by Guest | Apr 27, 2018 | Being Well
Emily Fanjoy, TCWRC Health Programs Coordinator
Health care professionals and social service providers understand that a person’s overall health is impacted more by what happens outside of the doctor’s office than by what happens during an annual visit. As YOW, a public health-focused initiative, convenes community partnerships and collaborators to formulate a plan to address the high rates of diabetes in Tillamook County, we are looking at root causes for type II diabetes and barriers to medical care for people who are pre-diabetic. That means looking across a broad spectrum of potential causes. A person’s relationships, past and present, and the home they grew up in could be a contributing factor to developing diabetes and to successfully managing it.
Healthy relationships promote overall health and well-being, while unhealthy and abusive relationships contribute to poor health in a variety of ways. Unhealthy relationships can negatively impact a person’s immediate and long-term health. Unhealthy relationships where one person in the relationship uses a variety of methods to gain and maintain power and control over the other person are, unfortunately, common. According to surveys from the National Domestic Violence Hotline, approximately 1 in 4 women and 1 in 7 men have experienced intimate partner violence. It occurs across every demographic line of socioeconomic status, education level, sexual orientation, race, and religion. It can happen to anyone. Tactics include: jealousy, preventing their partner from spending time with friends and family; controlling how their partner spends money; and shaming or humiliating their partner in public or in private.
Many people assume that abusive relationships are defined by the presence of physical violence, but research shows that emotional and psychological abuse are used long before any physical violence occurs. Over time the control tactics cause chronic, toxic stress for the person subjected to them. In terms of health impacts, psychological abuse is as important an indicator for health outcomes as physical abuse. This means a person can experience negative health consequences as a result of an unhealthy relationship without ever being physically hurt by their partner.
Controlling, abusive behavior harms the partner who is subjected to it, and it can also harm the health and wellbeing of children growing up in homes where it’s the norm. The Adverse Childhood Experience Study, or ACEs, demonstrated the connection between growing up with violence in the home and experiencing long term chronic health conditions, including diabetes. Our bodies are wired to respond to real or perceived threats by releasing the hormone cortisol to fuel the “fight, flight, or freeze” response in dangerous situations. This is helpful for self protection in the short term but, if the body is constantly producing stress hormones, the effect can be damaging over time. Cortisol directly impacts blood sugar levels and heart rate, and is linked to the development of gastrointestinal conditions, heart disease, diabetes, and other illnesses.
As with childhood ACEs, even after an unhealthy relationship has ended, the experience of abuse can negatively impact health. Successfully managing mental or physical health conditions while in an unhealthy relationship can be challenging. If you or someone you know are concerned that your relationship is affecting your health, there is hope for healing. At TCWRC, we believe everyone deserves a healthy, supportive relationship.
TCWRC serves people of all genders with free, confidential advocacy services, community resource referrals, support groups, community and professional education and outreach, and counseling services. Our advocates and 24/7 helpline are available to anyone who wonders about their relationship and about what resources are available to them. We’re located at 1902 2nd St, Tillamook, OR 97141; 503-842-9486 or 1-800-992-1679. You are not alone.
by Guest | Apr 20, 2018 | Being Well
Jessica Linnell, PhD, Oregon State University Extension Service, Family & Community Health
When I first moved to Tillamook two years ago to join the Oregon State University Extension Service as a professor in Family & Community Health, I started hearing something repeatedly from everyone I met, “We have culture of working together,” and there were many examples.
One of these stories came from my neighbor who told me about the flood in 1996. While he shared with me the details of how devastating the flood was, his focus was not on what happened but rather on how people came together to help one other.
Since the very beginning of my time living in Tillamook County, I have understood that no matter how big or complex a problem is, the people of Tillamook County will work together. In addition to the crises like floods that bring us together, we have some big, complex health issues in Tillamook County that also require the spirit of collaboration.
