What Drives Health?

What Drives Health?

We have seen many news media reports in recent months referencing the topics of underlying health conditions and health disparities. Factors underlying these issues are varied, complex and heavily intertwined. Tillamook County Wellness uses data and best practices to influence those factors in ways that lead to improved health for all people, especially those with a higher risk of developing chronic health conditions, such as type 2 diabetes.  As a program of Tillamook County Public Health, our partners work to improve health drivers at every level so that people can live happier, healthier lives. This involves strategies from multiple approaches and an understanding of what drives health at individual, population and public levels.

Population Health vs. Individual health – They are tied together! Individual choices, attitudes, and behaviors impact both our personal health and the health of our community. Individual behaviors contribute to cultural norms and these can be “contagious.” The more we see people doing something, the more likely we are to do the same thing.

Population Health vs. Public Health – Both work to improve the health of the public itself and fall under the umbrella of the field of health systems work.

Population health is a broad focus on understanding the conditions and factors that influence the health of populations over lifetimes. Population health also measures patterns and implements policies for the overall health and wellbeing of society. Healthcare professionals work to improve the health of populations by preventing disease, promoting healthy lifestyles, and addressing health inequities. Some outcomes that population health responds to are improving the health of the people with limited resources, implementing cost-effective strategies to address health disparities, and developing practice guidelines for practitioners. Providers use population health solutions to identify risk factors and coordinate specific care needs for patients.

Public health – According to the American Public Health Association (APHA), Public Health promotes and protects the health of people and the communities where they live, learn, work and play. Public Health works on a more personal level than population health. It promotes wellness to the public by encouraging patients to live healthier lives. Public Health workers also educate people to help prevent unhealthy habits, like smoking and substance use, from getting out of control. For example, social workers, nurses and caseworkers work with the healthcare industry in providing government assistance and counseling to the public under the public health umbrella.
Our community Wellness work combines facets of population and public health when addressing the health of our community. We follow the CDC’s research-based guidelines based on numerous factors that drive health.

Health Is More Than Health Care!
Health is more than what happens at the doctor’s office. A wide range of factors influence how long and how well we live from education and income, to what we eat and how we move, to the quality of our housing and the safety of our neighborhoods. For some people, the essential elements for a healthy life are readily available; for others, the opportunities for healthy choices are significantly limited.
According to the CDC, health care provided in a clinic setting accounts for less than 20% of our health. Our community and environment and social determinants of health, like housing, access to healthy food, income, educational attainment, and social supports among other things, can account for more than 50% of our health outcomes. Even outpacing genetic predispositions.

Across the country there are significant differences in health outcomes, from one county to the next, from one state to the next, and among racial/ethnic groups. For example, Blacks, Native Americans and Hispanics have consistently faced barriers to opportunity and good health. Increasing opportunities for everyone can reduce gaps in health. For example, providing better access to high-quality education and enrichment opportunities boosts skills that are key to landing a good job and for upward economic mobility. Additionally, early childhood care and education, good nutrition, physical activity and social-emotional learning contribute to significantly better health later in life.

Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty and discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.

Health disparities are differences in health or in the key determinants of health, such as education, safe and affordable housing and food security.
We are fortunate there are many dedicated and highly energized community partners working to improve community conditions for inclusive and equitable access to better health. There is more work to be done.
We want to be part of the solution to address community and population health! Tillamook County Wellness is committed to bringing people together to look at the many factors that influence health, and to pursuing strategies that can improve health for all and to make changes that will have a lasting impact. If you’d like to join us, please email us at info@tillamookcountywellness.org.

For more local health and wellness information, visit tillamookcountywellness.org or follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Team Explores Ways to Enhance Community & Economic Vitality  in Tillamook County

Team Explores Ways to Enhance Community & Economic Vitality in Tillamook County

Local representatives earn opportunity to participate in a national course on Balancing Nature and Commerce in Rural Communities and Landscapes  

Tillamook, OR – Earlier this year, a team from Tillamook County participated in a three-day course designed especially for rural communities seeking to capitalize on their natural and cultural assets. Working with national experts on sustainable tourism, economic development, natural and cultural resources, community health, transportation, and branding, the nine-person team looked at ways to leverage existing and emerging programs and community assets that make Tillamook County an appealing place to live, work and play.

