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Zika is a frightening disease few people had heard of until recently. Over the last few months, many Americans have become aware of the virus, spread by mosquitoes that if acquired during pregnancy can cause microcephaly (babies born with small heads) and other severe fetal brain defects. A few weeks ago, Harris County Public Health (HCPH) announced that the first child in the state of Texas was born with Zika-related microcephaly. The mother contracted the disease in Colombia, but gave birth at a one of our local hospitals. Our thoughts and prayers are with the child and family who are dealing with this heartbreaking consequence of the spread of the Zika virus.
As public health workers, this is one child too many to be born with this birth defect due to a mosquito-borne disease. The lifetime cost of treating a child with microcephaly is estimated to be more than $10 million. For public health, Zika is a very real threat in our communities. Especially since Harris County has the mosquito species that carries Zika.
Harris County has the nation’s foremost mosquito and vector control program in the U.S. However, even with a program as comprehensive as ours, we need your help to combat the virus. Since there is no vaccine or treatment for Zika infection, we believe heavily in the age old mantra of public health-prevention works. And while our mosquito control program is working with software giants like Microsoft on being able to test and identify the presence of Zika in our mosquitos, we rely on education, engagement and outreach to our community to prevent the spread of Zika.
We have been working vigorously with our partners and within our community to help them understand that health happens where you live, worship, work and play. We have designed culturally and linguistically appropriate outreach materials in the primarily languages spoken in our community, English, Spanish and Vietnamese. To enhance our program effectiveness, we have partnered with our local Walmart’s, Fiesta Marts, Lowe’s and ACE Hardware stores, WIC clinics, churches, schools and parks, to name a few.
Traveling abroad to Latin America, I have seen first-hand the devastation Zika can cause on a family and its community, which is why our team has been working diligently for months on Zika prevention and response plans. But, all of us know that there is more work that needs to be done.
Just like with any other disease or condition, individuals and families must also do their part to prevent getting Zika. Mosquitos spread a variety of diseases and cause over 1 million deaths worldwide each year.
Our message to our community is very simple: ¡Prevenga la picadura de día y de noche! - Prevent the Bite Day and Night! Essentially, do your part to prevent getting bitten by mosquitos wherever you go. Reduce mosquito breeding sites in and around your home-and make sure your mother, uncle, la tía Lolita, el primo José and abuela are doing the same.
As we always say in Spanish: “La unión hace la fuerza”. – Unity makes us strong. Public health and prevention work best when as an entire community comes together to address a health concern. Let’s work together to make sure that we don’t have to tell one more parent that their child is born with Zika-related microcephaly in our country.
Elizabeth Perez, MPH, is the Director at the Office of Communication, Education and Engagement (OCEE), Harris County Public Health, Harris County, Texas
Achieving a nation free of disparities in health and health care extends beyond the walls of federal offices. As we deepen our reach into this current era of public health, we step into an age of a greater understanding of the factors upon which better health is built—the conditions in which people are born, grow, work, live and age. This knowledge underscores our goal in building stronger relationships and alliances that achieve better health outcomes for all communities by bolstering the efforts of our partners.
Take for instance Oakland, CA, where minority male youth are benefiting from one of the funding opportunities that the HHS Office of Minority Health (OMH) awards to develop and implement health programs and activities across the nation. Our grantee, Youth Alive, is implementing innovative community policing approaches through a public health framework that help improve the health and well-being of communities of color through the Minority Youth Violence Prevention initiative. This program, and others like it, reflects the heart of our work in strengthening the capacity of community-serving organizations in their efforts to reduce health disparities in ways that address the social determinants of health.
OMH and our partners continue to stand at the forefront of responding to the needs of the community and driving monumental advancements in programs, policies, data and research. Together, over the past 30 years we have led health equity efforts at the grassroots level and seen these efforts through from recommendation to implementation. Since 1986, our office has provided tangible support to state and territorial offices of minority health, multicultural health and health equity; community and faith-based organizations; national associations and organizations; institutions of higher education; tribes and tribal organizations; and research institutions dedicated to improving the health of racial and ethnic minorities.
HHS OMH grantees are committed to developing strategies that provide minority and underrepresented students with a foundation to pursue successful careers in health professions; connect minorities and underserved populations to health insurance coverage and quality, affordable care; implement tailored state-level community interventions designed to address the most pressing disparities, including HIV/AIDS; fight against lupus, a chronic, autoimmune disease that disproportionately affects racial and ethnic minority populations; and many others.
The need to accelerate our efforts in innovative approaches to improve minority health remains evident by the persistent gaps in health and health care across communities of color, consequently leading to poorer health outcomes.
