Health | Spring 2024

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BEAVER

75 W 1175 N Beaver, Utah 84713 435-438-2482 GARFIELD

601 E C enter Panguitch, Utah 84759 435-676-8800 IRON

260 E DL Sargent DR. Cedar City, Utah 84721 435-586-2437 KANE

445 N orth Main Kanab, Utah 84741 435-644-2537

WASHINGTON

620 S 400 E St. George, Utah 84770 435-673-3528

HEALTH DEPARTMENT LOCATIONS

Heroes of Public Health

Dr. Ignaz Philipp Semmelweis Savior of Mothers

In 1847, while Dr. Ignaz Semmelweis was working as the Assistant Chairman of Obstetrics at the Vienna General Hospital, he suspected that “cadaverous particles” were being transmitted from the hands of the medical students doing autopsies in the morning to the mothers they attended to later in the day. The link between bacteria and disease had not yet been discovered. After experimenting with various solutions, he required the students to wash their hands with a chlorinated water and lime solution

before starting work and before each vaginal examination.

Despite the fact that the death rate of new mothers dropped from 11% to less than 3% and remained there for the next seven months, Dr. Semmelweis received only criticism from his colleagues for his efforts. The contention became so intense that he left and accepted the Chair of Obstetrics at the St. Rochus Hospital. The death rate in the obstetrical wards he oversaw dropped to 0.82% due to his hand washing requirements.

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Dr. Semmelweis was outraged at the indifference of his fellow physicians and began writing letters to prominent European obstetricians, denouncing some as irresponsible murderers. In 1865 his wife and con-

temporaries felt he was losing his mind and admitted him to an insane asylum where he died 14 days later. Dr. Semmelweis has since become known as the “Savior of Mothers.”

During an apprenticeship where he gained the experience needed to become a surgeon, Edward Jenner took note of a popular belief that milkmaids who had contracted cowpox were immune from smallpox.

In 1796, some thirty years after first hearing about the phenomenon, he extracted some fluid from sores on the hand of milkmaid Sarah Nelmes, who had recently contracted cowpox. He then convinced his gardener to allow him to infect his eight year old son. The boy developed a mild illness but completely recovered. A few weeks later, Jenner repeated the procedure but used fluid from smallpox sores. The result: the boy remained healthy...he was immune to smallpox.

When the medical community refused to publish his findings, Edward Jenner re-

peated his process on more subjects, including his own infant son, all with the same results. He called his new method “vaccination” after the Latin word for cow (vacca).

Despite his great discovery, Jenner faced an uphill battle among his skeptical medical peers. He persisted and provided smallpox vaccination free of charge to the poor. In 1801 Jenner wrote, “I hope that someday the practice of producing cowpox in human beings will spread over the world. When that day comes, there will be no more smallpox."

By 1977, smallpox, one of the great scourges of civilization, had virtually disappeared, the last case being reported that year in Somalia.

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Florence Nightingale was a social reformer and founder of modern nursing. She became well known after her efforts in caring for wounded British soldiers during the Crimean war in 1854, where she trained and managed a team of nurses. Focusing on hygiene and standards of care, they were able to significantly reduce death rates among the sick and injured.

After being seen making rounds at night to wounded patients, Nightingale became known as "The Lady with the Lamp". To this day, a lamp is often used internationally as a symbol of nursing.

Florence Nightingale went on to establish the Nightingale Training School for Nurses in 1860. She continued her mission to transform the practice of nursing and health care into a highly skilled profession based on evidence-based practices, along with the psychological and emotional needs of patients.

The school’s specialties included midwifery, which is the care of women in the process of labor and delivery. Speaking on midwifery, Nightingale said “though everybody must be born, there is probably no knowledge more neglected than this, nor more important for the great mass of women.”

She also emphasized the importance of sanitation and disease prevention in public health, especially among poor populations.

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Florence

Cholera is a bacterial infection of the intestines which causes profuse diarrhea and vomiting and has up to a 60% mortality rate if left untreated. In 1854, an outbreak of the dreaded disease hit the Soho district of London, causing most residents to flee and killing over 600 people over the course of a few weeks.

Obstetrician Dr. John Snow took to the streets of Soho as the outbreak raged in an effort to track down the source. Going door to door to identify where the victims lived and what they had in common, he created a map that helped him narrow his search to a specific area surrounding a water pump on Broad Street.

Dr. Snow wrote: “The result of this inquiry, then, is that there has been no particular outbreak or prevalence of cholera in this part of London except among the persons who were in the habit of drinking the water of the above-mentioned pump-well. I had an interview with the Board of Guardians of St. James’s parish, … and I represented the above circumstances to them. In consequence of what I said, the handle of the pump was removed on the following day.”

Dr. John Snow's detective work helped end what he later called “the most terrible outbreak of cholera which ever occurred in the United Kingdom”. He was able to show that contaminated water was responsible for the spread of cholera, and he traced the source of disease to nearby cesspools and sewage-polluted water from the Thames River, which was being piped directly to the pumps used for drinking water.

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During the American Civil War, educator and public health promoter Clarissa (known as Clara) Barton was living in Washington DC, providing nursing care and supplies to soldiers, often risking her own life - earning her the nickname “Angel of the Battlefield”.

After the war, with the support of President Abraham Lincoln, she opened the Office of Missing Soldiers in 1865, helping to reunite more than 22,000 soldiers with their families.

In 1869, while traveling in Switzerland, Clara discovered the Red Cross movement, an organized effort to provide aid to those injured in combat, regardless of nationality. She ended up volunteering for the Red Cross when the Franco-Prussian War broke out in 1870, providing aid to civilian populations.

Using her experience in Europe along with her work during the Civil War, Clara founded the American Red Cross in 1881 and served as the organization’s president until she retired in 1904 after a lifetime of service.

