Board of Health

Skokie Board of Health April 14th, 2016 Present Excused Absent Mr. Abbasi Ms. Urbanus Dr. Dave Ms. Nickisch Duggan Dr. Drachler Dr. Usman Dr. Sood Mr. Pandya Dr. Gaynes Ms. Varma Dr. Williams Dr. Polin Mr. Nidetz Dr. Vernon Dr. Prince Ms. Jones Thorne Dr. Werner Dr. Topouzian Dr. Catherine A. Counard, Director of Health Bruce A. Jones, Staff Dr. Krungras Shim Dr. Edward McCarren – Family Services Commission 1. Call to Order: The meeting was called to order at 7:31 p.m. by Dr. Drachler, Chairman. 2. Approval of Minutes: The minutes of the previous meeting were approved. 3. Presentation: Jeff Estrella, MD, MPH (c), Northwestern University MPH Student - Skokie Filipino Community Health Needs Assessment. Please refer to the accompanying presentation for all of the details. WHY STUDY THIS? Filipinos in Skokie 2014 Census estimates: 4,668 Filipinos which is 7.2% of total population Most common foreign ethnicity in Skokie 2012 Skokie Survey: “Do you and your family have enough money to pay for food, medicine, clothing and housing?” “Yes” = 86% “No” = 11% 61% of those answering “No” were FOREIGN BORN FACTORS THAT INFLUENCE THE FILIPINO IMMIGRANT EXPERIENCE Why do Filipinos come to the U.S.? Employment, Reuniting family, Time of immigration, The time and reasoning behind immigration are significant factors that shape the immigrant experience. Generational Gaps Differences between immigrants and first-generation “Filipino-Americans” & “Colonial mentality” Throughout history, many countries have occupied the Philippines and influenced the culture, but never at the cost of sacrificing core Filipino values (pride, community). INTERVIEW RESULTS Utilization of medical services, mental health, and diet were common issues brought up by the informants. After reviewing the interviews, we realized that cultural tendencies and values were at the root of these issues. #494942 UTILIZATION OF MEDICAL CARE Barriers: Awareness of available services Language/Communication and Cultural disconnect “What aspects of Filipino culture influence whether or not they seek health care?” “Barrio” mentality. Word-of-mouth referrals and Reluctance to seek help from outsiders. “Filipinos won’t see a doctor until they’re about to drop dead… part of it is because they’re scared of being diagnosed with something.” MENTAL HEALTH Filipinos secretly struggle with mental health. Depression Most common stressor = Isolation “Does Filipino culture influence their perceptions of mental health?” Religion, Fatalism, Indigenous traits, “Hiya” “There’s a huge stigma surrounding Filipinos’ views on mental health… they don’t acknowledge it and so they never seek help for it.” DIET AND OBESITY Diabetes - Asian Americans rank fourth highest in rates of diagnosed diabetes. Mortality - Diseases of the heart “How do traditions and culture influence the Filipino diet?” Customs & Types of food “No one really eats salads [in the Philippines] so if a doctor recommends adding it to our diet, we probably won’t do it.” WHAT CAN BE DONE? SHD must work to further understand and adjust the health-seeking behaviors of its Filipino population by: 1) Improving awareness of available services in Skokie. 2) Improving cultural competency of healthcare practitioners in Skokie. Possible first steps: 1) Advertise AHS and EFHC in church bulletins or Filipino restaurants in Skokie. 2) Providers – simply asking your Filipino patients about their family and friends (“Is your family living with you?”, “Do you have close friends here?”) can be a subtle way of screening for mental health risk and will also help build rapport and trust. 3) Make a computer screen saver containing a few common Tagalog greetings, terms, or foods and have healthcare clinics use it on their computers. Discussion during the presentation: Ms. Urbanus asked how many Filipino’s came to the flu clinic. Dr. Counard explained we do ask that question, but we are revising our intake form to capture additional information. Dr. Drachler had several thoughts. Does anyone go back to the Philippines or do they go back just to visit. How does their travel pattern affect language? Dr. Estrella said most are fluent in English and learn it before they learn Tagalog and once they come here they generally stay but some will travel back and forth. He also mentioned that they tend to move into an existing Filipino community “Barrio” #494942 Dr. Werner asked if any local Filipino’s organizations are addressing obesity or mental health issues. Dr. Estrella explained that the Alliance of Filipinos for Immigrant Rights and Empowerment (AFIRE) is trying to work on these issues. Dr. Estrella mentioned that there is more access to one of their most popular traditional foods “Lechon”. They considered it to be the star on the table during birthdays or any grand event for Filipino families. Mr. Abbasi mentioned another common Filipino food item Balut. Dr. Estrella explained a Balut is a developing bird embryo that is boiled and eaten from the shell. Ms. Jones Thorne asked if he found any other studies or information on other cultures that have the same health issues. Dr. Estrella mentioned that these issues found with Filipino community are not necessarily unique and could also be found in other ethnic groups and would need to be studied further. Dr. Counard added the Director of AFIRE said 70% of the Filipino immigrants are foreign borne which continues to increase and this also correlates to the 75% seen in our community health survey results. Dr. McCarren suggested having events where you provide medical care or possibly in churches and then could be establishing a relationship. Dr. Counard and Dr. Estrella added you would think this would work but it is very difficult to gain trust initially within the community. Dr. Shim asked about how strong Religion is or influences the Filipino community, since she knows it is very important in the Korean Community, and getting the churches involved might help. Dr. Estrella stated he