If you look at the latest health assessments of our county, chronic diseases dominate the top of the list. One of these is the alarming rise in type 2 diabetes. Recent estimates show that nearly 11 percent of Tillamook County residents are diagnosed with diabetes, which is more than the state average. Additionally, up to 25% are estimated to have prediabetes. This is why type 2 diabetes was selected as the priority health issue for the next phase of the Year of Wellness.
Addressing type 2 diabetes is going to require we all work together to create communities that empower healthy lifestyles. That is why we have integrated a model called Collective Impact to support this work. The Collective Impact model encourages organizations to move from isolated work to working together collaboratively, by creating a common agenda and sharing resources, materials, time, risks, benefits and rewards.
When businesses, organizations, and community members come together around one problem, they maximize their expertise and resources to create solutions that are effective, tailored to the community, and can be sustained over time.
To help illustrate how collective impact can be a useful approach in efforts like the Year of Wellness, I would like to share this quote from Community Tool Box, a resource from the University of Kansas.
“Not all problems are created equal – some are simple, some are more complicated, and some are truly complex. Each type requires a somewhat different approach to solving them.
- An example of a simple problem is learning how to bake a cake – the right “recipe” is essential, but once you’ve discovered it, replication will get you almost the same result every time.
- An example of a complicated problem is sending a rocket to the moon – the right “protocols and formulas” are needed, as are high levels of expertise and training. Experience is built over time to get to the right result, which can then be repeated over time with the expectation of success.
- An example of a complex problem is raising a child – there are no “right” recipes or protocols that work in every situation. There are many outside factors that influence the situation, and every situation is unique. Experience helps, but in no way guarantees success.
A single service program may be quite appropriate to addressing problems that are simple or only somewhat complicated. Collective impact, however, is an approach to solving complex social problems.”
The myriad factors that influence our risk for type 2 diabetes are the reason type 2 diabetes is a big and complex health issue. Our risk is not just related to what we eat and how much we exercise. It is also influenced by factors like our family history, access to health services, and family and social norms. Additionally, our physical environment as well as organizational and government policies can have a big impact on our ability to engage in healthy lifestyles. By harnessing our collaborative spirit, we will be able to maximize our potential to have collective impact on type 2 diabetes.
by Guest | Apr 13, 2018 | Being Well
By Marlene Putman, Director, Tillamook County Community Health Centers and YOW Task Force Leadership Team Member
The Tillamook County Year of Wellness (YOW) has been a lot of things since it was formed in 2015. Whether you participated in the on-line wellness tracker, joined a partner organization for an event, tried new recipes, or just became more aware of your personal lifestyle habits, you have been a vital part of this grass-roots effort to make Tillamook County a healthier and happier place to live, work and play.
Appointed by the Board of County Commissioners, YOW’s 22-member Task Force continues to meet regularly. To build on the work to date and to have an even greater impact on our population’s health, this body decided to focus on one community health priority: Preventing Type 2 Diabetes.
Risk factors for Type 2 Diabetes are the same as for many other chronic diseases, such as heart and lung disease, stroke and many forms of cancer. Tobacco use, poor nutrition and inactivity are key lifestyle behaviors that increase risk for chronic illness. Environmental factors like stress, lack of social support and reduced access to health-promoting activities, nutrition and healthcare also contribute to one’s risk.
Because environment and lifestyle play such a significant role in chronic disease risk, the new YOW framework will be focused on shaping policies and access to make the healthful choices the easier choices. Examples of this could include building walking trails, changing cafeteria menus, and holding walking meetings in the workplace. Joining newly formed walking groups, or starting your own, is a great way to become more active and increase social ties. YOW partners offer many wellness events, activities and classes. Taking a cooking class or joining a diabetes prevention class is another great way you can get started making healthier changes right now.
A key goal is to assess, and restructure when feasible, the environments where people live, work and play to optimize healthful choices. To reach our goal of reducing the number of people at risk for Type 2 Diabetes, it is important that these habits are established early in life. For example, families can plan more meals and snacks at home with more fruits and vegetables. They can take advantage of youth programming after school and over the summer months to ensure their kids stay active and develop positive social and emotional skills.