The website redcross.org states, “To this day Clara’s legacy lives on, reflected in the spirit of Red Cross volunteers and employees. Because of one woman, Clara Barton, the American Red Cross brings help and hope across the nation and around the world.”

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I

Jonas E. Salk

The Man Who Saved the Children

n 1947, American virologist Dr. Jonas E. Salk was approached by the director of research at the National Foundation for Infantile Paralysis. He was asked to participate in the foundation’s polio project, established by President Franklin D. Roosevelt who was a polio victim himself.

Dr. Salk devoted himself to the cause for the next eight years. Other researchers also working to develop a polio vaccine were experimenting with highly dangerous live vaccines and were unsuccessful. Salk decided to focus on a safer, “killed” virus.

After testing the finalized vaccine successfully on animals, it then needed to be tested on humans. In 1953, he announced that he - along with his wife and children - was among the first volunteers to be vaccinated. After preliminary results in 1954, Salk’s vaccine was ready for the much larger field testing.

With over 2.1 million participants, it became the most elaborate field trial of its kind, including physicians, public health workers, school personnel, volunteers, and more than 1.8 million school children. The celebrated announcement of a safe and effective vaccine was made on April 14, 1955. It was clear – the vaccine worked! One observer recalled, “It was as if a war had ended.” Dr. Jonas Salk was deemed a miracle worker, the “Man Who Saved the Children.”

Polio was once the leading cause of permanent disability in the United States. In 1952, at the height of the polio epidemic, nearly 58,000 cases were reported with more than 3,000 deaths and more than 20,000 people left with some form of paralysis. The tide turned once the vaccine saw widespread use, and less than 100 cases per year were being reported by the mid 1960’s .The last wild-virus Polio case acquired in the United States was reported in 1979. There are now just a handful of countries where the disease is still active.

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Health for the Ages

The current growth in the number and proportion of older adults in the United States is unprecedented. Many Americans are now living into their 70s, 80s, and beyond. By 2050, it is anticipated that Americans aged 65 or older will number nearly 89 million people, or more than double the number of older adults in the United States in 2010.

There are aspects of good health specific to the senior demographic, and since all of us will continue to age and become senior adults if we live long enough, these are principles everyone should pay attention to.

Death, disability, and decline associated with the leading chronic diseases are often preventable or can be de-

layed. Although the risk of developing chronic diseases increases as a person ages, the root causes of many of these diseases often begin early in life. Practicing healthy behaviors from an early age can greatly reduce a person’s risk of developing chronic diseases and associated disabilities. Here are some proven indicators for long-term good health, and most of them can be practiced at any age:

Physical activity: Regular physical activity is one of the most important things older adults can do for their health. Physical activity can prevent many of the health problems that may come with age, including the risk of falling, which becomes the leading cause of injury death in adults aged 65 and older. Older adults need to do

HEALTH MAGAZINE | SPRING 2024
Article originally published in HEALTH Winter 2017

both aerobic and muscle-strengthening exercise to improve and maintain health. Walking 30 minutes a day is a great start.

Eating fruits & vegetables daily:

Diets rich in fruits and vegetables may reduce the risk of some cancers and chronic diseases, such as diabetes and cardiovascular illness. Fruits and vegetables provide essential vitamins and minerals, fiber, and other substances that are important for good health. Appetites may decrease with age, which makes food choices even more important to make sure adequate nutrients are present in the food eaten.

of death in the United States for many years, mostly among adults aged 65 and older, and deaths from Covid-19 have surpassed those diseases during the past few years. Vaccinations against flu, pneumonia, and Covid-19 play an essential role in preventing hospitalization and death among the elderly.

Colorectal cancer screening:

"If I’d known I was going to live this long, I’d have taken better care of myself."

Body weight: Older adults benefit from maintaining a healthy body weight. Obesity is a risk factor for many chronic conditions, including stroke, heart disease, cancer, and arthritis.

Getting enough sleep: It is clear that sleep is very important to long term physical and mental health. Getting adequate sleep may decrease the chance of developing dementia.

Not smoking: Tobacco use remains the single largest preventable cause of disease, disability, and death in seniors in the United States.

Taking prescribed medications appropriately: Studies indicate that as many as 70% of older adults do not take prescribed medications as directed.

Vaccinations: Influenza and pneumonia have ranked in the top 10 causes

Colorectal cancer almost always develops from precancerous polyps in the colon or rectum. Screening tests can find precancerous polyps so that they can be removed before they turn into cancer. Screenings can also detect colorectal cancer early, when treatment works best. Two-thirds of all new cases of colorectal cancer are in people aged 65 or older.

Being married: Yes, it’s true, one of the most consistently documented ways to live a longer life is to be in a happy marriage.

Maintain brain health: Activities that challenge and stimulate your brain keep you interested and engaged in life (and healthier).

A well-known quote states, “If I’d known I was going to live this long, I’d have taken better care of myself”. We understand more about aging than we ever have, and the assumption that chronic disease is just part of getting old is not true. We all have the opportunity to step up to the challenge of maintaining health throughout our lifespan, and the sooner we start, the better!

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The Case For Moderation

Is it possible to take the “good health” message too far? In an age of extremes, it becomes easy to believe that everyone should be on the far end of the diet, fitness, and appearance spectrum in order to be healthy.

Questionable trends that win mainstream acceptance are nothing new. Heroin, cocaine, and arsenic, for example, have all been considered cure-alls in popular culture. Mercury ingestion for a wide variety of ailments persisted for centuries. Bloodletting, lobotomies, and even urine-drinking have all had their turn, and some have adherents to this day. In the 1920s and 30s, dehydrated tapeworm eggs were all the rage. Advertised under the heading “Eat! Eat! Eat! & Always Stay Thin,” it was a fad diet that worked to an extent, but, as you might imagine, the cure was much worse than the problem.

