Year of Wellness Readies for Year #3 with Focus on Diabetes

Year of Wellness Readies for Year #3 with Focus on Diabetes

By Bill Baertlein, Tillamook County Commissioner
When the Tillamook County Board of Commissioners proclaimed 2016 as the “Year of Wellness,” we were putting a spotlight on community health and the role we all play in supporting the health and wellbeing of our fellow citizens. 
As you will read in the special 2017 Progress Section, dozens of volunteers representing healthcare, private business, non-profit, and social service agencies have all worked together to increase awareness of and access to the abundant health-promoting activities, classes, programs, and events already being offered right here in Tillamook County. In recent months, our Year of Wellness Task Force (YOW) has convened for a series of strategic planning workshops facilitated by Steven Blakesley, OHSU North Coast Community Research Liaison and Jessica Linnell, OSU Extension Family & Community Health faculty.  Through the strategic planning process, the task force identified the need to focus on one community health priority in order to make a significant, measurable impact, and chose to address diabetes.  After selecting the health priority, the workshops involved learning how to find evidence-based approaches, adapting programs for Tillamook County, ways of tracking and measuring the work to determine if it is making a difference, and creating a framework for action.
Diabetes is a chronic disease that occurs when the body cannot use insulin properly or cannot make enough of it.  Insulin is a hormone that is needed to help regulate blood sugar levels, and when diabetes is not well managed or controlled, it can lead to serious health consequences, even death.  There are two types of diabetes: type 1 is a genetic, auto-immune disease, and type 2 occurs when cells become insulin resistant and the pancreas loses the ability to produce enough insulin over time.  Type 2 diabetes makes up 90-95% of all cases and is widely considered to be preventable.  Approximately 287,000 adults in Oregon live with diabetes and 1.1 million more individuals may be prediabetic according to the 2015 Oregon Diabetes Report.  That’s more than one-third of our state’s population. The report also states that the estimated cost to treat diabetes is $2.2 billion each year. 
According to the most recent Oregon Health Authority data*, approximately 9% of the citizens of Tillamook County have been diagnosed with type 2 diabetes and many more of our residents go undiagnosed or are considered prediabetic. People who are most at risk for developing type 2 diabetes are typically older, although many children are now being diagnosed at increasing rates.  Other factors include obesity, genetics, physical inactivity, and childhood trauma.  Unhealthy eating patterns, smoking, drugs, and alcohol are also factors.
To reduce our risk for type 2 diabetes, we can’t do much about our age or genetics, but we can create community programs around lifestyle changes.  Our local Food Bank, OSU SNAP-Ed, Food Roots, the Rinehart Clinic, Northwest Senior & Disability Services, and Adventist Health are just some of the local partners offering nutrition education and cooking classes.  The YMCA, and the North Coast Recreational District (NCRD), along with a host of dance, yoga, and outdoor recreation partners are here to help folks get moving.  We also have local waterways, parks, trails, and walking paths that are free and open to everyone. 
All of our healthcare partners have Care Coordinators who are ready and willing to assist patients with the challenges they face in changing their lifestyle habits. The Tillamook Family Counseling Center is also on board providing mental and behavioral health support.
As you can see, we have all the right ingredients in our community to help people reduce their risk of developing diabetes and other chronic health conditions.  And we have many resources available to support those who need a little help managing their health and disease risk.
In the coming months, our Year of Wellness Task Force will be working to create innovative strategies to build on these existing resources to help reduce our community’s risk and rate for this serious disease. We hope you are as excited about this as we are and that you will join us in this effort to make Tillamook County a healthier and happier place for everyone to live, work, and play
*Oregon Health Authority report http://www.oregon.gov/oha/PH/DISEASESCONDITIONS/CHRONICDISEASE/DATAREPORTS/Pages/index.aspx

Tillamook County Properties, Buildings and Parks Smoke/Tobacco-Free Starting Jan. 1, 2018

