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HomeMy WebLinkAbout03-2022 March 1 PHAB Minutes Deschutes County Health Services Public Health Advisory Board (PHAB) MINUTES MINUTES March 1, 2022 12:00 p.m. - 1:30 p.m. via Zoom videoconferencing Facilitator Dave Huntley, Chair Staff Coordinator Tom Kuhn, Community Health Manager Scribe Ethan Laing Next Meeting April Topic and Lead Introductions and Approval of December Meeting Minutes Dave asked if everyone has had a chance to review the minutes – February minutes as written are approved Announcements and Unfinished Business Group Updates: - None Legislative Update: Tom - 4052: Racism is a Public Health Crisis – would allow OHA to utilize grants for mobile units. Also help fund cultural and linguistic programs to help mitigate negative healthcare outcomes. Commissioner Chang commented that this bill going through ways and means committees is typical for anything that utilizes a lot of money – Doesn’t think this is a bad thing, and shouldn’t be delayed much longer - 11555: Expansion of home visiting nursing programs, including increased funding - The smoke buffer bill was dropped th - Monday, March 7 will be the end of the legislative session Health Heroes Award: Tom - Historically have done the Health Heroes awards, but took 2021 off. Tom would like to know if we should take this year off, go virtual, or delay for in-person in the fall. Health Heroes Award is an annual nomination from PHAB to an organization or individual that represents a hero in Public Health. Winners are invited to meetings and are sometimes recruited to PHAB. Peter would want to delay to the fall. Sarah would like to maybe adapt the ceremony to outdoors so we can have it earlier. Sharity also thinks the awards should move forward. Commissioner Chang things that the recognition is incredibly important, and would like to move forward with presenting Health Care as a positive community/cultural resource. The awards could help combat the negative political views towards healthcare workers. David seconds the sentiment shared – earlier would be better if it can be done safely. David is also willing to put in some extra work to advertise to the public and highlight past winners. Charla wants to also take this on, but “To promote and protect the health and safety of our community.” Updated 11/22/22 wants to be mindful of Tom’s bandwidth. Charla would like us to all pitch in and help get the awards off the ground. Tom commented that virtual rewards would be easier logistically and could be but together sooner rather than later. Tom also thinks that we could potentially get it up and running by May if virtual, but not sure if that’s feasible in the same amount of time. Commissioner Chang wonders if we could pull from resources in the County to get an in-person event out sooner. Potentially we could pull from our communications staff to help, since highlighting healthcare is so important to our community messaging. Tom clarifies that these award ceremonies are smaller events, but we could potentially make it larger. There is some criteria for nominations, Tom to distribute Homelessness work group update: Dave - Coleen, Emily, and Peter are working on analyzing our houseless population to minimize disease. The first meeting has happened, and Dave is working up updating documentation. They are currently in process of organizing future meetings and identifying how best to meet with the community. Increase in Congenital Syphilis Cases in Oregon – Kathy Christensen, Supervisor, STD/HIV & Adolescent Health It’s currently on the rise across the country. STI rates are critical health indicators and are often discussed in the context of individual sexual behaviors and sexual networks. In 2019, th Oregon ranked 11 in rate of 43 cases per 100,000 live births. Along the Southern border of our Country are the highest rates of the disease. Congenital Syphilis results from transplacental infection of the fetus. In primary (chancre) and secondary (rash), 80% of infants are affected. Early manifestations includes deformed bones, rhinitis, severe anemia, skin rashes, and brain and nerve disorders. Latent manifestations includes facial deformities, saber shins, joint swelling, neurologic deafness, and developmental disabilities. To diagnose, when the baby is born there is a blood draw which is compared to the mother. Physical and eye exams can also be part of the diagnosis. Treatment includes 10 days of antibiotics. Based on the stage of the infection, changes can be made. 248 cases of syphilis in pregnancy from 2014 to 2020. 69 (28%) of those pregnancies resulting in a case of congenital syphilis. 48% of cases were from persons who were houseless or unstably housed, including incarceration, moving homes, etc. Most patients reported 1 male sexual partner in the prior 12 months, max being 2. Time to ndrd prenatal care for cases – 19% were seen in the first trimester, 30% in 2, 12% in 3, and 39% no timely prenatal care. Regional STD Data: Central Oregon Gonorrhea Rates are on he rise along with the state, though Crook and Deschutes remain lower than the state rates. However, Jefferson has a higher rate. Syphilis Rates also mirror the Gonorrhea Rates. Jefferson County has also see a large increase in cases. Central Oregon had an increase of 91%. Due to the Jefferson County outbreak, there has been an increased emphasis on contact tracing. 