The wisdom of "moderation in all things" remains a time-proven key to lasting success for any health regimen. To begin with,

national data paints a portrait of American health behaviors that are, unfortunately, quite unhealthy - so moderation means stepping it up for many of us. Only about 22% of us eat five one-cup servings of fruits and vegetables a day. Just 20% of us exercise three or more days a week. Around 60% of Utahns are overweight or obese. So how many of us are getting enough fruits and vegetables, exercise, and maintaining a healthy weight? The answer is a dismal 6%, and chances are you fall into the other 94%. The good news is that you don’t have to be superhuman or make radical lifestyle changes to be healthy, because some very basic adjustments can make a significant difference.

Take fruits and vegetables, for instance. The current recommendation is that you incorporate five one-cup servings of fruits and vegetables into your daily diet. This will reduce your risk of heart disease, cancer, and type 2 diabetes while improving bone

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Article originally published in HEALTH Summer 2015

health, vision, memory, sleep, and life expectancy. Increasing fruit and vegetable consumption displaces fats from your diet, making it easier to maintain a steady weight. Even a small increase in the amount of produce you consume has benefits, so going from zero to one fruit or vegetable a day (a real improvement for some people) starts the process. The moderate approach is key; becoming vegan or vegetarian may not be realistic for most people.

Exercise has equally dramatic health implications. The current recommendation is engaging in moderate physical activity (like a fast walk) for 30 minutes for five days a week. That means that of the 168 hours in any given week, you should be moving for 2 ½ of them. That's only about 1.5% of our time, but the health benefits are remarkable, reducing heart disease, diabetes, weight gain, Alzheimer’s, osteoporosis, arthritis, back pain, cancer, and other ailments. Other benefits you're likely to notice with regular exercise include lowered stress, improvement in mood, improved learning ability, and increased self esteem and body image. There are few areas of health that are not improved with exercise. Interestingly, the exercise benefit curve rises sharply with the half hour-a-day mark, in-

creases at a slower rate until you hit an hour and then drops off. So, the first 30 minutes give the greatest benefit, followed by a substantial benefit that continues until you reach an hour of exercise a day. But the return for effort is much less after an hour. Some studies even suggest that the damage done after an hour may begin to outweigh the benefits of continued exercise, depending on the activity. Again, moderation comes to the rescue.

The ideal lifestyle we are advocating for is a moderately active one with a few more vegetables in the daily diet, which will help with healthy body weight. Not smoking, getting good sleep, and having healthy relationships are also worth your attention. Adopting such a lifestyle will reduce your chance of premature death by 70%. It will also help you feel healthier and happier throughout your lifespan.

The “extreme is best” perspective to health only works for a few people. The moderation approach is more realistic and attainable. Starting to act on the basics of good health today will bring dramatic long-term rewards in the future. In health, as well as in the other aspects of life, moderation truly is the best policy.

Check Your Sources

Originally published in HEALTH Winter 2022

Ask yourself these basic questions when evaluating information you find online or anywhere else, especially when it affects your health:

• Does the claim fall in line with what you know about the world and common sense?

• Is the claim advocating an extreme regimen, behavior, or quantity of something? “Moderation in all things” is more than a nice phrase, and “more is better” has its limits.

• Is this an effort to sell you something or does someone’s livelihood benefit from the decision you make about the claim? Look for indications of a “paid advertisement”.

• Is the source a lone expert? In general, sources that are supported by recognizable groups of authorities in an area of expertise are more reliable than a single individual. This guideline is not foolproof, but larger professional organizations often have a process in place that helps weed out bad information.

• Are there any underlying agendas? Sources that do not have a financial or political stake in the issue are more credible, such as the independent United States Preventive Services Task Force (USPSTF).

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Family Meal Time

the surprising benefits

Excerpts taken from HEALTH Winter 2019

Could sitting down and eating dinner together as a family protect your kids from making risky choices?

There are two terms we use often when studying behavioral and public health:

Risk factors are things that increase the likelihood that young people will develop emotional, physical, and emotional problems. Family-related risk factors include poor family management and discipline, family conflict, a family history of antisocial behavior, and parental attitudes that favor problem behaviors.

Protective factors help shield and buffer children and teens from negative influences. Protective factors that

families can offer include attachment and bonding, opportunities for prosocial involvement, and recognition of positive behavior. Prioritizing family mealtime has been found to be one of the best ways to build these factors in the home.

Protective and risk factors have been studied over the past 20 years in Utah through the Student Health and Risk Prevention (SHARP) survey. It is a voluntary assessment administered to youth in 6th, 8th,10th and 12th grades whose parents have given consent. It provides valuable information that is used to guide what types of programs should be implemented in order to prevent substance abuse and other highrisk behaviors.

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According to the most recent SHARP survey results, 72% of Southwest Utah youth feel attached to their parents, which is great news. However, when asked “Do you eat at least one meal as a family 5 or more times in a typical week?”, only 54% of youth answered “yes”, showing a 3-4% downward trend every two years since 2019. We are concerned that such a timeless protective factor is becoming less common and want to take the opportunity to remind parents of the benefits of family mealtime.

Research has shown that when parents create the expectation of eating together as a family, children feel less isolated and are less likely to experience suicidal ideation. Eating together at least five times a week is associated with lower rates of smoking, drinking, and illegal drug use among teens and preteens when compared to eating together twice a week or less. Teens who have family mealtime at least four times a week have a higher grade point average than their peers in the two or less category.

the conversation; the belonging or the connection, the time spent sitting down and eating together pays off in many ways.

Today's families have different challenges and seem busier than they have in the past. Here are some tips to enhance your family mealtimes:

• Be more intentional about positive interaction and affirming words.

• Come up with topics and questions that bring everyone into the conversation.

• Create expectations, like no electronics, everyone sits at the table, putting aside negativity, etc.

• Try to be consistent with what days, times, and how often you eat together during the week, so it's predictable and can fit into busy schedules.