The Conservation Fund designed and delivered the program to a total of six teams from regions in Pennsylvania, Virginia, and Puerto Rico, in addition to the team from Tillamook County. Groups were selected through an application process to participate in the program. Each community group included diverse representation from business and tourism, elected officials, civic leaders, public land managers, and engaged citizens.

The Tillamook County team assembled to attend the event which took place Feb 10-14, 2020, included:  Mary Faith Bell, County Commissioner; Deb Wilkins, USDA, US Forest Service; Michelle Jenck, Tillamook County Wellness; Nan Devlin/Arica Sears, Tillamook County & Regional Tourism; Sarah Absher, Tillamook County Community Development; Eva Wilson, Tillamook County Creamery Association; Claudine Rehn, Tillamook Estuaries Partnership (TEP); Joanne Woefle, Tillamook County Parks; & Erin Skaar, CARE.

Deb Wilkins initiated the application, stating, “In my role as Hebo District Ranger of the U.S. Forest Service and as co-chair of the Tillamook County Wellness Access to Physical Activity Committee, this seemed like the perfect opportunity for us. We know people are coming here to take advantage of our trails and outdoor recreation amenities. We want to make sure locals have those same opportunities and that everyone who uses these natural spaces can do so safely and with an understanding of how we can protect them. The long-term health of our economy and community depend on it.”

Tillamook Team members received a great deal of useful information from the course, such as the fact that outdoor recreation is a major economic driver, contributing more to the U.S. Gross Domestic Product (GDP) than the pharmaceutical industry.  National experts noted that it is the “soul of the community” that attracts investment, such as social events, openness to newcomers, community aesthetics, physical beauty and green spaces. Presenters gave practical tips for how to enhance community livability in ways that attract new businesses and jobs, instill community pride and protect the natural beauty of the region.

“The Tillamook County team application presented an ideal candidate for this program due to the strong ties throughout the community and their passion for protecting and enhancing the area’s natural and cultural resources,” said Director of The Conservation Fund’s Conservation Leadership Network, Katie Allen.  “It’s our goal to help communities foster valuable partnerships, reinforce development plans that balance environmental and economic goals and provide technical assistance to enable places like Tillamook County to become even more vibrant and thriving communities.”

Members of the Tillamook team are involved in a variety of local efforts that work collectively to increase access to culture, recreation and other measures that increase community livability and well-being. Research shows that these investments contribute to having a sense of belonging, which helps communities thrive.  Ensuring that youth and young families reap the benefits of this work was a theme during the course’s team planning sessions.

For more than 20 years, The Conservation Fund has delivered this course and other services to over 700 communities in the U.S. and Canada.  The national course is offered annually at the National Conservation Training Center in Shepherdstown, WV with place-based programs offered on request.

AUTHOR: Katie Allen, 304-876-7925, The Conservation Fund kallen@conservationfund.org

About The Conservation Fund
At The Conservation Fund, they believe that conservation should work for America. By creating solutions that make environmental and economic sense, they are redefining conservation to demonstrate its essential role in our future prosperity. Top-ranked for efficiency and effectiveness, they have worked in all 50 states since 1985 to protect more than 8 million acres of land. www.conservationfund.org

Health, Well-Being and the Outdoors

Health, Well-Being and the Outdoors

As stay-at-home restrictions begin to lift and the weather changes, people are ready to get outside. This reprint from a previous article on the health impacts of being outdoors gives us one more reason to celebrate where we live. Just remember to follow current guidelines when out and about with others. And keep washing those hands!

“Earth and sky, woods and fields, lakes and rivers, the mountain and the sea, are excellent schoolmasters, and teach some of us more than we can ever learn from books.” – John Lubbock

Fresh air offers a great benefit to our health. Living in congested city environments is associated with increased risk for many health complications; while those who live by bodies of water, like the ocean, rivers, and lakes, enjoy improved mood and sense of well-being.

