Health & Wellness Supplement - December 2012 by The Washington Informer

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REPORTERS

STAFF Denise W. Barnes, Editor Shantella Y. Sherman, Assistant Editor

UNITEDHEALTHCARE U

nitedHealthcare Community Plan is thrilled to partner with The Washington Informer for their 2012 Health and Holiday supplement. During the holidays, we often think about gifts we should give others. But there's one gift you should give yourself - good health. This year, be sure to get your annual flu shot and a pneumonia shot if needed. If you are 60 or over, now is the time to get your shingles shot. These shots are an important part of staying well and preventing health problems during the holiday season. Our goal at UnitedHealthcare is to help people live healthier lives and to make getting and receiving quality health care easy for seniors in the District all year long. The health of our senior citizens is not only important for their families but our communities as well. At UnitedHealthcare, we are committed to keeping our seniors and communities strong and healthy. Below are a few tips to make sure you and your

Karen Johnson is Executive Director of United Healthcare Community Plan in the District of Columbia. She has a great team behind her

family have a Safe, Happy important for people with and Healthy Holiday Season. diabetes to keep their toes yy Keep yourself warm: covered and warm in the Dress appropriately for the cold weather. cold weather, which means yy Wash your hands: Avoid wearing layers and keeping getting colds or respiratory your head and extremities viruses over the holidays; covered. yy Avoid winter weight gain: wash your hands regularly Many tempting, traditional with hot water and soap. holiday foods are loaded yy Seek counseling if you're with carbohydrates, eat in feeling blue: Depression is known to spike each year moderation. yy Don't get cold feet: It is around

Ron Burke, Advertising/ Marketing Director Lafayette Barnes, IV, Assistant Photo Editor Khalid Naji-Allah, Staff Photographer John E. De Freitas, Sports Photo Editor Dorothy Rowley, Online Editor Brian Young, Design & Layout AssureTech /www.scsworks.com, Webmaster Mable Neville, Bookkeeper Mickey Thompson, Social Sightings columnist Stacey Palmer, Social Media Specialist

Misty Brown, Michelle Phipps-Evans, Eve Ferguson, Elton J. Hayes , Gale Horton Gay, Barrington Salmon, Stacey Palmer, Charles E. Sutton ,James Wright, Joseph Young

PHOTOGRAPHERS John E. De Freitas, Roy Lewis, Khalid Naji-Allah, Shevry Lassiter

Key Dates for the Affordable Care Act President Obama’s re-election ensures that the ACA will be rolled out as planned. Here are some key dates in the law’s implementation: Jan. 1, 2013: New funding will be provided to state Medicaid programs to cover preventive services at little or no cost. Oct. 1, 2013: States receive two more years of funding to continue coverage for children not eligible for Medicaid through the Children’s Health Insurance Program (CHIP). Jan. 1, 2014: If your employer does not offer you insurance, you can buy it directly in an Affordable Insurance Exchange, a competitive marketplace for insurance, starting in 2014. For more on the implementation of the ACA please visit: http://www.healthcare. gov/law/timeline/

H-2 December 2012 / HEALTH, WELLNESS & NUTRITION SUPPLEMENT

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Ward 8 Residents Help Advance New Policies to Improve Children’s Health By Ruth T. Perot Director, HKHC DC Partnership, Executive Director/ CEO, SHIRE With the guidance of Ward 8 and other DC residents, the Healthy Kids, Healthy Communities DC Partnership has helped achieve recent and important changes in health care policies. These changes benefit the community as a whole, but especially children and youth who are overweight and obese. New policies are now in place that support after school meals, expand healthy eating options in neighborhoods, and improve the safety and maintenance of parks and other green spaces will make it easier for children and their families to get and stay healthy. In 2008, the Robert Wood Johnson Foundation (RWJF) selected the District of Columbia as one of nine lead sites in the country to push for healthy eating and active living policies. This work was assigned to the Healthy Kids, Healthy Communities (HKHC) DC Partnership, led by Summit Health Institute for Research and Education, Inc. (SHIRE). DC childhood overweight and obesity rates in Wards 7 and 8, among the highest in the nation, were of great concern. Our charge was to look at the “big picture” - to identify the environmental and systems changes that would make a difference in promoting healthy nutrition and increased physical activity. The partnership’s experience in Wards 7 and 8, collaborating with community organizations and individuals, was a key reason for our selection. We knew that children went hungry after school because, at that time, there was no after school meal program in the District. We knew that residents had too few healthy eating choices, such as easy access to fresh fruits and vegetables. Community members told us that they and their children wanted to exercise more but that parks were unsupervised, unsafe and not well maintained. These were big www.washingtoninformer.com

