Healthy Communities- December 27, 2013

Serve on the Traditional Health Worker Commission
The Oregon Health Authority’s Traditional Health Worker (THW) Commission will promote the role, engagement and utilization of the traditional health workforce, which includes Community Health Workers, Peer Support and Peer Wellness Specialists, Personal Health Navigators, and Doulas, in Oregon’s Integrated and Coordinated Health Care Delivery System. The Commission will advise and make recommendations to the Oregon Health Authority on the development, implementation, and sustainability of this program and ensure the program remains responsive to consumer and community health needs. The Commission will support and foster the utilization of the traditional health workforce as a strategy to assure the delivery of high-quality, culturally competent care and to achieve Oregon’s Triple Aim of better health, better care and lower costs. 

THW Commission Applications
Nineteen members will be appointed by the OHA Director to serve on the Traditional Health Worker Commission. Ten of these members must be Traditional Health Workers, at least six of whom must be appointed from nominees provided by the Oregon Community Health Workers Association. The other nine members must come from various medical and professional associations. Though the number of seats in the Commission will be limited, we will work to ensure that those who are not appointed to the Commission will have opportunities to provide input.

If you would like to be considered for an appointment on the Commission, please complete and submit this application no later than Friday, January 13, 2014. Priority consideration to the THW Commission and Subcommittees will be given to applications received by January 3, 2014.

if you have  questions, concerns, or to submit your application, please contact April R. Johnson:
Oregon Health Authority
Office of Equity and Inclusion
421 SW Oak Street, Suite 750
Portland, OR 97204

Reports and Articles
osu salt test

Consumers like bread with less salt, says OSU taste test
December 11, 2013
Consumers can’t tell the difference between regular bread and bread with 10 percent less salt, according to taste tests by Oregon State University.

Researchers at OSU’s Food Innovation Center in Portland asked nearly 200 people to sample slices of whole wheat sandwich bread made with normal salt levels as well as ones with 10 percent, 20 percent and 30 percent less salt.

People tasted a difference in the 20 percent and 30 percent reductions but they still liked the appearance, texture, smell and taste the same as the normal bread, which was made with 14 grams of salt per slice. They also said they would be willing to buy a loaf of any of the four samples.

Agencies agree to provide cultural training
(Madras Pioneer © 12/12/2013)
Representatives from law enforcement, the court system, local government and area agencies gathered Dec. 6, to sign a resolution agreeing to require ethics and cultural competency training for all staff members. A letter for Gov. John Kitzhaber?s office commended Jefferson County and local agencies on the step, and called it a “shining example” for the rest of the state.

We Don’t Know Nearly As Much About the Link Between Public Health and Urban Planning As We Think We Do
The Atlantic Cities
There’s growing concern that the communities we’ve built – full of highways, where few people walk, where whole neighborhoods lack food access – may be pushing us towards obesity, heart disease, and asthma. By this thinking, good architecture and urban planning can encourage us to walk more, it can mitigate pollution and more.

CDC’s Communities Putting Prevention to Work papers
The Centers for Disease Control and Prevention’s (CDC) Preventing Chronic Disease series “is dedicated to reporting practical scientific research, programs, and policy efforts to improve the health of communities.”  Now available is a collection of Communities Putting Prevention to Work (CPPW) papers featuring programs from Pitt County, NC; New York, NY; Nashville, TN; King County, WA; Cook County, IL; Philadelphia, PA; San Diego, CA.

An Apple a Day Keeps the Doctor Away
Prescribing an apple a day to all adults aged 50 and over would prevent or delay around 8,500 vascular deaths such as heart attacks and strokes every year in the UK — similar to giving statins to everyone over 50 years who is not already taking them — according to a study in the Christmas edition of The BMJ.

Released a Scientific Statement on December 5, “Factors Influencing the Decline in Stroke Mortality”. Here’s the web link to the abstract copied below and a link to the Statement. They also released accompanying documents–a one-pager “Top Ten Things to Know” and a slide presentation.

