Save the Date! National Rural Health Day

Mark your calendars! November 17th is National Rural Health Day and an opportunity to remember and promote healthcare providers in communities like ours. Small towns, farming communities, and frontier areas are places where neighbors know each other, listen to each other, respect each other, and work together to benefit the greater good. We know how great it is to live here, but we also recognize the challenges.

The third Thursday in November has been set aside to highlight rural communities as wonderful places to live and work, increase awareness of rural health-related issues, and promote the efforts to address these issues.

Rural communities have unique healthcare needs. Today more than ever, rural communities like Malheur County, must address accessibility issues, a lack of healthcare providers, the needs of an aging population suffering from a greater number of chronic conditions, and larger percentages of un- and underinsured citizens.

To follow along on social media, please use the hashtag #PowerofRural.

Hand, Foot, and Mouth Disease (HFMD) Outbreaks in Oregon

There has been a notable increase in outbreaks of Hand, Foot, and Mouth Disease (HFMD) in Oregon in the last month. HFMD is an infection caused by a virus. Symptoms of hand, foot, and mouth disease usually include fever, mouth sores, and skin rash. The rash is commonly found on the hands and feet.

Hand, foot, and mouth disease is common in children under 5 years old, but anyone can get it. The illness is usually not serious, but it is very contagious. It spreads quickly at schools and day care centers. We are aware of recent HFMD cases in Malheur County, as well.

Steps that can be taken to prevent infection include:

  • washing hands often with soap and water for at least 20 seconds (or using alcohol-based hand sanitizer if soap and water not available);
  • helping children wash their hands;
  • avoiding touching eyes, nose, and mouth;
  • avoiding close contact with sick people; and
  • cleaning and disinfecting frequently touched items.

Treatment of HFMD is symptom-based:

  • drink enough fluids to prevent dehydration; and
  • use of over-the-counter medication to relieve fever and pain from mouth sores. Never give aspirin to children.

Additional information on HFMD can be found at:

SMART Recovery Resumes Next Week

The weekly SMART Recovery meeting hosted at the Health Department every Thursday from 3-4 p.m. is cancelled this week (November 10th) due to the peer team attending a conference. Please join us next week or find an online meeting at

Self-Management And Recovery Training (SMART) is a community of mutual-support groups. At meetings, participants help one another resolve problems with any addiction. Participants find and develop the power within themselves to change and lead fulfilling and balanced lives guided by a science-based and sensible 4-Point Program. Learn more at

RSV Season is Here: Protect Those at Highest Risk

Take care! RSV season is here.

RSV season has been declared in Idaho and in Oregon with virus activity increasing earlier than usual. Respiratory syncytial virus, (RSV), is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults.

If you or a loved one is at high risk for severe RSV disease:

If you are at high risk for severe RSV infection, or if you interact with an older adult or young child, you can take extra care to keep them healthy with the following tips:

  • Wash your hands often
    Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer. Washing your hands will help protect you from germs.
  • Keep your hands off your face
    Avoid touching your eyes, nose, and mouth with unwashed hands. Germs spread this way.
  • Avoid close contact with sick people
    Avoid close contact, such as kissing, and sharing cups or eating utensils with people who have cold-like symptoms.
  • Cover your coughs and sneezes
    Cover your mouth and nose with a tissue or your upper shirt sleeve when coughing or sneezing. Throw the tissue in the trash afterward.
  • Clean and disinfect surfaces
    Clean and disinfect surfaces and objects that people frequently touch, such as toys, doorknobs, and mobile devices. When people infected with RSV touch surfaces and objects, they can leave behind germs. Also, when they cough or sneeze, droplets containing germs can land on surfaces and objects.
  • Stay home when you are sick
    If possible, stay home from work, school, and public areas when you are sick. This will help protect others from catching your illness.

Learn more on RSV surveillance from the Oregon Health Authority here. Read and share the CDC fact sheets RSV in Infants and Young Children and Older Adults are at High Risk for Severe RSV Infection.

How to talk with others about getting the COVID-19 vaccine

Here is the truth: COVID-19 vaccines and boosters are safe, and they work. They are highly effective at helping prevent hospitalizations and severe COVID-19 illness. Being vaccinated and boosted allows people to move through life with a semblance of normalcy.

