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JUNE 20 | 2013 | DEFENDER

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Defender Special Edition

Obesity problem

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By TIFFANY L. WILLIAMS Defender

besity is one of the most serious health problems impacting African-Americans today. Risks related to obesity range from sleep apnea to infertility to depression. Obese people can drive up health insurance costs and face job discrimination from employers who view them as undisciplined and

lazy. Facts and figures tell the story: • The Centers for Disease Control (CDC) cites poor nutrition coupled with a lack of physical activity as the leading cause of preventable death, coming in second to tobacco use. • The Office of Minority Health reports that four out of five African-American women are overweight or obese. • According to 2010 data, 71.7 percent of African American residents in the Houston-Baytown-Sugarland MSA areas were overweight or obese, compared to 77.8 percent of Hispanics and 62.5 percent of whites. Proper nutrition and physical health are fundamental parts of life that if not properly maintained can have fatal health consequences, as well as detrimental effects on other areas of life, including education,

finances and mental health. “Obesity is associated with multiple poor health outcomes such as diabetes, cardiovascular disease and cancer,” said Lorna McNeill, associate professor at the University of Texas MD Anderson Cancer Center. McNeill said diet and exercise are essentially “energy in and energy out” of the body. “If you’re not physically active as a young person or young adult, as you get older and you gain weight, you’re not engaging in physical activity at rates to compensate for your energy intake,” she said. Other health concerns related to obesity include hypertension, coronary heart disease, stroke, gallbladder disease, osteoarthritis and respiratory problems. Poor health can also reduce worker performance, resulting in more missed days from work and leading to higher medical costs. A CDC report titled “Vital Signs: State-Specific Obesity Prevalence Among Adults,” found that people who are obese incurred $1,429 per person extra in medical costs compared to people of normal weight. The report also summed up the consequences of being overweight: “Obesity is a costly condition that can reduce quality of life and increases the risk for many serious chronic diseases and premature death.”

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Inside AIDS Foundation Houston 3B Memorial Hermann Health System 4B Obesity causes & solutions 6B Kids battle obesity too 7B Texas Children’s Hospital 8B MD Anderson Cancer Center 10B

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Message from the Publisher

frican-Americans are in health seriously. According to the midst of a health crisis the U.S. Department of Health that threatens our welland Human Services Office of being and our future, and that’s Minority Health: the bad news. • Death rates for all major However, the good news is causes of death are higher for we can all do something about it, African-Americans than for starting right now. whites, contributing in part to a As Houston’s Leading Black lower life expectancy for both Information Source, the Defender African-American men and is committed to providing you, the women. reader, with information that will • In 2009, the average improve the quality of your life. American could expect to live Reading this special health 78.5 years, but the average edition is a step in the right direc- Sonceria Messiah-Jiles African- American could only tion. We begin with our cover expect to live 74.5 years. story on obesity, which sheds light on the problem, • African-Americans have the highest mortalithe causes and the solutions. ty rate of any racial and ethnic group for all cancers We also feature an article on what one local combined. organization is doing to combat AIDS/HIV and • African Americans are twice as likely to be how you can do your part by getting tested. diagnosed with diabetes as whites. In addition, In addition, our health partners are spotlightthey are more likely to suffer complications from ing their efforts to improve the well-being of our diabetes, such as end-stage renal disease and lower community. They are MD Anderson Cancer Center, extremity amputations. Memorial Hermann Health System and Texas • Although African-American adults are 40 Children’s Hospital. percent more likely to have high blood pressure, Facts and figures show that we must take our they are 10 percent less likely than their white

counterparts to have their blood pressure under control. • African-American males have almost 7.6 times the AIDS rate as white males. African-American females have 20 times the AIDS rate as white females. • African-Americans have 2.3 times the infant mortality rate as whites. They are three times as likely to die as infants due to complications related to low birth weight as compared to white infants. We should all make a commitment to take better care of ourselves and our children. Eat more fruits and vegetables. Drink more water. Lay off the junk food and unhealthy fast food. Start exercising. Get enough sleep. Don’t smoke or abuse drugs or alcohol. Take your meds. Get regular check-ups. Follow your doctor’s orders. Feed your kids healthy, balanced meals. For those who argue that it costs more to eat healthy, consider this: An apple and a tuna sandwich are no more expensive than a greasy box of fried chicken. A bag of salad and a rotisserie chicken costs less than hamburgers and French fries for four. So make some health changes that will contribute to a better life for you and your family. Live well and enjoy life!

