Health | Spring 2018

S O U T H W E S T U T A H P U B L I C H E A L T H F O U N D A T I O N | S P R I N G 2 0 18 FUTURE OF FLU

MARIJUANA FACTS

HEALTHY SLEEP

PG. 8

PG. 14-17

PG. 26

FRO M TH E H E ALTH O FFIC E R

HEALTH MAGAZINE | SPRING 2018

Welcome to the 18th issue of Health Magazine, where you’ll find informative articles on sleep, immunizations, safe drinking water, preventing flu pandemics, and financial preparedness. We also visit the topic of marijuana legalization. As the Health Officer for the five counties served by the Southwest Utah Public Health Department, I am involved in programs and policies that affect the health and safety of the 230,000 residents who live here. I feel the need to go on record to state that the proposed medical marijuana referendum for Utah is a bad idea, with potential consequences that would be catastrophic.

I am concerned about claims that marijuana (or cannabis) is harmless. The addictive nature of this substance is becoming more evident as we see dependence develop over time in up to half of regular users, with some experiencing withdrawal symptoms when they quit.

Cannabis itself is getting stronger. The marijuana of the 1960s contained around 1% tetrahydrocannabinol (THC), the chemical responsible for most of marijuana’s psychoactive effects. Today’s cannabis has THC levels as high as 30%.

Many of the health claims made by medical marijuana advocates are suspect. All major medical societies have issued statements that marijuana in a whole plant form - either smoked or eaten - is not medicine, and that the health benefit claims of legalizing marijuana is misleading at best. As well as being bad for your brain, lungs, and heart; marijuana use increases the risk of mental illnesses like depression, anxiety, and schizophrenia.

The legalization of medical and recreational pot use in Colorado allows each municipality in the state to determine whether or not to allow it. Most have now banned marijuana and more are following as the negative consequences of widespread use have become evident. The proposed law for Utah would not give that option to individual jurisdictions. The referendum also has too few restrictions on marijuana use and puts limits on taxation.

There are already provisions allowing the use of marijuana extracts in Utah, and the legislature could broaden those in the future. Research continues into what marijuana components might offer. I am in favor of letting the scientific process work to find actual medicines that are standardized, safe, and effective. Legalizing “medical marijuana” at this point simply allows recreational marijuana use under false pretenses. Making marijuana legal sends the message that there is no harm in using it, which is especially irresponsible when it comes to our youth, who are more vulnerable to the drug’s damaging effects. For example, research in New Zealand found that young, regular marijuana users were 60 times more likely to try other illicit drugs than those who had never smoked marijuana.

What does society look like when part of our younger generation becomes unable to live up to their full potential? Please support our lawmakers as they seek reasonable solutions to this issue.

Sincerely,

David W. Blodgett, MD, MPH SWUPHD Health Officer & Director

SWUHEALTH.ORG | PAGE 3

PREVENT

6 8 10 12

International

TRAVEL

By Mariette Armitstead The Hepatitis A

VIRUS

By Kari Abeyta Keys to

FINANCIAL HEALTH

By Jeff Shumway An action plan for averting the next

FLU PANDEMIC

By Jonathan D. Quick

PROMOTE

14 16 18 20

Scientific answers

MARIJUANA

By Logan Reid Marijuana

FACTS

Infographic Safe

DRINKING WATER

By Jeremy Roberts Emergency

WATER

By Paulette Valentine

PROTECT

22 24 26 28

Triple protection for kids

DTaP

By Lori McGuire Tabacco-free

Campus

By Kye Nordfelt & Kylaas Flanagan Your health &

Sleep

By Dr. Blodgett, MD, MPH 2017 Southwest Utah Public Health Department

Annual Report

The entire contents of this publication are Copyright ©2018 HEALTH (the magazine of the Southwest Utah Public Health Foundation) with all rights reserved and shall not be reproduced or transmitted in any manner, either in whole or in part, without prior written permission of the publisher. Health magazine hereby disclaims all liability and is not responsible for any damage suffered as the result of claims or representations made in this publication.

Printed by Hudson Printing Company / Salt Lake City, Utah / hudsonprinting.com

ON THE COVER

Cover illustration: Healthy brain activity of a 28 year old male based on a SPECT scan. See article on page 16.

QUESTIONS OR COMMENTS?

Email

info@swuhealth.org

HEALTH MAGAZINE | SPRING 2018

Ask your doctor if Not Smoking is right for you Not Smoking was pioneered in the 1940s, but is still effective today. Not Smoking has been used by millions of people to maintain healthy lung capacity and blood pressure. Not Smoking has been proven to prevent emphysema and lung cancer. Side effects include protecting the health of those around you, fresh breath, and thousands of dollars in savings every year. Not smoking is FDA approved for all ages. People who take Not Smoking into adulthood will most likely use Not Smoking for life. If you are currently Smoking and would like to switch to Not Smoking, call 1-800-QUITNOW or visit waytoquit.org for free assistance. People who switch to Not Smoking lower their risk of heart attack within 24 hours and add years to their lives.

Not Smoking. From the people who brought you Getting Off the Couch, Riding a Bike, and Eating Your Vegetables.

SWUHEALTH.ORG | PAGE 5

I N T E R N AT I O N A L

By Mariette Armitstead, rn SWUPHD NURSE

S

pring is just around the corner, and it’s time to start thinking about travel plans. Out of 30 million Americans who travel abroad each year, approximately 8 million will be traveling to lesser-developed countries where the incidence of tropical and infectious diseases is high.

Health Department. A travel consult involves education and instruction regarding immunizations, health risks, and disease precautions specific to your destination. It’s a good idea to schedule your consult a few months prior to travel in order to complete the necessary vaccinations and other preparations.

If you or someone you know is planning a vacation, tour, or church/humanitarian mission outside of the United States, you may want to consider getting an international travel consultation from the Southwest Utah Public

A travel consult is done by a nurse at the health department. These nurses take part in regular meetings where they receive guidance from doctors with the University of Utah. They are trained in the latest knowledge regard-

HEALTH MAGAZINE | SPRING 2018

ing health issues for travelers. When a client comes in for a consult, the nurse will access a database of over 200 countries that is updated weekly with the active health risks and advisories for each destination they plan to visit.

Underdeveloped countries often have poor sanitation standards. Many of the harmful diseases present in these nations are now preventable through vaccinations. While some shots are recommended for general travel, like hepatitis A and B, seasonal influenza, and tetanus, additional protection

PREVENT

should be considered for people heading to locations where food and water contamination are present. Typhoid, for example, is common in those places and a vaccine is available for that disease.

Since vaccines are not always 100% effective, there are other safety guidelines to follow in order to prevent food or water borne illnesses. These recommendations include avoiding raw vegetables and salads, ensuring your food is cooked well, and drinking only bottled or canned water, juices, and sodas.