“All great change in America begins at the dinner table.”
Ronald Reagan

Children benefit from regular family mealtime by being more likely to eat healthier foods and less likely to become overweight. Home cooked meals tend to be more nutritious and less expensive than eating out. Whether it's the quality of food or

• In a rush? Only 20-30 minutes are needed for some good interaction with a bite to eat.

• Involve everyone in preparing the meal and cleaning up after.

• Plan and shop ahead. This saves time, money, and helps kids look forward to dinner if they see a menu.

To see complete SHARP survey results, visit sumh.utah.gov/data-reports/sharp-survey

Ask Your Doctor If...

This is Herman, who was featured in several issues as he began his journey toward better health. From getting off the couch to exploring the great outdoors, Herman showed that anyone can take the steps to prevent disease and enjoy a longer, healthier life by asking questions with pretty obvious answers!

Ask your doctor if Getting Off The Couch is right for you.

Getting Off the Couch should be taken most days of the week in 30-minute doses. Works well when combined with Healthy Eating and Fresh Air. Side effects may include healthy weight loss & maintenance, decreased risk of heart disease, diabetes, & cancer; improved mood, better sleep, & longer life. Consult your physician if you haven't tried Getting Off the Couch in quite a while.

Ask your doctor if Not Smoking is right for you.

Not Smoking has been used by millions of people since the 1940s to add years to their lives, and has been proven to prevent emphysema and lung cancer. Side effects include fresh breath, saving thousands of dollars, and protecting the health of those around you. Not Smoking is FDA approved for all ages; people who start young are likely to use it for life. If you are currently Smoking and would like to switch to Not Smoking, contact 1-800-QUITNOW or waytoquit.org for free assistance.

Ask your doctor if Eating Vegetables is right for you.

Did you know that over half the food we buy is highly processed? That’s a lot of low-quality fuel being poured into a high-performance engine. Maybe it’s time you tried Eating Your Vegetables, a natural alternative to the food products many of us are surviving on. Taking five doses a day gives amazing results! Eating Your Vegetables provides nutrients, vitamins, minerals, and enzymes that will keep you healthy. Now available in a variety of shapes, colors and flavors!

Supplementing with Assorted Fruits is recommended for optimal results.

Ask your doctor if Getting Tested for Prediabetes is right for you.

If you’re an adult reading this, there’s a 1 in 3 chance that you have prediabetes (higher than normal blood sugar). Introducing Getting Tested for Prediabetes (GTFP); a simple, inexpensive way to find out if you’re on the road to becoming diabetic. GTFP is a finger prick (A1C test) that can read your blood sugar levels over the past 3 months, letting you know in minutes if you’re in the normal or prediabetic/diabetic range. Diabetes is the 8th leading cause of death in the US but can be prevented with simple lifestyle changes if detected early enough, so why not try GTFP today?

SPECIAL OFFER: FREE prediabetes screening & A1C test during the month of April 2024! See if you qualify at swuhealth.org/diabetes.

Ask your doctor if Bicycling is right for you.

Bicycling is a “revolutionary” treatment for sedentary lifestyles. Bicycling can relieve stiffness, fatigue, and the blues while increasing heart health, flexibility, and muscle tone. Bicycling actually transfers your body’s own energy into an efficient, active transportation alternative. It can be taken any time of day, alone or with other Bicyclists.

Side effects include well-developed calf muscles and increased fresh air intake. Add a helmet for safety.

Ask your doctor if Hiking is right for you.

If you’ve tried walking, then chances are you’ll love Hiking. Hiking is specially formulated to combine the benefits of physical exercise with exposure to the Outdoors, Vitamin D, and Natural Aromatherapy. Hiking helps open airways for deep breathing, improves balance, helps control weight, and lowers risk of chronic disease. Hiking can reduce symptoms of stress, anxiety, and depression. Best of all, it’s available free of charge. Initial investment in sturdy footwear is recommended along with safety and weather precautions.

Side effects may include loss of interest in electronic media and restlessness between excursions. Hiking may be addictive to some patients.

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Keeping Measles out of Utah

To vaccinate or not to vaccinate....that is the question I hear from many of the cautious, caring parents I encounter each day. There is so much conflicting information available in the media and on the internet, it's no wonder why so many parents struggle with this decision.

In April 2011, Utah had a measles outbreak starting with an unvaccinated person who traveled out of the country. It quickly spread to other unvaccinated people. In order to protect those who were not vaccinated, many people had to be excluded from school or work, sometimes for longer than three weeks (editor’s note: two more outbreaks occurred in 2014 and 2017, with the majority of cases being unvaccinated).

Measles is a virus that initially causes a cough, runny nose, and fever, then develops into a rash. Complications from measles can include ear infections, pneumonia, seizures, brain damage, and even death. Measles is one of the most contagious diseases in existence. An unvaccinated person can catch it by simply being in a room with a person that has measles, even after the infected person has already left the room. A person is contagious and can spread the virus before they feel sick with any symptoms.

The safest, most effective way to prevent illness from the measles virus is to get vaccinated. The measles vaccine has been available for use since it was licensed over sixty years ago. It is 97% effective after two dos-

Originally published in Winter 2012

es. Some of the side effects of the vaccine include fever, mild rash, and swollen glands. Rarely (1 in 3000-4000), children who are vaccinated develop a high fever that can cause a seizure. Fewer than 1 in 1,000,000 develop a serious allergic reaction. Almost everyone who is not vaccinated and is exposed to the measles virus will develop the disease. Many believe there is little chance they will be exposed to measles since we don't see very many cases anymore in the United States, but measles is still active in other parts of the world and causes over 130,000 deaths every year. Children are especially vulnerable to measles: 1 in 4 will need to be hospitalized, 1 in 10 will develop an ear infection, 1 in 20 will get pneumonia, and 1 or 2 in 1000 will die.