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AIDS Foundation Houston reaches out By MARILYN MARSHALL Defender

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IDS Foundation Houston has a long history of striving to prevent new HIV infections and empower those affected by the disease. Founded in 1982, AFH was the first AIDS service organization established in Texas. It serves area residents in 10 counties, and most of those residents are minorities – 61 percent of the agency’s clients are AfricanAmerican and 21 percent are Hispanic. Ninety-nine percent of AFH clients have incomes below $20,000 and 68 percent are HIVpositive. The agency finds that the dual effects of HIV and poverty cause many HIV-positive persons to fall into the cycle of homelessness. AFH offers permanent and transitional housing programs for individuals and families impacted by HIV. Supportive service planning addresses such areas as basic needs, family issues, financial stability and mental health and substance treatment. The agency also provides HIV-positive children and youth with various programs to help them lead productive lives and cope with the effects of illness and stigma. Here, AFH Director of Prevention Nike Blue discusses HIV and how the agency reaches out to area residents. Defender: How is AFH preparing for National HIV Testing Day on June 27th? Blue: We are gearing up to start our seventh year of testing thousands of young adults through the medium of hip hop music. Hip Hop for HIV Awareness is a locally grown and nationally known awareness and testing event that targets those at most risk of HIV transmission. AFH in partnership with the Houston Department of Health and Human Services have tested over 50,000 youth and young adults since 2007. This year we are launching our first day of testing at a local Walgreens (9200 Cullen at Reed Road) in

Get tested on June 27 Thursday, June 27, is National HIV Testing Day, and Americans are encouraged to “Take the test. Take control.” Nearly 1.2 million people are living with AIDS in the U.S., and one in five is unaware that they have the disease. In 2010, African-Americans accounted for an estimated 44 percent of all new HIV infections among adults and adolescents, despite representing only 14 percent of the U.S. population. For information on getting tested call AIDS Foundation Houston at 713-6236796 or visit aidshelp.org. the Sunnyside area. Testing will be from 12-7 p.m. on that day. Defender: What advice do you have for those who are hesitant to get tested? Blue: HIV is no longer a death sentence IF you test early and access care soon after finding out you are HIV-positive. A recent study gives evidence that HIV therapy works when people are actively engaged in their own health and well-being. The first step toward doing that is getting an HIV test – that is the only way to know whether you have the disease. People doing well on HIV therapy have a mortality risk identical to that of HIV-negative peers. Also, for those who aren’t moved by knowing their own personal status, think about your partner, your family and your community when it comes to HIV. Not knowing your HIV status hurts everyone and does affect entire communities. HIV is 100 percent preventable if we are all aware of our status. Defender: How does the AFH reach out to Houston’s African-American community? Blue: AFH reaches out through the develop-

ment of innovative events like Hip Hop for HIV and by providing life-saving supportive services like food and housing for people living with the disease. What have you found to be the biggest misconceptions surrounding HIV/AIDS? Blue: That people with HIV can’t be married to someone who does not have HIV, can’t have babies, can’t live a long full life. That you can get HIV from casual contact like hugging, sharing a drinking glass or kissing someone with HIV. Simply not true. How can the community help AFH? Blue: Donate. Support for the vital services we provide is needed all the time. Get the facts about HIV from our website and other reputable sources like the Centers for Disease Control and Prevention and spread the facts and not misconceptions. Get tested at least annually; if you have a private doctor don’t assume they are automatically testing you for HIV. You have to ask for it. Show compassion, support, and love toward people who are HIV-positive. The more we continue to stigmatize HIV and people with the disease the more this disease will spread.

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Memorial Hermann Community Benefit Corporation

Making a Difference in Our Community

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or more than 100 years, Memorial Hermann Health System has worked to advance and improve the health of the communities we serve in Southeast Texas. In 2007, Memorial Hermann established the Community Benefit Corporation to work with other healthcare providers, government agencies, business leaders and community stakeholders to ensure that all residents of the Greater Houston area have access to the care they need. Since its inception, the Community Benefit Corporation has made much progress towards establishing programs that are saving lives and helping us to better manage our community’s healthcare resources. The highlights of MHCBC programs include: • Improving access to care for Houstonarea children through school-based clinics and mobile dental vans. • Helping patients with chronic diseases manage their illnesses more effectively. • Educating area residents on how and when to access care. • Demonstrating why people should establish medical homes that help ensure more continuous and coordinated care and eliminate duplicate testing and waste.