These topics will be discussed in further detail during the international travel consult, in addition to other subjects such as health precautions in densely populated areas and safety alerts. Medications may also be prescribed for the prevention of malaria, motion sickness, altitude sickness, and traveler’s diarrhea. Clients should ask plenty of questions so they can have a clear understanding of how to stay healthy during their stay abroad. When the consult is completed, the traveler receives a printed country-specific report and an updated immunization record.

Another subject discussed in the travel consult is preventing diseases spread by insects.

Yellow fever is a mosquito-borne illness that can be life threatening. It is commonly found in areas of South America, Africa, and Asia.

Yellow fever vaccine is sometimes required in order to enter certain countries. There are numerous other diseases carried by insects, including Zika, malaria, chikungunya, dengue, and schistosomiasis. While there are no vaccines available for these diseases, other precautions can be taken, including using insect repellent, wearing long sleeves and pants, and sleeping under mosquito netting.

International travel consults are available at the health department offices in St. George, Cedar City, and Kanab. No appointment is needed but you can call ahead to ensure nurse availability (see page 31 for address and contact information). Bring your photo ID, a current immunization record, travel itinerary, LDS mission book (if applicable), and a list of medications. You may also be asked for your health history. This gives the nurse all the information needed to ensure a thorough consult and help you prepare for a safe and enjoyable trip. You’ll have the knowledge to be a more confident traveler and avoid returning home with any unwanted souvenirs!

Visit swuhealth.org/travel for more information on fees and discounted rates for groups and humanitarian/missionary travel.

SWUHEALTH.ORG | PAGE 7

VIRUS

By Kari Abeyta, RN SWUPHD NURSE

A

t the close of 2017, the U.S. was experiencing unexpected outbreaks of the hepatitis A virus in multiple states, including 200 cases (to date) in Utah. Hepatitis A activity in the greater Salt Lake area is linked to the San Diego outbreak, which has been the largest in recent history with nearly 700 cases. Many of them have required hospitalization and there have been 21 deaths. Most infections have occurred in the homeless population or among illegal drug users.

Hepatitis A virus (HAV) is a contagious disease that is spread person-to-person through contact with items that have been contaminated by feces. Depending on the environment, the virus can live on contaminated surfaces for months. Many household cleaners and waterless hand sanitizers are not able to kill this hardy virus.

The word “hepatitis” means inflammation of the liver.

There are a variety of illnesses or conditions that can cause hepatitis, HAV

being one of them. The incubation period is about 28 days, and the virus is excreted in a person’s feces two weeks before showing any signs of illness.

are infected usually do not have any symptoms and often forget to wash their hands after using the restroom, furthering spread of the disease.

Some infections do not cause any symptoms, but typically the illness has an abrupt onset of fever, nausea, vomiting, loss of appetite, abdominal pain, general discomfort, dark urine, and jaundice (yellowing of the skin and eyes). Illness usually lasts for a few weeks, but severe cases last for months. Children who

This highly contagious disease is widespread in Asia, Africa, and Central and South America. With the exception of recent outbreaks, why are infections less common in our country?

HEALTH MAGAZINE | SPRING 2018

At one time, HAV was the number-one cause of hepatitis in the United States.

PREVENT

Then, in the mid 1990s, a vaccine was introduced and the number of hepatitis A cases dropped by more than 90%. The hepatitis A vaccine is thought to provide nearly 100% protection after two doses administered at least six months apart. It contains an inactivated (killed) virus and is approved for use in people ages 12 months and up.

Some people experience pain, redness, or swelling at the injection site; or even fatigue and low-grade fever after being vaccinated. These symptoms are usually mild and there have been no serious adverse reactions reported.

Hepatitis A vaccine is one of the required vaccines for attending school in Utah. The Centers for Disease Control has also recommended the following groups be vaccinated for hepatitis A: • All children at age one year • Travelers to countries where hepatitis A is common • Family and caregivers of adoptees from countries where hepatitis A is common • Men who have sexual encounters with other men • Users of recreational drugs • People with chronic or long-term liver disease, including hepatitis B or hepatitis C • People with clotting-factor disorders Even if you don’t fall into one of the categories listed above, you may want to consider getting vaccinated to protect yourself against other risk factors such as eating out at restaurants or using public restrooms.

The risk of contracting HAV in the United States from these sources is relatively low, but cases do occur.

Another very effective method of preventing HAV infection - as well as many other viruses and bacteria - is to simply wash your hands. Frequent thorough hand washing with soap and warm water, especially when out in public or having contact with sick people, is essential in protecting your health.

INCIDENCE OF HEPATITIS A, BY YEAR UNITED STATES, 1984-2015

REPORTED NUMBER OF CASES

VACCINE LICENSED

SWUHEALTH.ORG | PAGE 9

HEALTH By jeff shumway SWUPHD BUSINESS MANAGER & HEALTH MAGAZINE PUBLISHER

R

alph Waldo Emerson once said that “the first wealth is health.” Interestingly, our health can be affected by stress over the other wealth... the cash version. Having our finances under control will bring peace of mind and lowered stress levels, which directly benefits physical well-being.

any other money coming in from other sources? If so, add that to the total.

Next, list all of your expenses, and that means everything. For example; your house payment, utilities, food, gas, car payment, car repairs and maintenance, car insurance (if you make an annual or semi-annual payment figure out what you would pay every month), TV, phone, internet, eating out, clothing, entertainment, charitable giving, etc. This list is not all-inclusive, and your expenses may be different than someone else’s. Just make sure that all expenses are included.

The first key to managing financial health is using a budget. Although creating a budget may seem overwhelming and frustrating to some, it’s actually a fairly simple and straightforward process, especially if taken step-bystep. The most important thing is to start now. If you are married, make sure to include your spouse.

Now add up all of your expenses. Then subtract your expenses from your income.

First, write down all income earned each month. This should be easy - what is the total If the number is positive, go back and douof your paycheck(s)? Write it down. Is there ble-check to make sure no expenses were left

HEALTH MAGAZINE | SPRING 2018

PREVENT

out. If you’ve covered everything and your number is positive, then good for you! You are well on your way to financial health.

If your expenses are greater than your income, then the next step is to find ways to reduce your expenditures. This can be challenging. Go through each item and ask yourself if it’s really necessary and if there is a way to cut back. These can be very hard questions. Make sure you give honest answers. Most of us can actually get by on less than we think.

After you’ve reduced your expenses, do the math again. If you are still in the negative, keep looking at ways to cut expenses. Do you need to eat out or have two sodas every day? Do you really need that cell phone plan, and what about TV and Internet? Do you really need three cars? What about the boat and the ATVs? Do you need to downsize your house?