Unfortunately, there is a lot of false information out there about COVID-19 vaccines that can lead some of our friends and family members to decide not to get vaccinated. Some may be skeptical of the vaccines’ safety and effectiveness, while others may be afraid of the vaccination process. Even though you may disagree, it can be a touchy subject and daunting to bring up in conversation.

If you want to engage friends and family in a conversation about COVID-19 vaccines, the best approach is a thoughtful approach. With holiday gatherings around the corner, now is the perfect time to prepare.

“It is important to enter the conversation not with the intention of convincing or persuading someone to change their mind, but to learn about their barriers,” said Dr. Ruth Zúñiga, Oregon Health Authority senior health advisor and licensed psychologist. “Once you understand someone’s barriers, maintain trust by trying to support them in whatever stage of their journey they’re in.”

Here are some tips for how to have a respectful and productive conversation about the benefits and safety of being vaccinated and boosted against COVID-19.

Have an open mind

Entering the conversation with an open mind will make it easier to gather information and understand the other person’s perspective. Listen with curiosity and don’t interrupt. Show them you are listening by paying attention, removing distractions like cellphones and keeping your body language relaxed. Even if you don’t agree with their reasoning, try to validate their feelings and show gratitude for their willingness to share: e.g. “I know this conversation can be difficult, and I appreciate you having it with me. I am sorry if this situation is causing you stress or confusion.”

Listen, withhold judgment

If you allow ample time for the other person to talk without reacting or responding, you have a better chance of having a positive and meaningful conversation. Ask open-ended questions to understand their perspective. You can start by asking them about specific concerns and where they get their information. Questions such as, “What are you concerned about?” or “What have you heard?” are respectful and do not expose your own opinions (which could shut them down or, worse, lead to arguing). Show that you are listening by responding to their comments with respect and kindness, and not changing the subject or steamrolling the conversation. If you don’t agree with what they say, avoid challenging or contradicting them.

Connect on shared values

During the conversation, point out where you agree on shared values. Acknowledging common ground between your viewpoints can help remove tension. For example, if someone is expressing fear over the safety of the vaccine, let them know you felt scared at first, too, but you felt better after being vaccinated. The conversation should be one of encouragement, not a fight or competition. Connecting on core beliefs (the desire to have a normal life, prioritizing health, fear of the unknown) can remind them you do not see them as ‘the opposition.’

Work to replace misinformation with new information

If their view is informed by misinformation, ask if it’s OK to share resources with them to address their concerns. But you should use the conversation to gather information first, not to lecture. Be an active listener, jotting down notes if appropriate, so you can follow up later with links to resources they may connect with later. Doing your own focused research for someone shows that you are willing to put in the effort to support them, but don’t overwhelm them with information. Respect their answer if they do not want to receive resources.

Offer in-person support

Depending on the situation, try offering support if they decide to look into getting vaccinated. Whether that means sitting together while you both research vaccination site locations, or joining them when they get the vaccine, can provide comfort. For some people, getting vaccinated is quick and simple. Others may not have the time or ability to access a vaccination clinic, and you could offer practical support such as transportation, babysitting or translating for someone who does not speak English if you can. Whatever stage in the process they are in, ask what would be helpful.  

Show them you care

The willingness to have a tough conversation usually comes from a place of love. When a person you care about acts in a way that you don’t agree with, it can be tempting to feel angry, hurt or frustrated. If you find yourself becoming upset during the conversation, take deep breaths and remind yourself – and your friend or loved one – that you are having this conversation because you care. Coming on too strong, or with the wrong intentions, can make people defensive and unlikely to change their minds.

You may not get the result you’re hoping for right away, but the health of our loved ones and communities is worth working for. By showing up and having the hard conversations, you show others that you’re ready to embrace them with open arms if they ultimately make the decision to get vaccinated.

Recognize when to stop

If you notice the conversation moving into an argument, or they seem overwhelmed or firm in their stance, be willing to retreat gracefully. Be patient with yourself and recognize that even the best intentions may not lead to the outcomes you desire. End the conversation with respect and without judgment. Feel good that you tried and leave the door open for further conversation.


Understanding Diabetes

November is National Diabetes Month, a time when we want to bring attention to diabetes. This growing epidemic affects many in Malheur County. Our own Registered Dietician, Hallie Hopkins, selected the article below from the Academy of Nutrition and Dietetics to raise awareness. Please read and reach out to someone who may be at risk of diabetes or would benefit from the information. Contact your primary care provider to find out how you can best prevent or manage diabetes.