• Establishing partnerships with providers and agencies to arrange specialty services that provide life-saving surgeries and treatments to patients. • Financially supporting community-based health clinics. These innovative programs are keeping children healthy and in school and extending care to parents so they can continue to provide for their families. They also are showing the uninsured how to access available resources and ensuring emergency and

trauma resources are used appropriately and accessible for the critically ill and injured. Memorial Hermann has worked very hard over the past years to create high quality, safe and coordinated care for our patients and this community. Delivering healthcare more efficiently will be even more important with the advent of Affordable Care Act. A critical component of the Memorial Hermann CBC is helping to encourage and facilitate community education around how best to use healthcare resources. An example of that effort is helping the community understand the necessity of establishing a medical home. “Educating the public is a key to reducing healthcare costs,” says Carol Paret, Chief Community Benefit Officer at Memorial Hermann. “It isn’t just the uninsured and immigrant populations who need help in getting healthcare for their families, the problem cuts right across the broad populace of our community. A lot of people with health insurance still don’t have a family physician and a medical home. The ER is the logical choice when you get sick, but most times, that is not an appropriate use of our healthcare resources.”

What is a Medical Home? A question often raised by the savviest of healthcare consumers is “What is a medical home?” Equally important is “Why establish one?” Defined, a “medical home,” provides comprehensive, patient-centered, preventive primary care. Establishing one is essential to keeping families healthy and managing chronic diseases such as diabetes, obesity and heart disease. When health is managed in a primary care setting, inappropriate use of the ER decreases, and the costs of healthcare are reduced. The “Houston Hospitals Emergency Department Use Study, prepared by UT Health School of Public Health, revealed that nearly 50 percent of emergency room visits in Harris County are primary care related. Such eye-opening data clearly shows that a broad spectrum of people from all walks of life, both the insured and uninsured, need help in learning how to use medical resources appropriately, including how to establish a medical home. Here’s a medical home primer:

What is a medical home? A medical home is a way to provide high quality health care services that best meet the needs of patients and families. It is not a building, house, or hospital. In a medical home, you have one provider who is your primary health care provider and who works with you in partnership to assure that all of your medical care is coordinated. Why establish a medical home? People may work with many doctors, nurses, and other health care providers. Often people must also work with school, employers, insurance, and social service professionals. Therefore, you can benefit from the team work provided by a medical home… Who is the primary health care provider? The primary health care provider is an internist, a family doctor, pediatrician, a nurse practitioner, a physician’s assistant, or sometimes a specialist. The primary health care provider is the person who provides you with comprehensive medical care. It should be someone you trust and who will partner with you to (among

other things): • Answer questions; • Share decision making; • Coordinate your care; • Provide resources and find out how well they worked; • Develop comprehensive plans of care that address your individual needs; • Build bridges among families and health, education, and social services; • Respect your values and culture; and • Promote health and quality of life for you and your family. In a medical home you will feel comfortable to: • Discuss questions or concerns; • Share information about your health; • Communicate with your doctor, clinic staff, and partners; • Ask for things to be explained differently when you don’t understand; and • Seek solutions in a mutually respectful way. When you and your primary care provider talk, build trust, and work well together, you will receive the best health care possible. Source: New York State Department of Health – http://www. health.ny.gov/prevention/immunization/having_a_medical_home.ht m

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JUNE 20 | 2013 | DEFENDER

Introducing Your Neighborhood Health Center Affordable, convenient, quality medical care for you and your family. Memorial Hermann offers affordable and fast healthcare to meet your urgent care needs. At our affiliated Neighborhood Health Centers, you don’t have to spend a lot of money to take care of basic health issues. Visits are only $48. Appointments are available, but walk-ins are welcome. For your convenience, we have three locations around Houston to serve you. Southwest 7600 Beechnut, Suite A (next to the Memorial Hermann Southwest ER) Houston, TX 77074 713.456.4280 Northwest 1800 W. 26th St., Suite 103 Houston, TX 77008 713.957.8400

Mon – Fri 8 a.m. - 7 p.m. Sat – Sun 9 a.m. - 3 p.m.