Most recently, OMH funded three new grant programs in 2016 totaling more than $7 million to support public health initiatives that impact lives across the nation. Through these efforts, we aim to improve health outcomes for minority and/or disadvantaged young people in transition from jail to their communities; promote healthy behaviors among minority and/or disadvantaged youth at-risk for poor health and life outcomes due to childhood trauma; and continue our work in reducing lupus-related health disparities.
We recognize the importance of partnerships with communities and organizations in closing the gap on health disparities and achieving better health. And as we support the work of these health equity champions, we also create a future where the intersection of health and social condition serves as the crucial nexus for ending health disparities in America.
J. Nadine Gracia, MD, MSCE, is the Deputy Assistant Secretary for Minority Health and Director, Office of Minority Health, U.S. Department of Health and Human Services.
Message from the HHS OMH Director: The Surgeon General is calling on us to lead
Every day, more than 75 people in our country die from a prescription drug or heroin overdose. In 2013, nearly 249 million prescriptions were written for opioids—enough for every adult in America to have a bottle of pills. A significant factor in the opioid epidemic is legally written prescriptions from doctors, dentists, nurse practitioners and physician assistants.
As a physician myself, I understand the important role that we—the doctors, nurse practitioners, dentists and physician assistants of America—can play in the effort to turn the tide on this epidemic. To help address the prescription opioid crisis, U.S. Surgeon General Dr. Vivek Murthy is taking historic action by sending a personal letter to more than 2.3 million health care practitioners and public health leaders. I want to make sure you see his letter, a copy of which I have included below. Please take a moment to read it and then visit www.TurnTheTideRx.org/join to join with clinicians from across the country in a simple but powerful movement to end this epidemic.
TurnTheTideRx.org provides clinicians with practical tools, information, and in-the-trenches stories from colleagues offering their insights into the epidemic. This new resource becomes another crucial tool in our work to reduce the behavioral health disparities that minorities experience, including lack of access to services and treatment. Some of these barriers to care include systemic issues of bias in the health care delivery system; discrimination; lack of insurance; and cultural, language, and communication barriers between patients and providers.
For the communities we serve at the HHS Office of Minority Health, we are for example concerned by the prescription opioid overdose deaths among American Indian/Alaska Native (AI/AN) populations–death rates that surpass those of non-Hispanic whites according to data from the CDC. And while AI/AN populations have the highest prescription opioid deaths rates of all Americans, the devastation of this epidemic is felt across all populations, including all racial and ethnic minority populations. Now is the time to shine a light on the hidden realities of mental and substance use disorders in communities of color—conditions that are often intensified by trauma. And, lack of health coverage and the ability to afford care are often reported as barriers to seeking treatment, further compounding the disparities generated by adverse social and economic conditions.
The HHS Office of Minority Health, along with Dr. Murthy, encourages you to spread the news about this new effort to combat the prescription opioid crisis to your networks and communities. We hope you will join the movement and be a part of the solution. Together we can turn the tide.
J. Nadine Gracia, MD, MSCE, is the Deputy Assistant Secretary for Minority Health and Director, Office of Minority Health, U.S. Department of Health and Human Services
About Turn the Tide Rx
Turn the Tide Rx is a national campaign created to enable “prescribers talking to prescribers.” Turn the Tide Rx aims to educate prescribers about the opioid epidemic, mobilize health care professionals to improve prescribing practices, provide the public with information to protect themselves and their families from opioid misuse and overdose, learn from communities around the country that are finding creative ways to tackle the opioid epidemic, and change the cultural perceptions around addiction so that it is not seen as a moral failing but a chronic illness that must be treated with skill, urgency and compassion.
UNITED STATES SURGEON GENERAL
Vivek H. Murthy, M.D., M.B.A.
I am asking for your help to solve an urgent health crisis facing America: the opioid epidemic. Everywhere I travel, I see communities devastated by opioid overdoses. I meet families too ashamed to seek treatment for addiction. And I will never forget my own patient whose opioid use disorder began with a course of morphine after a routine procedure.
It is important to recognize that we arrived at this place on a path paved with good intentions. Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.
The results have been devastating. Since 1999, opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed. Now, nearly 2 million people in America have a prescription opioid use disorder, contributing to increased heroin use and the spread of HIV and hepatitis C.
I know solving this problem will not be easy. We often struggle to balance reducing our patients’ pain with increasing their risk of opioid addiction. But, as clinicians, we have the unique power to help end this epidemic. As cynical as times may seem, the public still looks to our profession for hope during difficult moments. This is one of those times.
That is why I am asking you to pledge your commitment to turn the tide on the opioid crisis. Please take the pledge. Together, we will build a national movement of clinicians to do three things:
First, we will educate ourselves to treat pain safely and effectively. A good place to start is this pocket guide with the CDC Opioid Prescribing Guideline. Second, we will screen our patients for opioid use disorder and provide or connect them with evidence-based treatment. Third, we can shape how the rest of the country sees addiction by talking about and treating it as a chronic illness, not a moral failing.