A whopping 34.2 million Americans have diabetes. And, even more people are unaware that they are at high risk for developing prediabetes or progressing to Type 2 diabetes. Prediabetes is often considered a transition step to Type 2 diabetes, but with important lifestyle changes Type 2 diabetes can be prevented or delayed.

In all forms of diabetes, the body’s ability to make or properly use insulin is affected. Insulin is a hormone that is made by the pancreas, and it helps your cells store and use energy from food. If you have diabetes, glucose collects in the blood but doesn’t get transported into the cells. Thus, your body is not getting the energy it needs. Also, the high levels of glucose circulate through the body, damaging cells along the way.

Diabetes increases the risk of having a heart attack or stroke and may lead to kidney, eye and nerve damage.

Types of Diabetes

The causes of diabetes are complex and still not fully known. Although food doesn’t cause diabetes, it is part of the strategy for managing the disease.

There are three main types of diabetes:

  • Type 1 Diabetes: The pancreas either makes no or too little insulin. Type 1 is an autoimmune disease that often begins in childhood. The onset is sudden. Just 5.2% of adults with diabetes have Type 1. It cannot be prevented through diet or lifestyle, though they can be helpful in managing this condition.
  • Type 2 Diabetes: The pancreas does not make enough insulin or the body doesn’t use the insulin it makes. Type 2 usually develops slowly. Nearly 89% of individuals with this type of diabetes have a body mass index that is considered to be overweight or obese. Other risk factors include family history of diabetes, a history of gestational diabetes, impaired glucose metabolism, older age and physical inactivity.     
  • Gestational Diabetes: With gestational diabetes, the body doesn’t make enough insulin during pregnancy. It is thought that other hormones may block the action of insulin. Gestational diabetes often goes away after the baby is born. However, women who develop this type of diabetes are at greater risk for Type 2 diabetes later in life.

How to Reduce Your Risk for Diabetes

You can prevent or delay Type 2 diabetes by making changes to your eating style, being physically active and by losing a certain amount of weight if you have a body mass index (BMI) that is categorized as overweight or obese. These steps also lower your risk for diabetes complications. Visit a registered dietitian nutritionist to learn about lifestyle changes that can reduce your risk for Type 2 diabetes.

Signs, Symptoms and Testing

Signs and symptoms of diabetes include going to the bathroom frequently, being unusually thirsty, losing weight without trying, feeling tired or irritable, blurred vision, frequent illness or infection and poor circulation such as tingling or numbness in the feet or hands. If you have these symptoms, see a doctor immediately. You may need to have one of the following tests for diabetes:

  • Fasting Plasma Glucose: Indicates the amount of glucose in a sample of blood taken when a person is fasting (often they haven’t eaten anything for eight to 12 hours).
  • A1C Test: Measures a person’s average blood glucose range over the past two to three months. This test shows the amount of glucose that sticks to the red blood cell
  • Oral Glucose Tolerance Test: Results of this test show how the body uses glucose over time. This test is performed by a health care professional after an overnight fast. A blood sample is taken, the patient drinks a high-glucose beverage and then a blood sample may be taken every hour for up to three hours after drinking the beverage.

Managing Blood Glucose Levels

If you’ve been diagnosed with diabetes, a registered dietitian nutritionist, or RDN, will work with you and other members of your healthcare team to help you manage your blood glucose levels and reduce your risk of possible complications. Some goals your care team may work with you on include:

  • Keeping blood glucose levels within a normal range. Or, as close to normal as possible, which can prevent or reduce complications.
  • Keeping blood pressure in normal ranges.
  • Working to get healthy cholesterol levels.

People with Type 1 diabetes need daily insulin injections or an insulin pump. People with Type 2 diabetes can help control blood sugar levels through food choices, physical activity and, for some people, a combination of medication and insulin injections.

General healthful eating tips to help manage diabetes include:

  • Limiting foods and drinks that are high in added sugars.
  • Selecting smaller portions, spread out over the day.
  • Making your carbs count by choosing whole grains, fruit and vegetables, which will help limit sources of refined carbohydrates.
  • Enjoying a variety of whole-grain foods, fruits, vegetables, lean sources of protein, and low-fat or fat-free dairy products every day.
  • Eating less saturated fat and focusing on healthy fat sources such as avocados, olive and canola oil, nuts and seeds.
  • Limiting your consumption of alcohol, if you choose to drink. Be sure to discuss with your health care provider.
  • Using less salt.

