jefferson County Public Health
2012 ANNUAL REPORT
Healthy People Healthy Places In 2012, Jefferson County Public Health introduced Healthy People, Healthy Places, a collaboration of community organizations, government agencies and individuals committed to developing and implementing a community health improvement plan for Jefferson County, Colorado. When community members engage with health data, notice trends and choose health indicators to track, they will have a better understanding of the health issues facing our County and will want to get involved in creating solutions.
Letter from the Executive Director Jefferson County Public Health (JCPH) has focused much of its effort this past year on conducting a community health assessment and compiling the necessary data and health information to produce a community health profile – a health report card of sorts. The title, “Healthy People, Health Places,” reveals an important fact about health: people are only as healthy as the environment that surrounds and supports them allows. Public health has been charged with the responsibility of fulfilling society’s interest in assuring the conditions, including the environments, in which people can be healthy. The Centers for Disease Control and Prevention (CDC) is very clear in its description of the role of public health: Public health should prevent epidemics and the spread of disease, protect against environmental hazards, prevent injuries, promote and encourage healthy behaviors, respond to disasters and assist the community in recovery, and assure the quality and accessibility of health services. “ . . . we in the health department and our community In other words, public health cares for the entire community. The community health assessment and community health profile will be valuable tools to help JCPH meet this goal. With these data, and the support of the community and our health partners, we will work to develop a community health improvement plan. The goal of the improvement plan will be the creation of healthier places and healthier people in Jefferson County.
partners will be looking for effective solutions to include in the development of a 5-year community health improvement plan. . . . I invite you, your family and your friends to join us in this endeavor. Please visit www.healthypeoplehealthyplacesjeffco.com to find out how.”
I anticipate that these studies will show that Jefferson County is a healthy place, for the most part, but that we do have some problematic issues. We already know that tobacco and obesity are hurting our community. We know that where a person lives in the county affects his or her health. We know that access to quality health care and nourishing foods is not readily available to all in our community. The question is, what are we going to do about it? During the upcoming year, we in the health department and our community partners will be looking for effective solutions to include in the development of a 5-year community health improvement plan. We will be looking to the community to help create this plan and to help us implement it. I invite you, your family and your friends to join us in this endeavor. Please visit www.healthypeoplehealthyplacesjeffco.com to find out how.
Mark B. Johnson, MD, MPH, Executive Director
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So, what is killing us?
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here are many modifiable risk factors that are killing us in Jefferson County such as, unhealthy diet, alcohol abuse, and not accessing appropriate health care. However, two behaviors stand out most prominently and are linked to our top three causes of death -- tobacco use and physical inactivity. Decreasing the prevalence of these two risk factors in our community will improve the health of our County and decrease the number of deaths caused by cardiovascular diseases, cancers and unintentional injuries. And, because they are behaviors, we can often do something about them. Interestingly, the catalysts for these behaviors are often the same: stressors, level of education, economic status, and our physical and social environments.
Tobacco
Physical Inactivity Stressors
Cardiovascular Diseases 24.2%
Education Level
Poverty
Physical Environment
Cancers 21%
Unintentional Injuries 7.3%
The good news is that we can take action. • Stop smoking or using other forms of tobacco. • Eliminate your exposure to secondhand smoke
• Get active • Eat healthy food
What determines our health?
• Support policies for tobacco-free and smoke-free places • Manage stress response in a healthy way • Model healthy behaviors
• Manage stress response in a healthy way • Model healthy behaviors
Social and Economic Conditions Health & Behavior Choices
30%
40%
Access to Quality Health Care
20%
Physical Environment
10%
Meet our Current Health Improvement Plan Partners Arvada Economic Development Association Calvary Episcopal Church City of Lakewood/Health Disparities Clear Creek Valley Medical Society City of Golden Colorado Parks and Recreation Association Colorado State University Extension (CSU) Exempla Lutheran Medical Center Family Tree Jefferson Center for Mental Health Jefferson County Board of Health
Jefferson County Board of County Commissioners Jefferson County Economic Development Jefferson County Housing Authority Jefferson County Human Services Jefferson County Open Space Jefferson County Planning and Zoning Jefferson County Public Schools Kaiser Permanente Elected Officials Metropolitan Community Provider Network Seniors’ Resource Center St. Anthony Hospital
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Moving Forward . . .
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s we look into the future and plan for a healthier Jefferson County with better access for all to healthy eating, physical activity and health care, we would also like to review some of Jefferson County Public Health’s accomplishments in 2012.
2012 In Review Pertussis on the Rise
2012 brought a heightened awareness of pertussis disease. “Whooping cough” spread through our communities and threatened the lives of some of our most vulnerable populations, the very young, the elderly and those with chronic health conditions. JCPH Communicable Disease/Immunization Program responded to the pertussis outbreak by following up on 298 cases and partnering with Jeffco Public Schools and childcare centers to increase protection against pertussis and minimize further spread of this respiratory illness. JCPH administered 564 DTap and 1,049 Tdap vaccines in 2012.
