Health | Spring 2016

HEALTH SOUTHWEST UTAH PUBLIC HEALTH FOUNDATION | SPRING/SUMMER 2016 LUNG DISEASE Breathe Easier

AMERICA'S FAVORITE VEGETABLE PG. 4

Tomato Gardening

PG. 16

AIR QUALIT Y In Southwest Utah

PG. 24

SOUTHWEST UTAH PUBLIC HEALTH DEPARTMENT PROGRAMS 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

NURSING SERVICES

HEALTH PROMOTION

Baby Your Baby Breastfeeding Consultation Case Management Child Care Resources/Referrals Early Intervention Health Screenings/Blood Tests Home Visitation Immunizations International Travel Clinic Maternal Child Health Mobile Clinic (rural counties) Pregnancy Testing Prenatal Resource Referrals Reproductive Health School Exemptions, Education & Tracking School Health/Nursing WIC

Bicycle Safety Car Seat Classes Certified Car Seat Inspections 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 Youth Coalition Coordinators

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

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

M AGA Z I NE BOARD

PREVENT

4 LUNG

Disease

By David Blodgett, MD, MPH

6 IMMUNIZATION Pioneer

By Mindy McBride, RN

8 RADON

On the Radar

By Shallen Sterner

EDITOR

PUBLISHER

DEPUT Y DIRECTOR

HEALTH OFFICER

DESIGN

David Heaton

Jeff Shumway

Chris White

David Blodgett, MD

Kindal Ridd

10 ACTIVE

Transportation

By Kye Nordfelt

PROMOTE

12 NUTRITION

"Shokuiku" and School Lunch

By Shawn Christiansen, PH.D Professor & Matthew Schmidt, M.S., R.D.

14 SLEEP

Is Not Optional

By Heather Stewart

16 AIR

Quality in Southern Utah

By Robert Beers

18 PLAY

Unplugged

By Jordan Merrill

L ET T ER F R O M T H E H EA LT H O F F IC ER Welcome to the 12th issue of HEALTH magazine, an effort we began in 2010 to deliver valuable, health-promoting information to the residents of southwest Utah. The Foundation and this publication support the mission of the Southwest Utah Public Health Department (SWUPHD), which serves Washington, Iron, Kane, Beaver, and Garfield counties. The SWUPHD operates under the direction of the Southwest Board of Health, which is comprised of a county commissioner and an appointed citizen from each of the five counties.

While our services cover a wide range of needs, one aspect of public health we are focusing on in this issue is clean air. Protecting the quality of the air we breathe, whether in the environment or in our homes, is vital to good health. We hope the articles regarding this topic, along with the others selected for this issue, will be enlightening to you.

PROTECT

21 CLEAN

Air

By Kylaas Flanagan

22 DISASTERS

& Threats

By Paulette Valentine

24 AMERICA'S FAVORITE Garden Vegetable

By Al Cooper

28 2015 ANNUAL REPORT

For the Southwest Utah Public Health Department

Sincerely,

ON THE COVER

HEALTH SOUTHWEST UTAH PUBLIC HEALTH FOUNDATION | SPRING/SUMMER 2016 LUNG DISEASE Breathe Easier

AMERICA'S FAVORITE VEGETABLE PG. 4

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

Tomato Gardening

PG. 16

AIR QUALIT Y Southwest Utah

PG. 24

Special thanks to Kristen, Claira, and Allison Nielson at the Kanab "Balloons and Tunes" hot-air balloon festival.

30 The entire contents of this publication are Copyright Š2016 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

QUESTIONS OR COMMENTS?

Email info@swuhealth.org

D I S E AS E

By David Blodgett, MD, MPH SWUPHD Director & Health Officer

L

ung disease is fairly common. Chronic lower respiratory ailments are the fourth leading cause of death in the United States.

In its broadest sense, lung disease is any problem of the lungs that prevents them from working properly.

Lung disease can be divided into three general categories:

makes it hard for the lungs to take in oxygen and release carbon dioxide. People with this type of lung disorder are not able to breathe deeply and often say they feel as if they are "wearing a really tight straight jacket." Pulmonary fibrosis and sarcoidosis are examples of lung tissue disease.

to injury. Overall, it is not wise to intentionally inhale anything but air into your lungs; the one exception being medication prescribed by a physician. Emphysema is also largely due to cigarette smoking. The causes of other lung diseases, like sarcoidosis, are not well understood.

1. AIRWAY DISEASES These diseases affect the tubes (airways) that carry oxygen and other gases into and out of the lungs. They usually cause a narrowing or blockage of the airways.

Examples of airway diseases are asthma and Chronic Obstructive Pulmonary Disease (COPD). Emphysema and chronic bronchitis are types of COPD. People who have these illnesses often compare their respiration to "trying to breathe through a straw."

3. LUNG CIRCULATION DISEASES These diseases are caused by clotting, scarring, or inflammation of the blood vessels in the lungs. They restrict the lungs’ ability to take in oxygen and release carbon dioxide, and may also affect heart function. An example of a lung circulation disease is pulmonary hypertension.

Nearly 25 million people in the United States have asthma, including 7 million children. The incidence of asthma in the young has been increasing, from about 5% of children in 1990, to about 8% currently.

2. LUNG TISSUE DISEASES These diseases affect the structure of the lung tissue.

Scarring or inflammation of the tissue makes the lungs unable to expand fully. This

Some lung diseases have well-defined causes. 78% of lung cancer cases are caused by cigarette smoking. Other inhaled substances are also carcinogenic (having the potential to cause cancer), including marijuana smoke and e-cigarette vapor. The air exchange surfaces in the lungs are very sensitive

ASTHMA

While all of the causes of asthma are not well understood, the way this disease affects breathing is fairly well known, and treatments for asthma are improving.

According to the National Institutes of Health (NIH), the following exposures are among those shown to "cause" asthma in susceptible children: prenatal exposure to tobacco smoke

HEALTH

(mother smoked), environmental tobacco smoke, cockroach and dust mite allergens, and infection with the respiratory syncytial virus (RSV). This list will likely continue to grow.

People who have asthma have inflammation of the passages that bring air into the lungs, resulting in swelling and sensitivity. The airways tend to react strongly to certain inhaled substances. The muscles around them tighten, narrowing the airways and reducing air to flow into the lungs. Additionally, cells lining the airways begin to secrete more mucus than usual, making it even harder to get air into the lungs. This reaction can worsen into a serious asthma attack.

While most people with asthma respond well to medications, about 4,400 people still die from this condition each year. Asthma can be very disruptive in the lives of those who have it. Most people have triggers that cause their asthma to flare into an attack, like those mentioned above.

AIR QUALITY

Air pollution, including ozone gas, can also cause asthma and COPD symptoms to worsen, so environmental air quality is a critical issue for those suffering with lung disease, as well as the rest of us.

Just as there are standards set to improve and maintain the quality of outside air, measures have also been established to protect air quality inside public buildings and businesses, such as the Utah Indoor Clean Air Act. Air standards in the home, however, depend on the residents. Substances that cause or exacerbate lung disease in the home, which have already been mentioned, can cause the air quality inside your house to be worse than outside.

Consider the following steps to protect air quality inside your home: • Never allow cigarette, marijuana or e-cigarette smoking in your home.

• Keep a clean home; vacuum and dust frequently.

• Minimize or eliminate allergens that may affect you or your family.

• Air your home out once a week by opening doors and windows.

Newer homes, especially, are built more airtight and can use a good airing out.

• Have your home tested for radon gas (see page 8).

It is my hope that the air we breathe - and the ability to breathe itself - are things we all continue to enjoy throughout our lives.

SWUHEALTH.ORG

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I M MU N I ZAT I O N

By Mindy McBride, RN SWUPHD Nurse

H OW ED WARD J E NNE R ’S CO NTROVERSIAL DISCOVERY DEFEATED SMALLPOX

E

dward Jenner was born in 1749 in the village of Berkeley, England. Orphaned at the age of five, he was raised by his older siblings. He grew up with a curiosity toward nature and spent much of his time along river banks collecting bird eggs and fossils (which he later called “monuments to departed worlds”).

shaped his later career. He and some classmates were brought to a stable where they underwent a process that included bleeding, starvation, and deliberate infection with smallpox. They were put in isolation and the disease allowed to run its course. Edward recovered and was immune to smallpox, which routinely killed 400,000 Europeans each year.