If you have been diagnosed with diabetes, an RDN can create a simple eating plan for you. This plan will take into account your medications, lifestyle and any other health issues. The expert advice of an RDN can help you achieve your goals for managing your diabetes while ensuring you get the nutrients your body needs.

Contributor: Ester Ellis, MS, RDN, LDN

Public health warning: Stop using vaping products

No vaping products should be considered safe. Using an e-cigarette is sometimes called “vaping.” E-cigarettes may contain nicotine, volatile organic compounds, ultrafine particles that can be inhaled deep into the lungs, heavy metals, cancer-causing chemicals, and flavoring such as diacetyl, a chemical linked to serious lung disease. E-cigarettes can be used to deliver marijuana and other drugs. Youth marijuana vaping in Oregon rose 295% between 2017 and 2019. More recent reports point to an increase in daily use among youth.

The Oregon Health Authority urges everyone to stop using all vaping products. State and federal officials are investigating
the cause of serious lung injuries and deaths linked to the use of marijuana and nicotine vaping products. Symptoms of severe respiratory illness related to vaping may include cough, shortness of breath, or chest pain. If you’ve recently vaped and are having difficulty breathing, please seek medical attention immediately.

The Oregon Quit Line provides free help 24/7:

  • Call 1-800-QUIT-NOW (1-800-784-8669) or visit
  • Español: 1-855-DEJELO-YA (1-855-335356-92) or
  • Text DITCHJUUL to 88709
  • For help quitting cannabis, call Oregon’s Drug and Alcohol Helpline at 1-800-923-4357 or text RecoveryNow to 839863.

Open Enrollment for Health Insurance Nov 1 – Jan 15

Watch more videos on the Oregon Health Insurance Marketplace YouTube page.

The annual open enrollment period for health coverage begins Nov. 1. Open enrollment is the only time when anyone who are not offered coverage from a job or a public program like the Oregon Health Plan or Medicare can enroll in health coverage through the Oregon Health Insurance Marketplace, often with financial help.

Eligibility rules have changed this year, making health coverage more affordable for thousands of Oregonians. Previously, people offered health coverage through a spouse or parent’s employer could not access financial help if the least expensive plan offered to only the employee was considered affordable. New rules allow people who previously were ineligible for financial help through the Marketplace if that coverage is considered unaffordable to the enrollee.

“If you were previously not eligible for financial help, apply again,” says Chiqui Flowers, director of the Oregon Health Insurance Marketplace. “Nearly 80 percent of Oregonians who applied for financial help qualified in 2022 averaging $483 per month. That could be you too!”

Sorting through health coverage options can be confusing, but Oregonians should know that there are tools. offers a quick and easy-to-use window-shopping tool where users can preview what plans and savings are available to them. The tool also allows users to see which plans cover their prescription drugs and are networked with their preferred doctors or hospitals. A new tool available at can help you figure out if job-based coverage is considered affordable.

Free expert help is available to make the process of signing up for health coverage and choosing a plan less stressful. Reach out to one of the Assisters below for help.

  • CAREAssist Community Partners for Malheur County: EOCIL
    • Kelly Rumsey
      541-889-3119 ext. 104 or 1-844-489-3119 ext. 104
    • Brenda Nuñez (bilingual Spanish)
      541-889-3119 ext. 107 or 1-844-489-3119 ext. 107
  • Malheur County Health Department:
    • Lisa Almaraz (bilingual Spanish)
      541-889-7279 x136

Red Ribbon Week Inspires Kids and Community

It’s Red Ribbon Week! The Malheur County Health Department stands with drug prevention efforts in our community and across the nation. We believe that prevention is critical, recovery is possible, and we are all responsible for our children and their right to grow up drug-free.

The Red Ribbon Campaign is the oldest and largest drug prevention program in the nation, reaching millions of young people during Red Ribbon Week, October 23rd – October 31st each year.

Learn more about how to prevent youth drug use from one of the following excellent SAMHSA resources:

Join us in celebrating Red Ribbon Week by reaching out to the kids and parents in your life and showing your concern about the level of drug use in our county and your care for all to have a healthy, happy life drug-free. Call 211 if you need connection to resources or 988 for the National Suicide and Crisis Lifeline.