memorialhermann.org

Northeast 9813 Memorial Blvd., Suite H Humble, TX 77338 281.319.8500

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Being overweight Causes & solutions By TIFFANY L. WILLIAMS Defender

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besity is an epidemic in the African-American community. What is causing the problem? What are the solutions? Lorna McNeill, associate professor at the University of Texas MD Anderson Cancer Center, said higher obesity rates are linked to individual behaviors, social and cultural norms, environmental factors and policies that prevent AfricanAmericans from living healthy lifestyles. “[Obesity] stems from our diets,” she said. “For the most part, it’s not genetic, it’s determined by behavior. For instance, having preferences for southern cooking and fried food. “African-Americans are also more likely to live in neighborhoods that have higher locations of fast food restaurants and [less] full-service supermarkets and physical activity resources,” McNeill said. “If we do have parks, they’re usually not well-maintained. Then, there is sometimes more crime, so people have fear of walking outdoors.” Rebecca Lee, director of the Texas Obesity Research Center at University of Houston, said Houston in general can contribute to obesity. “Some specific characteristics about Houston that make it easy to put on weight are our ‘eating out’ culture and many, many restaurants, good and bad; the intense heat and humidity in the summertime that make physical activities outdoors difficult, and lack of infrastructure for active commuting.”

Solving the problem

Lee said steps are being taken to help heavy Houstonians out. “Healthy strategies that are underway in

10 tips for

fighting fat

Houston include improving walking and bicycling infrastructure to help people move more and drive less, community gardening initiatives, and restaurants that are offering more food options that are healthy and lower in calories.” Aside from efforts around the city, there are also steps individuals can take to help combat or prevent weight gain and obesity. McNeill suggests reducing fat intake, monitoring oils and saturated fats and including more fruits and vegetables in one’s diet. “Most people eat about twice as much as they should at any given restaurant meal,” Lee said. “[People should] eat fresh food and avoid heavily preserved, pre-prepared and packaged food.” Lee also said simple steps such as staying physically active and avoiding sitting or lounging around too much – particularly in front of the television or computer – are ways to fight obesity. “The average person can probably just adjust their diet and increase their physical activity, and they can be successful at losing weight,” McNeill said. “For those who need more specialized help, there are different medically supervised programs. “We would recommend those types of approaches over more extreme ways, such as trying to fast your way through it.” Lee also warns against unhealthy weight-loss plans. “Some not-so-healthy strategies are anything that causes dramatic and rapid changes,” Lee said. “These are almost never sustainable and may injure the body, one’s spirit, and motivation to live a more healthful life.” McNeill said dieters must be patient. “Losing one pound a week is a healthy way to lose weight,” she said. “It took time to get the weight on; it’s going to take time to get it off. There is no miracle drug.”

There are more than 72 million obese or overweight Americans, with the highest rates among African-Americans. Individuals are considered overweight if their body mass index (BMI), a correlate of body fat, is between 25.0-29.9, and obese if their BMI is 30.0 or above. (To calculate your BMI visit cdc.gov/ healthyweight/assessing/bmi/). Below are quick tips from the CDC and other experts to combat obesity. 1. Make a commitment to stay healthy. It’s a lifestyle change. 2. Avoid diet plans or fads that promise rapid weight loss. It takes time.

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Obes

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3. Try losing one pound per week. Since one pound equals 3,500 calories, you need to reduce your caloric intake by at least 500 calories per day. Invest in a good scale and weigh yourself regularly. 4. Consume five servings of fruits and vegetables per day, along with low-fat dairy, lean meats and whole grains. Limit starchy vegetables such as corn and potatoes. 5. Avoid drinks that are high in sugar such as soda and juice. 6 Limit fried foods and fatty meats. Try foods low in saturated fats, trans fats, cholesterol, salt (sodium) and added sugars. Always read nutrition labels. 7. Reduce your portion size when consuming high-

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Kids battle excess weight

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calorie foods and try a lower-calorie version of your favorite less healthy foods. 8. Begin with moderate-intensity exercise for at least 30 minutes one or two days a week. Try walking, water aerobics, bike-riding, doubles tennis or pushing a lawn mower. Work your way up to jogging, running, swimming laps, singles tennis or basketball. 9. Take the stairs instead of the elevator and park further away at the mall or grocery store. 10. Strengthen your muscles at least two days a week with activities that work all the major muscle groups of your body (legs, hips, back, chest, abdomen, shoulders, and arms).