problems that required creative solutions. RWJF wanted us to focus on policies and we were in accord. Policies make change possible for large groups of people, not just the few who are lucky enough to participate in a short-term program. So we went to work. First, we made sure our partnership included organizations and agencies that knew how to get things done. Then, we went back to the community – consulting residents through surveys, focus groups and conversations – to find out what policies we should pursue. We also engaged youth as advocates. For example, they helped create a DVD, “Play That Game” that described the benefits of play and exercise in parks and open spaces. Each of the HKHC partners played a key role. D.C. Hunger Solutions took the lead in pushing for Federal funding for after school meals. With the help of HKHC and other advocates, DC received funding in 2009. Our partners from DC Public Schools and the Department of Parks and Recreation kept us informed about that policy’s implementation and impact. The DC Department of Health, another HKHC partner, spearheaded a push for healthy eating alternatives, such as healthy vending carts, expanded farmers’ markets and better choices at corner stories - policy efforts supported by data from another partner, DC Office of Planning. Groundwork Anacostia River DC advocated with SHIRE for policies to improve DC parks. HKHC also pushed for the hiring of neighborhood residents as Park Ambassadors to supervise, maintain and promote the use of parks and other natural resources for recreation and gardening. An important sign of progress are recent policies enacted by the DC Council to create a Park Policy and Programming Division within DPR. HKHC’s four-year collaboration has taught several lessons. When engaged, members of

our community will provide answers to the DC’s obesity crisis that can be translated into policies with broad impact. Reversing childhood obesity requires a lot more than just eating right and exercising. We also need policies that will make it easier for DC residents to make healthy living choices. Youth are key players. When they understand the benefits, they become powerful advocates for better health and environment improvements. Partnership works. We can do far more working together than when we operate in silos. That’s why the Healthy Kids Healthy Communities DC

(left to right) Alexandra Ashbrook, Dennis Chestnut, Autumn Saxton Ross, Daniela.Grigioni, Ruth T. Perot, Michele Tingling-Clemmons, Natii Wright and Joni Eisenberg.

Partnership is committed to continue and expand! http://www.shireinc.org/ Tel: (202) 371-0277 Email: shire@shireinc.org About Summit Health Institute for Research and Education, Inc. (SHIRE) Established in 1997, the Summit Health Institute for Research and Education, Inc. (SHIRE) is a nonprofit 501(c) (3) organization dedicated to the promotion of health

and wellness for all people. SHIRE works to eradicate health disparities and aid vulnerable populations in attaining optimal health. Communities, government agencies, corporations, and foundations look to SHIRE as an effective and trusted resource to identify inequities, propose solutions, and galvanize grassroots groups to address access to health care and quality of care issues among the underserved, particularly communities of color.

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HEALTH, WELLNESS & NUTRITION SUPPLEMENT / December 2012 H-3

Avoid Hysterectomies Dr. Kevin Smith and Innovative Treatment For Fibroids By Nyia Curtis

ynisha McCray developed uterine fibroids 12 years ago and began experiencing the pain and side effects from them soon after. McCray tried several methods to eliminate them, but to no avail. As the physical and mental anguish began to take their toll, she had the fibroids surgically removed. “I tried birth control and Depo-Provera hoping that my fibroids would get smaller, but they did not,” she said. “After my fibroids were removed in 2006, I was told that they could still come back.” McCray, 40, is one of numerous African-American women who have uterine fibroids, or leiomyomas, which are benign tumors that can occur inside the uterine cavity, within the uterine wall or on the surface of the uterus. They are the lead-

ing cause of hysterectomies in women. Half of all American women will have fibroids in their lifetime, but black women are three times more likely to develop them than women of any other race. Unfortunately, McCray’s fibroids did return, forcing her to undergo a blood transfusion that left her iron and energy level low. Her gynecologist recommended that she undergo a hysterectomy, and McCray felt it was her only option—until she met Dr. Kevin Scott Smith at Howard University Hospital. Smith, chief of the Division of General Obstetrics and Gynecology in the Department of Obstetrics and Gynecology, calmed her fears and offered an alternative: a minimally invasive procedure called a hysteroscopic myomectomy. During this procedure, a pencil-thin telescope allows the