Years from now, I want us to look back and know that, in the face of a crisis that threatened our nation, it was our profession that stepped up and led the way. I know we can succeed because health care is more than an occupation to us. It is a calling rooted in empathy, science, and service to humanity. These values unite us. They remain our greatest strength.
Thank you for your leadership.
Earlier this year, when the word “Zika” was just becoming known in the U.S., promotores de salud, also known as community health workers (CHWs), in Miami, Florida were already taking action and learning about the prevention and control of mosquito-borne diseases. In February, the Miami Dade Florida Health Department convened a community meeting that resulted in a call for more multilingual community education and awareness of Zika. The Florida Community Health Worker Coalition partnered with the Health Council of South Florida , the Miami Clinical and Translational Science Institute, and the Miami-Dade Health Action Network to facilitate a series of Zika education workshops for CHWs .
This series of free, accredited, and multi-lingual capacity-building workshops specifically tailored for CHWs/promotores took place in March and April of this year. The workshops tackled the public health challenges that arise before and during the emergence or re-emergence of vector-borne diseases, as well as strategies for their control. The infographic below highlights the lessons learned about Zika virus, dengue fever and chikungunya.
This capacity building effort identified the need to educate and update communities frequently about how to prevent Zika, especially as our knowledge about the transmission and impact of the disease continues to change. CHWs are uniquely situated to spur community members to ask themselves, “What can I do to protect myself, my family, and my community from Zika?” and then serve as the resource to engender appropriate action in the community, with health care professionals and local government officials.
The Centers for Disease Control and Prevention (CDC) recommendation for the best way to prevent diseases spread by mosquitoes is to avoid mosquito bites by controlling mosquitoes outside and inside the home, using repellent registered by the Environmental Protection Agency with DEET, picaridin, IR535, or oil of lemon eucalyptus or para-menthane-diol.
Zika can also be transmitted through sex; infections that occur during pregnancy can cause microcephaly and other severe fetal brain defects. As a result, the CDC recommends all pregnant women with sexual partners (male or female) who live in or traveled to an area with Zika, use condoms or a barrier method during sex or abstain from sex for the remainder of their pregnancy. Many people infected with Zika virus won’t have symptoms or will only have mild symptoms. That is why is so important to avoid mosquito bites, control mosquitoes, and protect pregnant women from getting Zika. We all can do our part to #StopZika.
Ed. note: This was originally published on the HHS.gov blog.
Summary: The 100-Day Challenge will help catalyze community action to establish bold, creative, and innovative ways to help homeless youth find stable housing.
In communities across our country, too many young people face the harsh reality of not having a safe place to lay their heads and sleep for the night. In our recent Street Outreach Program report, we learned that most older youth become homeless for the first time because they are asked to leave home by a parent or caregiver. More than half have tried to stay at a shelter but it was full. More than 60% were raped, beaten up, robbed, or otherwise assaulted. Nearly 30% identified as gay, lesbian or bisexual, and nearly 7% identified as transgender. About half of the youth had been in foster care, and those who had been in foster care had been homeless for much longer compared to youth who hadn’t.
It doesn’t have to be this way. To do better, we are teaming up with A Way Home America and the Rapid Results Institute to launch a 100-Day Challenge to end youth homelessness.
The purpose of the 100-Day Challenge is to help catalyze community action to establish bold, creative, and innovative ways to help homeless youth find stable housing. The short timeline is intentional, inviting communities and their cross-sector partners to generate urgency and action.
The 100-Day Challenge will launch on September 7, 2016, in three communities -- Austin, Cleveland, and Los Angeles, who were chosen through a competitive process for their innovative approaches to addressing youth homelessness. We are grateful for the leaders who are willing to work in these communities to solve this daunting challenge. The 100-day challenge is only one part of a comprehensive solution. Together with our federal partners, the Department of Health and Human Services is committed to ending youth and family homelessness by 2020.
At the Administration on Children, Youth, and Families, we support the plan by working to support vulnerable youth experiencing homelessness through programs like Basic Center, Transitional Living, and Street Outreach and in partnership with the Children’s Bureau and the nation’s child welfare systems to prevent homelessness before it begins.
By working together to put into place proven practices along with continuous bold new thinking we intend to make the goal a reality. Our youth deserve nothing less.
To learn more and follow the challenges, visit www.awayhomeamerica.org.
For information about how the federal government is involved in ending youth homelessness, go to the Federal Framework to End Youth Homelessness.
Rafael López is the Commissioner for the Administration on Children, Youth and Families