ng the Houston area for over 80 years

ike overweight adults, overweight kids tend to eat too much, exercise too little, and suffer the consequences. Statistics show that more than 9 million children and teens are considered overweight in the U.S. In Houston, one in three children is overweight or obese. Beverly Gor, a registered dietitian who conducts community research at MD Anderson, said, obesity typically affects children in minority communities at higher rates, with Hispanic boys and African-American girls most at risk. According to the 2012 State of Health Report for Houston and Harris County: • 34 percent of Houston high school students are overweight or obese. • Only 18 percent of Harris county 4th graders engage in at least 30 minutes of moderate physical activity at least five days a week. • 79 percent of Texas high school students eat fewer than five servings of fruits and vegetables per day. • 60 percent of Harris County 8th graders view more than two hours of television per day. Obesity can lead to serious health conditions such as type 2 diabetes, high blood pressure and heart disease. And most children who are obese or overweight tend to become obese or overweight adults. Gor added that obese youth tend to be bullied more than “children with normalized weight,” leading to issues with mental health and low self-esteem. For some children, obesity is linked to socioeconomic factors. According to the Children’s Defense Fund, kids in predominantly minority and low-income neighborhoods have reduced access to supermarkets and fresh produce. One study found that only 8 percent of Black residents lived in areas with one or more supermarkets, compared with 31 percent of white residents. In addition, children living in neighborhoods with limited access to walking paths, parks, playgrounds or recreation centers are significantly more likely to be overweight or obese.

What can be done

There are ways to help prevent childhood obesity. Gor is also program director for Can Do Houston, a non-profit that works to fight obesity in underserved communities (candohouston.org). Some of the services they provide include

teaching cooking classes, building community and school gardens and educating parents about the importance of physical activity and reducing screen time – the number of hours children spend in front of TV, computer and videogame screens. Rebecca Lee, director for the Texas Obesity Research Center at the University of Houston, said there are other steps parents can take. “Parents can actively promote their children’s understanding of healthier habits by [explaining] why nutrition and physical activity are important, providing fresh fruits and vegetables that are prepared and ready in the fridge as a snack, and helping children to sample a diverse range of fruits and vegetables multiple times. “Helping kids learn active games, sports and activities and maintaining a healthful lifestyle themselves while the children are watching can all help with preventing and treating obesity in children,” she said. Gor said breastfeeding also helps to prevent obesity. “A lot mothers are using formula and may tend to overfeed their babies,” she said. “Breastfeeding is more baby-driven. When the baby is full they quit nursing. When a mother is feeding her child from a bottle and there are a few more ounces, she may encourage her baby to take more formula.” In addition to better nutrition and increased physical activity, Gor also said parents should support and encourage their children. “You don’t want to stigmatize the child and make them feel bad,” she said. “If you have only one child who is overweight and others who aren’t, then the whole family needs to change the eating habits, not just the overweight child. “And this won’t hurt because everybody will be improving their eating habits, ” she said.


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Vaccines: Facts and myths

healthnotes Traveling internationally with children

By The Center for Vaccine Awareness and Research at Texas Children’s Hospital

Myth: Healthy children do not need to be immunized. Fact: Vaccines are given to prevent infectious diseases in healthy children who were the victims before vaccines were available. Even healthy children can get sick and be admitted to the hospital or even die from a vaccine-preventable disease. Vaccinations are an important way of helping your child stay healthy. Myth: Since most vaccines are not 100 percent effective, there’s really no need to get them. Fact: It’s true that vaccines are not effective 100 percent of the time, but that doesn’t mean that you should skip any recommended vaccination. Most vaccines protect against disease 85 percent to 99 percent of the time, making vaccination the best way to avoid these diseases. In addition, for some vaccine-preventable diseases, the seriousness of the disease may be less for someone who has received the vaccine. Finally, the more people who get the vaccine, the less likely the disease will be present in the community where it can spread to people who are unable to get the vaccine either because they

are too young or have certain medical conditions. Myth: It’s not safe to get more than one vaccine at a time. Fact: When parents first read the child-and-adolescent vaccine schedule, it’s not unusual for them to be concerned about how many vaccines

are given at one time. However, research has shown it is safe for healthy individuals to receive more than one vaccine at a time. Not only is it safe, but it also protects the person as quickly as possible. Myth: Vaccines cause the illnesses they’re supposed to prevent. Fact: This myth almost always surfaces during flu season because other respiratory illnesses are common at this time. In regards to the influenza vaccines, neither the inactivated influenza vaccine (the flu shot) nor the live attenuated influenza vaccine (nasal spray) can cause a person to develop influenza. In regards to the other vaccines on the schedule approved by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the American Academy of Family Physicians, the chance of contracting the disease a vaccine has been proven to protect against is minimal to impossible. Visit www.vaccine.texaschildrens.org to learn most information about vaccines.