Restaurant Inspections Get a Make-Over
JCPH is proud of its Food Safety Program and the work they do to help protect citizens and visitors from foodborne illness. In 2012, the program made some changes in the frequency of inspections that will even further protect our public. For many years, routine food safety inspections have been conducted at all retail food establishments at least twice a year. In 2012, the program implemented a Risk-Based Restaurant Inspection Program. This means that the frequency of inspections is now based on the risk of the operation. Food service establishments with recurring violations can expect more unannounced visits. Prioritizing inspection activities will allow the program to focus resources on the highest risk facilities and reduce incidence of foodborne illness. Online restaurant inspection reports back to 2006 are available at www.jeffco.us/health.
Supporting Tobacco-Free Living
When just one person quits using tobacco, positive change happens. Years of life are added, disease risk and financial burden are reduced or avoided, and new opportunities for health and well-being can emerge. Imagine that change being multiplied by tens of thousands - that’s what good policies can do. When strong tobacco policies are in place to protect people from tobacco and secondhand smoke exposure, the benefits are exponential and the impact endures for generations to come. A Michigan study found that the implementation of a local smoke-free law contributed to a 60% reduction in youth smoking within two years. Smoke-free laws are also associated with reduced heart attacks, improvements in air quality, and support for those trying to quit. For these reasons, JCPH worked with individuals, citizen coalitions and community leaders in 2012 to strengthen and expand local tobacco control policies. These efforts resulted in two local tobacco ordinances covering more than 162,000 residents and countless visitors and workers in the communities of Golden and Lakewood. For information about these ordinances and how to support change and tobacco-free living in your community, visit www.tobaccofreejeffco.org.
Health and Parks Go Hand in Hand
Jefferson County Public Health and Jeffco Parks teamed up to present Jeffco Outdoors in 2012. Jeffco Outdoors is about the many health benefits nature has to offer and connecting people to parks close to home. Opportunities are abundant where you can move, breathe and play outside, and Jeffco Outdoors helps you find places to get healthy and stay healthy. Be active, manage stressors, and reduce exposure to tobacco, visit: www.jeffcooutdoors.org.
Flu Season
The 2012 flu season was early and severe throughout most of the country. Jefferson County reported 96 hospitalized influenza cases and one child death by the end of the year. Getting an annual flu shot is still the best protection for all ages against influenza illness. In 2012, JCPH held extra flu clinics, increased outreach to schools and childcare centers and gave 1,287 influenza vaccines.
Injury Prevention Across the Lifespan
In 2012, JCPH completed a Local Capacity Injury Prevention Tool developed by the National Association of City and County Health Officials (NACCHO) to identify injury prevention priorities. As a result, JCPH developed Injury Prevention Across the Lifespan, a program to address injury prevention from infancy through adulthood. JCPH also designated a public health nurse to focus on assessing, implementing and evaluating best practice injury prevention strategies. A grant from the Colorado Department of Transportation enabled JCPH to increase education and outreach to the Jefferson County and Lakewood Head Start programs regarding child passenger safety. Funds from the County’s Maternal and Child Health Block Grant, in collaboration with other community organizations, are being used to promote teen motor vehicle safety. JCPH works with The Children’s Hospital of Colorado, the Colorado Department of Public Health and Environment, the Jefferson County Child Fatality Review Team, and other community organizations to promote safe sleep environments for infants. JCPH is also collaborating with the Consortium of Older Adults and Jefferson County Aging Well to promote wellness and prevent falls among our older populations. Please visit www.jeffco.us/health for more information.
“I like the dreams of the future rather than the history of the past.” -Thomas Jefferson
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2012 Achievements and Health Outcomes
Jefferson County Public Health is committed to promoting health and preventing injury and disease for the residents of Jefferson County, Colorado. Public health is what we as a society do collectively to prevent illness and premature death and promote health in our neighborhoods and communities. Public health professionals monitor and diagnose the health concerns of communities and promote policies, practices and behaviors to assure our populations stay healthy. It is the collaborations and efforts of all of us that ultimately determine the County’s health. With the support, policy oversight and mandates of the Jefferson County Board of Health, our programs work to prevent and control contagious diseases and epidemics; investigate health and safety hazards; protect our environment; prevent foodborne illness; link people to health care services; promote active living and healthy eating; and, advocate and enforce laws that protect the health and safety of everyone. Administrative Services (Admin) provides
department administration and financial management as well as the Emergency Preparedness and Response Program and Vital Records Program. • 7,147 birth and 6,280 death certificates (first copy) were issued providing residents with essential identification documents as well as providing a snapshot of the number and causes of death in the county throughout the year. •
JCPH Emergency Preparedness and Response Program updated or wrote 12 plans; provided 18 key planning projects; represented JCPH on 17 national planning committees; participated in or provided 23 emergency related trainings; participated in 3 regional exercises, and coordinated or responded to 28 disease outbreaks.