YOW is about working together at every level of a community – between friends, family, and co-workers, between organizations, and with leadership at the local and state levels – to maximize community health while at the same time, reducing the cost burden of chronic disease.
It is important to note that YOW partners provide many services for people who have Type 2 Diabetes, Prediabetes and other chronic health conditions, such as heart disease. This good work will continue and will likely only be enhanced through the continued partnerships and networking that emerge from the new YOW framework. We continue to convene partners around key health promotion topics where resources can be shared and used for maximum community benefit.
Tillamook County is a special place where elected officials, healthcare leaders, businesses and non-profit directors work together. YOW is even more special in that passionate community volunteers can serve on committees and help shape which actions will best help us reach our goal of preventing Type 2 Diabetes. If you are interested in learning more, contact our coordinator, Michelle Jenck, at (503)812-8354.
We strive to ensure that Tillamook County residents have evidence-based, relevant health and wellness information at their fingertips. Visit tillamookcountyhealthmatters.org or download the Tillamook County YOW App for the latest blogs and recipes. View our calendar and classes pages to learn how you can get connected to wellness events in our community. And follow us on Facebook for news and updates on partner events, classes and walking group details.
by Guest | Apr 6, 2018 | Being Well
Early Childhood Development is a big deal. Many health, behavior and learning concerns can be addressed during the earliest years of childhood, setting the stage for a healthier, happier and more successful adult life. Because we don’t know what we don’t know, pre-natal care and annual well-child visits are key. It’s important to seek out professional guidance to optimize maternal and child health through appropriate nutrition and developmental interaction. Knowing which milestones to watch for during those critical first five years of a child’s life and receiving early intervention to address delays can be life-changing to a child.
Annual well-child visits to primary care providers may seem like a waste of time and money if a child appears to be developing normally but they are an opportunity to ensure both the family and the child have the resources they need to be successful. Providers and parents can consult the on-line “Ages and Stages” tool to assess a child’s progress. Talking with your child’s healthcare provider about behavior can also provide important information about a child’s development.
Home visits for pregnant and new moms are also available through the Tillamook County Community Health Centers and CARE’s Healthy Families program and provide a great way for families to learn ways to optimize their child’s development. Another great way to catch early developmental needs is through screenings. Children ages 2-6 can be seen at the annual Early Childhood Screening Fair, scheduled this year from April 18-20 at the Tillamook County Fairgrounds. At this FREE event, children receive 12 screenings including: Physical, Nutrition, Hearing, Vision, Child Development, Behavior, Dental, Speech and Lead. Families must call for an appointment: 503-815-2292. Door to door transportation can be made available upon request. There are many great parenting resources available to help ensure kids are developing on track. A fun tool called VROOM, which can be found on-line or as an App, provides free downloadable daily activity tips for parents with children ages 0-5. Every day, research-based, age appropriate tips are sent to mobile phones encouraging ‘brain-building moments’ between parents and their children. Each tip is easy to do and is customized for each child based on their age. Caregiver-child interaction plays a very large role in a child’s development. Vroom helps busy families incorporate brain-boosting moments into everyday activities.
Local parenting classes are also available. The next class is a 7-week long Active Parenting Class which will meet in South County on Tuesdays from 5:00-7:30 p.m., April 3 – May 15. Join other parents in learning about child development and what behavior to expect from your child at their age. You can also plan to increase your techniques to redirect bad behavior and re-duce stress in the family. Cost is $30.00 per adult and includes light dinner and materials. To learn more or to register, 503-842-8201 Ext 276 or JillV@tfcc.org.
YMCA to host Healthy Kids Day April 21
Healthy Kids Day is a national YMCA initiative to not only maintain but improve childhood health and well-being during the summer months. For so many school-age children, physical and cognitive activity and access to healthy food choices cease when the school year ends. Research shows that kids are prone to gain more weight and fall behind in studies when they don’t get up, get out, and grow during the summertime.