What are the main risks children face when traveling internationally? “The risks associated with travel vary depending on where one is going, for how long, the age of the person and any other medical issues,” Dr. Heidi Schwarzwald, director of the Travel Medicine Clinic at Texas Children’s Hospital, said. Infants and toddlers, sometimes they need their vaccines early to make sure they are fully protected from endemic diseases when they travel. For any child, there may be additional vaccines needed to protect them prior to traveling. There are some recommended medications for travel: Malaria prophylaxis, medication for diarrheal illness, etc. Texas Children’s has a special Travel Medicine Clinic to help the Houston community prepare children who will be traveling overseas. Whether going for a week or a year, travel brings unique risks for children, many of which can be prevented by seeking the services of a specialist prior to the trip. Ideally, you and your child should seek medical care related to your trip six weeks or more prior to traveling. Many of the vaccine series take a month to complete. Then, it takes time for the vaccine to be fully effective. By seeking care and advice early, you can make sure your family receives all the necessary protections prior to travel.

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Measles: An important lesson for parents A young mother sits in the pediatrician’s office with her child. As the doctor begins to explain the immunizations the child will receive, the mother interrupts and says, “Ok, but not the MMR vaccine. I’ve heard it causes autism.” Despite numerous reassurances and 30 minutes of discussion, the child leaves without receiving the vaccine that protects against measles, mumps and rubella. It’s a scene that has played out in countless numbers of pediatric offices across the globe. After all, it’s just one vaccine, right? Wrong. Before the MMR vaccine was available, almost every child suffered from measles.

“Each year, approximately 500,000 Americans contracted measles and 500 people died. Fortunately, the MMR vaccine brought much needed relief to American families and reduced measles incidence by more than 98 percent,” said Rachel Cunningham, immunization registry and educational specialist at Texas Children’s Hospital. Six out of the seven children were not immunized because of parental concerns about the MMR vaccine. In short, parents today often find themselves more concerned about the vaccine than the disease. Parental concern is understandable given the conflicting and frightening information on the internet and in the media. When the question was first raised whether vaccines, in

particular the MMR vaccine, caused autism, scientists answered loud and clear. Study after study found no link whatsoever between the MMR vaccine, or any other vaccine, to autism. Many parents consider measles a harmless childhood illness and decide that the perceived risk of autism is greater than the real risk of measles. Subsequently, they forgo the MMR vaccine, leaving their child vulnerable to this dangerous vaccine-preventable disease. Measles should not be taken lightly. It can cause persistent fever, dehydration, diarrhea, ear infections, pneumonia and death. Pneumonia, in particular, is concerning given that is causes 60 percent of deaths from measles.

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Healthy, happy kids make for healthy, happy communities.

Every child deserves a chance to grow up healthy and strong – and every parent deserves to know their child’s health is in the hands of someone they trust. That’s what it means to have a medical home – a relationship with a trusted physician who follows your child’s health throughout childhood. We offer access to health care that’s convenient and affordable, right in your neighborhood. • Affordable health care from birth to age 18 • Well visits, sick visits, immunizations and much more • Low-cost, flexible options regardless of your ability to pay for services • Medicaid and CHIP accepted

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health Boost your walking workout to prevent cancer By MD Anderson Cancer Center

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Recipe

alking can be a great way to get the daily activity your body needs to prevent cancer. But, a casual stroll won’t do the trick. For walking to count as exercise, you should be a little out of breath and feel your heart beating a little faster. You should be able to talk in short sentences, but not sing. Follow these tips to get the most health benefits from your walking workout.

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Wear the right shoes

Injuries are one of the most common reasons people stop an exercise routine. So if you want to make a habit of walking, start by wearing sturdy athletic shoes that provide good support. Select shoes with a toe box wide enough for your feet and with good flexibility around your toes. And, choose a rounded heel that will allow a rolling motion from toe to heel.