Environmental Health Services (EHS) works to
prevent, investigate and respond to health threats in the County from environmental sources such as our air, water, land, the food we eat and the domestic and wild animals and insects we encounter. EHS inspects facilities including schools, daycares, restaurants for adherence to public health safety and disease control measures. • 4,795 food-service establishment inspections were performed and 122 food handlers were educated to protect people from common foodborne illnesses such as E. coli, Salmonella and hepatitis A. The JCPH Retail Food Inspection web page was visited 49,033 times by persons seeking information on food-safety records of various eateries. • 240 land development and rezoning cases were reviewed for compliance with public health requirements. • 620 inspections of childcare centers, pools and camps were performed protecting children and adults from disease and safety hazards. • 598 onsite wastewater system inspections were performed and 162 permits were issued to protect residents from waterborne illnesses and protect the county’s groundwater from contaminants. 673 time-of-sale wastewater permits were approved and 289 additional properties were added to the septic system computer database, providing easier access for public queries. • The Zoonosis (animal-borne disease) Program investigated potential disease threats such as hantavirus pulmonary syndrome, bubonic plague, tularemia, West Nile virus, and rabies. 153 specimens were submitted for testing. Results returned with 11 bats testing positive for rabies, 1 cat and 1 squirrel testing positive for plague and 1 rabbit testing positive for tularemia.
Health Promotion and Lifestyle Management (HPLM) works to improve health through policies,
programs and activities enabling people to increase control over their health. Policies, programs and services promote healthy eating and active living, tobacco free environments and access to health communications and public information. Policy work involves working with elected officials and our communities to adopt policies that promote healthy eating, tobacco free public places and built environments that support safe walking, biking and multimodal transportation. • 13,904 women and children were provided with nutrition education and counseling and food prescription vouchers to be used for healthy foods at local grocery stores. • The JCPH web site had 229,960 views and 3,803 followers of our social media pages for diverse public information and health education materials. 75,000 educational materials were distributed via library and educational displays in the community increasing citizen knowledge of prevention initiatives. • Tobacco control policy campaigns in four communities are helping to advance local laws which will increase smoke-free workplaces and public places as well as reduce youth access to tobacco products. These efforts resulted in two local tobacco ordinances covering more than 162,000 residents and countless visitors and workers in the communities of Golden and Lakewood.
Jefferson County Board of Health Bonnie McNulty - President Maureen Sullivan - Vice President Beverley Dahan - Secretary Greg Deranleau - Member Linda Reiner - Member
Jefferson County Board of Commissioners Donald Rosier – Chair, District 3 Faye Griffin – Chair pro Tem, District 1 Casey Tighe – District 2
Community Health Services (CHS) programs
and services work to improve health and quality of life through communicable disease surveillance, prevention, control, education and treatment. Diverse programs provide essential preventive health screenings, health education, public health nursing interventions, resource referral as well as access to health care for the County’s uninsured or underinsured residents. • 7,813 immunizations were given protecting the County’s children and adults from vaccine preventable diseases. • 6,855 disease surveillance contacts were made to investigate and follow-up in response to potential communicable disease threats. • 3,632 nurse home visitations were made to improve health outcomes for infants and mothers. • 659 individuals were assisted with access to health care via screenings for eligibility for Medicaid and/or Child Health Insurance Plan; 13,623 enrolled in Medicaid and CHP+ received follow-up in the Healthy Communities Program to assure that they accessed health care benefits and community resources; 5,522 were assisted with referrals to community health care resources. • 12,200 clinic visits were made by individuals seeking dental, reproductive health and chronic disease prevention screenings and consultation.
JCPH Budget 2012 Total 2012 Revenue = $12,956,641 HPLM 22%
ADMIN 15%
EHS 16%
CHS 47%
Total 2012 Expenditures = $12,956,641 HPLM 23%
ADMIN 12%
EHS 17%
CHS 48%
Where to Find Us: Arvada: 6303 Wadsworth Bypass, Arvada, CO 80003
303-275-7500
Edgewater WIC: 1711 A & B Sheridan Blvd., Edgewater, CO 80214
303-239-9580
Lakewood: 260 S. Kipling Street, Lakewood, CO 80226
303-232-6301
Administrative & Environmental Health Offices: 1801 19th Street, Golden, CO 80401
303-271-5700
Vital Records: 800 Jefferson Cnty Pkwy, Suite 1300, Golden, CO 80401
303-271-6450
Emergency Preparedness: 800 Jefferson Cnty Pkwy, Golden, CO 80401
303-271-8391
www.jeffco.us/health
Jefferson County Public Health