Sometime after being sent to school at age eight, Edward had an experience that may have

This deliberated infection was called variolation. It was risky, but considered a better alter-

native than catching smallpox.

It was also expensive and unaffordable to the poor villagers. At the time, smallpox was a brutal disease with a high death rate.

Survivors could be left with disfiguring scars, bone deformities, or blindness.

At age 14, Edward Jenner began an apprenticeship where he gained the experience needed to become a surgeon. It was during this period that he took note of a popular belief among country

HEALTH folk that milkmaids who had contracted cowpox were immune to small- from smallpox sores. The result: the boy repox. mained healthy...he was indeed immune to smallpox.

Jenner moved to St. George’s Hospital in London in 1770 to complete his training under John Hunter, a renowned surgeon and experimentalist When the medical community refused to who introduced Jenner to the scientific method. The two remained life- publish his findings, Edward Jenner repeatlong colleagues and friends. Jenner remained fascinated by the natural ed his process on more subjects - including world and became a leading expert on hibernation and bird migration. his own infant son - all with the same reHe became acquainted with the great naturalist Joseph Banks and helped sults. He called his new method vaccinahim catalog his collection brought back from Captain Cook’s voyage tion, after the Latin word for cow (vacca). through the Pacific Ocean.

Despite his great discovery, Jenner faced At 23 , Jenner returned to the countryside of Berkeley and established an uphill battle. Vaccination challenged himself as the local physician and surgeon. As his career blossomed he the popular practice of variolation and bought a home, which served as a place to practice medicine, continue threatened to put those who practiced it experiments, and raise a family. During his lifetime he made discoveries out of business. But he persisted. A small in purifying tartar emetic which was widely used for treating parasitic dis- thatched hut was constructed in the coreases. He pioneered research into heart disease by observing fatty deposits ner of Jenner’s garden where he provided in postmortem patients and associated unnatural changes in heart valves smallpox vaccination free of charge to the with what is now known as rheumatic fever. poor. In 1801 Jenner wrote, “I hope that someday the practice of producing cowEdward Jenner could have been remembered for these and many other pox in human beings will spread over the varied accomplishments, including flying a hydrogen balloon for 24 miles world. When that day comes, there will be (causing panic among villagers but helping him meet his future wife), be- no more smallpox.” ing elected to the Fellows of the Royal Society for his observations and published works on cuckoo birds, or finding the fossilized remains of a sea The world made gradual progress towards monster (now known as a Plesiosaur). Jenner’s greatest gift to the world, Jenner’s prophetic hope. In the years folhowever, was the discovery he made thirty years after first hearing the lore lowing his death, variolation became forabout milkmaids and smallpox, which, many would later declare, “saved bidden by England’s Parliament and vaccimore lives than the work of any other man”. nation was later recognized as the preferred method to prevent infection from smallpox.

In 1796 Jenner decided to apply the scientific method to what some called Finally, in the 1960s, Dr. Donald A. Hendera “wives tale”: son led a team from the Centers for Disease Control to actively stop smallpox outbreaks KNOWN: Smallpox is more dangerous than variolation and cowpox is on a global scale. He used a disease surveilless dangerous than variolation. lance process of locating smallpox victims and then vaccinating the “ring” of family HYPOTHESIS: Infection with cowpox gives immunity to smallpox. and friends associated with them, which TEST: If variolation with smallpox after infection with cowpox fails to pro- effectively prevented further spreading of duce a smallpox infection, immunity to smallpox has been achieved. the disease. Public health workers in many CONSEQUENCE: Immunity to smallpox can be induced much more countries used this model with great success over the next decade. safely than variolation.

Jenner employed the help of Sarah Nelmes, a milkmaid who had recently contracted cowpox. He extracted some fluid from sores on her hand, then convinced his gardener to allow him to infect his eight year old son, James, with cowpox. If Jenner’s hypothesis was right, the boy would end up being immune to smallpox. He made two scratches on James’ arm and applied the infected substance. James developed a mild illness but completely recovered. A few weeks later, Jenner repeated the procedure but used fluid

1977 marked a great event in human history: smallpox, one of the great scourges of civilization, had now virtually disappeared, the last case being reported that year in Somalia. Edward Jenner’s dream had finally come true, and he is now considered the father of immunology.

Children being vaccinated against smallpox (Virginia, 1945 / U.S. National Archives & Records Administration) SWUHEALTH.ORG

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O N T H E R AD A R

By Shallen Sterner SWUPHD Environmental Scientist

M

ost people know that smoking is the leading cause of lung cancer. What some may not know is that the second leading cause of lung cancer is radon gas. Utah residents should take some time to place radon on their healthy living radar by learning what radon is and how we can protect ourselves from it.

Radon gas is a naturally occurring byproduct of uranium decomposition. This gas is radioactive and can be harmful, even in small amounts. The concern about radon gas is due to the U.S. Environmental Protection Agency (EPA) estimate that radon causes over 20,000 deaths each year. Unlike smoking, radon is more of a hidden danger because our senses cannot detect it. It is invisible and odorless, mostly affecting humans when it seeps into homes from the soil over time.

How much radon gas in a house is too much exposure?

The EPA recommends reducing the levels of radon in homes to less than 4 picocuries per liter (pCi/L). The national average indoor radon level is estimated to be about 1.3, and

about 0.4 of radon is normally found in the outside air. The levels in Utah houses are very different from city to city and from county to county. Radon sampling data can be found by going to the web site www. radon.utah.gov and clicking on the “Test Results by Zip Code” link. Homeowners should keep in mind that radon levels can be so sensitive that the levels can even vary from house to house. For this reason, homeowners should find out what the radon level is in their own dwelling.

A homeowner should take a single sample to find out if their home has a radon level greater than 4 pCi/L. A shortterm test is the best place to start. This test is simple and not very expensive. There are several different types of shortterm test kits that can be purchased online or at your local home improvement store.

Utah residents can order a reduced-price ($8) test kit by going to www.radon.utah.gov and clicking on the link “Order Radon Test Kit”. Those who are not interested in doing the tests themselves can find contact information on this website for local qualified

radon testers by clicking the “Certified Measurers” link.

I personally purchased the $8 dollar test kit and ran a test in my home. The test was very easy to setup and use. Reading and following the instructions thoroughly is important to avoid rendering the test invalid.

My test results came back at 1.0 pCi/L, so I feel confident that this level will present very little risk to my family.

Conducting a second test may provide greater peace of mind to ensure that a home has radon levels below the standard.

Make sure to perform at least one of the tests in the winter, because radon levels tend to be higher in the winter months.

Homeowners with high radon levels may need to take action to fix their homes. Several techniques can be used to reduce radon levels, including hiring a residential mitigation provider that has been approved by the state of Utah. A listing can be found on the same website mentioned above by clicking the “Certified Mitigators” link.

These are simple steps you can take to help keep your family safe and prevent unwanted health problems.

HEALTH

The Utah Department of Environmental Quality selected five Utah student winners for the 2016 National Radon Poster Contest. Among the winners were two sixth-graders from Fossil Ridge Intermediate School in St. George. Lexie Tueller won first place in the 4-6 grade division with Sofia Noel Hancock selected as runner-up. Each winner received $100 along with $100 for their school. Environmental health staff from the Southwest Utah Public Health Department presented awards to the students at their school. This is the first time south-

west Utah has had winners on the state level for this contest.

Later, on January 8th (2016), Lexie and Sofia were personally congratulated by Governor Herbert at the State Capitol (see photo on page 30), as he declared January “Radon Awareness Month.� There were over 700 entries from around the state; illustrating the dangers of radon, where it comes from, how it gets into our homes and how residents can test their homes for this invisible, radioactive gas.