“Vaccines are only effective if widely disseminated. The success of immunization requires coordinated efforts to distribute vaccines among populations, and to encourage their use. When these efforts are neglected, or actively obstructed, the diseases of the past return.”

journal, cited concerns about the combined measles/mumps/rubella (MMR) vaccine, claiming a link between the MMR vaccine and the development of autism. In 2010, The Lancet retracted the study due to ethical misconduct of the author, and in 2011 the research was declared fraudulent. There have been many international studies conducted since then that found no link between the MMR vaccine and autism.

Galea, MD, DrPH, Dean and Professor, Boston University School of Public Health

What about measles vaccine and autism? A 1998 study published in The Lancet, a British medical

The false link between the MMR vaccine and autism is just one example of conflicting information that parents must sift through as they try to figure out what's best for their children. The internet is a wonderful tool, but it can be confusing, overwhelming, and misleading. It's a good idea to seek out information from reliable sources, such as the Centers for Disease Control (cdc.gov) and the Children’s Hospital of Philadelphia (search online for Vaccine Information Center).

Baby Blues?

Or is it post-partum depression?

Article originally published in HEALTH Spring 2019

The birth of a child is a joyful and often overwhelming event. For some women, physiological and psychological changes can be acute and result in postpartum depression.

An estimated 1 out of 7 women experience postpartum depression (PPD). PPD is a serious condition that can interfere with a woman’s ability to provide care for her baby and herself. PPD can cause feelings of hopelessness and emptiness, and some women

feel like they do not love their babies. It can be caused by dramatic drops in estrogen and progesterone levels, which occur naturally after childbirth.

Impaired thyroid function can also be a contributing factor. Postpartum inflammation of the thyroid is a rare condition that negatively affects mood and energy level. Thyroid dysfunction is easily tested for and treated.

Other causes of PPD include feelings

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of anxiety, being overwhelmed, and a loss of control. These are normal emotions experienced after childbirth, but in the case of PPD, they lead to extreme feelings of helplessness, exhaustion, and depression.

Any new mother can experience PPD. A prior history of any type of depression, having bipolar disorder, and the experience of high stress events in the previous year are some factors that increase the risk of PPD.

If you are pregnant and have risk factors, tell your doctor. Your doctor can monitor you during your pregnancy for signs and symptoms of depression. There are depression screening tools specifically developed for PPD. These questionnaires are administered before and after delivery to help gauge depression levels. PPD is highly responsive to treatment. Counseling and support groups have proven to be helpful. Women with high levels of depression can also be prescribed antidepressants during and after pregnancy.

and it should not cause feelings of shame or guilt. It is a medical disorder and medical intervention is crucial.

Postpartum depression should not be confused with the normal mood swings that occur after childbirth. These normal mood swings are also known as the “baby blues” and include anxiety, crying spells, and sleep loss. Baby blues usually start a day or two after delivery and diminish after 2-3 weeks. PPD is much more severe and typically begins 1-4 weeks after delivery. Without treatment it can last up to a year.

Rare but even more serious is postpartum psychosis. This involves delusions, hallucinations, and suicidal thoughts. Postpartum psychosis is an emergency. Seek help immediately by calling 911 or going to the emergency room. Get a neighbor, friend, or family member to drive you to the hospital or stay with you while you wait for emergency response.

Discuss any concerns with your doctor and listen to family members and friends if they are worried about your welfare. Having PPD does not mean you are a bad mother

Awareness of PPD is the first step in overcoming it. Knowing there is treatment provides hope for those who are affected by it.

For resources mihp.utah.gov

Breathing Easier a public health success story

Smoking, prior to the 1900’s, was largely unheard of. Widespread smoking came with the advanced mechanization of the modern cigarette in the early 20th century. With new technology, tobacco companies had the ability to mass produce an almost limitless supply at very little cost. In addition, the companies increased their marketing efforts and had begun using mass media to promote their products. Tobacco consumption exploded during World War I when cigarettes were widely distributed to soldiers in their daily rations as morale boosters. By the 1920’s more than half of all young adult males in the United States were smokers. Women also began smoking in greater numbers in the first half of the century. Smoking became a popular and widely accepted behavior, even among physicians.

Although there had already been some articles published alluding to the risks of smoking, the 1920’s brought the first medical reports linking cigarette smoking with lung cancer. Up until then, the increased incidence of lung cancer was thought by many to be caused by workplace contaminants such as asbestos and radioactive materials. Evidence of smoking-related illness continued to accumulate into the 1950s but not much of this information was reaching the public as the media was reluctant to report on findings due to financial influence from the tobacco industry. By the mid-1960s, at the peak of its popularity, 42 percent of adults in the United States were current smokers.

In 1961, the American Public Health Association, along with several notable medical

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organizations including the American Can- cer Society and American Heart Association, called for a national commission on smoking. In 1962, newly appointed Surgeon General Luther L. Terry organized an objective com- mittee of medical experts to complete a comprehensive review of thousands of scientific articles related to smoking and health. The review took over a year to complete and culminated in a report that would dramatically impact the country and beyond. Terry’s re- port, which was released in January 1964, became the lead story in all media outlets. One of the findings published in the report was that documented smokers, compared to non-smokers, had a 10 to 20-fold risk of developing lung cancer. The report also blamed smoking as a cause of other major health conditions, like heart disease. This report would become one of many to be issued on the health consequences of smoking.

The mid-1960s brought the first legislation related to the hazards of smoking. In 1965, cigarette manufactures were mandated to print a health warning on all cigarette packaging. That same year the National Clearinghouse on Smoking and Health was cre- ated; its main role was to develop national education programs about the risks of smok- ing. The Fairness Doctrine was also passed, which required broadcast media companies to air anti-smoking messages to counter the tobacco industry’s advertising. This practice would continue until the 1971 ban of all overair advertising of cigarettes. Beginning in 1973, a few states began to implement smoking restrictions in some public spaces and restaurants. Public perception on the health risks of smoking also began shifting at this time. In 1954, according to a Gallup Survey, less than half the American people believed smoking caused cancer, but by the late 1960s that number had risen to more than 75%. By 1979, the smoking rate had dropped from 42% to 33%.