did not know the exact number but would estimate 90% are Catholic, but again it was difficult to engage these different groups. At this time Dr. Counard introduced Dr. Shim to the Board as a potential new member. Dr. Shim asked if what the rate of smoking is in the Filipino community. Dr. Estrella said he did not know the rate but would not be surprised if it was a hirer rate than other cultures. Dr. Drachler questioned how Filipino’s rise in the hierarchy within the church community. Dr. Estrella explained it is not necessarily a goal but more a sense of another community as they do value religion. He also mentioned that they tend to accept a referral from other church member’s regardless of ethnicity since they are considered part of their community. Mr. Abbasi mentioned the Filipino community is having an annual picnic event at the Skokie Park District and maybe we could reach out to them there. Mr. Abbasi said he will get the date and location to Dr. Counard. Dr. Drachler mentioned it will be interesting to see how the other ethnic communities compare to the Filipino community and how they fit into the Skokie community landscape and there will be much more to come in the future on these topics. 4. Update on the abolishment of the State Board of Health: Dr. Counard thanked everyone who filed slip after slip after slip to help defeat a bill, SB2416, to abolish the State Board of Health. The bill proponent contended that advisory boards are unnecessary layers of bureaucracy. Skokie Board of Health members were very helpful to this effort: they recruited professional organizations to oppose the bill. Dr. Drachler asked what if any hidden agenda there was for this bill. Dr. Counard thought it was geared towards eliminating government oversight and fewer regulations. Dr. Counard mentioned that they met with the Senators about the issue and she did not have to give her testimony as the bill was not called for a vote. #494942 Dr. Vernon asked how the bill currently stands. Dr. Counard explained an amendment came out which basically included the following changes: - Time allowed for reviewing rules decreased from 90 days to 30 days. - Per Diem was eliminated for the Board members. - Language eliminated that stated the Director needed to provide the Board a written response with reasons if there is a disagreement on an issue. Dr. Counard explained that the bill has come out of committee and will need to go through both houses but it is an agreed upon bill at this time. NIPHIC and others will be monitoring it carefully. 5. Chair’s Report: Dr. Drachler reminded the Board that they need to schedule their annual summer dinner meeting date and to select a location. Mr. Nidetz suggested they go to a Filipino restaurant. Ms. Urbanus mentioned there is a caterer on Main Street that makes the Filipino roast pig. Dr. Drachler suggested August 18th as the best possible date or August 11th. A notice will be sent out regarding the event. Dr. Drachler mentioned a notice from the Mayor about volunteering as a Home delivered meals driver and the Skokie Big Brother & Big Sisters Program and to contact the Human Services Division if interested in volunteering. Dr. Drachler and Dr. Counard will be attending the May 2nd budget hearing for the upcoming Board of Health FY17 budget. Dr. Drachler explained that there are openings for one or two new Board members. Dr. Drachler is still trying to recruit a Lawyer with an interest in Health law for the Board. Dr. Drachler commented that at the Boards & Commission dinner both Ms. Nickisch Duggan and Dr.Williams were both honored for their 5 years of service. 6. Director’s Report: March Monthly Report highlights – a copy is attached: Community Health Survey Closes! The community health survey closed with 1,910 surveys received! There were 90 surveys submitted in languages other than English the majority (60) were in Arabic. A full evaluation of the survey results will be completed by May District 219 School–based Clinics Meeting Nurse Susan Reisberg and Dr. Counard attended a meeting between District 219 staff and representatives of the Heartland Health Centers that operate the school-based clinics at Niles North and Niles West. Dr. Counard emphasized the importance of the clinics as part of the community effort to ensure access to healthcare for all students. A number of process issues were discussed, and potential solutions considered. Influenza Seven Skokie residents, ranging in age from 37 to 94 years, were hospitalized with influenza during March. Two lived in a nursing home. None were vaccinated. Five of the seven died. #494942 Chickenpox death A man undergoing treatment for leukemia died from disseminated chickenpox (varicella zoster virus). He contracted the infection from his father-in-law who had shingles, which is caused by the same virus. The Health Department offers the shingles vaccine at cost ($180) for Skokie residents. Dr. Drachler asked about the anti-smoking poster contest. Dr. Counard mentioned that the anti-smoking poster contest student winners will be announced at the May 2nd Board of Trustees meeting as well as the presentation of the “Public Health Partners of Excellence Awards. This year there is one award recipient: the University of Illinois at Chicago School of Public Health. 7. Old Business Dr. Drachler commented that he had driven by the Manufactured Gas Plant (MGP) site on Oakton Street and not much is being done. Ms. Urbanus thought there were some funding issues. Mr. Jones commented that they may not have received their No Further Remediation (NFR) letter from the Illinois Environmental Protection Agency (IEPA) which could be holding up the renovation of the site. Dr. McCarren spoke about a document he prepared on the Smoking 21 issue which will be going to Mayor as well as the Governor and other state officials. Dr. Drachler welcomed the support from his commission on the topic. 8. New Business None. Adjournment The meeting adjourned at 8:49 p.m. #494942