By Lexie Tueller, First Place Winner (4-6 grade division)

SWUHEALTH.ORG

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TR A N S PO R TAT I O N

I

n the late 80’s film Field of Dreams, Ray, a novice farmer, has an impression to build a baseball field in rural Iowa and is told, “If you build it, they will come.” He listens, builds the field, and sure enough; players and audiences show up.

By Kye Nordfelt SWUPHD Health Promotion Division Director

that are comfortable for bikers (e.g. bike lanes and paths) and pedestrians (sidewalks and safe crossing), residents feel more comfortable biking and walking to work and other destinations. Additionally, if communities establish places of work and shopping areas closer to residents’ homes, people bike and walk more - “if you build it, they will use it.”

This popular phrase, “If you build it, they will come” has been applied to many projects and is a phrase I think about when a city decides to invest in developments and I noticed this in my own roads that are built for active family when we moved to St. George. My wife and transportation. our five kids have increased What do I mean by active our walking and bike riding transportation? Studies show due to the Virgin River trail that when a city builds roads and the nice, wide streets in

MY OTHER CAR IS A BICYCLE

Craig Shanklin President of the Southern Utah Bicycle Alliance

I

f you ask most people, they might say that the bicycle is a piece of sports equipment used for fun, exercise, or recreation. However, it actually originated as a form of transportation. In fact, at the turn of the 19th century, there were millions of bicycles in the United States and most all were used for daily transportation…going to work, school, errands, or even for long distance travel.

downtown St. George. The incredible, easy-to-access mountain bike and hiking trails have also inspired us to be more physically active. Living in St. George has made it easier and more fun to get our recommended amount of daily physical activity.

So what is the recommended daily level of exercise? It’s 30 minutes of moderate activity for most days of the week, and it’s sobering to consider that 60% of us in Washington County aren’t there yet.

This lack of exercise contributes to the fact that up to 60% of adults in our community

With the advent of the automobile came an increase in health issues tied to our growing inactivity…we didn’t move as much as we used to. However, the tide is turning and people across the country have been rediscovering the bicycle as a form of transportation. According to the League of American Bicyclists, the number of trips by bicycle more than doubled in the United States in just 10 years. In addition to the positive health benefits of cycling, it is also much less expensive than a car, and it’s fun. With National Bicycle Month approaching in May, it might be a good time to consider using your bicycle as a transportation option. A good place to start is with a short trip; not too far, but one for which you would have normally taken the car.

are overweight or obese (having a Body Mass Index score higher than 25), which in turn contributes to increases in chronic disease and medical costs.

Many of the major towns and cities in our area “have built it”, and I invite you to support city councils that focus on continuing to build roads that are safe for biking and walking. One final invitation; National Bike to Work Week is coming up, so dust off your bike and pedal to and from work as much as you can from May 16th20th. It might turn into a great habit!

As you gain experience with bicycle commuting, you can extend your distances and explore new routes that were never available to you in a car. As you begin riding more, you may need to consider a new bike that is suited for transportation; perhaps with fenders, a rack and panniers, or a basket. Another option that is increasingly popular for bike commuters is the eBike, a bicycle with a small motor and battery that helps speed you up or climb our local hills. You still have to pedal and you’re still getting exercise, but you can go further and faster.

So the next time you reach for the car keys, consider the possibility of riding your bike. You just may get hooked.

HEALTH

ACTIVE TRANSPORTATION: GOOD FOR THE ECONOMY

By Marc Mortensen, Assistant to the City Manager, St. George

I

t wasn’t long ago that I was speaking to a group of elected officials and citizens in a city council meeting about the role of active transportation in St. George. In that meeting I asked everyone who rode a bike or walked to school as an elementary school student to raise their hand. Every hand went up. I then followed up with the question, “How many of your elementary aged kids and grandkids now do that today?” Almost no hands went up. So what has changed?

a variety of ways, such as decreased transportation costs, increased property values, decreased health care costs, and increased employment and tourism.

Today, hundreds of cities and towns across the country are experiencing a resurgence in traditional planning which includes a return to designing neighborhoods and commercial centers around pedestrians and cyclists, in addition to automobiles. Aside from better health, cleaner air, and improved safety, cities are investing in active transportation (also referred to as active lifestyle, alternative transportation, or human-powered transportation) infrastructure for economic reasons.

Cincinnati researchers.

In a 2014 survey conducted by the American Planning Association on Economic Growth and Competitiveness, 81% of Millennials and 77% of Active Boomers said that affordable and convenient transportation alternatives to the car are at least somewhat important when deciding where Recently, when I asked my 8-year-old to live and work. son if he wanted to ride his bike to From a real estate perspective, trails school he replied, “You mean I could (natural and paved) can have signifido that if I want? That would be so cant, positive spillover effects on propcool!” I’m embarrassed to say that he erty values when these properties are didn’t even consider that as an option located within reasonable distances until I mentioned it. to the trails, according to University of Active travel modes play important roles in a diverse transportation system. Where walking and cycling conditions are good, typically 10-20% of local trips (1.5 miles or less) are by these modes. Walking and cycling provide access to public transit; often the best way to improve and encourage public transit travel is to improve local walking and cycling conditions.

In St. George, we believe that an active lifestyle is at the core of our brand and Providing active transportation op- a key component to future economic tions can benefit local economies in growth and sustainability.

SWUHEALTH.ORG

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“SH OKU I KU” & S C H O O L LU N C H

By Shawn Christiansen, Ph.D Professor & Matthew Schmidt, M.S., R.D. Guest Columnists

S

L ESSO NS L E ARNE D FRO M JAPANESE SCHOOL LUNCH CULTURE

ince 1980, the incidence of childhood obesity has doubled in the United States, and has quadrupled for adolescents.

Eighty percent of children who were overweight between the ages of 10 and 15 years old were obese at 25 years of age. Estimates suggest that if these trends do not change, this will be the first generation that will not outlive their parents in terms of average life expectancy.

Entering into obesity at earlier ages increases the risk of developing diseases such as hypertension, cardiovascular disease, and metabolic syndrome. Social risk factors are also issues for overweight and obese children, including lower academic performance, social isolation, anxiety, and depression.

American school lunches have been criticized for lacking variety and having low nutrient content. Efforts are being made to create systemic changes to school lunch, but implementation is slow and cultural change even slower. One of the simplest and most important changes in school lunch programs would be to provide a wide selection of fruits and vege-

tables and getting kids to eat curriculum. Shokuiku gives them. students the ability to make appropriate food choices through various experiencTHE JAPANESE es related to practicing a EXAMPLE healthy diet.

Japan has consistently ranked as one of the coun- We conducted a study comtries with the highest aver- paring two schools in northage life expectancy. Japan ern Utah with two Japanese also has very low rates of schools (in Miyazaki and Uji) obesity (less than five per- and found several principles cent) and cardiovascular dis- that are worth considering. ease. A major factor in these findings is the Japanese diet, which is based on a great ENCOURAGE variety of healthful foods at VARIETY each meal that are eaten in We found that Japanese small portions. schools provide a greater variety of food on a daily The Japanese school system basis and a greater numhas played a pivotal role in ber of vegetables. The Utah providing education on the schools provided 26 different importance of a healthy diet, foods in a two-week period, one with variety and bal- including five vegetables ance. While there are some (about 19% of the total foods innovative schools in the offered). The most comUnited States that provide monly selected vegetables nutrition education along by children were carrots, potatoes, and tomawith healthy meals, these corn, toes; typically as a sauce. An schools are often the excep- average of six different fruits tion rather than the rule. (representing about 25% of Japan’s unique elementary the total foods offered) were school lunch standards are provided, including apples, supported by the nation’s grapes, oranges, pears, and laws and food culture. Fur- pineapple. Some fruit was thermore, Shokuiku, or the consumed in juice form. acquisition of knowledge about food and nutrition, The meals provided to the is formally included in the children in Miyazaki, Japan

in a two-week period had a total of 49 different foods, including 25 vegetables. Uji had 35 food varieties with 18 vegetables. Vegetables in both schools made up 51% of the total food items and included cabbage, spinach, konnyaku root, bamboo, onion, mushrooms, carrots, radishes, peas, taro, cucumbers, and hijiki (sea grass).

