Board of Health

Skokie Board of Health May 12th, 2016 Present Absent Excused Mr. Abbasi Dr. Prince Dr. Gaynes Dr. Drachler Trustee Bromberg Dr. Sood Ms. Urbanus Ms. Nickisch Duggan Dr. Dave Dr. Topouzian Dr. Usman Ms. Jones Thorne Dr. Varma Dr. Werner Mr. Nidetz Dr. Vernon Mr. Pandya Dr. Williams Dr. Polin Guest, Sara Waller, UIC Dr. Catherine Counard, Director of Health Mr. David Clough, Staff Call to Order - The meeting was called to order at 7:35 p.m. by Dr. Williams, Acting Chairman. Approval of Minutes – Minutes from the April meeting were reviewed and approved. Community Health Survey Results, Sara Waller – Copy of presentation attached A. Demographics: Health Department Intern and UIC student, Sara Waller presented on data from the Community Health Survey. The Health Department collected 1,910 completed surveys, ninety of which were in foreign languages. Respondents were more likely to be female but age was fairly representative of Skokie’s population. Thirty-two percent of respondents were foreign-born with the top five countries of origin being: the Philippines, India, Iraq, Pakistan, and Syria, consistent with Skokie census data. Their time in the U.S. ranged from four months to ninety years. The racial and ethnic breakdowns of respondents were close to the census data with the exception of a smaller percentage of Asians and a higher percentage of Assyrians. Twenty-five percent of respondents spoke a language other than English at home. The top five languages were Assyrian, Urdu, Spanish, Tagalog, and Russian. The income distribution was a perfect bell curve which Ms. Waller attributes to special efforts to go to places like the food pantry and a variety of local employers to get respondents from all economic strata. Almost all demographic measures were closer to representing Skokie census data than they were in the last survey five years ago. B. The top health concerns for Skokie were calculated by assigning a numerical value for each level of concern and then averaging the values for all responses. Top concerns were support for aging, obesity, physical fitness, healthy foods, and substance abuse. US-born respondents were more likely to be concerned about mental health and substance abuse whereas foreign- born respondents were more likely to rate healthy foods and dental care as a concern. Differences across age groups revealed three interesting patterns. First, support for aging  was a high concern for all age groups even those between eighteen and twenty-four years of age. A possible explanation for this is multigenerational households in which younger residents are watching struggles their elderly relatives are facing. Second, mental health was a top concern for the 45 to 64 year old age range. Third, dental care was only a top concern for respondents over the age of sixty-five. Dr. Williams pointed out that Medicare does not contain a dental component thereby leaving many seniors with good health insurance and no dental insurance. He also suggested that the mental health concern among middle-aged adults might be older parents of special needs adult children. The top issues found in the open ended question about health concerns in Skokie were access to health care services, diet and exercise, support for aging, substance abuse, and health disparities. Seven hundred and fifty four people wrote in answers. Dental and vision care were the two services that respondents had the most difficulty accessing. The only difference between answers given by US-born and foreign-born individuals was a higher concern for mental health in US-born and a higher concern for medical care for seniors in foreign- born respondents. Foreign-born respondents were also more likely to report a poorer quality of health than US-born respondents. C. Insurance rates in Skokie show a significant disparity with only one percent (1%) of US-born respondents being uninsured compared to thirteen percent (13%) of foreign-born respondents. Ms. Waller stated that we have to look deeper to see if this is due to the foreign-born respondents not having been in the country long enough to have insurance. Dr. Polin asked if we had data on whether or not the respondents were citizens because non- citizens do not qualify for Medicare or Medicaid. Ms. Waller reported that after some discussion we did not include a citizenship question on the survey because it would be too sensitive. Mr. Clough pointed out that even though the uninsured rate among foreign-born respondents was high it was half of what it was in 2009. Dr. Williams attributed this to the work of navigators working at Federally Qualified Health Centers (FQHCs) like Erie and Asian Human Services. D. Miscellaneous: 1. FQHC aware: Only a quarter (25%) of all respondents were aware of the two FQHCs in Skokie; the majority of those who were aware were poorer and more likely to be foreign- born. 2. Having sufficient money for basic necessities: Twelve percent (12%) of respondents said they don’t have enough money and these respondents were twice as likely to be foreign- born. 3. Tobacco use: Twelve percent (12%) reported that they or someone in their household smoked and thirty-seven percent (37%) of those were aware of the Health Department’s Courage to Quit classes. Only nine percent (9%) reported using other tobacco products and the top five alternative tobacco products were hookah, cigars, e-cigarettes, pipes, and #497127  chewing tobacco. Mr. Nidetz pointed out that the Wall Street Journal had an article on e- cigarettes stating that they were leading to more tobacco initiation than actual cessation. 