The main thing to remember when cutting back is to be honest with yourself. A lot of stress and family discord can come from living a lifestyle that doesn’t match your income. You may have to give up some things in the short term while you pay off those credit card bills and other debt, but in the long run

it will be worth it and you’ll be grateful you made those temporary sacrifices.

Then continue this process until you have no debt except for your home.

In his book, How to Stop Worrying and Start Living, Dale Carnegie says, “The idea of a budget is not to wring all the joy out of life.

The idea is to give us a sense of material security-which in many cases means emotional security and freedom from worry."

You may be surprised how fast your debt disappears. You may be tempted to start adding back in some of the things you cut out in order to make your budget work in the first place. Don’t do it.

Another important part of your budget should be saving a portion of your income each month.

According to financial expert Dave Ramsey, you should save a $1,000 emergency fund as quickly as possible, which should only take a few months. This may mean finding a temporary part time job. Remember, you won’t be able to stick to your budget in an emergency if you don’t have any money set aside for those unforeseen events.

Ramsey’s recommendation at this point is to save 3-6 months worth of basic expenses. Think of it as insurance against an unexpected loss of income. You’d still be able to get by while you get your feet back on the ground and find new employment. You would also be able to avoid going back into debt during that time.

Once you have your emergency fund in place, Ramsey suggests making progress toward paying off any debt you have. Make a list of all of your debts, smallest to largest (not including your house payment), and pay extra money toward the smallest debt until it is paid off. Once the smallest debt is gone you can start attacking the next one, adding all the extra money you can to the regular monthly payment.

Consider investing in yourself by updating your job skills, getting a certificate, or more education to increase your earning power.

It may take some time, patience, and discomfort to complete these basic steps, but imagine the sense of security you would have!

Then you could start thinking about setting money aside for retirement, your children’s college funds, and paying off your home early. Financial peace of mind is within reach of anyone, just take it a step at a time and...

START NOW

CREATE A BUDGET.

CUT SPENDING AND UNNECESSARY COSTS.

SAVE AN EMERGENCY FUND.

REDUCE DEBT, SMALLEST TO LARGEST.

PLAN FOR THE FUTURE.

Living with out-of-control finances can be extremely stressful, and stress impacts your physical health.

Take action to protect your health by following these simple steps toward financial wellness.

SWUHEALTH.ORG | PAGE 11

AN ACTION PLAN F O R AV E R T I N G T H E N E X T F L U

By Jonathan D. Quick ORIGINALLY PUBLISHED IN THE JANUARY 20, 2018 EDITION OF THE WALL STREET JOURNAL

T

his year’s flu season is hitting early and hard, the worst the U.S. has seen in more than a decade. Every day more people are falling ill and getting hospitalized, and some are dying, including young children. Though we are not yet at the peak of flu season, schools have closed in communities across 49 infected states.

Businesses can expect employee absenteeism to soar, and the Centers for Disease Control and Prevention expect the death toll to rise.

Despite medical advances, we are just as vulnerable today to a flu pandemic as we were a century ago. Vaccines in recent years have, on average, reduced the risk of flu illness among those vaccinated by just 40% (less than 30% this year). Current antiviral drugs only slow the virus—we have no reliable way to destroy it.

A flu as deadly and contagious as the 1918 strain remains a very real possibility.

Worse, in today’s world, it would be able to leapfrog on the back of air travel and spread quickly through our much more urbanized populations. It could kill 200 to 400 million people world-wide and throw the global economy into a deep downturn.

The outbreak has thrown the health-care system into turmoil, with some hospitals unable to treat the people flocking to emergency rooms and clinics. Crucial supplies are running low across the nation, including lifesaving ventilators, and staff Despite the starkness of the threat, we shortages are deepening as nurses and seem to be so used to wasting lives and reother personnel fall ill. sources every year on flu that we’ve grown numb to the annual onslaught, much less Our current flu crisis eerily coincides with to the prospect of something far worse. the 100th anniversary of the 1918 Span- There are five critical actions we need to ish Flu Pandemic, which killed 50 to 100 take to stop future pandemics. million people world-wide. The disease arrived in the U.S. early that year, resulting First, we must accelerate the development in a cascade of illness and suffering, family of a universal flu vaccine that would ofand community chaos, stymied businesses fer broad protection against most types and industries. of flu. Flu viruses are perpetually evolv-

HEALTH MAGAZINE | SPRING 2018

PREVENT

ing through mutation in order to evade human immunity, and today’s vaccines target the most frequently mutating parts. A universal vaccine would eliminate the need for annual flu shots by attacking those parts of the virus least apt to mutate and most common across different strains. It would be akin to ripping out the roots of a giant deadly weed rather than just chopping off each year’s new growth.

A universal flu vaccine would be a triumph for humankind on a level with the smallpox or polio vaccines.

Half a dozen major labs around the world are taking alternate approaches to create one. But we need more public and private investment for these labs to continue through the costly and unpredictable development process to the finish line of a safe, effective vaccine.

Second, we need more targeted investments in vital areas of flu prevention and treatment. This includes better antiviral medicines, more accurate and widely available diagnostic tests, and low-cost face-masks that are truly protective.

Tamiflu, Relenza and other antiviral drugs are modestly effective, especially when taken early by individuals at high-risk of flu complications.

This year’s most dangerous flu strain (H3N2) is not showing resistance to these drugs, but others strains have.

When used appropriately at home, low-cost diagnostic tests can help in making decisions about staying home from school or work, which can reduce the burden on hospitals and doctor’s offices.

But the tests available today vary in their ability to detect different flu strains, and they are less accurate for adults. As for the inexpensive surgical masks available in pharmacies, they aren’t the germ-barrier that people think they are. Wearing one in a crowded subway is unlikely to help you if the person next to you is ill with the flu.

Third, we must do much more— through media campaigns and pro-

grams in schools, workplaces and communities—to encourage the adoption of personal prevention habits. Good flu prevention habits (staying home when sick, proper hand-washing, covering sneezes and coughs, etc.) have been shown in previous flu pandemics to significantly reduce transmission of the virus.

Social “distancing” measures, such as school closures and the cancellation of large gatherings, also reduce the spread of flu. During the 1918 outbreak, infection rates varied dramatically among U.S. cites, depending on how quickly localities undertook such measures. By acting early, New York City had the fewest number of deaths of any city on the East Coast. Pittsburgh delayed and paid with the highest mortality rate.

Fourth, every school, business, government agency and place of worship and even every household should have a flu-preparedness and emergency response plan. Annual drills and exercises are essential refreshers and provide an opportunity to update the list of actions to take to reduce the spread of flu, maintain essential services in the face of absenteeism and step in to help others. Hospitals and doctor’s offices, particularly, should use annual drills to review methods that can reduce demand and stretch capacity during large-scale epidemics. Households and individuals can find help on Ready.gov, and businesses can work with public health officials.