Starchy foods like potatoes are not counted as vegetables in Japan, while they make up a significant part of the U.S. vegetable intake.

Only two to four different fruits were offered within a two-week period in the Japanese schools, representing between six and eight percent of the total foods offered. Fruits are often considered a dessert in Japan and are at the bottom of the country’s food guide system. The “Spinning Top” is Japan’s equivalent of the USDA’s “My Plate.” Only two servings of fruit per day are suggested in the Spinning Top as compared to five to six servings of vegetables.

Sugary desserts are a common feature in American school lunches and we observed Utah children often eating their dessert while leaving the healthier choices on their plates.

HEALTH EAT HOME-STYLE

In America, school lunch is most often eaten in the cafeteria, with children sitting at long tables; eating quickly so they can enjoy recess before the bell rings. In Japan, school lunch is eaten in the homeroom class and becomes an important daily ritual. The children are responsible for arranging their tables or desks together to form smaller communities (typically four students).

They are encouraged to learn proper mealtime greetings and manners. They are encouraged to eat all of their food but they are allowed to control the portion size. This teaches them to regulate their eating.

During lunch time, teachers eat with their class and encourage their students to try different foods. In this setting, teachers play a major role in modeling healthy eating behaviors and provide personalized nutrition education. Even if students do not initially like a food they are encouraged to at least put the food in their mouth and try it. Children start eating together and end the meal together, much like a family. Everyone participates in serving and cleaning up after the meal, which teaches connection and responsibility. Recess for Japanese children is not tied to lunch time, allowing children to enjoy their food and eat slowly. We also observed that Japanese children actually eat the wide variety of foods offered and there is very little waste, compared to the large trash cans full of wasted food observed in American lunchrooms.

similar changes in American food culture, especially among families. Research shows that a child may need to be exposed to a new food up to 15 times before they will try it. By contrast, Japanese children at both school and at home are exposed to a great variety of food and encouraged to try new ones.

The ritual of sharing mealtime as an experience that impacts health and relationships is alive and well in Japanese classrooms, yet is underutilized in both schools and homes in America. A recent U.S. study found that eating at the kitchen or dining room table, talking meaningfully about the children’s day, and remaining at the table until everyone is finished eating are correlated with lower body mass index (BMI). Eating together as a family influences better academic performance in chil-

食育

dren along with lower rates of substance abuse, promiscuity, eating disorders, and suicide risk. Children who routinely eat regular meals with their families consume more fruits and vegetables, less harmful fats, and drink less soda. Families dining together and teaching their children to eat a wide variety foods may have a greater impact than external government policies or increased funding.

schools’ reliance on food that is USDA-subsidized or provided by traditional wholesalers, but is often processed. In surveying school children in Utah, we found that many of them threw their food away because they found it unappetizing. Much of the food was canned or ready-made and warmed up instead of prepared from scratch. Many children wanted a wider variety of fruits and vegetables and food that was tastier, healthier, and of better quality. In Japanese elementary schools, the majority of food is scratch-made, which generally has higher nutrient content, is better tasting, and less likely to be thrown away.

SPRING/SUMMER 2016

There is much that can be learned from studying Japanese Shokuiku. In our many years of traveling to Japan, we have been impressed by the tradition that permeates all of Japanese culture, including the care and respect given to mealtimes. We often found the quality of the dining experience comparable to that of a fine restaurant, whether eating with peers in a homeroom class or at the family dinner table. We consistently found that food was prepared fresh and included great variety.

Food is meant to be savored, shared, and part of an experience that feeds both body and soul. Think of the remarkable transformation that would take place if we adapted these principles from Japan.

What better way to start than with our children, in order to give THE JAPANESE TERM FOR them a better “FOOD EDUCATION” chance for a healthier life than current trends are predozen vegetables because dicting. they were served in a meal.

For example, a lunch might Dr. Shawn L. Christiansen is dean consist of rice with soybeans; of the College of Education and an entrée with chicken, car- Human Development at Southern rots, peas, mushrooms, and Utah University lotus root; and a salad with Matthew Schmidt is an Assistant daikon radish and mizuna (a Professor of Nutrition at Southern Japanese green).

Utah University and a Registered One way Japanese schools are able to get so many vegetables in each meal is by adding them to soups, salads, and rice. Many Japanese school lunches had over a

SHOKUIKU:

As part of the holistic approach to food and nutrition, a garden is maintained at the school where children work and learn about soil, agriculture, biology, food appreciation, and self-sufFRESH ficiency. During the fall months, approximately 25% VS. PROCESSED Many schools in Japan used of the items served for lunch Just increasing variety will local or farm-grown foods came from the school garnot change behavior without compared to American dens. A compost pile was SWUHEALTH.ORG

also maintained to utilize any food waste for fertilizing the garden.

Dietician

To see the Japanese school lunch phenomenon for yourself, visit YouTube and search for “School Lunch in Japan - It’s Not Just About Eating!”

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IS NOT OPTIONAL

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By Heather Stewart Guest Columnist

hen push comes to shove, it’s often our sleep that gets shoved aside. After all, there are only 24 hours in a day, and when you’re juggling heavy work loads and family responsibilities, not to mention regular exercise, cutting into your sleeping hours seems reasonable, even praiseworthy. Think again, says Dr. Robert J. Farney, head of the sleep medicine division for Intermountain Healthcare, Urban Central Region. Farney says this attitude is “biological arrogance” and warns there is a high price to pay for those lost hours of sleep.

DAMAGED RELATIONSHIPS. “For a very long time, people regarded sleep as an option,” says “The most common and perFarney. In reality, he says, cutting back on sleep is “highly detri- haps earliest indication of mental.” He lists several negative impacts of long-term, partial sleep inadequacy is irritabilsleep deprivation. ity, and so interpersonal relationships are affected. If you IMPAIRED COGNITIVE FUNCTION. are in a situation where you “Most people are aware that if you don’t get enough sleep, have to work with people, at you’re likely to feel tired, sleepy and inattentive,” says Farney. any level, your ability to interBut those feelings are signals that your cognitive functioning act with that person is going is impaired. “By inattentiveness, that means whether or not to be impaired if you are sleep you are staying on task mentally … or whether the mind is deprived.” leaving and doing other things, and time-sharing without you realizing it.” He adds, “We know that when people have that CARDIOVASCULAR & problem, they’re less likely to persevere in working through CEREBROVASCULAR problems; it’s easier to just cut corners or do something with- THREATS. out spending the time.”

Farney says partial sleep deprivation has been linked IMPAIRED MEMORY. to a disruption of the body’s “If you are not attentive, then your ability to take in new infor- coagulation factors—in other mation and then put that into long-term memory is impaired. words, a sleep deprived perThe first step in memory is attention. You have to be attentive, son will produce more blood you have to be receptive, cognitively, and actually making ef- clots, which could lead to forts to remember things, and that doesn’t happen if you are heart attack or stroke. sleep deprived.”

METABOLIC IMPAIRMENT. IMPAIRED JUDGMENT. Researchers have induced in“People who are sleep deprived over days and days in an ex- sulin resistance in otherwise perimental situation get progressively worse—that is, their healthy people by depriving error rates increase progressively for every day that they are them of full nights of sleep, in a sleep-deprived situation—and I don’t mean totally sleep says Farney. So, essentially, deprived, I mean getting five hours of sleep per night rather lack of adequate sleep can than seven hours,” explains Farney.

RUNNING ON EMPTY

HEALTH

lead to a pre-diabetic state. Additionally, chronically tired people tend to gravitate to high-caloric foods to score a hit of energy; over time, this can cause weight gain and exacerbate insulin resistance.

Farney discourages people from bringing their mobile devices or e-readers to bed with them for the same reason.

GET ENOUGH EXERCISE. “Not working out for an hour, but just good, physical activity,” he says.