4. Fresh fruits/vegetables: The majority of respondents regularly purchased fresh fruits and vegetables. Those who did not either reported that fresh fruits and vegetables were too expensive or that they spoiled too quickly. 5. Regular Exercise: Sixty-five (65%) percent of respondents reported getting regular exercise. Ms. Waller noted that this was lower than the rate of exercise indicated in the citizen survey. Mr. Clough explained that our survey specified three periods of brisk exercise for twenty minutes or more per week and this could have led to lower response rate. The most common reason for not exercising was not having enough time. Dr. Dave asked if we would be doing focus groups to get insight into the responses to some of those questions. Dr. Counard reported that we did plan to and were currently doing key informant interviews with members of some of Skokie’s largest immigrant groups. Mr. Clough reported that, for example, we had plans to interview the head nurse from the Assyrian Pharmacy and hope to organize a focus group to be conducted there in Assyrian. Dr. Williams and the Board of Health thanked Ms. Waller for all of her hard work on the survey. Dr. Counard thanked her for the extra amount of effort that went into obtaining results in other languages. Chair’s Report Dr. Williams reported that the American Dental Association asked him to put together a webinar on tobacco products and regulations that offers Continuing Education credits. The FDA has issued new guidance and will now be regulating e-cigarettes, cigars, and other alternative tobacco products. Dr. Williams reported on additional efforts to coordinate care for underserved communities by FQHC’s. One effort includes using cloud computing to upload HIPPA approved patient population data so electronic systems are aligned. This is being used to notify FQHC’s if their clients are going to the Emergency Room (ER). This system is being used to address the issue of high risk, uninsured individuals who use the ER as primary care. In one Chicago FQHC, care managers are going to the ER once notified to redirect clients back to the FQHC so they don’t seek more expensive care in the hospital. Unnecessary ER visits create a great cost for tax payers and patients because the tests and treatment available at the hospital are much more expensive. Dr. Williams gave the example that if someone goes to the ER for a dental emergency they will receive an MRI instead of a regular dental x-ray. In Dupage County, emergency dental patients are now being redirected to Midwestern University instead of going to the ER. Dr. Sood shared articles regarding the FDA regulations of e-cigarettes and California raising the minimum age to purchase tobacco to 21. Dr. Williams pointed out that an exception for active duty military was made for the California law. Dr. Counard reported that Dr. Drachler has been re-appointed as Chairman of the Board of Health for two more years. The Board applauded this decision. #497127 Health Director’s Monthly Report – a copy of the report is attached Public Health “Beating Diabetes” Event – Stickney Township The Skokie, Evanston, Oak Park, Stickney Township and Cook County Health Departments held a joint “Beating Diabetes” event during national public health week. Rose Pest Control Begins Assisting with Rodent Abatement The Health Department hired Rose Pest Control Company to assist with rodent abatement activities during the peak months of April – November. Evanston similarly contracts with Rose for this purpose. Having the additional help will allow Health staff to increase surveillance and control measures to prevent rodent infestations. Food Safety Student Project Mr. Alan Hatia, Master of Public Health student from the UIC School of Public Health, completed his evaluation of the Skokie Food Safety program. For his project Mr. Hatia analyzed 364 routine inspection reports from institutional and industrial cafeterias, schools, carry-out and catering, restaurants, and retail stores with deli and/or meat cutting departments. He identified three areas for the Health Department Sanitarians to target: (1) food handling practices, to prevent cross contamination and ensure food is maintained at the proper temperature; (2) clean equipment and utensils, requiring strict cleaning and sanitizing procedures; and (3) management of physical facilities: ensuring the safe storage and use of toxic or poisonous materials and that management is certified in food safety. High Density Alley Pilot for Rodent Control The Health Department is piloting a program of placing traps for several weeks at a time along alleys with persistent rodent sightings. The traps will be set and checked daily during the week. We are initiating this approach because is not always possible to locate the rodent burrows for treatment in an area. Trustee Bromberg reported on some of the changes in nurse license management at the state level. They have been working with students to analyze nursing school data to assess whether the state will have enough nurses to address the aging population in Illinois. They have also moved from sending post cards for license renewal to sending e-mails. There are 188,000 licensed nurses in Illinois and they have e- mails for all but 600 of them. Trustee Bromberg referred all licensed medical professionals in Illinois to Idfpr.com to renew their licenses. New Items : There will be a photo taken at the June 8 Board of Health meeting. Members are encouraged to notify Dr. Counard if August 18th will work for the Board of Health dinner. Meeting adjourned 8:44PM. #497127