doctor to see of the inside of the uterus without an incision. Fibroids within the uterine cavity can be removed using resecting tools small enough to pass through the telescope. It is performed on an outpatient basis. “Dr. Smith examined me and told me that I would be fine,” McCray recalled. “He made me feel comfortable, and he said that I would not need a hysterectomy. He removed my fibroids last May, and I have been wonderful ever since.” Smith says that fibroids have a dramatic impact on the female reproductive tract and reproductive potential, and that more than 50 percent of hysterectomies performed for AfricanAmerican women are related to symptoms of uterine fibroids. “When everything is matched, the relative risk and incidence of fibroids is two- to three-times greater in African-American women than Caucasian women,”

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"Smith says there are numerous ways now to treat fibroids without the use of traditional surgery" Smith says. According to the National Women’s Health Network, many women with uterine fibroids don’t feel any symptoms. However, for about 30 percent of women in their childbearing years, fibroids can cause heavy or painful periods, abdominal pain and reproductive problems,

including miscarriages and infertility. Smith says there are numerous ways now to treat fibroids without the use of traditional surgery. For more information, contact the Howard University Hospital Department of Obstetrics and Gynecology at 202865-4164

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HEALTH, WELLNESS & NUTRITION SUPPLEMENT / December 2012 H-5

1,000 Days to Make a Difference Bishop Don DiXon Williams

uring this time of year, many of us are filled with joy as we reflect on our many blessings—ample food, satisfying employment, and loving families. However, many people in this country and around the world cannot afford to eat regularly, impacting every other aspect of their lives. Within the African-American community, poverty and food insecurity rates are much higher than they are for the general U.S. population. While 20.6 percent of all households with children struggle to put food on the table, 29.2 percent of African-American households with children are food insecure. As of 2011, the latest year for which data is available, nearly 28 percent of African-Americans are living in poverty. Worse, 42.7 percent of African-American children under the age of five live below the poverty line. Hunger and poverty are putting more and more African-American

women and children at risk of poor nutrition. Current research shows that malnutrition during the 1,000 days from pregnancy through a child’s second birthday produces permanent changes in the child’s brain structure and function. Malnutrition during this period can cause irreversible damage to children, resulting in diminished intellectual capacity, impaired immune function, shorter height, and impaired vision. This damage reduces a child’s ability to achieve in school and be productive throughout his or her life. Studies show that a malnourished child’s earning potential is reduced by 10 percent over the course of his or her lifetime, compared to a well-nourished child. Even proper nutrition after this period can’t undo the damage, which effects his or her cognitive and emotional function and increases the risk of future heart disease and diabetes. However, by improving nutrition for women and children during this period, we can give children a better start in life. Nutrition assistance programs will continue to play a vital role in

combating hunger in the United States. Because eligibility for these programs is need-based, participation is an indicator of both nutritional and economic hardship. Participation in these programs has greatly increased in conjunction with rising poverty since the start of the recession. Two nutrition programs, the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) and Women, Infants and Children (WIC), are particularly vital for protecting the health and nutrition of African-American women and children. SNAP supplements the food budgets of the neediest people through a plastic card that can be used at grocery stores or other authorized locations. The program currently serves more than 45 million Americans. Nearly 57 percent of all SNAP participants are women and nearly 50 percent are children. More than 22 percent of SNAP participants are African-American, and 13.1 percent of participants are African-American women. The WIC program safeguards the health of low-income women

and young children up to age 5 by providing monthly packages of nutritious food. WIC also provides information on healthy eating, breastfeeding support, and referrals to health care. Families living in or near poverty can participate. For example, a family of four with an income up to $40,409 would be eligible. WIC served more than 9 million women and children in 2010, nearly 20 percent of whom are African-American. Studies show that participation in WIC improves nutrition and leads to healthier pregnancies, birth outcomes, and better growth and development of young children. Hunger costs our country an estimated $167 billion annually in lost productivity, reduced educational outcomes, and increased healthcare costs. Children who are persistently poor are much less likely to be consistently employed as adults. Nutrition programs are vital lifelines to millions of African-American women and children. Unfortunately, these programs face drastic budget cuts as Congress continues work to reduce our nation’s deficit. This is not the time to cut back nutrition programs: they are designed to expand in times of heightened

In a world of plenty, hunger is an outrage. Be a part of the solution.