Preparedness also includes making sure that a range of health professionals are ready to act quickly. We must be able on short notice, for instance, to staff call centers with nurses and other medical personnel to provide information to the public, and we must have mechanisms set up for rapidly dispensing antiviral drugs.

Finally, we must stop starving state and local health departments of needed funds for preparedness. We depend on these agencies to stand sentry for the nation’s disease de-

SWUHEALTH.ORG | PAGE 13

tection—not only for flu but for all infectious diseases and agents of bioterror. Their job is to slow and stop the spread of a pandemic while limiting the impact of such an emergency on the functioning of society. That’s a very tall order and can’t succeed at current budget levels.

Every dollar spent on preparedness results in savings, by my own calculations, of $2 to $10 from reduced emergency costs and economic disruption. The overall return on investment would be substantial, considering that the U.S. loses as much as $90 billion a year on direct and indirect flu costs, according to researchers at the CDC. Beyond the flu threat, the benefit of preparedness is that it builds a system that works in the face of any biological, chemical or radiological emergency or natural disaster.

It might seem impossible to prevent future pandemics, but when leaders in public health, government and business have come together in the past, we have won the wars against smallpox, SARS, Ebola and a whole host of other devastating attackers.

Too often, however, we have waited until the body count and panic rose to a crescendo.

What turned the tide in every instance was the combination of urgency and political will. We need to approach the problem of flu as if all the fury of a pandemic were bearing down upon us today.

Dr. Quick is a senior fellow at Management Sciences for Health in Boston and an instructor in global health and social medicine at Harvard Medical School. His new book, “The End of Epidemics: The Looming Threat to Humanity and How to Stop It” was published January 30, 2018 This article appeared in the January 20, 2018, print edition of the Wall Street Journal. Used with permission from The Wall Street Journal, WSJ.com. Copyright 2018 Dow Jones & Company, Inc. All rights reserved.

SCIENTIFIC ANSWERS TO COMMON QUESTIONS

By Logan B. Reid GUEST COLUMNIST

M

arijuana has become a controversial and divisive topic. We are exposed to conflicting claims and "facts" from both sides of the issue, and sources found online can present skewed or inaccurate information about this substance. Popular culture also plays a role, but what are the real facts? Are there legitimate findings by researchers, scientists, and medical professionals after decades of studying the properties of marijuana? Here are some simple, science-based answers to four common questions about marijuana:

ing over 100 compounds that are called cannabinoids. The two most commonly known compounds in the plant are CBD (a non-psychoactive compound) and THC (a psychoactive compound that has a significant effect on mental processes). 1

HOW DOES MARIJUANA EFFECT/IMPACT THE BRAIN?

It reduces higher functioning. When marijuana is consumed, the bloodstream carries the chemicals throughout the body, impacting the entire system, including the brain. Marijuana use can cause functional impairment in cognitive abilities. The WHAT IS MARIJUANA? degree and duration of the impairment It’s a plant. The scientific term is Can- depends on the age when an individual nabis sativa. It's a tall, spindly plant that begins using, how much is used, and the contains more than 500 chemicals, includ- length of use. 2

HEALTH MAGAZINE |SPRING 2018

PROMOTE

There are both short and long term impacts. Marijuana impairs higher brain function; including reduced learning, memory, problem solving, decision making, behavioral control, and motor coordination. Longitudinal studies over time have demonstrated that people who used cannabis heavily in their teens and continued through adulthood showed a permanent drop in IQ of 8 points. Additional research from Harvard Medical School in 2014 found that even casual marijuana use impacts the volume, shape, and density of grey matter in the brain.

IS MARIJUANA ADDICTIVE? Yes. 1 in 10 adults who use marijuana will become addicted to it, and 1 in 6 adolescents will become addicted.3 In fact, more people are receiving treatment for marijuana addiction than any other illicit drug. Even in Southern Utah, nearly 40% of people in treatment for substance abuse addiction list marijuana as their primary drug of use. 4 A likely reason behind the increasing number of people entering treatment for marijuana addiction is the increase in potency of the drug. Back in the 60s the average marijuana plant had less than 0.2% THC (the psychoactive chemical in cannabis). By 2010, THC levels were over 12%, and some reports now show levels higher than 35%. In other words, marijuana today is very different from the marijuana of a few decades ago, leading to many more people becoming addicted.

IS MARIJUANA MEDICINE? No, but we can (and do) use the plant to create medicine, just like various other drugs. Many medications derived from marijuana plants are available by prescription; including Dronabinol, Sativex, Nabilone, CT-3, Cannabinor, HU308, Taranabant, and Rimonabant. Others are in the process of approval. Whether it’s aspirin, morphine, or any other drug that has come into use in the past 50 years, a process is expected to be followed to ensure the safety of medications. These drugs are rigorously tested through clinical trials, approved by the FDA, then prescribed by doctors who are trained on potency and dosage schedules.

The term “medical marijuana” simply refers to the use of the plant - either smoked or consumed as an edible - for “medicinal purposes”. Some states have voted to allow it to be called “medicine”, making marijuana the first drug not held to the same standards as those which have been required to go through a scientific approval process.

The American Medical Association does “not endorse state-based medical cannabis programs, the legalization of marijuana, or that scientific evidence on the therapeutic use of cannabis meets the current standards for a prescription drug product.”

The American Psychiatric Association asserts that “there is no current scientific evidence that marijuana is in any way beneficial for the treatment of any psychiatric disorder. Current evidence supports a strong association of cannabis use with the onset of psychiatric disorders. Medical treatment should be evidence-based and determined by professional standards of care; it should not be authorized by ballot initiatives.”

The American Glaucoma Society says: “there is no scientific basis for use of these agents [cannabis] in the treatment of glaucoma.”

The American Cancer Society states that: “better and more effective treatments are needed to overcome the side effects of cancer and its treatment.

The ACS does not advocate the use of marijuana or the legalization of marijuana.”

The legalization of marijuana has not been without consequences. Neighboring states that have done so have seen increases in admissions for addiction treatment, fatalities from car crashes, hospitalizations for overdoses and poisonings, crime around dispensaries and grow sites, and opioid overdose deaths. Marijuana is not a harmless substance, and allowing a psychoactive plant to be defined and prescribed as medicine by legislation ignores the foundations of health science.

Logan Reid is a Licensed Prevention Specialist and Director of Prevention & Education Services at Southwest Behavioral Health Center. Visit southwestprevention.com for more information.

Sources: 1. National Academies of Sciences, Engineering, and Medicine. 2017. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Washington, DC: The National Academies Press.

2.M.H. Meier, Avshalom Caspi, et al. 2012. “Persistent cannabis users show neuropsychological decline from childhood to midlife.” Proceedings of the National Academy of Sciences.

3. Treatment Episode Data Set (TEDS): 2016. National Admissions to Substance Abuse Treatment Services, DASIS Series. Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Rockville, MD. 4.. Hall, 2015. What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction. 110(1):19-35.

