the United States experience a serious mental illness in a given year.
  • Approximately 46.6 million adults in the United States face the reality of managing a mental illness every day.
  • Half of all lifetime mental health conditions begin by age 14 and 75% by age 24, but early intervention programs can help.
  • Up to 90% of those who die by suicide have an underlying mental illness as revealed by psychological autopsy. 46% of those who die by suicide have a diagnosed mental illness.
  • Suicide is the 10th leading cause of death in the United States. With effective care, suicidal thoughts are treatable, and suicide is preventable.

What is Stigma?

People experiencing mental health conditions often face rejection, bullying and even discrimination. This can make their journey to recovery longer and more difficult. Stigma is when someone, or you yourself, views you in a negative way because you have a mental health condition. Some people describe stigma as shame that can be felt as a judgement from someone else or a feeling that is internal, something that confuses feeling bad with being bad.

Navigating life with a mental health condition can be tough, and the isolation, blame and secrecy that is often encouraged by stigma can create huge challenges to reaching out, getting needed support and living well. Learning how to cope with stigma and how to avoid and address stigma are important for all of us.

Get Help

Recovery is possible. Help is available.