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need—like now. Cutting programs that have helped keep millions of Americans from going hungry would take a huge toll on families living in poverty while having little effect on the budget deficit. Many of us help people in need by contributing to food pantries and charities. This is crucial, but we cannot “food-bank” our way out of hunger. All the food that churches and charities collect combined equals only about 5 percent of what is provided to hungry and poor people through federal nutrition programs. As a nation, we should consider childhood nutrition a moral obligation and an investment in our future. We must use our voices and pens to encourage lawmakers to end hunger. For more information, please visit www.bread.org. Bread for the World is a collective Christian voice urging our nation’s lawmakers to end hunger at home and abroad. Bishop Don DiXon Williams is Bread for the World’s racial/ethnic outreach associate. He sits on the board of bishops of the United Church of Jesus Christ, Baltimore, MD.

Hunger and poverty are putting more and more African-American women and children at risk of poor nutrition. By improving nutrition for women and children during the 1,000 days from pregnancy to a child’s second birthday, we can give children a better start. To learn more, please visit www.bread.org.

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Moderation Key to Healthy Holiday Eating By Shantella Y. Sherman WI Assistant Editor

eulah Hicks is a master chef of soul food staples. In addition to making the best low-country pork ribs glazed in fresh peaches, Hicks brags that her homemade peach cobbler made with good old-fashioned lard, leaves the table before holiday guests sit down to the main course. At 73, Hicks, who hails from Forsyth County, Ga., realized that while she was in reasonably good health, her cooking was negatively impacting the health of her children and grandchildren. While Hicks, who has high blood pressure, rarely eats what she cooks – (“just a little saucer of something on holidays”), decided to take part in a daylong health fair sponsored by First Rising Mt. Zion Baptist Church in Northwest and Howard University Hospital to learn more about healthier food preparation. “My four granddaughters are all big girls; they’ve been eating pretty rough since they were kids. Three of them have blood pressure issues and one has sugar (diabetes). I can’t tolerate a lot of foods the way I used to so I only cook the souse and ribs, stuff like that, when the holidays come, but the girls have been eating it regularly… They cannot be so young and be unhealthy,” Hicks said. But as Hicks learned during her health tour was that most Americans with chronic health conditions “go off the rails” during the holidays, indulging to a point of causing emergency episodes. Each year between Thanksgiving and New Year’s Day visits to American emergency rooms skyrocket as those with chronic health conditions overindulge on foods that exacerbate existing ailments. For some, it is a matter of will power; for others, eating the wrong foods, literally puts their lives at risk. Area health officials are admonishing revelers, whether living with diabetes, high blood pressure, or congestive heart failure, to err on the side of caution and allow “moderation” to be the watch word.

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Tsedale Zerabruk, a pharmacy manager for Rite Aid, said that holidays bring about feelings of great happiness or immense sadness, both of which lead to overeating or a reliance on salty or sweet comfort foods. Zerabruk, 38, cautions diabetics, particularly, to eat smaller portions. “There are a lot of parties and food being eaten at restaurants and in people’s homes where the preparations cannot be guaranteed healthy to people trying to manage their sugar intake. Others are depressed at being alone or at the loss of family members earlier in the year and turn to alcohol – which has a lot of sugar or sugar binging. For diabetics, mismanagement can mean loss of vision, limbs, or life, so holidays present a dangerous time for them if they are not careful,” Zerabruk said. A few helpful hints: “After holiday meals, a best practice is to take a little exercise. A small workout – even a walk around the block will increase metabolism and aid the digestion of sugars,” Zerabruk said. “If unable to stay away from all of the extra sweets, be sure to check sugar levels. Take it at the beginning of the day and then adjust your sugar intake accordingly. Above all else, stick to the prescription regimen. A lot of people neglect their medications because of the holidays or they forget to take their medications. We get a lot of emergency requests for missed dosages. Not taking medications or not taking them on time increases the likelihood that problems will result from holiday eating.” Kaiser Permanente Medical Technician Robin Vernon, who offered Hicks tips to better holiday meals, said it was imperative to prepare smaller, healthier meals for guests. “Whenever a tremendous spread of foods like macaroni and cheese and yams, hams, and fried foods are on one table, moderation and portion sizes are keys to healthy eating. We know that it is difficult for some to avoid salt when eating out or preparing for large groups, but an effort must be made. It is not impolite when eating at someone else’s home to let them know about dietary restrictions the same way you would if you