SWUHEALTH.ORG | PAGE 15

Let us talk about the

MARIJUANA FACTS

A 2016 study published in the Journal of Alzheimer’s Disease showed abnormally low blood flow in multiple brain regions in marijuana users. Prior studies have also suggested that the hippocampus physically shrinks with marijuana use. This illustration is based on SPECT scans comparing blood flow in a healthy brain (left) to one of a young weekend marijuana user (right).

1915 Utah was the second state (after California) to ban cannabis.

2014 Utah became the first state to legalize the use of CBD oil for epilepsy without legalizing other forms of marijuana.

Although some states have decriminalized marijuana and legalized medical and/or recreational use, marijuana is still considered an illegal drug by federal law.

On Colorado’s legal marijuana: “Now, as citizen groups attempt to put the brakes on the growing industry, a heated debate has emerged about the drug’s societal impact. Doctors report a spike in pot-related emergency room visits—mostly due to people accidentally consuming too much of potent edible pot products. Police face new cartel-related drug operations. Parents worry about marijuana being sold near their homes and schools.”

-Is Pot Losing Its Buzz in Colorado? (Fortune Magazine, 7-1-16)

Doctors can not write prescriptions for medical marijuana, just “recommendations”.

HEALTH MAGAZINE |SPRING 2018

PROMOTE

Marijuana is the illicit drug most frequently found in the blood of drivers who have been involved in vehicle crashes, including fatal ones.

People who begin using marijuana before the age of 18 are four to seven times more likely to develop a marijuana use disorder than adults.

Marijuana use in adolescents may serve as a catalyst for schizophrenia in individuals already susceptible to the disorder. It can also worsen symptoms in patients who already have schizophrenia. Marijuana can produce an acute psychotic reaction in non-schizophrenic people who use marijuana, especially at high doses.

2016 presidential candidate Gary Johnson entered the race as a strong advocate for marijuana legalization, but stopped smoking pot during the campaign and pledged to remain abstinent if elected to the White House. "I want to be completely on top of my game, all cylinders,� he said in an interview with USA Today.

Impairs perception, learning, memory, attention span; increases risk of mental illness

Bloodshot eyes, dilated pupils Increases heart rate and alters blood pressure, poses risk to those with heart disease and hypertension

Increased risk of emphysema and chronic bronchitis. Twice as much tar as cigarette smoke

Can result in cannabinoid hyperemesis syndrome, which causes unrelenting vomiting, nausea and stomach pain

Impairs hand-eye coordination

Impairs balance and motor coordination, reduces exercise capacity

SWUHEALTH.ORG | PAGE 17

SAFE WATER

By Jeremy Roberts SWUPHD ENVIRONMENTAL HEALTH DIVISION DIRECTOR

W

ater is essential for human survival. We take for granted that we can turn on a faucet or push a button to access safe drinking water to quench our thirst. Within the Southwest Utah Public Health Department’s boundaries there are over 185 public water systems - the most in the state - that provide water to their customers. A public water system is one that has over 8 connections or serves over 25 people at least 90 days out of the year.

There is actually a lot of work being done behind the scene (or faucet) to ensure that the water we drink is safe.

A new water system first has to go through an approval process with the Utah Division of Drinking Water (DDW). This includes submitting plans and using materials that meet various rules and industry standards. The same process must be followed each time the water system changes or expands.

Each system is required to designate a trained individual who oversees safety and operations. The operator will also oversee contractors who work on the water system to make sure approved materials and techniques are being used.

HEALTH MAGAZINE |SPRING 2018

PROMOTE

A system’s water is sampled on a routine basis depending on the number of customers served. Sampling checks for potential contaminants that might be present, including coliform and E. coli bacteria. Samples are tested at a water lab like the one operated by the health department in St. George, before being submitted to the DDW. In 2017, the health department tested over 900 samples that were submitted for bacterial analysis. The lab can also perform tests on private drinking water systems upon request.

At least every three years a sanitary survey is conducted by local or state inspectors on each drinking water system. This provides an opportunity for the trained water operator and the inspector to coordinate on any changes that might need to be made.

Water systems also plan for emergency situations, including bacterial contamination or breaches. Floods, fires, earthquakes, or other natural or human caused disasters can also impact drinking water safety. Sometimes, in collaboration with the DDW and the health department, a water system may alert customers to not consume the water or issue a boil order.

According to the DDW, a boil order is issued for a water system when recent testing shows the presence of organisms that could cause illness, or when physical problems in the water system have significantly increased the possibility of bacterial contamination. A boil order instructs customers to bring water to a rolling boil for a at least one minute. When it cools, refrigerate the water in clean containers. During boil advisories or orders, you should boil

all water used for drinking, preparing food, beverages, ice cubes, washing fruits and vegetables, and brushing teeth.

We consumers also play a part in keeping drinking water safe. Water bills will often include education on how to prevent “cross-connections”, or places where drinkable and contaminated water could meet, like backflow through a garden hose.

Backflow preventers should be installed on all outside hose bibs if it doesn't already have one built in.

Leftover chemicals should never be added to water systems or poured into gutters or on the ground, which could lead to ground and surface water contamination. Properly dispose of chemicals according to directions or at local household hazardous waste collection facilities.

We are fortunate to have system operators, public health officials, and consumers who work together to keep our drinking water safe. Because of these efforts, we don’t have to worry about many of the illnesses and disease outbreaks associated with impure water in many parts of the world.

SWUHEALTH.ORG | PAGE 19

EMERGENCY STORAGE

By Paulette Valentine SWUPHD EMERGENCY PREPAREDNESS & RESPONSE DIVISION DIRECTOR

I

magine getting the unexpected news that your tap water is no longer safe for drinking, brushing your teeth, bathing, or washing dishes? What if the water supply were completely cut off?

before the water was declared safe to drink. The state provided millions of cases of bottled water and filters to residents there, but we can’t always count on government agencies or other sources to provide for our needs in an emergency. The most important first responder is you, so how prepared are you for a disruption in the water supply? Could you provide for your family’s water needs for a day? Several days? Weeks?

Sudden loss of access to water can happen during utility repairs, freezing, broken pipes, or contamination.

Natural disasters like earthquakes and floods can compromise water lines for days or weeks. In 2014, lead contamination in the water at Flint, We recommend storing at least one Michigan resulted in a public health gallon of drinking water per person emergency that lasted for over a year (or pet) per day. Have enough for

HEALTH MAGAZINE |SPRING 2018

PROMOTE

three days minimum, but at least two weeks’ worth (or longer) is better.

Also, consider sanitation needs and hotter climates. Purchase bottled water or use clean, sturdy, food-grade plastic containers and fill with water from an approved public drinking water system. Since tap water in Southwest Utah contains residual chlorine, there is no need to treat the water in the containers, although it should be changed every six months. Other emergency home water sources include water heater tanks, ice cubes, and juices from canned goods.