Outdoor environments around bodies of water and trees like evergreen and cedar have more negatively charged ions which research shows is good for health. Ocean air from the mid-Pacific contains significantly less particulate matter compared to air from large cities. Ions are tiny, electrified particles of matter. Ionization along with oxygen and the absence of pollutants help to make “fresh “air, which has more negative ions. Negatively charged air has been shown to kill germs, decrease the survival of airborne bacteria and viruses, boost immune function and even improve symptoms of depression. Alternately, positively charged air is associated with feelings of unpleasantness and lethargy. (Links to research articles and additional information on this topic can be found at https://www.healthline.com/health/negative-ions.)

Fresh air is also dependent on trees. Trees draw particulates, ozone and pollutants from the air into their leaves cleaning the air. The University of Chicago studied the number of trees in Toronto Canada and found a relationship to public health. Their 2015 study published in Scientific Reports showed that planting ten trees per city block related to increased perceptions related to a person’s health. People living on those blocks suffered less from obesity and hypertension as compared to neighborhoods with fewer trees and had the same health impact as being 7 years younger.

People living in a neighborhood with less than 10% tree canopy were much more likely to have symptoms of depression, stress and anxiety a Survey of Health of Wisconsin found. Many other studies are examining how higher amounts of green space in cities leads to mental health benefits. Even outdoor exercise and community gardening, as explored by Harvard School of Public Health, are linked to mental health benefits such as recovery of mental fatigue, reduced stress and improved restoration. A growing body of research shows nature is a potent therapy for depression, chronic disease and contributes to creative thinking.

“I go to nature to be soothed and healed and to have my senses put in order.” – John Burroughs

 

AUTHOR: Ginny Gabel, RN, Community Wellness Education, Adventist Health Tillamook

For more local health and wellness information,  follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Stay Home, Stay Safe, Stay Healthy

Stay Home, Stay Safe, Stay Healthy

We will all remember the Spring of 2020 because of the stay at home restrictions put in place to help stop the spread of disease.   To make the most of this time, we are sharing some great advice from our friends at the Oregon Dairy & Nutrition Council.
 
Eat Well. Our bodies need the best fuel every day, and this is a great time to focus on healthy food choices.  Eating a balanced diet, which includes lean proteins, fruits, vegetables, dairy and whole grains, can help keep you healthy. And, it’s easy! Use the USDA’s MyPlate app as your guide.  Think about food groups when planning meals and snacks.  Try for at least two food groups for a snack – fruit and cheese, for example – and at least three for a meal – whole grain pasta, tomato sauce with added vegetables, and lean ground beef.  Pour a glass of milk to round out the meal.
 
Drink plenty of fluids. Your body depends on fluids to survive, and most healthy people can stay well hydrated by drinking water and other fluids whenever they feel thirsty. Water is recommended, but when you want something different, consider drinks that won’t add unnecessary sugars to your diet, like milk. Milk not only tastes great, it also is an affordable, excellent source of 9 essential nutrients. And, did you know that three of the nutrients – vitamin A, vitamin D, and protein – are essential for a healthy immune function?

Get fresh air. While doctors don’t typically prescribe sitting on your porch to cure an ailment, they do say that stepping outside can help to impact both our physical and mental health.  Open a window, take a walk, or sit on your porch. “Taking a short break outdoors can leave you feeling refreshed and more energized to get back to your daily tasks,” says Dr. Jimmy Johannes, a pulmonologist at Long Beach Medical in this article. Plus, it’s easy to keep a safe “social distance” outdoors!
 
Keep moving. Just because the gyms are closed doesn’t mean you should stop your exercise routine. Use this time as an opportunity to try something new. Many gyms are offering online classes, and many at home programs are offering free trials. Who knows? Maybe now is the time to start training for your next 5k or marathon. It starts with the resolve to keep moving. Need to get started? The Department of Health and Human Services offers physical activity guidelines and practical ways to be active on their website.
 
Get plenty of sleep. Getting a good night of sleep not only helps you feel and think better, it can also help you manage stress. Start with a healthy evening routine.  Turn off the screens, including your phone, an hour before bed and pick up a good book, meditate, write, play music or find another relaxing activity that will settle your brain.  Being “stuck” at home doesn’t mean it’s a good idea to binge-watch your favorite television show and, remember that getting 7 to 9 hours of sleep will help you stay healthy.
 