But don’t exercise in the hours before bed—that will stimulate your Sometimes getting to sleep is the brain. problem. Simple behavior changes make it more likely that you’ll go AVOID ALCOHOL, NICOTINE, to sleep and stay asleep. “It’s every CAFFEINE AND OTHER MEDICAcommon sense thing that you can TIONS. “Some people drink alcohol with think of,” says Farney. the thought that they’ll get sleepy,

but alcohol is metabolized quickly MAKE YOUR BEDROOM A and as it goes away, you get a reSANCTUARY FOR SLEEP. Keep your bedroom cool, com- bound insomnia,” says Farney. Nicfortable, quiet and dark. A fan or otine and caffeine are both stimua white-noise machine can reduce lants, and many other medications noisy distractions, while blackout can interfere with sleep, particularcurtains will minimize light, espe- ly pain medicines. Even over-thecially for shift workers. Hide the counter medications can disrupt alarm clock—its light can be dis- sleep, says Farney, so it is important tracting, and if you’re having trou- to be aware of side effects. ble sleeping, a constant reminder of the time can make it hard to quiet your mind.

GET READY FOR BED

TURN OFF THE MONITORS. The key is to avoid what Farney calls “activating the brain.” And television is a primary culprit of that because of the light emitted from the monitor. “So you should not be watching television or playing video games—those activities are particularly bad,” he says. “The light has an effect on circadian systems … the light is a drug to the brain, literally.”

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HOW MUCH SLEEP DO YOU NEED?

Farney says the amount of sleep you need is highly individual, but typically around seven to eight hours a night. Some need more, and some need less. But very few can function well with only four or five hours a night.

Heather Stewart is managing editor of Utah Business magazine, where this article was originally published in November 2013

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Q U A L I T Y IN S O U T H E R N U TA H

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By Robert Beers SWUPHD Environmental Health Division Director

eople enjoy Southern Utah for many reasons, but the clean air and environment are often mentioned by tourists and residents alike. Public opinion polls indicate that people throughout the nation and state are concerned about the quality of the air we breathe and the steps being taken to improve it.

Efforts are being made to maintain the high air quality standards enjoyed in our corner of the state.

The Southern Utah Air Quality Task Force was formed in 1996 at the request of St. George Mayor Daniel McArthur. Primary goals have been to address concerns about fugitive dust (dust that becomes airborne due to human activity) and to raise awareness about air quality issues in local communities.

The creation of the Air Quality Task Force led to the Southwest Utah Public Health Department partnering with St. George City to operate air quality monitoring equipment borrowed from Summit County during the summer months from 2008 to 2011. St. George City purchased its own monitoring equipment in 2012, followed by a second air monitor in 2015. This equipment is now used to monitor fugitive dust in the region, and the data collected is being analyzed by health department scientists.

Poor air quality can have a negative effect on people and the environment.

Obviously, people with asthma or other medical concerns related to breathing problems are more susceptible to bad air quality. Individuals who experience respiratory problems should remain indoors when levels Representatives from pub- of dust, smoke, and other lic health, government, pollutants become elevatindustry, transportation, ed. business, economic development organizations, and Fortunately, air quality in communities throughout Southern Utah is generalWashington County have ly very good and is much been involved with the Air better than the closest Quality Task Force since metropolitan areas. Local air quality can be affected its creation.

by weather patterns, climate, industrial activities, automobiles, high winds, construction or excavation work, forest or brush fires, and agricultural burning. Air pollution in our district is almost always a direct result of regional fires, high wind events, or unusual weather patterns.

Southern Utah does not often exceed air pollution standards set by the Environmental Protection Agency. Occasional inversions in Southwest Utah are generally shortlived due to the mild climate. For this reason, the Southwest Utah Public Health Department is not required to enforce “No Burn Days” or other restrictions that are broadcast by news media along the Wasatch Front.

Utah’s Division of Air Quality (DAQ) has the responsibility to regulate state and federal air quality laws and regulations throughout the state. For additional information about air quality programs and issues, visit airquality.utah.gov.

Conditions for our area can be viewed at this website by clicking the “Current” button and selecting “Washington County”.

HEALTH T H E PA N G U I TC H VA L L E Y B A L LO O N R A L LY

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U N PLU G G E D

By Jordan Merrill SWUPHD Health Educator

H E L PING KIDS P L AN A FUN, ACTIVE SUMMER

H

ave you or your kids ever complained, “We have nothing to do this summer?” Then the next thing you know, the TV and other electronic devices go on - often for hours at a time - and a mind numbing sedentary form of entertainment sucks your summer away.

We’ve all been there, of course, but now there is a better alternative, thanks to Play Unplugged. Whether this is a new idea to you, or you heard about it last year but didn’t get around to doing it, now is the time to get informed and engaged in a wonderful program that will provide a summer-changing experience for your family!

Since then, Play Unplugged has expanded statewide; providing rewarding activities and fun memories for everyone involved.

HOW DOES THE PLAY UNPLUGGED PROGRAM WORK?

Children can choose from a list of self-directed activities to complete; such as hiking, jumping on a trampoline, washing the car, geocaching, or bug collecting. Local businesses sponsor one of these unique activities and then distribute a collectable Brag Badge which includes their business name. Kids who complete the activity must then visit these local businesses with their parents to collect the Brag Badge, bringing increased exposure to businesses as kids get involved in making their summer more active.

The best part for parents is that Play Unplugged helps kids manage and coordinate fun adventures on their own. This happens through easy tracking and fun images on Brag Badges that motivate kids to collect more. Additionally, they have the opportuniPlay Unplugged started ty to earn other prizes and rewards just for four years ago in Heber participating and collecting badges.

City, Utah when two fathers, concerned about The goal is to encourage healthy lifestyles their kids’ screen time, cre- and reduce obesity in kids and teens, all ated an amazing model that while fighting the screen addictions and provided a way for local isolation that many young people face tobusinesses to increase foot day. Parents who got involved with Play Untraffic while getting kids plugged in 2015 loved the program and gave moving and more active. some wonderful feedback:

HEALTH “We loved the Play Unplugged program!

My kids were excited to collect badges. We went to a lot of businesses that we never knew existed before..

It was fun to set goals, then see my kids reach those goals and even surpass them! We can’t wait to participate next year!”

“We loved it. We did things we haven’t done while living here over 20 years. The kids looked forward to trying new things and loved being able to make plans to accomplish their badges each day.”

“I like to have my kids stay active during the summer and this program helped immensely! Some things I wouldn’t have thought of doing on my own. I would love to see this program continue!”

had and hear their stories. Play Unplugged is a program we hope to be involved with for many years to come.”

ter summer this year, now that hundreds of families and businesses have seen the benefit of this revolutionary idea.

“What a great way to get kids off their screens and enjoy life the way it was meant to be enjoyed!”

To find out more about enrolling your kids in this free summer program, or if you want your business to sponsor a Brag Badge in “Great community pro- any of of these cities, please call (435) 625-1289 or visit

“My kids were really excited to do the activities and earn the badges. I didn’t expect them to be gram!” so responsive but they Sponsored locally by the really loved it!”

Southwest Utah Public

Health Department, Play Businesses had a similar Unplugged is in its secpositive reaction: ond year in St.George and Kanab, and is going on its “We loved watching the kids come third year in Cedar City. in to collect their brag tags. It was These areas are primed fun to see the excitement the kids and ready for an even bet-

WEPLAYUNPLUGGED.COM.

StGeorgeUnplugged CedarCityUnplugged

CALVIN AND HOBBES © 1990 Watterson. Reprinted with permission of UNIVERSAL UCLICK. All rights reserved.

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AI R

By Kylaas Flanagan SWUPHD Health Educator

YOUR RIGH TS ACCO RDIN G TO THE UTAH INDOOR CLEAN AIR ACT

O

ne of the best parts of my job is that I get to meet new people all the time.

When introducing myself and mentioning that I work as a tobacco cessation and prevention educator, people often come back with something like the following:

is required by law to address the situation, and if the individual is uncooperative, he or she must be asked to leave the premises.

If you talk to a manager but nothing is done, you can call your local health department.

We’re committed to finding solutions to these problems.

Them: “Last week I left [in- Often we can follow up with sert public place] and there a complaint within one busiwere people smoking right ness day. outside the doors. It really bothered me!”