had an allergy,” Vernon said. Vernon, 25, suggests the person cooking for others, as a consideration, provide a few dishes that are prepared without salt or seasoned without meat. “Also try baking or sautéing foods rather than frying them. When you factor in the manner in which meals are prepared and that a lot of people are using canned items that are loaded with salt and other preservatives, the results can be really bad on those with blood pressure problems – even when they are young,” Vernon said. Vernon noted the “Freshman 15” – the 15 pounds gained my most college freshman as a result of stress, eating junk food, and prepackaged meals – is now a reality for junior high and high school students who are able to purchase junk foods and fast foods inside their schools or en route from home to school. “Food for a lot of people is an addiction so it is unrealistic to expect them to stop eating things entirely; but I do stress moderation above all else,” Vernon said.

BE ABLE TO BUY MORE. The Supplemental Nutrition Assistance Program (SNAP, formerly known as Food Stamps) helps boost your budget so that you can get more of the nutrition you need. AARP Foundation is making it easier than ever to sign up for SNAP. We’re committed to working toward ensuring that every older District of Columbia resident has a life free from hunger.

CALL 202-671-4200 TO SEE IF YOU OR SOMEONE YOU CARE ABOUT IS ELIGIBLE FOR SNAP BENEFITS.

HEALTH, WELLNESS & NUTRITION SUPPLEMENT / December 2012 H-7

Trimming Pounds over the Holidays Ways to Limit your Holiday Weight Gain By Elton Hayes WI Staff Writer

he holidays can be compared to a person with a credit card. In the same way that shoppers are seduced into buying items they don’t need and overextend themselves financially, many do the same with food and pack on the pounds. From Thanksgiving to New Year’s Day, people feast on cookies, candied yams and cakes, not to mention all the other favorite family recipes that everyone looks forward to piling on their plates. But in January, the price of overeating comes due. However, it’s possible to enjoy the holidays without having to worry about the end results. “Staying healthy during the holidays doesn’t mean that you have to give up your favorite holiday treats,” said Mayra Ruiz, 42, a personal trainer with YMCA of Metropolitan Washington.

“Instead, watch what you eat. Be mindful of your portions. If you can’t make it to a gym, take snacks with you when you do your holiday shopping and make sure you eat four to six times a day. That way, your metabolism stays at the same level.” Nutritionists estimate that the average American gains between one to five pounds over the holidays. In addition to the amounts of food consumed, factors such as time spent home from work and the hours spent traveling by car or aircraft don’t bode well for a body trying to burn unwanted calories. All hope is not lost, Ruiz said. There are countless activities one can do to stay active over the holidays without going to a gym. For starters, she encourages people to use the stairs, rather than the elevator, when shopping. She also suggests parking in spaces further away from the grocery store or shopping mall. “Park as far as you can and walk,” she said. “Little things like this will make all the difference.” The preventative maintenance

doesn’t stop with physical activity. There are a number of ways to enjoy your favorite holiday foods without going overboard. Instead of grabbing the largest plate in the cupboard when eating Christmas dinner, try taking one a bit smaller, Ruiz said. Portion control is a great way to ensure that you don’t overindulge. Ruiz also said to snack on foods throughout the day, so that one’s not overly hungry at Christmas gatherings or dinners. “Prior to going to a party, make

sure that you eat before. That way, your craving will be under control,” said Ruiz. “Always look for the healthy snacks such as the vegetable trays. You don’t have to completely give up the good food; you just have to be mindful around it.” Trimming the pounds can also be a family affair. Fitness and dance-themed games on video game consoles like the Nintendo Wii and XBOX360 provide an enjoyable way for everyone to shed the holiday pounds.

But none of these tips will make a difference unless people have the discipline. At the end of the day, it all comes down to willpower. “Enjoy the holiday season; spend time with your loved ones. But make it a commitment and stick to healthy eating and [to] some type of exercise, even if it’s just 15 to 20 minutes of walking down the stairs or doing lunges or squats inside of your house,” Ruiz said.

