At an annual celebration on Saturday night, Upstream Public Health announced a top-five list of the biggest public health issues facing Oregon in 2017, and gave an award to a “Public Health Innovator.”
“The greatest obstacles to better health are social factors such as housing, income and racial justice,” says Executive Director, Mel Rader. “We know these factors have a much greater impact on health than all of our healthcare services. Our challenge moving forward will be to find innovative approaches to improve the social conditions that impact health, and as well as promote healthy activities such as diet, exercise and reduced tobacco use.”
Rader shared the following list of Top Five Public Health Issues Facing Oregon in 2017:
1. Physical activity among children
2. Youth Smoking and Vaping
3. Racial Justice
4. Affordable Housing and Houselessness
5. Early Childhood Dental Disease
Upstream Public Health, a public health advocacy and research organization founded in 2002, is working on all five of the issues, through state and/or local policy efforts, and in one case, (#5) they are managing a pilot program to provide direct services.
The Chair of Upstream’s Board of Directors, Ellen Falbo (Senior Vice President and General Manager, Private Label Cards at Genesis Financial Solutions), presented the Public Health Innovator Award to the Oregon Community Health Workers Association (ORCHWA, pronounced Orch-wuh). Falbo presented the award to Mohamed Abdiasis, chair of the ORCHWA board of directors, explaining that Community Health Workers are at the forefront of culturally-inclusive health services and social change to support health. ORCHWA is a new organization, founded in 2011, helping make this work happen, and happen well.
ORCHWA convenes culturally specific organizations, community health workers and health care organizations to address critical needs in training, funding and advocating for community health workers.
Upstream’s party on Saturday night was called the “Good Health Gala,” and it brought together over 150 people to the Portland Art Museum, despite the stormy weather for a delicious dinner and successful fundraiser. The party was sponsored by: HealthSparq, the Harbourton Foundation, Multnomah County, Stoel Rives, CareOregon, and the OHSU/PSU School of Public Health. The keynote speaker was Dr. David Bangsberg, the founding dean of the OHSU/PSU School of Public Health.
See below for the long descriptions of the top five issues, and the text for the award.
Upstream Public Health creates the social and environmental conditions so that all Oregonians can be healthy and thrive. Upstream acts as a catalyst to drive healthy changes, making Oregon a better place to live, work, study, and play. www.upstreampublichealth.org
Top Five Public Health Issues Facing Oregon in 2017
Physical Activity among Children
Physical activity has a larger impact on health than almost any other behavior. However, many factors are impacting physical activity among kids, including the design of our neighborhoods, access to quality parks and playgrounds, impact of screen time, and the amount of physical education and recess provided in school settings. Only slightly more than half of Oregon students meet the recommended levels of physical activity in order to promote good health.i
Now, in 2017, Oregon is set to implement new standards for the number of minutes of physical education that need to be provided in schools. It will be critical that schools take the steps necessary to hire new teachers, ensure adequate facilities and implement quality physical education classes.
Youth Smoking and Vaping
Youth smoking has seen a steady decline over decades as many strategies are put in place to prevent smoking among youth. However, in the last few years, we’ve seen youth tobacco and nicotine use go in the other direction. E-cigarette use, in particular, tripled in one year, making e-cigarette use more common than any other tobacco or nicotine product among youth. Oregon was also found to have the highest rate of sales to minors of tobacco products.
Lifelong smokers have been found to live, on average, ten years shorter lives than nonsmokers.ii In addition, the vast majority of smokers start before age 21. It is therefore critical that we implement new strategies to prevent youth from taking up tobacco and nicotine products, in order to promote long term health and reduced healthcare costs. Strategies at the top of list include to create a state licensing system for tobacco retailers to reduce sales to minors, and to look at increasing the age to 21 for selling cigarettes.
Racial Justice
Race and ethnicity continue to be among the most significant factors that impact health. Racial bias in housing, education, jobs and healthcare take a toll on the physical and mental health of people of color. This can start as young as preschool.iii In Portland Public Schools, African American students are nearly five times more likely to be expelled or suspended than White students.iv
In the most recent years, incidents of violence between police and community members as well as the election cycle has intensified discussion of race in America. At the local level, many counties and health systems are developing strategies to reduce health inequities through community health improvements plans (CHIPs). In addition, the Oregon Health Authority, for the first time, is developing a metric to measure and assess progress toward health equity.
Affordable Housing and Houselessness
Population growth and increasing real estate prices, have caused rental prices to shoot up. In one report, Portland saw the highest rent increase of any major city in the country. The rent crisis has spilled over into suburban and rural areas as well. This trend has led to increased homelessness, and substandard housing.
- Since 1980, housing prices in Oregon have risen 315% making it 4th in the nation for housing prices, and Oregon is the 3rd most unaffordable rental market in the US according to the National Low Income Housing Coalition
- This makes other critical needs for health such as food, managing chronic health conditions, having funds to pay utilities and transportation all that much more difficult to meet
Chronic homelessness has been found to increase healthcare costs by $20,000 or more per year, often much more than the cost of housing itself.v In addition, high rental prices lead to low income communities being pushed into the suburbs or rural areas, more household costs and increased travel time.
Early Childhood Dental Disease
Dental disease is the most common chronic disease among children, and is cumulative over time. Dental health at a young age has a critical impact on lifelong dental health. In addition, dental and gum health have been increasingly linked to many chronic diseases including heart disease and diabetes. Dental health has been impacted by high rates of soda consumption, long wait times for dentists accepting Medicaid, and few community-based programs to address dental health in the age range of 0-5 years. The state Oral Health Strategic Plan has laid out a number of strategies to implement to improve oral health, including community-based models to provide preventive services, better integration of medical and dental care, and strategies to improve nutrition among young children.vi
Upsteam Public Health’s 2017 Public Health Innovator Award
Winner: Oregon Community Health Worker Association (ORCHWA)
Community health workers (CHWs) work at intersection of health and social service to ensure community members can access the care they need.
The Oregon Community Health Worker Association (ORCHWA) is helping make this work happen, and happen well. They convene culturally specific organizations, community health workers and health care organizations to address critical needs in training, funding and advocating for community health workers.
In community engagement events in Multnomah County’s Community Health Improvement Plan, residents repeatedly talked about how much they need people who understand their culture, their family needs, and their traditions when they interact with the health care system. Community Health Workers (CHWs) are trained community members who connect residents to health care service supports. In Oregon, they are a health educational resource and key members of health care teams that help clients manage chronic conditions. CHWs are from the community they serve and therefore familiar with the languages, cultural needs, and potential historical and current trauma residents face.
This winning effort ensures that community members have support to address risk factors that affect them where they live, work and play – such as physical activity, nutrition and tobacco use. This innovative approach is a long-standing tradition in many cultures and countries across the world that is once again gaining a foothold in our health care system. ORCHWA, and the partners they work with, deserve much of the credit for legitimizing and expanding the role of CHWs in Oregon.
For more information about Community Health Workers, see this informational video: https://www.youtube.com/watch?v=JtIY7CQf-EU