Remember to stretch

Before and after you walk, take a couple of minutes to stretch, focusing on your calves and hamstrings. Stretching before you walk helps warm up and prepare your muscles. And, stretching after you walk will help relax your muscles — and make them ready for your next walk.

Check your form

Walking with your head down or leaning back could hurt your lower back. So, stand straight with your head up and shoulders back.

Take quicker steps, not longer

The best way to achieve a brisk pace isn’t taking longer steps — it’s taking quicker ones. Power your walk by bending your elbows and pushing off your toes as you take each step.

Increase your intensity

As you get into the habit of walking, aim to increase your intensity. This will boost your fitness level, which can help build muscle mass, speed up your metabolism, strengthen your heart and burn more calories.

‘Comfort food’ that’s guilt-free

Southern food is meant to soothe your soul. But, cooking “comfort foods” with fatty ingredients can harm your health. Eating too many high-calorie foods can lead to weight gain. And, being overweight increases your chances of getting cancer. But, “comfort food” can be healthy food! If you do it right, you can balance down-home taste with health.

Easy, Healthy Food Substitutions Try some of these food substitutions when you cook your next meal. INSTEAD OF THIS: USE THIS: White rice Brown rice, bulgur, kasha, quinoa or whole wheat couscous Eggs (1 egg) 2 egg whites or ¼ cup of egg substitute Butter, margarine or vegetable oil Cooking spray, chicken or vegetable broth or olive oil Pork bacon Turkey bacon, lean ham, Canadian bacon Regular bouillons and broths Low sodium bouillon and broths Cream Evaporated skim milk Regular cheese Low fat or lite cheese To up your intensity, gradually include hilly areas in your route. Or, try interval training. Walk at your standard brisk pace for five minutes, speed up for two minutes, slow down, then speed up again and repeat.

Break up walks into short intervals

Just starting a walking routine? Break your walking workout into three 10-minute segments or two 15-minute segments until you get stronger.

Black, red and pinto beans, as well as lentils and peas, are packed with nutrients that protect our cells from cancer. Beans also are a healthy, low-fat source of protein and a rich source of fiber. And, eating more fiber may reduce your risk for colorectal cancer. Try this healthy recipe for New Orleans Red Beans. It goes perfectly with a side of rice. Remember to cook brown rice instead of white. That way you’ll sneak in a serving of whole grains, which is another great way to get fiber. Ingredients 1 lb dry red beans 2 quarts water 1½ cups chopped onion 1 cup chopped celery 4 bay leaves 1 cup chopped sweet green pepper 3 tablespoons chopped garlic 3 tablespoons chopped parsley 2 teaspoons dried thyme, crushed 1 teaspoon salt 1 teaspoon black pepper Directions Pick through beans to remove bad beans; rinse thoroughly. In a 5-quart pot, combine beans, water, onion, celery, and bay leaves. Bring to boiling; reduce heat. Cover and cook over low heat for about 1½ hours or until beans are tender. Stir and mash some of the beans against side of the pan to thicken the mixture. Add green pepper, garlic, parsley, thyme, salt and black pepper. Cook, uncovered, over low heat until creamy, about 30 minutes. Remove bay leaves. Serve over hot, cooked brown rice, if desired.

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Nutrition Content Makes 8 servings Calories: 171 Total fat: 0.5g Saturated fat: 0.1g Carbohydrates: 32g Protein: 10g Cholesterol: 0mg Sodium: 285mg Dietary fiber: 7.2g Recipe from National Cancer Institute Down Home Healthy Cooking

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JUNE 20 | 2013 | DEFENDER

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Your dad’s Lungs are Worth Fighting For MoM’s grandMa’s uncLe’s

If you or someone you love has been diagnosed with lung cancer, insist on MD Anderson, the nation’s top-ranked cancer hospital. Our world-renowned cancer experts are at the forefront of lung cancer discoveries and have pioneered the most advanced life-saving treatments available today. We create customized treatment plans with options such as minimally invasive surgery and innovative radiotherapy techniques. When your loved one is fighting lung cancer, you can never give up. We’re here to help. Contact us today.

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Houston Defender: Health Edition June, 2013  

Obesity causes & solutions takes center stage in this health special along with AIDS Foundation Houston; Vaccines: Facts and myths; and Boos...