Tillamook County Properties, Buildings and Parks Smoke/Tobacco-Free Starting Jan. 1, 2018

Ordinance 82 was approved by voters November 7th and bans the use of tobacco products on all County-owned properties, with one exemption and according to the definition of ‘Tillamook County property’ as defined in the Ordinance. The County property definition specifically does not include county roads. Section 5 of the Ordinance provides an exemption for smoking ‘in designated campsites in developed overnight camping areas unless temporarily suspended by the Parks Manager due to high fire hazard condition’.
Tillamook County joins over 64 cities and counties in Oregon to be smoke/tobacco free. There is no smoking at any Tillamook County property, which includes at boat ramps, day-use parks or in parking lots. Smoking in campgrounds is allowed per the referenced exemption above and on County roads per the referenced County property definition.

Thank you Tillamook voters for making our County healthier – now everyone can breathe easier in our Tillamook County parks and properties.

Strategies That Work: Quitting Smoking/Tobacco

Strategies That Work: Quitting Smoking/Tobacco

by DeAnna Pearl, Prevention Specialist, SOS Tillamook
 

Did you know . . .
On average, it takes 7 attempts to quit smoking for good? Planning with a friend or supportive family member can help.  The key is to pick a date and make a plan.  

On Nov. 16th, thousands of people quit tobacco use during the annual Great American Smoke Out.  Don’t smoke or chew?  Encourage someone you know to pick a date to quit or to kick off their plan to quit.  By quitting – even for 1 day – you will be one step closer to achieving better health.

As a former tobacco cessation specialist, many people successfully quit smoking or chewing “cold turkey.”  Others work with their doctor or mental health provider to identify the best way to help them quit. Regardless of outside support, understanding one’s personal values and reasons to quit are key to long-term success.  Here are some other strategies from kidshealth.org that have been shown to help people become tobacco-free.

Set a quit date. Pick a day that you’ll stop smoking or using tobacco. Put it on your calendar and tell friends and family (if they know) that you’ll quit on that day. Think of the day as a dividing line between the smoking you and the new, improved nonsmoker you’ll become.
Throw away your cigarettes and/or chew — all of it. People can’t stop using tobacco with cigarettes or chew cans around to tempt them. So get rid of everything, including ashtrays, lighters, and, yes, even that pack you stashed away for emergencies.
Wash all your clothes. Get rid of the smell of cigarettes as much as you can by washing all your clothes and having your coats or sweaters dry-cleaned. If you smoked in your car, clean that out, too.
Think about your triggers. You’re probably aware of the times when you tend to use tobacco, such as after meals, when you’re at your best friend’s house, while drinking coffee, or as you’re driving. Any situation where it feels automatic to have a cigarette/chew is a trigger. Once you’ve figured out your triggers, try these tips

  • Break the link. If you smoke when you drive, get a ride to school, walk, or take the bus for a few weeks so you can break the connection. If you normally smoke or chew after meals, do something else after you eat, like go for a walk or talk to a friend.
  • Change the place. If you and your friends usually eat takeout in the car so you can smoke, sit in the restaurant instead.
  • Substitute something else for tobacco. It can be hard to get used to not holding something or not having a cigarette in your mouth. If you have this problem, stock up on carrot sticks, sugar-free gum, mints, toothpicks, or lollipops.

 
 

Tobacco – the Good, the Bad, and the Profit Motive

Tobacco – the Good, the Bad, and the Profit Motive

By Clark Miller, LCSW
National indicators seem to show significant reductions in tobacco use (cigarette smoking) over past years. What does that mean? It’s not clear why smoking has decreased.  Could it be due to increased costs, prevention efforts, switching to e-cigarettes, attention in young people switched to texting and personal devices?