Water that is impure or potentially contaminated can be treated for drinking unless it contains fuel or toxic chemicals. Possible sources are rainwater, streams, rivers, ponds, lakes, and springs. The Centers for Disease Control recommends the following procedures: Boiling is the surest method to kill disease-causing organisms, including viruses, bacteria, and parasites. Bring clear water to a rolling boil for at least one minute (at elevations above 6,500 feet, boil for three minutes) and let cool. If the water is cloudy, first filter it through a clean cloth, paper towel, or coffee filter; or allow it to settle and draw out the clear water. You can improve the flat taste of boiled water by pouring it from one container to another and then allowing it to stand for a few hours, or by adding a pinch of salt for each quart of water.

If you don’t have safe bottled water and if boiling is not possible, you can disinfect filtered and settled water with household bleach: 1. Add ⅛ teaspoon unscented household chlorine bleach per gallon of water.

2. Stir the mixture well.

3. Let it stand for at least 30 minutes before use.

Disinfectants can kill most harmful viruses and bacteria, but are not as effective in controlling parasites such as cryptosporidium and giardia, which can be removed with some portable water filters. Choose one that has a filter pore size small enough to remove parasites. Most portable water filters do not remove bacteria or viruses, so a disinfectant such as iodine, chlorine, or chlorine dioxide should still be added after filtering.

Clean water is essential to life. Humans can only last a few days without it.

Stored water - and the means to boil and disinfect other sources - could very well be the most important items in your home’s emergency preparedness storage.

BOILING IS THE SUREST METHOD TO KILL DISEASE-CAUSING ORGANISMS, INCLUDING VIRUSES, BACTERIA, AND PARASITES.

SWUHEALTH.ORG | PAGE 21

TRIPLE IMMUNITY FOR CHILDREN

By Lori McGuire, RN SWUPHD NURSE

I

magine not being able to breathe because your throat is covered with a thick gray membrane. Or being stricken with painful muscle contractions. Or watching a baby coughing uncontrollably and gasping for air. These symptoms of once-common diseases are preventable with the DtaP vaccine.

The DTaP vaccine helps protect against diphtheria, tetanus and pertussis. It is given in a series of five doses to children starting at 2 months to 6 years of age. The vaccine is most effective when all doses of the vaccine series are administered. The DTaP is required for admission to school in the state of Utah.

DIPHTHERIA

is a bacterial disease spread by droplets through coughing and sneezing. The bacteria invade the lining of the respiratory tract and produce a toxin that ultimately destroys these tissues. The dead tissue then forms a thick membrane that coats the inside of the throat, making breathing and swallowing difficult, if not impossible. With treatment, the mortality rate for people infected with diphtheria is about 10%. Without treatment, the death rate reaches nearly 50%.

Diphtheria used to be a common illness in the United States. In 1921 there were over 200,000 cases of the disease and over 15,500

HEALTH MAGAZINE | SPRING 2018

deaths. Although diphtheria is now rare in the U.S. thanks to the development of a vaccine, it still occurs in other parts of the world where access to vaccines is limited.

TETANUS,

also known as “lockjaw”, is another bacterial disease.

Tetanus bacteria are present in soil and dust and are anaerobic, which allows them to thrive in an environment that lacks oxygen.

Tetanus disease is associated with puncture wounds, such as a dog bite or stepping on a dirty nail. A common symptom of tetanus is spasms of the jaw muscles, which can make opening the mouth difficult, thus the name “lockjaw”. Tetanus

can also cause spasms and rigidity in other muscles - including those used for breathing and can be fatal without treatment.

Like diphtheria, tetanus disease is rare in the U.S. due to vaccination efforts but is still a problem in other nations. However, since tetanus bacteria are commonplace in the environment, people should get a booster every 10 years.

DIPHTHERIA

PROTECT

The DTaP and Tdap vaccines offer protection against the same three diseases to persons of different ages. Both are injected into a muscle, usually in the thigh for a baby or toddler and in the shoulder for an older child or adult. Side effects may include muscle soreness and a lowgrade fever.

PERTUSSIS

In 2016 there were almost 16,000 cases of pertussis and 7 deaths in the U.S., 6 of which occurred in babies under 1 year of age. Pertussis is most serious for infants under 6 months of age, since they are too young to be fully immunized. They can cough uncontrollably until they stop breathing, and are often hospitalized.

That's why it's important for those in close contact with infants (older children and adults) to get a Tdap shot, which covers the same diseases as the DTaP vaccine but is formulated for older ages. This vaccine is now required for entry into 7th grade in the state of Utah and is recommended for women at each pregnancy.

TETANUS

PERTUSSIS,

or “whooping cough” is a highly contagious respiratory disease. The pertussis bacteria damage the tiny hair-like cilia that line the upper respiratory system. This damage causes airway swelling and is the reason for the violent coughing fits associated with pertussis. These coughing fits can be so severe that they may result in vomiting or even rib fractures. The coughing spasms force all of the air from the lungs, causing the afflicted person to gasp for air when inhaling, making the distinctive “whooping” sound for which the disease is named. These coughing fits can last for months.

It’s important to continue to vaccinate against these diseases, which are serious problems throughout the world but are kept at bay in developed countries due to ongoing immunization efforts. For more information about these or any other vaccines, contact your local health department (see page 31) or your health care provider.

SWUHEALTH.ORG | PAGE 23

By Kye Nordfelt SWUPHD HEALTH PROMOTION DIVISION DIRECTOR

& Kylaas Flanagan SWUPHD HEALTH EDUCATOR

D

THINGS HAVE CHANGED

o you remember what it was like to sit in a restaurant, airplane, sporting event, or even an indoor business meeting while someone close to you smoked a cigarette? Smoking anywhere used to be common and acceptable. Fortunately, over the last few decades, awareness of the dangers of tobacco has increased, along with the public’s willingness to protect themselves from cancer-causing smoke. Many communities have worked with health officials and policy makers to pass

ordinances protecting non-smokers, even at common outdoor gathering places.

Every city in Southwest Utah bans smoking in outdoor public places; including parks, fairgrounds, and storefronts. Many businesses and organizations also ban tobacco use on their properties. These efforts protect against secondhand smoke, support people trying to quit, and send a clear message to children and teens that smoking - along with second-hand smoke - is unhealthy.

HEALTH MAGAZINE | SPRING 2018

PROTECT

COLLEGE CAMPUSES: THE NEXT FRONTIER

Currently, over 2,000 U.S. colleges and universities have a smoke-free policy, a number that has quadrupled since 2010. Most of these campuses also prohibit using e-cigarettes, or “vaping”.