Minorities’ Health Would Benefit Most from Beverage Sugar Tax, Researchers Report
ScienceDaily: December 16, 2013
Taxing sugar-sweetened beverages is likely to decrease consumption, resulting in lower rates of diabetes and heart disease, and these health benefits are expected to be greatest for the low-income, Hispanic and African-American Californians who are at highest risk of diabetes, according to a new analysis led by researchers at UC San Francisco

Will Value-Based Purchasing Increase Disparities in Care?
NEJM: December 26, 2013
(This is a fascinating article about how the way metrics are used to incentivize health care influences results)
Financial incentives for improving quality and efficiency have gone mainstream in U.S. health care. After years of small-scale pilot projects, demonstrations, and experiments, the Affordable Care Act mandated that Medicare payment to hospitals and physicians must depend, in part, on metrics of quality and efficiency. The first program to do so is Hospital Value-Based Purchasing (HVBP), which began affecting Medicare payments to acute care hospitals in October 2012.

In the first year of HVBP, hospitals received incentives for performance on clinical-process and patient-experience measures. In subsequent years, hospitals will also receive incentives for performance on outcome-based measures, such as 30-day mortality. All hospitals begin with a reduction in their base operating payment, known as a “withhold.” The sum of these withholds from all participating hospitals becomes the pool for the incentive payments that are distributed in a given year. On the basis of its performance on quality measures, a hospital receives a payment that is more than, less than, or the same as its withhold.

Sodium Reduction in Communities Program Highlighted:
The Journal of Public Health Management and Practice  has released a special supplement highlighting the methods, progress, and lessons learned during the first two years of the Sodium Reduction in Communities Program (SRCP).

In 2010, the Centers for Disease Control and Prevention (CDC) launched the SRCP to increase the availability and accessibility of lower sodium foods for consumers.  Through this 3-year program, communities worked to develop effective strategies for lowering sodium in the ingredients and products served in schools, work sites, grocery stores, restaurants, and congregant meal programs for older adults.

Some of the success stories include:

  • In Schenectady County (New York) a group of restaurants lowered sodium content of its menu items by reducing portion size, using lower sodium products, and reducing the amount of sodium added to food during cooking. Analysis of menus shows these changes may have impacted 25% of menu items.
  •  In the Los Angeles County School District, strategic menu planning with an emphasis on choosing lower sodium foods and ingredients resulted in lower sodium content in school meals.

For more information about the importance of reducing sodium in preventing heart disease and stroke, visit

Trends in the Prevalence of Excess Dietary Sodium Intake — United States, 2003–2010
MMWR: December 20, 2013
Excess sodium intake can lead to hypertension, the primary risk factor for cardiovascular disease, which is the leading cause of U.S. deaths (1). Monitoring the prevalence of excess sodium intake is essential to provide the evidence for public health interventions and to track reductions in sodium intake, yet few reports exist. Reducing population sodium intake is a national priority, and monitoring the amount of sodium consumed adjusted for energy intake (sodium density or sodium in milligrams divided by calories) has been recommended because a higher sodium intake is generally accompanied by a higher calorie intake from food (2). To describe the most recent estimates and trends in excess sodium intake, CDC analyzed 2003–2010 data from the National Health and Nutrition Examination Survey (NHANES) of 34,916 participants aged ≥1 year. During 2007–2010, the prevalence of excess sodium intake, defined as intake above the Institute of Medicine tolerable upper intake levels (1,500 mg/day at ages 1–3 years; 1,900 mg at 4–8 years; 2,200 mg at 9–13 years; and 2,300 mg at ≥14 years) (3), ranged by age group from 79.1% to 95.4%. Small declines in the prevalence of excess sodium intake occurred during 2003–2010 in children aged 1–13 years, but not in adolescents or adults. Mean sodium intake declined slightly among persons aged ≥1 year, whereas sodium density did not. Despite slight declines in some groups, the majority of the U.S. population aged ≥1 year consumes excess sodium.

Hypertension Guidelines Can Be Eased, Panel Says
The New York Times
New guidelines suggest that people over 60 can have a higher blood pressure than previously recommended before starting treatment to lower it. The advice, criticized by some physicians, changes treatment goals that have been in place for more than 30 years.



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