DO E-CIGARETTES APPLY? Vapor products are covered Me: “What did you do at that under the Utah Indoor Clean point? ” Air Act in the same places Them: “Nothing. I just that traditional cigarettes are. held my breath and walked Sometimes this is confusing through the cloud of smoke.” because e-cigarette manufacturers push contradictory Was that the proper re- information to their consumsponse? No. So what can ers. Utah law prohibits the you do? Ask the individual to use of either an electronic or move away from the doors, or traditional cigarette indoors ask an employee to address or within 25 feet of an enthe situation. If you feel un- trance, window, or air intake comfortable addressing the of a public place; this superindividual, go to a store man- sedes any marketing claims ager and ask them to tell the that may be packaged with person to move. The business the product.

WHAT IS THE PURPOSE OF THE UTAH INDOOR CLEAN AIR ACT The Utah Indoor Clean Air Act is intended to protect the thousands of individuals in our community who have health problems that can be aggravated by the particulate matter exhaled by smokers.

Examples include children with asthma or seniors with chronic obstructive pulmonary disease (COPD). Pregnant mothers are also vulnerable, and their developing babies are affected by tobacco smoke too.

The U.S. Surgeon General has repeatedly stated that there is no safe level of exposure to secondhand smoke. In Utah, we are doing our part to prevent people from coming into contact with secondhand smoke through legislation like the Utah Indoor Clean Air Act. There are also ordinances in many of the parks and outdoor gathering places throughout our five county area that prohibit the use of

HEALTH tobacco. The indoor and outdoor ordinances not only protect people from secondhand smoke, but they also help discourage kids from using the products by keeping tobacco use from appearing commonplace.

complained about smoking on their premises and we’re able to advise them on developing a plan to handle future occurrences.

ers from the effects of secondhand smoke, has included e-cigarettes, and will likely continue to evolve as more products are introduced that impact public health.

Remember where people could light up forty years ago? Restaurants, bars, Standards developed to protect our If we receive a complaint, we make grocery stores, doctor’s offices, city health and well-being are put in place for good reason. Just as the Surgeon sure that it is followed up in a time- buildings; practically anywhere.

General’s smoke-free campaign in the ly manner and ensure that the business in question, regardless of the In 1976, David Hughes Horne advo- 1980s empowered non-smokers to desituation, is able to be fully informed cated for stricter laws concerning in- mand their right to breathe clean air when it comes to enforcing the Utah door smoking laws in Utah, and that’s in public places, we encourage you to Indoor Clean Air Act. Usually busi- when the Utah Indoor Clean Air Act speak up and take action in your own nesses are very cooperative when we was formed. Over time, the policy has community. tell them a customer or a passerby been updated to help protect othTHE UTAH INDOOR CLEAN AIR ACT PROHIBITS: USE OF A TOBACCO PRODUCT (INCLUDING E-CIGARETTES) INSIDE A PUBLIC PLACE. SMOKING OR VAPING WITHIN 25 FEET OF A PUBLIC ENTRYWAY, WINDOW, OR AIR INTAKE.

TOBACCO PRODUCTS INCLUDE: CIGARETTES, CIGARS, ELECTRONIC CIGARETTES, VAPORIZERS, HOOKAH, PIPE TOBACCO

NEED TO SUBMIT A COMPLAINT? CALL ONE OF OUR OFFICES (SEE INSIDE FRONT COVER) AND ASK FOR A HEALTH EDUCATOR. VISIT BIT.LY/UICAACOMPLAINT AND COMPLETE THE FORM.

WANT TO KNOW MORE ABOUT E-CIGARETTES? OUR HEALTH EDUCATORS ARE EXPERTS ABOUT THESE PRODUCTS, ESPECIALLY THEIR IMPACT ON YOUTH.. IF YOU’D LIKE TO HAVE US PRESENT INFORMATION TO YOUR BUSINESS, SCHOOL, OR COMMUNITY WORKGROUP, CALL US!

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& T H R E ATS

By Paulette Valentine SWUPHD Emergency Preparedness Director

H I GH-IM PACT DISAST E RS THAT COULD AFFECT SOUTHW EST UTAH

A

n essential part of being prepared is knowing what hazards may come your way. In analyzing risk assesments, local emergency preparedness officials list four large-scale disasters which would pose a significant threat to the southwest Utah region: earthquake, flood, fire and pandemic disease.

EARTHQUAKE

The largest earthquake in recent history for our district was in September 1992 near St. George, with a 5.8 magnitude. While major quakes here are rare and difficult to predict, we live close to major fault lines and should prepare for these unexpected events.

Take a tour of your home and secure any heavy objects that could cause injury or damage if they fell; including bookcases, entertainment centers, decorations, and water heaters.

The best reaction when experiencing an earthquake is to DROP to the floor, COVER your head with your arms or a sturdy object like a table or desk, and HOLD ON until the shaking stops. Earthquake-related injuries and deaths in the United States are often caused by falling or flying objects and debris rather than collapsed structures.

HEALTH

PANDEMIC

FIRE

FLOOD

Despite being an arid region, the most common natural disaster experienced here is, ironically, flooding. Winter storms, spring runoff, and summer monsoons can be severe enough to breach dams and overflow riverbanks.

Flash floods can appear without warning and transform a shallow creek into a raging torrent in a matter of seconds, even when storms seem distant.

We’ll always have to deal with floods due to our weather and geography.

Southwest Utah has experienced several “100-year floods” just in the past decade, most of them in Washington County. In 2005, flooding in the Santa Clara River caused by heavy rainfall over wildfire-stripped ground destroyed 15 homes, damaged many more, and took one life. In 2010, record rains put the Virgin River on par with Colorado River flow rates. Damage was minimal, thanks to prior prevention efforts. Late summer rains in 2012 caused flooding in Santa Clara and Enoch, impacting over 140 homes and businesses. September 14th, 2015 saw the deadliest flash flooding event in Utah’s history, causing 21 deaths in Hilldale and Zion National Park.

Staying safe from floods involves avoiding canyons if there are storms in the region, staying away from the edges of flooding waterways, and never attempting to drive across a flooded roadway, even if the water level seems low. Flooding can also contaminate drinking water, so stay informed through local media outlets regarding health warnings. Be prepared for possible evacuation with 72-hour kits and other essentials, including important documents.

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Fire season in our area typically runs from April to September. High temperatures, low humidity, strong winds, and plentiful dry fuels provide a formula for wildfires that simply awaits a spark. Many wildfires are caused by humans, in the form of cigarettes, burning debris, campfires, fireworks, hot metal surfaces, and firearms. Others are ignited by lightning, especially during the monsoon months of June and July. The largest wildfire in Utah history was started by lightning on July 6, 2007. Known as the Milford Flat Fire, it burned over 560 square miles until being contained after nine days by a crew of 400 firefighters. While wildfires in southwest Utah have destroyed thousands of acres, burned structures, and knocked out power lines, they rarely result in human injuries or casualties.

The likelihood of damage from wildfires can be reduced when property owners create defensible space around buildings. Clearing flammable brush and trees from the perimeter and planting fire-resistant vegetation offers protection to a home while increasing safety for the firefighters who might be defending it. Be prepared for evacuation in the same way you would for floods.

According to the American Red Cross, structural fire is actually the most common disaster threat to homeowners and businesses alike. The worst culprits? Unattended stove top cooking, space heaters during winter, smoking, faulty electrical cords, and candles. We never think it will happen to us, so we may not give it as much thought as we should. But house fires can be prevented by reducing risks in the first place, and by installing - and practicing with - smoke detectors and fire extinguishers.

The “Spanish” influenza pandemic of 1918–1919, sometimes referred to as the “mother of all pandemics”, caused an estimated 50 million deaths worldwide. The 20th century saw two more flu pandemics in 1957 and 1968, resulting in 70,000 and 34,000 deaths in the United States, respectively. The 2009 swine flu (H1N1) pandemic was the most recent, costing an estimated 280,000 lives worldwide. Influenza viruses remain a likely candidate for the next pandemic. Influenza strains come around every year, but a pandemic occurs when a new flu strain (which we have little or no immunity against) shows up and spreads.