Quality health care for our community. Elizabeth Taylor Medical Center

1701 14th Street, NW Max Robinson Center

2301 Martin Luther King Jr. Avenue, SE Yavar Moghimi, md | Psychiatrist

202.745.7000 | www.whitman-walker.org H-8 December 2012 / HEALTH, WELLNESS & NUTRITION SUPPLEMENT

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Cancer and the District

DC Cancer Stats (2008) 1 Top 4 Cancer Deaths

Allied health professionals can play a role in the prevention and screening, diagnosing, and treatment of patients with cancer. Medical Assistants perform a wide range of duties in a physician’s office or clinic, from scheduling appointments to assisting physicians during patient examination. Phlebotomists, entry-level laboratory professionals, collect blood specimens, while Medical Laboratory Technicians (MLT) assist in the processing of blood and other specimens. Electrocardiographic (ECG) Technicians may perform an ECG tracing before a surgical procedure. Meeting the healthcare needs of the District requires a strong healthcare workforce, including well-trained allied health professionals. Many cancers can be successfully treated if detected early, and programs for risk reduction and prevention, such as smoking cessation, can reduce the cancer burden.

500

Number of DC Residents

Cancer has a tremendous impact on Washington, DC, residents and communities. Although the District has a relatively small population, it has the highest incidence and mortality across multiple cancers. In 2008, 2,741 District residents were diagnosed with cancer. That is about the same number of people it would take to fill 44 DC Metrobuses.1

Top 4 Cancer Diagnosed

400 300 200 100

Prostate

Breast

Lung

Colorectal

For more information about cancer in the District, as well as cancer prevention and screening resources in your community, visit dccanceranswers.org.

DC Department of Health (DOH)

Stephen’s Story Stephen is a Washington native, born and raised in the District. In 2009, he was diagnosed with Stage 4 Hodgkin’s Lymphoma. Over the last four years, Stephen has had more than ten procedures, been on dialysis for a time, and uses inhalers to compensate for his diminished lung capacity. A cancer activist, he serves as a DC Cancer Consortium Patient Advocate.

Graduate School USA has teamed up with the DC Cancer Consortium to ensure that its curriculum prepares students to work in the District’s healthcare system and assist physicians and nurses in caring for District residents like Stephen. Graduate School USA’s Center for Health Sciences offers associate degree programs in Medical Assistant and MLT, and certificate programs in Medical Office Administrative Assistant, Phlebotomy Technician, and ECG Technician. Infsoion: Ses 7 ary . u n Ja 8 p.m 6-

Stephen’s story courtesy of the DC Cancer Consortium.

600 Maryland Avenue SW Washington, DC 20024 (202) 314-3643 • graduateschool.edu/health healthsciences@graduateschool.edu www.washingtoninformer.com

INF-121312-CHS

HEALTH, WELLNESS & NUTRITION SUPPLEMENT / December 2012 H-9

DC Primary Care Association Visionary Leader Calls On You! By Sharon A. Baskerville I’m a big fan of jigsaw puzzles. Growing up, this was a family activity that brought us together around the table over the challenge of putting the 3,000 pieces into the one whole final picture that was promised on the cover of the box. It always looked

daunting and impossible when we first dumped those pieces on the table. Over the years, however, we developed a rhythm and strategies that convinced us that no matter how impossible it looked we would be able to make it whole in the end. Everyone had an area to work on, but the very first thing that

had to happen was to pick out all the border pieces and create the framework. Everyone pitched in for that. Pieces became lines and lines became sections and finally we put them all together to make a frame. Then we went for a particular color or pattern section and began sorting and connecting again, each working

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Sharon A. Baskerville

“I urge each of you to bring your puzzlesolving skills and expertise, so we can keep filling in the gaps to make health equity a reality in Washington, DC. One thing I know for sure… we’ll never finish it without you!” to make our part come together, sometimes squabbling over which piece belonged where, but always with the sense that our piece was important to finish so we could move to another. Fragmented sections now covered the table, but each section had a picture recognizable enough to help us understand where in the framework it belonged. Once we had gotten this far, we could see the way to make sense of it all and began connecting sections to the framework and to other sections as the larger picture began to emerge. In a puzzle that large, however, we were always left with lots of gaps to fill and a pile of random and not easily identifiable pieces that we needed to really work together on to make all our work and effort finally make that beautiful picture on the cover emerge. In reflecting on my work over the years with DCPCA, the analogy of the jigsaw puzzle was my inspiration in some ways. The picture on the box is the “vision of health equity.” We’ve pulled the scattered pieces together, built the framework, and been working industriously on different sections of that puzzle. Big chunks of it are done... expanded coverage is a reality; new facilities to expand primary care capacity have been built or are under construction; electronic health records and a health information exchange has been implemented to connect us better to our patients and other providers; and measureable quality and performance improvement tools are in