The 1980s would bring about the most successful anti-smoking campaign ever, beginning with the appointment of C. Everett Koop as Surgeon General, who served from 1981 to 1989. In the year he took office, close to 400,000 deaths were attributed to smoking. During his tenure, he took on the tobacco industry, accusing them of deceptive advertising and pushed for stronger warning labels on cigarette packaging to replace the generic label that had been in use. He wanted con-

sumers warned about the specific health risks of smoking related to cancer, heart disease, lung conditions, and pregnancy.

Koop would also release several notable reports during his time in office, including the 1982 Surgeon General report, which held smoking as responsible for 30 percent of all cancer deaths. Koop would also be the first to state that smoking was an addiction and not just a “habit” as it had been previously characterized.

Smoking was still permitted almost everywhere; in schools, public transportation, even hospitals. In a 1984 speech announcing his Campaign for a Smoke-Free Society by 2000, Koop implored smokers to quit to protect their own health and enlisted non-smokers across America to demand their right to breathe smoke-free air. As Koop would say, “The right of smokers to smoke ends when their behavior affects the health and well-being of others.” His 1986 report supported his stance by showing that people exposed to secondhand smoke were at risk for many of the same diseases that afflicted smokers.

By the mid-to-late 1980s, more than 40 states had adopted smoking statutes of some type, government organizations began adopting smoke-free policies, and Congress banned smoking on short domestic flights. Public opinion on smoking continued to change, and by the end of Koop’s time in office, adult smoking rates had dropped to 26%.

Despite the snowball effect of anti-tobacco education and policies over the decades, smoking is still the leading preventable cause of disease and death in the U.S., responsible for about 1 in every 5 total deaths each year, including over 41,000 from secondhand smoke. 16 million Americans are currently living with a smoking-attributable disease.

While we have not yet reached Koop’s goal of a “Smoke-Free Society,” we are making progress. More than half of all adults who have ever smoked cigarettes have quit. Smoking rates have declined almost every year since their peak of 42% in 1965. Currently, the national adult smoking rate is 11.6%. Utah, which was rated as the second healthiest state in the nation in 2023 (Hawaii being the first), has the lowest adult smoking rate in the country at 6.7%.

SWUHEALTH.ORG | PAGE 23

Gardening 101 getting started

Gardening is an enjoyable hobby that can have positive impacts on mental and physical health. Being outdoors and around plants boosts moods and lowers stress and anxiety levels. Gardening is a low-impact exercise that can lower blood pressure and growing your own vegetables encourages healthy eating habits.

The winter months are an ideal time for both new and experienced gardeners to plan for the upcoming growing season. Start by determining what to include in your garden and where you will plant it. No one has unlimited resources, so decide what fits within the space and time you can devote to your garden. Next, focus on growing things that you and your family will enjoy. Finally, leave a little room to be adventurous. It’s always fun to grow something you’ve never tried before.

As you are planning what to grow, remember to select varieties that fit with your overall garden plan. Different varieties of the same vegetable can have different colors, flavors, sizes, and growth requirements. As part of this selection, you might be offered a choice between heirlooms or hybrids. Heirloom vegetable varieties can literally be heirlooms. These are the family favorites your parents and grandparents saved seeds from to plant year after year. Heirloom varieties are open-pollinated, which means if the seeds are collected and grown again, they will produce more vegetables of the same type. Heirloom varieties are often praised for having superior flavor.

Hybrid varieties are not open-pollinated. Instead, they are created by intentionally crossing two varieties of

the same species to gain the best traits of each. Hybrids often have bigger fruit, larger yields, and improved disease resistance. However, seeds from hybrid varieties are not true-to-type, meaning some seeds might produce plants like the hybrid or they could produce plants more like the original crossed seeds.

When considering what vegetable varieties to plant, it is also important to consider the days to maturity. This refers to the average number of days before a plant begins producing vegetables. In Utah, this is particularly vital in areas with higher elevations. High-altitude gardens may have fewer days where the temperatures are suitable for growth, and some varieties may not have time to mature before the first frost.

Another challenge for Utah gardeners is working with poor soil that is often alkaline and high in salinity. Incorporating organic matter like compost is the best way to improve the overall quality of the soil, but having your soil tested can help you understand the specific challenges you might be facing.

Growing vegetables in raised garden beds has become popular. In areas with poor soil, this can be a practical choice, because you can focus on improving the soil in a small, defined area. An ideal size for raised garden beds is 3-4 feet wide by 12-18 inches deep.

Container gardening in grow bags or large pots is another viable option. Growing vegetables in containers allows you to use spaces like decks and patios that would not otherwise be suitable. For people living in apartments, container gardening might be the only method available.

Whether you decide to plant a garden in the ground or a raised bed or container, you might consider the concept of food-scaping. Rather than planting vegetables in straight rows, try combining vegetables, herbs, and flowers in decorative groupings to create an edible landscape.

All plants use sunlight as their energy source, but the strength and duration of light needed varies from plant to plant. Most vegetables prefer at least 8 hours of direct sunlight. The high solar intensity and low relative humid-

ity in Utah make sunburn injury to plants common. Using a 20-30% shade cloth can improve vegetable production.

Nearly all garden vegetables can be easily started from seeds. Purchase seeds from a reputable supplier. For the best results, use seeds packaged for the current year. Most gardeners have a collection of seeds left over from previous years. The longer seeds are stored, the less energy reserves they have to germinate and produce strong, healthy plants.