This year we are excited to partner with NW Parenting and bring back BlockFest, a research-based parent-child exhibit that raises awareness of science, technology, engineering, and math (STEM) by learning through play. Two decades of research show that children build number and math skills from a very early age, and that those who are strong in early math skills excel in math in the later years.
By establishing year-round healthy habits, families who play and eat healthy together take preventative measures against chronic diseases, such as Type 2 Diabetes. To aid in this effort, Tillamook YMCA kicks off the summer by inviting local community partners to participate in Healthy Kids Day and promote programs and activities that encourage health and well-being in both children and families. Participants can expect to play games, engage in activities, and learn about the valuable health and wellness resources Tillamook County has to offer.
All attendees will receive a raffle ticket to be entered into a drawing for some great door prizes, including admission to the Oregon Zoo and Sky High Sports Trampoline Park! Healthy Kids Day is a FREE event open to the public and will take place Saturday April 21st 10:00 am-1:00 pm in the YMCA gymnasium located at 610 Stillwell Avenue in Tillamook. For more information call (503)842-9622.
by Guest | Mar 23, 2018 | Being Well, Eat Well
By Laura Swanson
“I’ve been doing some research,” said Dr. Mark Bowman, Medical Officer at Adventist Health Tillamook Regional Medical Center, “And I can send you the studies,” he added, as we continued our conversation about why the Year of Wellness focus on type 2 diabetes prevention is so important. “The statistics are interesting and according to the research, having diabetes is equal to having heart disease,” Bowman stated. “The risk to your health is equal to having previously had a heart attack; that’s the impact that diabetes has on the body.” That’s why it’s important to control diabetes as it lowers the risk for complications.
As Dr. Bowman continues his practice of Functional Medicine, which focuses on the individual and finding the underlying causes for symptoms, ongoing and leading edge research provides a basis, but research is done with a tightly controlled group. “It’s almost impossible to replicate the conditions of a research group in reality,” explains Bowman. It’s an incomplete puzzle with different individual responses. Other systems that are impacted by diabetes, in addition to the increased risk for coronary disease are macro-vascular, kidney disease, retina deterioration, neuropathy, and hypertension.
Diabetes symptoms can be controlled with medication, but lifestyle changes are the “key and safest” medicine for slowing, and even reversing diabetes. “You can have a patient on insulin therapy for decades, but in most cases, the pancreas eventually loses the ability to continue producing high levels of insulin. Insulin resistance occurs at the cellular level,” explained Dr. Bowman.” It signals the body to increase fat cells and more insulin is required …it’s a vicious circle.” He continued, “When you make some simple lifestyle changes such as healthier eating and activity, you can delay and even reserve insulin resistance. It’s not easy for some people, and an individual approach is necessary.” That’s why Dr. Bowman is focusing on Functional Medicine. “It’s not a one-size-fits-all kind of medicine,” he added.
“The research is constantly being done and the findings continue to change our treatment options,” said Dr. Bowman, as he prepared to head to New York City for the Integrative Healthcare Symposium. “We are hearing more references to dementia and Alzheimer’s as ‘type 3’ diabetes,” said Dr. Bowman. “The impacts are micro-vascular and there is a link between reducing inflammation and improving systems functions. You can delay the progression with anti-inflammatory foods.” There it is again – “Food as medicine.” It’s more than an apple-a- day, according to Dr. Bowman, “Eat and drink as ‘clean’ as possible, reduce exposure to internal and external chronic stress. Seventy-percent of serotonin (the neurotransmitter chemical that impacts mood and more) is produced by the bacteria in the gut.”