Do something good. Times are stressful. People are uncertain, confused and cooped up. A great way to help manage your own stress is to take time each day to do something for someone else. Check on a neighbor, share a roll of TP, call a parent or grandparent, sew some masks for healthcare workers, or donate funds to your local food bank. While you are at it, thank a farmer for continuing to produce food for your family. Even doing something small for someone else will boost your mood- and theirs too!

AUTHOR: Stacy Foster, Industry Relations and Communications Manager, Oregon Dairy and Nutrition Council     

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Wayfinding in Uncertain Times

Wayfinding in Uncertain Times

In March, following the stay-at-home order, I went on a final grocery run, checked in with family by phone, and settled in at home. I told myself, “There’s plenty I can do at home, it’ll be fine.” I planned for my needs and, despite harrowing news from friends abroad, I felt secure. One month later, many of us have been laid off and are fighting for unemployment benefits while others are working increased hours as essential staff. Retirees are strategizing for their daily needs, children are adjusting to on-line school. Parents working from home, juggling job duties and childcare and technology challenges. Many of us are feeling waves of exhaustion, frustration, overwhelm. How do we make sense of these feelings? How do we grieve our lost routines with the uncertainty of the path ahead? We can turn to Elizabeth Kubler-Ross’s famous ‘Stages of Grief’ model to organize ourselves for this journey. It is important to remember the stages are not linear; we don’t walk through them sequentially.

Denial: Denial can serve a helpful purpose in getting us through the first few days and weeks following loss. In the midst of COVID-19, denial can show up when we think, “This is just a flu and I don’t get sick, I’ll be fine.” Denial can push us to busy ourselves in work, or find other constant distractions. As time passes, denial often dissolves and gives rise to other stages.

Bargaining: When things are beyond our control, as with grief and COVID-19, bargaining is a way to regain a sense of authority. “I’ll stay home for now, but this better be over by June” or “If I stay home, everything will be fine by my birthday in August.” Recognizing that we can’t bargain our way to a better situation is a step towards resolution.

Anger: In the midst of COVID-19, much anger has been expressed at government leaders, international travelers, entire cultures. Anger is a valid emotion and worth exploring, but it is not okay to take it out on those around us.

Sadness/Depression: For many of us the sadness of our circumstances is becoming undeniable. We feel the sadness o missed graduations, birthdays and holidays; we long for contact with friends and loved ones. Missing everyday milestones can be heartbreaking and lead to increased feelings of loneliness and depression. It’s okay to be sad right now.

Acceptance: Originally identified as the final stage of grief, acceptance is when we recognize the reality of our circumstances: we are in a pandemic, we are socially distancing and staying home in order to protect one another, and we don’t know when this will end. Acceptance of the present moment, no matter the pain, is where we find some
emotional freedom.

Meaning-Making: In the sixth stage of grief, introduced by Davis Kessler and endorsed by Kubler-Ross, we discover meaning-making as a byproduct of acceptance — once we accept our reality, we can make something out of it. When we create meaning, we are able to see our struggles in new ways. Meaning-making does not eliminate pain, but it can
give it purpose.

There are endless ways of making meaning of this time. By connecting with friends and spiritual communities online, we can explore a new side of relationships and new textures to our faith. When we advocate for equity in healthcare and unemployment benefits, we give our anger a voice for change. Trips to the grocery store for neighbors in higher risk categories connects us with others in a valuable way. When we spend reflective time by ourselves, we remember our needs and values, and tune into our deeper selves. When we find enjoyment in the often-tedious task of cooking, mealtimes become creative activities. Noticing endearing quirks in our pets can fill us with gratitude for the ways they enrich our lives. Listening to music reminds us to move, dance, play. Spending time outside can help us connect with nature, appreciate rural life, enjoy songbirds and notice signs of spring. Through these practices, both great and small, we can find value.

In the coming months, as leadership and health professionals adjust our current restrictions, we will dance between stages — we might revisit denial, move directly towards anger, wade back into bargaining. At each stage, we can meet ourselves with compassion, remembering this grief process and, again, move gently towards meaning-making.