When sowing seeds, follow the directions on the packet. If the instructions do not specify, planting depth is based on the size of the seed. Usually, three times the width of the seed is recommended. In Utah, warm-season crops like peppers and tomatoes are typically started indoors and transplanted when outdoor temperatures allow. You can purchase transplants from a nursery or garden center, or you can start them yourself from seeds.

Watering effectively is one of the most important parts of creating a successful garden. For beginners starting on a small scale, hand watering with a watering can or hose works well. Hand watering is time-consuming, and larger gardens usually incorporate some kind of irrigation system. Spray irrigation is easy to set up but is less efficient and can lead to weeds. Drip irrigation is more efficient but can clog if not maintained properly. Whichever type of watering you choose, inspect your plants regularly to ensure they are receiving the right amount of water.

Plants also need nutrients to grow. Many plant nutrients are readily available in the soil, but a soil test can determine if any are lacking in your garden. Nitrogen moves through the soil quickly, so adding supplemental nitrogen is important for optimal plant health. Fertilize vegetables early in the season, and be careful not to over fertilize.

Gardening is a learning process. Enjoy the process and take advantage of the numerous online resources to help you be more successful. You can also contact your local Utah State University Extension office for advice and classes tailored to your local growing conditions (visit extension.usu.edu/locations).

Alcohol and your Health

What is most likely to kill you? When I’m asked that question as a medical professional, I find myself giving two answers. The first comes from asking another question: what is the most likely diagnosis on a death certificate? The answer is heart disease, cancer, or stroke. However, sometimes I find more meaning in the answer to a second question: what are the underlying causes of death, or what conditions led to what is listed on the death certificate? The answer to this question often includes behavioral habits like diet, exercise, sleep, smoking, and alcohol consumption. These are things we can actually do something about to improve health and wellbeing.

It might seem surprising that alcohol, widely consumed around the world, plays such a large role in premature death.

According to the Centers for Disease Control (CDC), alcohol use led to more than 140,000 deaths and 3.6 million years of po-

tential life lost each year in the United States from 2015-2019, shortening the lives of those who died by an average of 26 years. Drinking was responsible for 1 in 5 deaths among adults aged 20-49 years. The economic cost of excessive alcohol consumption in 2010 was estimated to be $249 billion.

The World Health Organization (WHO) recently published a statement in The Lancet Public Health journal: “When it comes to alcohol consumption, there is no safe amount that does not affect health. Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago – this is the highest risk group, which also includes asbestos, radiation and tobacco. Alcohol causes at least seven types of cancer, including the most common cancer types, such as bowel cancer and female breast cancer. Ethanol (alcohol) causes cancer through biological mechanisms as the compound breaks

HEALTH MAGAZINE | SPRING 2024

down in the body, which means that any beverage containing alcohol, regardless of its price and quality, poses a risk of developing cancer. The risk of developing cancer increases substantially the more alcohol is consumed. However, the latest available data indicates that half of all alcohol-attributable cancers are caused by ‘light’ and ‘moderate’ alcohol consumption.”

The CDC identifies the following risks of alcohol consumption:

Short-Term Health Risks. Alcohol use has immediate effects that increase the risk of

• Injuries, such as motor vehicle crashes, falls, drownings, and burns.

• Violence, including homicide, suicide, sexual assault, and intimate partner violence.

• Alcohol poisoning, a medical emergency that results from high blood alcohol levels.

• Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can result in unintended pregnancies or sexually transmitted diseases, including HIV.

• Miscarriage and stillbirth or fetal alcohol spectrum disorders among pregnant women.

Long-Term Health Risks. Over time, alcohol use can lead to the development of chronic diseases and other serious problems, including

• High blood pressure, heart disease, stroke, liver disease, and digestive problems.

• Cancer of the breast, mouth, throat, esophagus, voice box, liver, colon, and rectum.

• Weakening of the immune system, increasing the chances of getting sick.

• Learning and memory problems, including poor school performance and dementia.

• Mental health problems, including depression and anxiety.

• Social problems, including family problems, job-related problems, and unemployment.

• Alcohol use disorders and dependence.

The WHO reiterates “We cannot talk about a socalled safe level of alcohol use. It doesn’t matter how much you drink – the risk to the drinker’s health starts from the first drop of any alcoholic beverage. The only thing that we can say for sure is that the more you drink, the more harmful it is – or, in other words, the less you drink, the safer it is.”

Some studies have suggested that light consumption of alcohol could help prevent heart attacks, diabetes, and stroke. This effect, if true, is only for those who consume less than one drink per day for women and two drinks per day for men. The WHO’s statement in the Lancet addresses this issue as follows:

“To identify a ‘safe’ level of alcohol consumption, valid scientific evidence would need to demonstrate that at and below a certain level, there is no risk of illness or injury associated with alcohol consumption. Currently available evidence cannot indicate the existence of a threshold at which the carcinogenic effects of alcohol ‘switch on’ and start to manifest in the human body.

Moreover, there are no studies that would demonstrate that the potential beneficial effects of light and moderate drinking on cardiovascular diseases and type 2 diabetes outweigh the cancer risk associated with these same levels of alcohol consumption for individual consumers.”

While avoiding alcohol consumption is the ideal course for everyone, some groups should never consume alcohol. These include anyone who is:

• Younger than age 21.

• Pregnant or may be pregnant.

• Driving, planning to drive, or participating in other activities requiring skill, coordination, and alertness.

• Taking certain prescription or over-the-counter medications that can interact with alcohol.

• Suffering from certain medical conditions such as liver disease.

• Recovering from alcoholism or are unable to control the amount they drink.