Flu pandemics may vary in impact, but can be prevented in the same way as the seasonal flu. Wash your hands often and thoroughly with soap and water, especially after going out in public or encountering sick people. Hand sanitizer is the next best thing. Avoid touching your face. A common route of infection is you touching a surface and picking up the virus, then infecting yourself by touching your eyes, nose, or mouth. Get vaccinated if there’s one available. If you’re sick, STAY HOME, and cough or sneeze into your sleeve.

If a pandemic hits, the health department will be a primary source of information regarding status, prevention, and vaccine availability, through our website (swuhealth.org), social media (swuhealth), and local media.

Over the past few years, an unprecedented number of local emergency responders, community partners, churches, businesses, and residents have participated in a series of exercises to test and improve pandemic plans that are intended to reduce the impact of a disease outbreak. Although such an event is unpredictable, being prepared at the community, family, and individual levels can go a long way in reducing panic and preventing infection.

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A M E R I C A’S FAV O R I T E

V E G E TABLE

By Al Cooper Guest Columnist

I

n Nahuatl, the language of the descendants of the ancient Maya, it was probably Tomatl. To the Italians who fell in love with it, the name was El Pomo d’Oro (the golden apple). To English settlers, it was thought to be merely another member of the deadly nightshade family to be avoided at all costs.

After its long and curious journey from Central America to Spain and Italy and back to America – now in a red skin thanks to the Italians’ continuous selection process -- the modern world knows it as the Tomato, and it has long been America’s favorite backyard garden vegetable. Those who study such things tell us that 86% of all home gardens are residence to this vegetable, which is actually a fruit.

No other backyard vegetable lends itself to genetic tinkering quite like the tomato, with some commercial seed catalogs offering over 1000 varieties, including both open-pollinated and hybridized. Even without the tinkering, plants often produce their own anomalies; an offspring with a different shade of color, a slightly different shape, an earlier ripening or

a sweeter taste, thus introducing what after a few more generations becomes worthy of a new name altogether.

With the aid of bees, other insects, and a bit of nature’s karma, the laws of reproduction and survival-of-the-fittest have their way.

Plant scientists have long been at work creating bigger, better, faster-growing, redder, or otherwise “improved” varieties for an eager commercial market. The modern food marketing industry is hungry for tomatoes that are visually attractive throughout their developing life (whether actually ripe or not), with predictable size and maturity. They should be firm enough to tolerate machine harvesting and handling, repeated exposure to transport, boxing, and artificial ripening treatments.

And they should “hold well” in retail display. And they must be available 12 months a year.

However, the typical home gardener looks forward to a fresh, sweet, juicy tomato straight from the garden with an old-time “tomato” flavor that reawakens memories of good times spent with grand-

parents and friends. If it has a few dings and a soft spot or two, who cares; that’s what a knife is for. And if it doesn’t look like it will last a week longer, so what. There are a dozen more just like it hanging on the vines outside.

THE ARGUMENT FOR OPEN-POLLINATED TOMATOES Since my youth I have been growing tomatoes, first in New Jersey, the “Garden State”, then in Vermont, when the “Green Mountain State” had more cows than people, then Kansas, the “Sunflower State”, next at 7,000 feet in the Wasatch Mountains of Utah, and finally in the 100+ degree summers of southern Utah’s red rock country.

My father’s old-time and proven varieties were Stone, Rutgers, Marglobe, Beefsteak, Oxheart and Bonny Best.

They never failed and we consumed them fresh from the garden (my Dad always had a pocket knife and a salt shaker in a back pocket) and home-canned by the hundred-quart winter supply. It was in eastern Kansas during the 1960s that tomato culture became a passion, thanks

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in part to membership in the Seed Savers’ Exchange and an older brother whose experimentation had made of him a garden “wizard” and my mentor. Together we held blindfolded tasting contests along with other “seed savers” around the country. That is when we discovered for ourselves that open-pollinated Brandywine - an old-time Amish heirloom - was the clear champion of taste and flavor and a strong grower to boot.

The South American Peron came in second in the same categories.

In the world of heirlooms, I also like Pineapple for its size and bi-color beauty, Dinner Plate for size and flavor, and Mortgage Lifter (also known as Radiator Charlie’s). The most productive single tomato plant I ever grew was the Triple-crop Climbing Tomato while in Kansas. An extra-deep planting hole with gravel for drainage and a stash of well-rotted horse compost became the base. A two-inch diameter polyvinyl tube, tall enough to protrude above ground level, was placed against the side as the tomato vine was covered with a soil/compost mix. Direct root watering was facilitated all during the growing season by way of the “plumbing” tube. A tall cage was added to provide a strong tower for the plant which eventually attained ten feet in height and produced three bushels of fruit very similar in quality to Brandywine.

The obvious payoff for open-pollinated tomatoes, of course, is their ability to reproduce their kind year after year by planting its parent’s seed. Herein too comes the grower’s unique ability to develop his or her own sub-variety. If my desire was to improve maturity time and size I would save the seeds each year from the earliest-to-ripen fruit and the largest example. Following this strategy year after year emphasizes those qualities in offspring by the natural method of selection. Perhaps even more importantly, those chosen “children” will be attuned more and more to the particular mini-climate which exists in your backyard.

SOME GUIDANCE FOR SEED-SAVERS There is more to the art of saving seeds for future planting than picking and drying seeds from ripe tomatoes. You may say that since “volunteer” seeds from last year’s crop keep coming up on their own in your compost heap, how can it not be just that simple?

If you could observe nature up close, you would indeed learn the routine. An overripe tomato forgotten or left on the vine falls to the ground, where the ever-present bacteria begin to break it down by a brief process we may carelessly think of as “rotting”. Then

HEALTH winter comes, it gets pressed into the welcoming leaves and residue of the passing season as winter’s snow and thawing come and go. Voila, magic comes with the spring and our seed becomes a plant blessed with the genetic codes of its history, and new life. Those are the steps and they can’t be ignored.

Similarly, I squeeze seeds from the chosen tomato, rinse them slightly before placing them in a paper cup with some water just covering them. A loose piece of plastic wrap covers them before I place the cup on a convenient sun-warmed window sill where I can watch as they form a skim of white foam as they begin to ferment. A slight smell will be emitted in the process, which takes about a week before it comes to a natural end.

Then I clean and dry them before placing them in a small baggy and storing them in my overhead freezer for at least several weeks, which duplicates nature’s winter rest.

Once thawed and thoroughly dry, I place them within a small piece of aluminum foil, folding them into small flat squares on which I write the variety and date. They are ready for storage in a dry dark corner of my seed box.

Properly handled, they will lars each year. A little mystery remain viable for years. adds excitement to a process that never grows stale.

THE ARGUMENT FOR HYBRID VARIETIES THE DANGERS Not all hybridization pro- OF “MONOCULTURE” grams are commercial or Prior to the discovery that the market/profit driven. Benefits lowly potato (the Lumper varisuch as disease and insect re- ety) would thrive in Ireland’s sistance, more uniform ripen- unfriendly soils, the English ing, more compact plant size, landlords had to import barstronger vine development, ley, corn, and wheat to feed protection from sunburn, the people who managed and and dozens of other desir- farmed their lands. Then a able improvements make great food shift took place, hybrids very attractive to the replacing a grain-based diet home gardener. My first eat- with potatoes that folks could ing tomatoes every year come grow themselves, which in from my Early Girls while turn enriched the pockets of I can always be assured of the landlords who no longer continuous and predictable had to pay for imported food. quality from a half-dozen However, since the potato disease-free Celebrity plants. I reproduces itself vegetativelike my Bushmasters for com- ly – that is by dividing the pact spacing plants which sprouts from one generation bear over a long season, while to the next – each potato and the now decades-old and its progeny are genetic clones much-loved hybrid Big Boy is of their parents, with identical still with us and has led to an strengths and weaknesses. abundant procession of “Boys” and “Girls” worth growing.