The trend looks like a good thing. If we leave it at that, however, we run the risk of not using this information to shape effective health policies.  A lot of time and money is invested in educating people about the health consequences of substance use, and the health of Americans rests on public education and sound policy. That’s important right now: against concerns of major public health groups like the Centers for Disease Control (CDC), the Food and Drug Administration (FDA) is betting on new harm reduction methods that would actually encourage development and marketing of e-cigarette use. That’s despite preliminary evidence that the rise of e-cigarettes may be drawing more young people to smoking.

Is there really a downward trend for problem tobacco/nicotine use? If we remember that nicotine is the addictive component in tobacco, and look at trends in the delivery of nicotine and its health effects, those apparent gains could be in question.
–          The use of e-cigarettes to deliver nicotine “safely” is booming, including for youth .
–          What are the health risks for e-cigarette use? We need more research but it is clear that it is not an entirely healthy alternative.

What is known about e-cigarettes and nicotine?
–          Nicotine, however delivered, increases risk of onset of type 2 diabetes, increases the risk of onset of serious complications of diabetes, like kidney disease and nerve damage, and of worsening of those complications.
–          Addictive behavior involving nicotine increases risk (AKA the gateway effect) of problem use of other substances (like alcohol and opioids).
–          Compulsive use of nicotine among youth predicts dependence into adulthood
So, it’s not so simple, and there’s more. The tobacco giant Phillip Morris is pushing hard for approval for a new delivery system that will put tobacco back into the e-cigarette. Tobacco will be heated in a way that provides nicotine and the taste of tobacco, but not, reportedly, the toxic chemicals released by combusting tobacco. This would be a new, potent way to get and keep Americans addicted to tobacco.

For individuals who want to stop use of tobacco and nicotine, what are the effective treatments? Nicotine replacement (like patches) as well as some medications can help quitters get through the physical cravings lasting through initial weeks of stopping. Most relapse occurs months to years after stopping, typically in reaction to a major stressful event, and treatment itself, for long-term success, uses talk therapies to target the beliefs, emotional needs, social risk factors, lack of coping skills, and psychological associations underlying risk of using again, as well as strength of motivation for change.

Most people quit without use of replacement or medication aids, sometimes with the help and support of friends and family, or internet resources. The primary factor predicting success is intrinsic motivation which comes from a combination of a growing awareness of personal values and reasons for stopping, and is supported by a type of individual counseling called Motivational Interviewing.

The most effective treatment is not treatment, but prevention, an important topic that highlights the strong, established correlations among: adverse childhood experiences (ACE) and how they affect neurodevelopment in children.  ACEs create increased vulnerability to anxiety and other forms of inner distress, which make self-regulation and impulse control difficult and which increases risk of substance use and other behavioral health problems. Prevention efforts are key to reducing the multitude of behavioral and physical health problems associated with ACE.

Living Tobacco Free

Living Tobacco Free

By J.R. Becraft, MPH and Michelle Jenck, M.Ed.

Want to find freedom from nicotine and tobacco products?  For many it’s a tough challenge.  The basics of behavior change are similar for most people.  It helps to begin by identifying where we are in the “Stages of Change” to determine what our next steps might be.

Pre-Contemplation:  Are we simply not ready to quit, “pre-contemplating” the choice? Are we unaware that we need to change behaviors to protect those around us and live a longer and higher quality life?

Contemplation: Are we beginning to recognize that we want or need to make a major change in our life? Are we contemplating the pros and cons of quitting? Are we exploring why we want to quit along with the barriers that make it hard to take action?

Preparation: Are we really ready to change? Are we mapping out the positive small steps toward the new desired behavior? Do we see ourselves being successful in making that change? Have we set a date? Have we identified resources within and outside of ourselves? Do we have a plan for dealing with setbacks including treating ourselves with the same compassion we would offer to a friend?

Action: Are we taking specific actions right now? Did we quit, even if only for a little while? Are we redesigning our routine and our environment to avoid using tobacco?  Have we begun to adopt new habits to help reduce stress and avoid triggers?

