On the surface, 2014 and the first half of 2015 have been an amazing time considering the number, variety and severity of public health issues the Central District Health Department has encountered.
District Four of the seven around the state — which covers the 450,000 Idahoans in Ada, Boise, Elmore and Valley counties — has confronted two very serious salmonella outbreaks, the bubonic plague (only in animals so far and mostly in Canyon County), West Nile virus, E. coli, norovirus, rising rates of sexually transmitted disease and a nasty thing called cryptosporidium, a waterborne disease caused by contaminated drinking water or recreational water.
The first salmonella outbreak got a lot of people sick and resulted in the closing of the Pho Tam restaurant in Boise. The second, linked to food served at the Boise Co-op deli sickened hundreds — the largest foodborne outbreak in Idaho history. Though some salmonella strains in these cases are known, it remains unknown exactly what circumstances led to the food products — including turkey, tomatoes and onions in the Co-op case — becoming contaminated.
These facts and trends were among the things the Statesman Editorial Board learned during our recent visit with CDHD Director Russell Duke, and his colleague, Kimberly Link, epidemiology program manager.
I have always been fascinated with the work of local, state and national public health organizations, ever since reporting in Minnesota years ago on subjects like toxic shock syndrome and grave illnesses experienced nationwide linked to a tainted L-tryptophan food supplement.
The more I learned about CDHD and its broad, comprehensive approach to public health — that it employs 160 and operates with a $10 million budget — the more it became clear these “headline” crises are cause for concern occasionally and seasonally, but most of us won’t be victims. We would be better off to consider health strategies that take aim at killer diseases and trends we can do something about.
So I asked Duke to let Idahoans know what he and his staff thought are the major health issues Idahoans should focus on. Following are excerpts of his group’s response.
Sixty three percent of Idaho adults are either overweight or obese, and 28 percent of Idaho’s third-graders were overweight or obese, according to a statewide study of third-grade kids in 2008-09. With Idaho ranking 23rd in the U.S. for adult obesity, CDHD identifies obesity as a serious public health issue for the communities it serves. To combat this, CDHD is closely involved in efforts to create behavior-changing policies within the community. Recently, Boise’s Healthy Initiatives increased standards for child care providers by training them to improve nutrition standards, reduce screen time, increase activity and provide on-site breastfeeding amenities to create early prevention of obesity among Boise children. CDHD was a partner in this important health-focused initiative and is presently working with Boise on additional Healthy Initiatives efforts to promote healthy life choices.
We know that the quality of our mental health impacts other behaviors and life choices. Those with uncontrolled mental health issues are at an increased risk of tobacco and substance use, being overweight, participating in risky sexual behaviors and other tendencies that can negatively affect quality of life and health. CDHD has recently entered into partnership with the Region Four Behavioral Health Board, established by the 2014 Idaho Legislature. This board will work to address behavioral health in Ada, Boise, Elmore and Valley counties and will be overseen by CDHD, allowing community mental health and substance abuse resources to be pooled and provided to those in our communities who can benefit.
Idaho’s number of sunny days per year top 200 in most parts of the state, but too much sun early in life can lead to serious health problems later, including skin cancer. Idaho ranks among the top 10 states in the U.S. for skin cancer. Because of this, CDHD believes skin cancer to be a public health risk that requires additional attention. Programs to educate child care providers and teach parents of young children the importance of protecting kids from the sun beginning at infancy. The Team Sun Safety program assists child care providers in reducing skin cancer by adopting sun safe policies, creating sun safe environments, and using sun protective clothing and sunscreen.
Despite the successes of nationwide marketing restrictions on tobacco and significant shifts in public perception regarding its use, tobacco remains one of the leading causes of preventable disease and premature death. In Idaho, 17 percent, or 187,000 Idaho adults, smoke. Equally alarming is the fact that 14 percent of Idaho’s ninth- to 12-graders smoke, and current electronic cigarette use among U.S. middle and high school students tripled from 2013 to 2014.
Family planning, parental support, childhood immunizations and teaching kids and parents the importance of early cavity prevention — CDHD believes that each of these preventive health services are essential to building healthier families, both physically and mentally. Recently, CDHD began a program to assist families with young children. Parents as Teachers recognizes that parents are a child’s most important teachers in life, and works to give parents tools to be successful in raising healthy and happy children.
Robert Ehlert is the Statesman's editorial page editor. Reach him at 377-6437 or follow @IDS_HelloIdaho