In September of 1845, a wind and fog-driven fungus (probThe list of great hybrids is ably phytophtora infestans) nearly endless, answering as blew its way into southern many different needs as could Ireland; blackening the leaves be assembled. Two pieces of and then the tubers themadvice for most newbie gar- selves, destroying much of deners: talk to your successful the season’s potato crops. 1846 neighbors and local nurseries became known as Ireland’s to find out what varieties do Year of the Great Dying, well in your neighborhood, when there was no harvest. and add one new variety to More than one million peothe old tried-and-true regu- ple would die from starvation

and the epidemics which followed, launching the vast migration of Irish to the United States, Canada, and Australia.

By the way, the historic Lumper potato is still grown by heirloom gardeners today.

What plant scientists have learned from such variety losses is that “monoculture” – dependence on a single food variety – is fraught with peril, leaving earth’s populations more vulnerable to famine and starvation. We need to be constantly going back to open-pollinated plant stocks to breed new and improved types, which requires a viable stock of breeding fruit and vegetable varieties to draw upon, such as the one maintained by the Seed Savers Exchange in Decorah, Iowa.

This volunteer organization stores more than 25,000 varieties in its temperature-controlled vaults.

In addition to the fact that a conservator of non-hybrid plant seeds need never have to repurchase viable seeds from an outside source, there are other reasons why seed-saving is more than just a rewarding pastime; one being the preservation of the world’s food supply! In truth, there would be no hybridizers if there were not a deep supply of original varieties to crossbreed in the first place.

THE BIRTH OF A NEW TOMATO In the midst of the Great Depression, a West Virginian named Charles M. Byles, who had been farsighted enough to locate his service station at the base of a steep hill famous for causing radiator problems, found himself perfectly situated to introduce customers to his own tomato plants. Byles had devoted six years to perfecting, through pollination and selection, a tomato whose virtues were soon broadcast far and wide. They sold for one dollar per plant and allowed Charles to pay off his $6,000 mortgage while many Americans were losing their properties. Today that large and tasty heirloom is known as Mortgage Lifter, or among some collectors as Radiator Charlie’s, and it has long been one of my favorite old-timers.

SWUHEALTH.ORG

SPRING/SUMMER 2016

PROTECT

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2 015 A N N U A L R E P O R T BOARD OF HEALTH C omm issioner Victo r Iv erson » w ash i ng ton cou nt y

Lind a Rider

» w ash i ng ton

cou nt y

The Southwest Utah Public Health Department (SWUPHD) serves the 210,000 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.

FRIE NDS OF P UBLIC H E A LT H

SERVING OUR COMMUNITY

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

NURSING SERVICES

JAMES EARDLEY Comm issioner D ale B rinkerhof f » i ro n co u nty

D r. Clayton Pett y » i ron cou nt y

C omm issioner Jim M atso n » k ane cou nt y

Rosalind M etcal f

» k a ne

co unty

Comm issioner M ik e D alton » b e aver cou nt y

Kennet h Elm er

» b e aver

cou nt y

Comm issioner D av i d Tebbs » g a rf i el d co u nty

N ic k Reynold s

» g ar f i el d

cou nt y

For mer Washington C ount y C om m issioner

James Eardley was a county commissioner for Washington County and also served on the Southwest Utah Board of Health for 16 years (January 1999 to December 2014).

During that time he advocated for public health-related issues that not only benefitted residents of the five counties, but had a statewide influence as well.

ROB VAN DYKE Kane C ount y Attor ne y

Rob Van Dyke was instrumental in the adoption of county tobacco regulation ordinances. He also chairs the Kane County Community Coalition and organized the Kanab City Youth Soccer League to promote physical activity for kids.

MONTY THURBER Eng ine er ing Ass o ci ate St. G e orge Cit y

Monty Thurber has overseen the development of biking and walking trails in St. George and advocated for active communities through the planning and engineering process. He is developing the first active transportation plan in southern Utah and helping to create and expedite lasting change in infrastructure that will benefit generations to come.

• Immunizations: 14,560 doses (4,998 flu vaccines) • International travel consults: 570 • TB (Tuberculosis) tests: 1,396 • WIC (Women, Infants, & Children): 15,001 client contacts

VITAL RECORDS • Birth certificates issued: 5,233 • Death certificates issued: 2,060

ENVIRONMENTAL HEALTH • Total Inspections (including plan approvals) performed by staff : 5,209 • Water samples analyzed ( for swimming pool and drinking water facilities): 4,393 • Public pools & spas in district: 660 • Restaurants / food establishments: 1347

EMERGENCY PREPAREDNESS • MRC (Medical Reserve Corps) registered volunteers: 418 • POD (Point of Distribution) agreements: 220 (These are organizations and businesses that would receive medical supplies/medications in a public health emergency and distribute them to their staff and clientele) • Emergency preparedness presentations to community: 63 • The division also conducted 52 workshops and exercises involving 3,811 people in preparation for the March 2016 full-scale pandemic exercise.

HEALTH PROMOTION • Families participating in the Play Unplugged program: 528 • Smoking cessation trainings for health care providers: 94 • Certified car seat installations for families: 100 • Graduates of END (Ending Nicotine Dependence) class for teens: 50 • Our staff was awarded the 2015 Butt Kicker of the Year by the State of Utah for excellence in helping prevent youth tobacco use.

• Assisted Glendale, Kanab, and Beaver in passing ordinances to ban tobacco use in parks and public property.

528

familes participated in play unplugged

revenue

grants: 48% fees: 29% count contribution: 22% other: 1%

7,293

3,292 births

14,560

total immunizations given

4,998 flu shots

418

vital records issued

medical reserve core volunteers

660

88.2%

public pools & spas in distric

children fully immunized by kindergarten 2015 data for the five counties served by the SWUPHD.

heart disease leading cause of death

1,347

food service inspections

top 4 disasters to prepare for

flood, fire, pandemic, earthquake

66

hospitalized flu cases

2 015 A N N U A L R E P O R T

NURSING AWARD On March 19th, 2015, Southern Utah University hosted their annual Celebration of Southern Utah Nursing. Seven local nurses were selected for awards after being nominated by community members and health care professionals. Among them was Lynne Cardon, RN, who works in the SWUPHD St. George clinic. She was honored as the Outstanding Community/Public Health Nurse for the year.

IN MEMORIUM DANIEL “BOONE” HULET TOP 5 BABY NAMES IN 2015 (1957-2015)

“Boone” was the Kane County Commissioner appointed to serve on the Southwest Utah Board of Health from 2003 to 2010. He was a visionary in support of public health and the proper role of local government, and instrumental in establishing public health services that continue to benefit Kane County. He passed away on December 15, 2015 and will be greatly missed.

WASHINGTON COUNTY

Female: Emma/Ivy/Madison/Olivia/Ellie Male: Liam/Matthew/Easton/Oliver/Jack

IRON COUNTY

Female: Paisley/Avery/Claire/Eliza/Ellie Male: Jaxon/William/Andrew/Carter/Cooper

BEAVER COUNTY

Female: Alexa/Allie/Avery/Brailey/Brielle Male: Hudson/Arrowe/Asher/Braxton/Easton

KANE COUNTY

CONTEST WINNERS MEET THE GOVERNOR Governor Herbert congratulates winners of the 2015 Radon Poster Contest, Fossil Ridge Intermediate students Sofia Noel Hancock (2nd from left) and Lexie Tueller (2nd from right) meet Governor Herbert. See story on page 8.

Photo courtesy of Utah Governor’s Office

SWUHEALTH.ORG

SPRING/SUMMER 2016

Female: Emery/Sawyer/Alexis/Anelysia/Annalise Male: Axton/Brantley/Bryson/Carter/Corbin

GARFIELD COUNTY

Female: Alexie/Alissa/Avery/Elizabeth/Esther Male: Blaine/Brandt/Chase/Hank/Kanon

PREVENT

30

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FREE TDAP BOOSTER

One of the most important shots for your baby may be the one YOU get!

Offer ends July 2016 -Just visit one of our clinics. See magazine, inside front cover for locations.

Even if adults have been immunized, whooping cough immunity can fade over time. The Centers for Disease Control (CDC) now recommends that adults get a "Tdap" booster to prevent getting sick and spreading the illness to infants in the home. This is a single dose vaccine that protects against pertussis as well For adults ages 19-64 who are uninsured as tetanus and diptheria.

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