18 cases have been linked together recently. The contact tracing process requires labs to send reports to the County. Contact with health care provider and then contact and interview with the case. Currently using social media and working to use Accurint. Elicit sexual contacts information from interview has the same process stated above. Finally, assure all cases and contacts receive treatment. Central Oregon HIV cases have fluctuated quite a bit over the last few years. About 24% of gonorrhea and syphilis cases reported IVDU in 2021. Methamphetamine use of gonorrhea and syphilis cases was reported at 42%. OHA Guidance: Treat all patients with signs or symptoms consistent with primary or secondary syphilis. Treat anyone who reports sexual exposure to someone with syphilis. Test all pregnant people at the rd first prenatal visit and again with routine 3 trimester labs. Pregnant people who present late “To promote and protect the health and safety of our community.” Updated 11/22/22 for prenatal care should be screed for syphilis. People of childbearing potential diagnosed with syphilis should be offered contraception. Deschutes County STD/HIV Services include case investigation and contact tracing, STD treatment for cases and contacts, consult for complicated cases, PrEP navigation, and HIV case management. Dave wanted to know if the HIV cases presented were new cases. Kathy was able to say that they were, Jessie also mentioned that in Central Oregon that there is an issue with late/delayed diagnosis. Jessie mentioned a possibility for this is that the testing might not be at the forefront of PCP minds. The recommendation is to get tested at least once. Dave also asked about as part of looking into the connection of IVDU and STIs, are we working on syringe exchange expansion? Jessie stated that there is certainly an increase in referrals, and would be interested in looking into increased access. Peter commented on the cost of syringes, and wonders if that’s a boundary. Kathy said we have a deal to get syringes for cheap, so cost is not currently a concern. Colleen wanted to know what structural changes are needed to help mitigate the increased rates. Kathy mentioned that the connection between STIs and methamphetamines appears to be the strongest connection, so we should target factors that increase risks of meth use including homelessness. Jessie did note that there currently doesn’t appear to be much cross over between HIV and Congenital Syphilis, but as the infections spread that may change. Sarah was wondering about what health promotion strategies after the pandemic you may be considering, and would like to see if I can embed some info into my classes. Sarah’s email: sbaron@cocc.edu Food Security – Adrea Rodriguez-Lovejoy, Environmental Health Specialist III Adrea showed us a picture of a worker picking coffee, and wanted to stress fair trade practice. The lack of practice results in incredibly low wages, and ironically food insecurity amongst farmers. Food waste is one of the leading causes of food insecurity – there is actually enough food for everyone on the planet. The problem is the food isn’t matched up with the right people who need it. Adrea worked as a food safety inspector, and during the course of these inspections she witnessed thousands of pounds of food being thrown away. Only about 1.4% of food from restaurants are being thrown away. Most food is wasted at the productions phase, and the end phase of the process (such as grocery and restaurants). Food insecurity is the lack of consistent access to enough food for an active, health life. This is different from hunger. Nearly 16 million children go to experience food insecurity. Many people working in the food system take poverty-level wages. 1 in 6 people in Deschutes County were food insecure. This was an increase due to increased labor/wage insecurity. Food insecurity is associated with other community stressors. It is also tied to use of Medicaid, SNAP, and other welfare safety nets. COVID has worsened food insecurity, and local community also affects food security. We can see that Hispanic and black communities are also hit harder. There are also area’s known as ‘food deserts’ where convenience stores are more common than grocery. Oregon is known for having a high rate of elderly enrollment in SNAP. Adults and children who experience food insecurity also experience an increase risk to healthcare outcomes, including both physical and mental health. The immune system relies intricately on how the body is nourished. People with food insecurity are worse off battling and prevent infection. Obesity and undernutrition are both associated with micronutrient deficiencies. Obesity has a correlation to a decrease in antibodies. Our Response: utilize the Give and Grow program, which supplies local food banks with health food using the extra produce from farmer’s markets or from home gardens. Some of the food gathered goes into Fresh Harvest Kits, which includes spices, ingredients, and recipes. The Warm Springs Community Action Team and he High Desert Food and Farm alliance are partnering to better help vulnerable populations within Warm Springs. HDFFA “To promote and protect the health and safety of our community.” Updated 11/22/22 collaborating with COCC to redirect food from the dining hall to at-risk youth populations. Deschutes County Public Health established feeding sites utilizing excess food from cafeterias. DCPH connected COCC to local food kitchens to help distribute this food. He federal bill emersion good Samaritan food donation act helps protect businesses and individuals who donates food. Environmental Health has a role in promoting food security, and commits to identifying solutions. Paths ahead includes audits of the current feeding sites in Central Oregon, support existing programs, reestablish programs stopped during the COVID-19 Pandemic, and education. Adjourn 1:30pm Action Items:  Tom & David to follow up with PHAB on the Health Hero Awards Board Members Present: Tom Kuhn, Dave Huntley, Charla DeHate, Colleen Sinsky, Peter Boehm, Commissioner Phil Chang, Sarah Baron, Renee Wirth, Shariy Ludwig Staff Members Present: Tom Kuhn, Ethan Laing Guest Presenter: Kathy Christensen, Rita Bacho, Jaclyn Alfaro, Jessie Terpstra, Adrea Rodriguez-Lovejoy, Amber Knapp, Vinny Cancelliere PHAB – Public Health Advisory Board PH- Public Health “To promote and protect the health and safety of our community.” Updated 11/22/22