We have shared many articles in HEALTH Magazine over the years, encouraging practices that anyone can incorporate into their lives to live longer, healthier, and happier. Sometimes the answer is adding or increasing a healthy behavior, other times it is to avoid or remove things that will likely have a negative impact on health. We have warned about the impact of poor diet, cigarette smoking, vaping, and marijuana use, but this is the first time we have highlighted alcohol consumption as a major contributor to poor health and early death. Excessive alcohol use acts as a poison to the body and mind, with additional negative impacts on employment, relationships, and communities.

SWUHEALTH.ORG | PAGE 27

2023 ANNUAL REPORT

BOARD OF HEALTH

Commissioner Gil Almquist

» Washington County

Kenneth Snow

» Washington County

Commissioner Paul Cozzens

» Iron County

Kent Peterson

» Iron County

Commissioner Celeste Meyeres

The Southwest Utah Public Health Department (SWUPHD) serves the approximately 290,000 residents of Washington, Iron, Kane, Beaver, and Garfield counties.

SERVING OUR COMMUNITY

CLINICAL SERVICES

• Immunizations administered: 12,953

• International travel consultations: 857

• TB (Tuberculosis) tests: 1,033

• Screenings for diabetes )prediabetes screenings and A1cs): 290

• Total deaths in 5-county district: 2,604

• Total births in the 5-county district: 3,874

• Vital Statistics certificates (includes birth & death certificates): 29,455

COMMUNITY HEALTH

• Pregnant women enrolled in WIC: 310

• Clients enrolled in WIC: 3,738

• Telephone and clinic breastfeeding support: 1,753

• Community events: 14

• Community coalitions: 21

• Sponsored mobile dental clinic patient visits: 54

• Certified car seat installation checks: 195

Jerica Bauer

» Kane County

Commissioner Wade

Hollingshead

» Beaver County

» Kane County Scott Symond

» Beaver County

Commissioner Jerry Taylor

» Garfield County

Nick Reynolds

» Garfield County

• Vaping and tobacco education reach: 836

• Quit-line referrals: 351

• Children served by TOP Star (obesity prevention): 494

• Safe Route Youth Education reach: 9,694

EMERGENCY PREPAREDNESS

• MRC (Medical Reserve Corps) registered volunteers: 227 (815 hours volunteered)

• Sponsored emergency preparedness trainings & events: 232 (5,540 participants)

• Full-Scale Strategic National Stockpile / Medical Countermeasure Exercises (Flu “Shootouts”): 10 Locations (1,380 Flu Shots Administered)

• Health Care Preparedness Coalition Members: 130

• AFN (Access & Functional Needs) Coalition Members: 230

• Narcan kits distributed: 600

• People trained to administer Narcan: 230

• Reportable diseases investigated (57 different diseases): 1,743

• Top 5 diseases (cases): #1. Coronavirus: 3,351 #2. Influenza: 1,308 #3. STD/STI: 903 #4. Respiratory Syncytial Virus (RSV): 426 cases #5. Norovirus: 143

ENVIRONMENTAL HEALTH

• Total food service inspections and consultations: 4,946 (1,713 routine, 319 temporary food, 139 follow-up, 2,775 consultations)

• Food Handler Cards issued: 10,434

• Water samples analyzed (for swimming pools and drinking water facilities): 8,022 (6,376 pool, 1,527 drinking water, 119 other)

• Public pools & spas in district: 838

• Restaurants/food establishments in district: 1,249

• Total septic inspections and consultations: 7,260 (518 inspections, 6,742 consultations)

HEALTH MAGAZINE | SPRING 2024

SOUTHWEST UTAH PUBLIC HEALTH DEPARTMENT

2023 FRIENDS OF PUBLIC HEALTH

Every year, the SWUPHD selects members of the community who have demonstrated exceptional support and service to the field of public health.

COLTEN BRACKEN, MD

Main Street Family Medicine Enterprise

Dr. Bracken and his clinic hosted a Mobile Health Fair during the Enterprise’s Cornfest, promoted our Create Better Health class and has been incredibly supportive in helping us connect with the local community.

DEB ZAIS, RN

Medical Reserve Corps volunteer

Deb, who was also part of our COVID-19 immunization efforts, has contributed valuable volunteer hours over the past year and has been a great liaison with the Sun River senior living community, where she is a resident.

Former Superintendent Washington County School District

Larry showed remarkable dedication and collaboration with our health department during the recent COVID-19 pandemic, resulting in a better educational experience for thousands of students.

SHAWN DENEVAN

Radio Director

Utah Tech University District

Shawn is Utah Tech University’s Radio General Manager and has facilitated the health department’s ongoing weekly Health Update radio show on 100.3 FM for the past year while providing consultation on local messaging strategies.

SWUHEALTH.ORG | PAGE 29

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100.3 FM (St. George Radio): Every Thursday @ 3pm: Health Update

FREE DIABETES SCREENING & A1C TEST DURING APRIL 2024!

Have you been screened for prediabetes? 1 out of 3 adults have it, but 80% of them don’t realize it.

Find all past 25 issues of HEALTH magazine here. Enjoy!

We’re offering FREE A1C prediabetes tests during the month of April 2024! Just go online to swuhealth.org/diabetes and take the screening. If you score a 5 or above (and you’re not already diagnosed with diabetes or prediabetes), you’re eligible! Then, call our nearest office (phone numbers are on the screening form) to make an appointment for your free A1C test. You’ll get results a few minutes after the finger-prick blood test. Resources will be provided if you test positive for prediabetes or diabetes (type 2).

HEALTH MAGAZINE | SPRING 2024
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HEALTH DEPARTMENT

Revenue

By the Numbers for 2023

Washington, Iron, Kane, Beaver, & Garfield Counties

Residents

Immunizations administered

Restaurants eating establishments

Deaths

Medical Reserve Corps Volunteers

Public pools & spas

Births

Clients enrolled in WIC

@SWUhealth 2017-2023 Utah Best of State NON PROFIT ORG US POSTAGE PAID SALT LAKE CITY, UT 841 PERMIT # 6563
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