Why are so many institutes of higher learning going tobacco-free? Universities have a very specific population - mostly students aged 18-24 - who are targeted by tobacco companies in an effort to hook young adults who may become lifetime users. The U.S. Surgeon General reports that 99% of current smokers tried their first cigarette before the age of 26. Tobacco-free policies support healthy lifestyles among students, faculty, and visitors. Vulnerable populations are also protected, including pregnant women, people with asthma, and recovering smokers.

In 2013, Dixie State University became the first public university in Utah to establish a tobacco-free policy. While some argued that the rule would harm enrollment, student numbers at DSU continue to increase. Del Betty, DSU Dean of Students, says “Our tobacco-free campus is one of the things people like the most about our university. We also hear from pregnant students who say it’s nice to be able to walk from one building to the next without people blowing smoke in their face.”

The University of Utah recently approved a similar policy which will go into effect this summer.

WHO’S NEXT?

Southern Utah University in Cedar City could become the third out of the state’s colleges and universities to adopt a tobacco-free policy. A recent survey at SUU showed that 80% of students and 75% of faculty and staff are in favor of a tobacco policy change on campus.

“These policies are all about health”, says Beatty. ”You cannot argue with data showing that smoking and second-hand smoke ultimately kills people.”

A

T R U S T E D

C O M M U N I T Y

SWUHEALTH.ORG | PAGE 25

R E S O U R C E

AND YOUR HEALTH

By David W. Blodgett, MD, MPH SWUPHD DIRECTOR & HEALTH OFFICER

W

e all know what the lack of sleep can do to us. Irritability and moodiness are followed by slowed speech, flattened emotional responses, impaired memory and an inability to multitask. If sleeplessness continues, brief periods of microsleep occur which cause lapses in attention - or “zoning out” and nodding off while reading or driving.

Then come hypnagogic hallucinations, which normally happen during the state between waking and sleeping.

There is no doubt that sleep is important, and research continues to support that fact. Groups like the American Pediatric Association and the Centers for Disease Control are now saying that adequate sleep is as important to health as exercise and nutrition.

IMPROVE YOUR MEMORY Your mind is surprisingly busy while you snooze. During sleep you can strengthen memories or "practice" skills learned while you were awake in a process called consolidation. In other words, if you’re trying to learn something new, whether it’s Spanish or a tennis swing, you’ll perform better after sleeping.

REDUCE INFLAMMATION Research indicates that people who get six or fewer hours of sleep a night have higher blood levels of inflammatory proteins.

Inflammation is linked to heart disease, stroke, diabetes, arthritis, cancer, and premature aging. People who are chronically sleep deprived are more likely to develop these diseases.

HEALTH MAGAZINE | SPRING 2018

PROTECT

bility by reducing stress, anxiety, and depression.

SPUR CREATIVITY

The brain appears to reorganize and restructure memories during sleep, which benefits AVOID ACCIDENTS creativity. The emotional components of those memories are also strengthened, spur- The National Highway Traffic Safety Adring the creative process as well as enhanc- ministration reported in 2009 that fatigue accounted for the highest number of fatal ing relationships single-car accidents due to driver perforIMPROVE GRADES AND WORK mance, surpassing alcohol!

PERFORMANCE

According to a 2010 study in the journal Sleep, inadequate rest leads to significant functional impairment at school, Students who don’t get enough sleep had worse grades than those who did, making it clear that sleep deprivation impairs learning and performance.

SHARPEN ATTENTION A lack of sleep can result in ADHD-like symptoms in children. Kids don’t react the same way to sleep deprivation as adults do.

While adults get sleepy, kids tend to get hyperactive. A 2009 study in the journal Pediatrics found that seven and eight year olds who got less than eight hours of sleep a night were more likely to be hyperactive, inattentive, and impulsive.

PROTECT YOUR HEART

Insufficient sleep for just one night can be as detrimental to your driving ability as having an alcoholic drink. Falling asleep while driving is responsible for at least 100,000 crashes, 71,000 injuries and 1,550 deaths each year in the United States.

A SLEEPY NATION Lack of sleep takes a toll on many of us.

Surveys conducted by the National Science Foundation between 1999 and 2004 revealed that at least 40 million Americans suffer from over 70 different sleep disorders and that 60% of adults report having sleep problems a few nights a week or more. Most of these problems go undiagnosed and untreated. In addition, more than 40% of adults experience daytime sleepiness severe enough to interfere with their daily activities at least a few days each month, and 20% report having this problem a few days per week. Furthermore, 69% of children experience one or more sleep problems a few nights or more during a week.

Short sleepers, typically defined as people who get less than six hours of sleep a night, as well as people who don't spend enough time in the deepest stages of sleep, are at Teenagers with poor sleep habits are more higher risk of heart attacks and strokes than than twice as likely to use drugs, tobacco, those who get at least seven hours. Lack of or alcohol. Sleep loss also interferes with edsleep also increases cholesterol levels. ucation, with 60% of grade school and high school children reporting that they are tired MAINTAIN A HEALTHY WEIGHT during the daytime. 15% of them admitting to Recent research also suggests that a lack of falling asleep in class. sleep could be contributing to problems like weight gain and diabetes. Sleep deprivation According to the National Center on Sleep reduces sensitivity to insulin, the key blood Disorders Research, the annual cost of sleep sugar-regulating hormone, making it harder deprivation and disorders is estimated to be metabolize blood sugar properly. Short sleep $15.9 billion in direct costs and up to $100 also boosts levels of the hormones that make billion in indirect and related costs. us hungry while reducing secretion of the hormones that help us feel full.

You know what it’s like to feel refreshed and ready for the day after a good night’s sleep.

LOWER STRESS AND IMPROVE MOOD Consider the benefits of getting adequate rest Sleeping well means more to our overall every night and take this as an order from well-being than simply avoiding irritability. your doctor to protect your health by improvA good night’s sleep increases emotional sta- ing your sleep.

SWUHEALTH.ORG | PAGE 27

2 017 A N N U A L R E P O R T B OA R D O F H E A LT H Commissioner Vi c t o r Ive r s o n » w ash ing ton count y

D r. C r a i g Bo o t h

» w ash ing ton

count y

Commissioner Dale Br i n k e r h o f f » i r on cou nty

D r. C l a y t o n Pe t t y » iron count y

The Southwest Utah Public Health Department (SWUPHD) serves the nearly 230,000 residents of Washington, Iron, Kane, Beaver, and Garfield counties. Our mission is to protect the community's health through the promotion of wellness and the prevention of disease.