place to be able to tell the story of improving health outcomes. The picture is filling in nicely. But that pile of not easily identified pieces remains... the gap filling part that really requires us to work together to make sense of them all. We have to divvy them up, examine the shapes, work together to see where they fit, and pass pieces around to the most strategic side of the table. We have to be diligent about pieces that look like they fit, but in the end have to be moved to another place to make it all work, and most especially, we have to make sure no pieces fall on the floor and get lost. What’s in our pile of pieces? Poverty, homelessness, mental health and substance abuse, jobs, violence, poor education, and the environment are in there. And I am sure as we sort, we’ll identify many more. It takes real solutions to fill all of these gaps to truly begin to define ourselves as a healthy community. I urge each of you to bring your puzzle-solving skills and expertise, so we can keep filling in the gaps to make health equity a reality in Washington, DC. One thing I know for sure… we’ll never finish it without you! Sharon A. Baskerville is the former chief executive officer of the District of Columbia Primary Care Association.

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Happy Healthy Holidays: Sunshine Vitamin Tips By Misty Brown WI Staff Writer ’Tis the season to be healthy and happy with lots of good cheer. Bundle up and go outdoors to get a heaping helping of the “sunshine vitamin” known as vitamin D. Practice these simple tips and enjoy the holiday season. The Bottom Line: Here’s what the researchers at the National Institutes of Health have to say about Vitamin D: “Very few foods naturally have vitamin D. Fortified foods provide most of the vitamin D in American diets. The body makes vitamin D when skin is directly exposed to the sun, and most people meet at least some of their vitamin D needs this way. Skin exposed to sunshine indoors, through a window, will not produce vitamin D. Cloudy days, shade and having dark-colored skin also cuts down on the amount of vitamin D the skin makes. People who avoid the sun or who cover their bodies with sunscreen or clothing should include good sources of vitamin D in their diets or take a supplement. Recommended intakes of vitamin D are set on the assumption of little sun exposure.” Before taking dietary supplements, consult your doctor. www.nih.gov Seniors: Last year, 61-yearold Sharon Little, a French-Canadian, trekked up to the base camp of Mount Everest in Nepal and swears by her regimen of taking 6000 mg of vitamin D daily. “I was the only woman of nine in my camp. I was the only one who was in the camp walking around in my thermawear undergarments and experienced no altitude sickness or physical colds or flu, like many.” In her homeland, the medical establishment advocates a wholistic regimen. “A healthy diet with www.washingtoninformer.com

adequate calcium and vitamin D, and regular physical activity, help to achieve strong bones and may reduce the risk of osteoporosis,” according to WebMD.

Walking: “Ten to 15 minutes of sunshine (without sunscreen) are sufficient for the average person. However, the risk of skin cancer is a factor for some. For maximum absorption, the sun needs to shine on your face, upper torso and legs. My family and I take winter walks on a daily basis. We visit the Hopi Labyrinth and Ceremonial Stone Cherokee Arbor in Leakin Park in Baltimore,” said Antonio Carpenter, the lodge keeper at the Ancient Wisdom Teachings Spiritual Lodge, a fellowship of indigenous wisdom teachings. Email:antonio.carpenter@ gmail.com Winter Sports: Keith Brunson, a 45-year-old, physical therapist who lives in Carmel, N.Y., is an avid sports fan. “If you attend any football game outdoors, you will get an ample dose of your sunshine vitamin. My 10 year-old daughter, Janiece, attends the football games with me. Jumping up and down at games are serious fun exercises and you will sweat. My wife, Tami’, enjoys skiing. Parents should encourage or allow their children to participate in or play winter sports – sledding, snowman building, making snow angels, snowboarding and ice-skating.” Decorating & Chores: “Shopping, running errands, putting up Christmas decorations, planting spring bulbs, raking leaves, shoveling snow, sweeping sidewalks and taking out [the] trash on a sunny day, provides vitamin D and a decent workout. My three boys love playing outside even if it is the tag game,” says 42-year-old, Shawna Malone, executive director of Three60World, Inc. Malone lives in Columbia Heights. HEALTH, WELLNESS & NUTRITION SUPPLEMENT / December 2012 H-11

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CSTXXXX_DC_Ad_9.5x12.37_4c.indd 1 H-12 December 2012 / HEALTH, WELLNESS & NUTRITION SUPPLEMENT

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