Then there are those pesky genes and again how each individual’s systems function. One study looked at ways of reducing the complications of diabetes, with findings that an A1C level under 7 reduced onset of other chronic problems. It involved intensive lifestyle therapy, not medication. “There is current dialogue about diet and diabetics,” said Bowman. “Lower carb, plant-based. It’s all about reducing sugar, and carbohydrates and grains that metabolize into sugar.” Dr. Bowman was most looking forward to a presentation by Dr. Mark Hyman (A leader in Functional Medicine), “Food: What the Heck Should I Eat?” – which is also the title of his newest book. Our next interview with Dr. Bowman will be about the NYC symposium.
“We can continue to increase awareness and educate about lifestyle changes,” said Dr. Bowman. “encourage people to make healthier choices, develop particular ways and habits that have positive impacts on their quality of life.” He continued, “We get a label as diabetics, and internalize, suffering shame because ‘we must have done something wrong.’ By talking about diabetes, and many chronic diseases such as hypertension, lipid, and hormonal imbalances we can let people know there are ways to turn it around. Don’t suffer in silence, or simply, Band-aid with a pill.” He continued, “It’s an individual life journey and there’s a time and place for all tools. Increased awareness and acceptance of the different lasting options will ultimately help patients enjoy a satisfying life.”
by Guest | Mar 16, 2018 | Being Well
Two-for-one sales are always popular. We get twice as much for the cost of one. What if we can get a three-for-one deal? Wouldn’t that be awesome? In healthcare, this is referred to as the “Triple Aim.” Developed by the Institute for Healthcare Improvement, this framework sets a goal of improving population health, as well as quality of individual care, while at the same time reducing healthcare costs.
It may sound too good to be true, but great strides are being made to accomplish the Triple Aim. This isn’t just a good idea. It is necessary, given escalating rates of preventable illness and healthcare costs. Because the factors that influence health extend beyond the healthcare system, other sectors must become part of the “Triple Aim” solution. Government, schools, businesses, faith-based and civic organizations are just some of the partners that can help.
The Centers for Disease Control and Prevention (CDC) has developed the Health Impact Pyramid, a resource that helps communities understand how to get the best return on investment when working to improve population health. Traditionally, most of the time and money invested in helping people get or stay healthy happened at the top of the pyramid in the form of counseling, education and clinical interventions. While these are important strategies, they require more individual effort and often do not fully address the underlying, root causes affecting individual health.
Research has shown that investments in factors that influence a person’s education, employment and housing status, known as socioeconomic factors, can achieve a much higher rate of return. For example, community investment in early childhood development and care impact a child’s success in school and this will likely lead to a better job down the road. Education and employment status are associated with better health in adulthood.
The second level of the pyramid relates to making default choices healthier where people live, work and play. If we live close to a store that sells fruits and vegetables, we tend to eat more of those foods than someone who must travel a long distance to purchase them. Similarly, conveniently located sidewalks, bike lanes and trails make being active easier. Research shows that people who live in walkable communities are more active and healthier.
Continuous, paved pathways provide safe, accessible opportunities for all citizens to become more physically active. Currently, there are few places like this in Tillamook County. Kilchis Point Reserve, near Bay City, is a popular trail. Another good example is Bud’s Fitness Trail at Tillamook Junior High School. These paths allow people of all abilities to enjoy being active outdoors and accommodate strollers, walkers and wheelchairs. These off-road paths, such as the planned Crosstown Connections rail spur between Goodspeed Park & Hoquarton Slough, allow families with small children to recreate safely, even allowing a young child to skate, ride a bicycle or scooter – all important activities for physical development and social connectivity.
These paths are free to the public and open year-round. The return on investment comes from the increased health and community livability these resources provide. Development of the proposed Salmonberry Rail Trail within our coastal communities stands to not only generate significant economic development but also positive community health benefits.
The U.S. Surgeon General’s “Step It Up!” initiative encourages communities to invest in creating more walkable spaces near population centers. YOW partners are teaming up to highlight existing walking locations throughout Tillamook County. Community-based walking groups kick off the first week in April. Full details can be found on tillamookliving.com and will be featured in this column next week.