SERVING OUR COMMUNITY NURSING SERVICES • Immunizations administered: 14,102 • International travel consults: 585 • Health Screenings: 434 • TB (Tuberculosis) tests: 1,728 • WIC (Women, Infants, & Children) client contacts: 13,442

VITAL RECORDS • Births: 3,553* • Deaths: 2,085* • Total vital records issued: 14,923 (*provisional)

ENVIRONMENTAL HEALTH Commissioner Jim Matson » kane count y

Ro s a l i n d Metcalf

» k a ne

cou nty

Commissioner Mike Dalton » b e ave r count y

Ke n n e th El m e r

» b e ave r

count y

Commissioner Jerry Ta y l o r » g ar fi eld cou nty

• Total food service inspections and consultations: 3,694 • Food Handler Cards issued: 273 • Water samples analyzed (for swimming pools and drinking water facilities): 5,000 • Public pools & spas in district: 707 • Restaurants / food establishments in district: 947 • Total septic system inspections and consultations: 3,925

EMERGENCY PREPAREDNESS • MRC (Medical Reserve Corps) registered volunteers: 458 • POD (Point of Distribution) agreements: 237 (organizations and businesses set up to receive medication and supplies in a public health emergency for distribution to their staff/ clientele) • Events held (exercises/drills, trainings, etc.): 144 (7,944 participants) • Access and Functional Needs (AFN) Coalition created to assist vulnerable populations in an emergency. 26 agencies, businesses, and organizations are participating.

HEALTH PROMOTION • Certified car seat installation checks: 246 • Low-cost car seats distributed: 124 • Parents and teens receiving training on safe driving skills: 1,513 • Provided funding to St. George City to install over 300 way-finding signs along their trail system.

• Facilitated passage of tobacco-free policy for Washington County Fairgrounds.

Nick Re y n o l d s

» g ar f ield

count y

HEALTH MAGAZINE | SPRING 2018

2017 FRIENDS OF PUBLIC HEALTH Every year, the SWUPHD selects three members of the community who have demonstrated exceptional support and service to the field of public health.

DEIDRE BARLOW, RN

Community Health Nurse Mohave County Department of Public Health Deidre Barlow (second from left) became a close partner to the health department during the 2017 E. coli outbreak in the Hildale/Colorado City community, which straddles the border between Utah and Arizona.

Deidre was a vital part of the small investigation and response team that carried out long hours of field work, often going door-to-door to gather information that would help stop the outbreak and prevent further spread of the disease. Deidre was indispensable with her medical knowledge and close ties with the communities on both sides of the state line.

LINDA RIDER, RN

Infection Preventionist (DRMC, retired) Former Board of Health member Linda Rider (left) served on the Southwest Board of Health for 13 years as an appointed member, lending her expertise to the board and the health department. She facilitated close cooperation between the department’s disease surveillance program and Dixie Regional Medical Center, where she worked for 14 years before retiring in 2016. In 2014, Linda volunteered to join an Ebola Treatment Unit in the West African Nation of Liberia

BRADLEY G. LAST (R)

Utah State Representative, District 71 Representative Last (second from left) has long been a sponsor and supporter of public health initiatives during his time in the legislature. This year he is running a bill that would allow for closer inspection of stores that sell tobacco and e-cigarette products to ensure that they are not being sold to underage children. In recognition of his work, the Utah Department of Health honored him with their anti-tobacco advocate award called the “Butt Kicker” award. We appreciate Representative Last for his efforts in improving public health in Southwest Utah.

BEST OF STATE Our foundation’s HEALTH Magazine won the 2017 Best of State medal for “Community Development- Public Sector Publication”, which was awarded at the May 17th gala.

Pictured from left to right, Christ White (SWUPHD Deputy Director), David Heaton (Editor/SWUPHD PIO), Jeff Shumway (Publisher/SWUPHD Business Manager), Mindy Bundy (SWUPHD Nursing Director), Kindal Ridd (Designer/SWUPHD Media Specialist), Mike McEvoy (Hudson Printing), Paulette Valentine (SWUPHD Director of Emergency Preparedness), David Blodgett, MD, MPH (SWUPHD Director and Health Officer)

SWUHEALTH.ORG | PAGE 29

146

certified car seat instalations

revenue

contracts: 53% fees: 24% county contribution: 22% other: 1%

14,923

vital records issued

707 public pools & spas in district

3,553 births

14,102

total immunizations given

458

medical reserve core volunteers

2,085 deaths

3,694

food service inspections

most common natural disaster flood

5,000

230,000

water samples analyzed

population of Southwest Utah (5 counties)

HEALTH MAGAZINE | SPRING 2018

2017 data for the five counties served by the SWUPHD.

SOUTHWEST UTAH PUBLIC HEALTH DEPARTMENT OUR MISSION IS TO PROTECT THE COMMUNITY'S HEALTH THROUGH THE PROMOTION OF WELLNESS AND THE PREVENTION OF DISEASE.

B E AV E R

IRON

75 West 1175 North 260 East DL Sargent Dr. Beaver, Ut. 84713 Cedar City, Ut. 84721 (435)438-2482 (435)586-2437

WAS H I N G TO N

KANE

GARFIELD

620 South 400 East St. George, Ut. 84770 (435)673-3528

445 North Main Kanab, Ut. 84741 (435)644-2537

601 East Center Panguitch, Ut. 84759 (435)676-8800

SW U H E A LT H . O R G

NURSING SERVICES Baby Your Baby Breastfeeding Consultation Case Management Child Care Resources/Referrals Health Screenings Immunizations International Travel Clinic Maternal Child Health Mobile Clinic (rural counties) Prenatal Resource Referrals School Exemptions Education & Tracking School Health/Nursing WIC

HEALTH PROMOTION Bicycle Safety Car Seat Classes Certified Car Seat Inspection Points Community Training and Outreach Healthy Dixie Liaison Healthy Iron Co. Liaison Injury Prevention Safety Resources Physical Activity & Nutrition Resources Resources to Quit Tobacco Tobacco Compliance Checks Tobacco Education(retailers) Tobacco-Free Housing Data

ENVIRONMENTAL HEALTH Air & Water Quality Body Art Regulation Child Care Inspections Food Handler Permits Hotel Sanitation Inspections Pool Inspections Restaurant Inspections School Inspections Septic System Inspections Tanning Bed Sanitation Inspection/Enforcement Temporary Mass Gathering Permits Used Oil Utah Indoor Clean Air Act Inspection/Enforcement Water Lab

EMERGENCY PREPAREDNESS Bioterrorism Prep/Planning Community Training & Outreach Free Emergency Resources Hospital Surge Planning Mass Flu Vaccination Events Medical Reserve Corps Pandemic Prep/Planning Preparedness Buddy Strategic National Stockpile (SNS) Coordination

VITAL RECORDS Birth Certificates Death Certificates Disinterment Certificates Divorce Certificates Marriage Certificates

COMMUNICABLE DISEASES Disease Surveillance & Control Epidemiology Tuberculosis Program

NON PROFIT ORG US POSTAGE PAID SALT LAKE CITY, UT 841 PERMIT # 6563

@SWUhealth