AUTHOR: Terra Marzano, Licensed Clinical Social Worker, Rinehart Clinic

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Keep Calm and Breathe On

Keep Calm and Breathe On

May is Mental Health Awareness month, which is very timely considering the added stress, anxiety and uncertainty caused by COVID-19. Generally speaking, stress isn’t all bad. It drives us to perform well in certain situations such as meeting deadlines and delivering public speeches. The challenge with stress is when it becomes chronic. Constant stress and anxiety can cause increased levels of certain hormones, such as cortisol, which can cause systems of our body to react in ways that negatively affect our health.

A certain amount of stress is inevitable, so it is important to find ways to successfully manage stress levels to reduce those negative health consequences. In recent years, people have been turning to meditation, yoga, tai chi and qi gong to help manage the effects of stress and improve their overall health. Once considered solely Eastern religious practices, these activities are becoming increasingly popular among the general public and with researchers due to proven benefits to physical and mental health as well as brain function.

Thanks to a growing body of research, we have a better understanding of how these practices help people manage stress levels and improve health. According to a 2018 article published in Frontiers in Human Neuroscience, the beneficial effects of these activities are well established and share a common foundation. A large-scale review of research studies named in the article states that these types of activities “reduce multiple physiological stress markers” including “heart rate, blood pressure, cortisol levels and inflammatory bodies” (Pascoe et al., 2017). The underlying mechanism associated with these health improvements is tied to the function of a specific nerve, called the Vagus Nerve, and its relationship to breathing.

Contemplative activities like meditation, yoga, tai chi and qi gong all involve paying attention to and modifying breath patterns. Specific breathing techniques shared by these practices include: 1) slowing down breath cycles, reducing the number of breaths per minute, 2) emphasis on slowing exhalations compared to inhalations and 3) shifting from “chest breathing” to “belly breathing,” often referred to as diaphragmatic breathing.
Practical cues for this type of breathing include:

  • Relaxing muscles around the face, neck, shoulders, arms, and ribs

  • Inhaling and exhaling through the nose with the mouth closed

  • Allowing the lungs to fully expand with each inhale and fully “deflate” with each exhale

  • Allowing the rib cage to expand and diaphragm to lower with each inhale and then reversing that process with each exhale

Research has consistently supported the benefits of these breathing practices in that they lower heart rate, blood pressure and blood lipid profiles; all factors tied to chronic disease risk (Ospina et al. 2007). More current research involving the vagus nerve is helping to explain why breathing in this way causes these changes. The vagus nerve is a unique part of the nervous system. It has two branches that run from the brainstem throughout the whole body, connecting directly with all organs and systems of the body, including the heart, lungs and digestive system. Simply stated, one branch of the vagus nerve is involved in the flight/flight reaction (sympathetic nervous system) and the other branch involves the rest/digest system (parasympathetic nervous system). Just as the name implies, the parasympathetic system puts the brakes on the sympathetic nervous system, helping the body shift from a fight or flight stress response to a more relaxed state. Slow, relaxed breathing activates the parasympathetic rest and digest system, sending signals of safety and security to the organs of the body, causing physiological changes that support optimal heart, lung and digestive functions.

In a nutshell, breathing activities such as those mentioned here, help reorient the body’s nervous system response. Over time and with consistent practice, we are better able to recognize unhealthy reactions to stress and use breathing techniques to balance the systems of our bodies in ways that improve our health and lower our risk for disease.

In addition to classes offered through the YMCA, NCRD and other local partners, there are many free on-line resources for developing these breathing techniques. Michelle Jenck, who holds a Master of Education in Health and Kinesiology, has created a short video demonstration (https://youtu.be/2Ft1vFiMsV8) of a simple breathing activity. During this time of uncertainty and added stress, consider adding a five-minute breathing practice to your daily routine to help regulate and improve your body’s stress response.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/

AUTHOR: Michelle Jenck, M.Ed. Health & Kinesiology 

For more local health and wellness information follow Tillamook County Wellness on Facebook, Instagram and Twitter.