Maintenance: Once we have made changes, what are we doing to assure we stick to them? Can we succeed step by step—according to a simple, careful plan? Will we seek the resources within and without to succeed long-term?  Are we able to view setbacks as just that and get right back on track?

Success: Are we stable in our new behaviors? Have our new habits become automatic and have our old ones fallen away?
For resources and information:

  • Call 1 800 QUIT NOW
  • Insurance is required to cover tobacco cessation support. Your doctor or mental health provider and pharmacist all have tools and counsel to help.
  • Friends and family can provide vital encouragement.
  • Across Oregon and in Tillamook County with its Year of Wellness, communities are becoming places where the healthy choices are the easy choices. Tobacco-free zones will help you on the path to freedom.
September becomes “Self-tember”:  Make Me Time Priority

September becomes “Self-tember”: Make Me Time Priority

By DeAnna Pearl, MAT, BS, CPS, SOS Tillamook Prevention Program Specialist

For anyone who’s been looking for a good reason to treat yourself consider this: You probably don’t do it often enough, and putting “me time” on the back burner is a big part of why we can all feel run-down, frenzied, and overwhelmed. Self-care, to the rescue!

What is Self-Care?
Self-care is care provided “for you, by you.” It’s about identifying your own needs and taking steps to meet them. It is taking the time to do some of the activities that nurture you. Self-care is about taking proper care of yourself and treating yourself as kindly as you treat others.

First Care for Yourself
On an airplane, an oxygen mask drops in front of you. What do you do? As we all know, the first rule is to put on your own oxygen mask before you assist anyone else. Only when we first help ourselves can we effectively help others. Caring for yourself is one of the most important things you can do for yourself. It is also one of the easiest things to forget. But you benefit greatly from self-care and so do others in your life.

Since self-care is a very individual thing, there’s no set prescription for how or when to do it. That said, mental health professionals recommend taking at least 20 minutes a day to do something for ourselves, which seems pretty darn reasonable to us. Lost for ideas? Don’t fret. We’ve rounded up some sweet strategies that’ll help slash stress, boost happiness, and improve total health. Practice any of these self-care behaviors (or any others that occur to you!) daily, weekly, or even hourly—whatever feels best to you.

Why is Self-Care Important for Women?
Women spend much of their lives nurturing others. When we find ourselves focusing more on others than ourselves, we become worn out, stressed out and run down. For those of us who spend time helping and caring for others, it is too easy to neglect our own needs. It’s like “running on empty” when we don’t take the time to re-fuel. We spend so much time and effort caring for our partners, children, pets, friends, family members, employers and employees. Add to that the numerous volunteer activities, errands, housework, family functions, meetings, etc.—and there isn’t much time left for caring for ourselves.

Women need to balance the stress and activity of daily life with activities that bring a sense of peace and wellbeing to their minds and bodies. Women who neglect their own needs and forget to nurture themselves often become unhappy, have low self-esteem and feel resentment. Self-care means treating yourself as a worthwhile person and showing that you are valuable, competent and deserving.

Self-Care Strategies
We cannot take care of others, if we aren’t taking care of ourselves – include self-care into your daily routines with these helpful ideas:

  • Take one thing at a time. •Solve little problems. •Be realistic. •Be flexible. •Adopt a positive attitude. •Avoid over-scheduling. •Learn to relax. • Treat your body well. •Adopt a healthy lifestyle. •Eat healthy food. •Exercise. •See your doctors regularly. •Get enough sleep as often as you can. • Take time off when you are sick. •Watch what you are thinking. • Share your feelings. •Talk about stress with friends and family. •Talk to a doctor, spiritual advisor, or other professional for help. •Learn to ask for help. • Be aware of your limitations. •Personalize your work and home environment.
  • Take time for self-reflection. • Say “no.” •Limit your exposure to media (e.g., news stories, movies) that deals with sad, violent, or tragic themes.